Despite research and major advances in the treatment and prevention of colic, it still remains one of the number one killers of adult horses. It has been said that near 100,000 horses will suffer at least one episode of colic in a year and close to 65,000 horses will face a life-threatening situation due to the colic episode. Colic is the one condition in equine veterinary medicine that keeps owner, trainers, and veterinarians up and awake at night. It is one of the most common veterinary conditions that horse folks inquire about preventing.
SYMPTOMS OF COLIC: Colic, a vague term, means nothing more than abdominal pain. It is not a specific disease, but a group of diseases leading to clinical signs demonstrating abdominal pain. The clinical signs of colic can be mild to severe. You could write a chapter in the "book of colic" on the clinical signs alone. Owners and veterinarians describe things that most horses do to little subtle changes that the owner has never seen before. The more common clinical signs of colic include:
CAUSES OF COLIC: There are various causes of colic including medical, surgical, and nongastrointestinal. The gastrointestinal system (GI) is so complex it sets us up for a multitude of problems that lead to the signs of colic. The gastrointestinal system consists of essentially 6 parts including the esophagus, stomach, small intestine, large intestine, cecum, and small colon. There are at least 100 feet of gastrointestinal parts that make up the entire system.
The horse has adapted well to continuous grazing of grasses. The major component of grass is cellulose and the long digestive system allows the horse to break it down and utilize it the best it can. There is significant bacteria in the large intestine and cecum that allow the remaining cellulose to break down and be utilized. Because modern day management practices don't always match up with the horse's adaptation to continuous grazing, we have set the horse up for disruptions of digestive function and potential colic.
TYPES OF COLIC: In the simplest of terms, causes of colic can be broken down into a few groups. These include:
Distension: These are types of colic where there is no physical obstruction to the gastrointestinal tract. Although there is no physical obstruction, the GI system cannot move feedstuffs through. Therefore, the GI system becomes distended with feces and/or gas and therefore the horse becomes painful. These signs can vary from very mild to severe. Clinical signs can appear rapidly or slowly. Types of colic in this category are tympanic/gas colic and spasmodic colic. These horses traditionally respond to medical intervention. However, some may not respond for a few hours to a day.
Blockage: Feedstuffs and fecal matter cannot move through the GI tract due to an obstruction. These obstructions can be caused by the feedstuff, fecal matter, enteroliths, parasites, sand, or a foreign body such as baler twine, plastic, or hair. The clinical signs of these types of colic can be mild to progressively severe. These types of colic will usually respond to medical intervention, but some will require surgical intervention to remove the obstructing impaction.
Enteritis/Colitis: Inflammation of the GI bowel wall leads to decreased motility and subsequent intestinal distension and pain. These horses can be mildly uncomfortable to extremely painful and showing signs of shock. These types of colic include, bacterial diarrhea, gastric ulcers, Potomac horse fever, and anterior enteritis. These horses usually respond to medical intervention. However, the occasional horse will require surgical intervention.
Obstruction with Partial/Complete Vascular Compromise: These types of colic are considered to be the most severe and life-threatening. These cause constant and severe pain with rapid development of shock. Due to the compromised blood supply, the intestines become inflamed and eventually die. This releases toxins and bacteria into the peritoneal cavity and bloodstream leading to the development of shock and eventual death if medical and surgical intervention is not completed. Examples of these types of colic include: torsion/twisted intestine, strangulating lipomas, epiploic foramen entrapments, intestinal incarceration, intussusceptions, and displacements.
TREATMENT OF COLIC: Colic is traditionally categorized into medical or surgical colic. Based on the response to medical treatment or the physical examination findings, the horse may require surgery to fix the cause of colic. Some horses will be treated initially with medical intervention and if there is no response or improvement surgery will be recommend.
There are horses that demonstrate signs of colic that have no gastrointestinal issue. These are horses which can be very confusing because they are showing clinical signs of colic, but not demonstrating any gastrointestinal issues. Conditions such as myositis, pleuropneumonia, exertional rhabdomyolysis (Tying Up), or laminitis all have clinical signs which can be confused with colic.
Although some causes of colic are relatively simple GI upset, some do require more intensive medical or surgical intervention. One of the biggest challenges we face in deciding which treatment to pursue is differentiating the causes of colic. Veterinary intervention is so importante because the horse has so many different causes of colic and determining the cause of pain can be quite difficult. We recommend contacting your veterinarian immediately when your horse shows any signs of colic.
When your veterinarian is asked to examine your horse for signs of colic he/she will perform a complete thorough physical examination consisting of rectal temperature, pulse rate, respiratory rate, gut sounds, and mucous membrane color. The examination will also include passing a nasogastric tube and performing a rectal examination. This will help determine the section of GI tract involved in the clinical signs of colic. Other diagnostics that he/she may perform include collecting an abdominal aspirate to determine the severity of the GI issue and performing an ultrasound examination to evaluate the gastrointestinal tract. The veterinarian may also perform a chemistry profile and complete blood count to help determine the systemic involvement. From these findings, your veterinarian will determine the best course of treatment for your horse.
People always ask what to do while the veterinarian is on his/her way to the farm. We recommend you do the following when your horse shows signs of colic or you just aren't comfortable with his behavior:
• If possible, take his temperature, pulse and respiration rates.
•Note what his appetite has been like in the past day or so, and the consistency and frequency of defecation.
•Has his water intake been normal?
•Are his gums a normal color?
•Think about whether he has had access to any unusual feedstuffs in the past day or so, whether any medications have been administered, and whether there have been any changes in management.
•Now call your veterinarian.
•It is important to take all food away from the horse until the veterinarian arrives.
•Walking the horse can be a useful way of distracting him from the pain, but he should not be walked to exhaustion.
•If the horse insists on rolling, there will be little you can do to prevent it. If possible, try to get the horse to an area where he will do himself the least damage when he rolls. But do not get hurt yourself.
•Do not administer any drugs until your veterinarian has seen the horse, or unless he/she tells you to do so.
So the next time your horse shows signs of colic or you are concerned, please take the time to observe your horse for a few moments and then call us. A quick response to your horse may be the difference between life and death. The veterinarians at Conley and Koontz are ready to assist you with your next veterinary emergency.Ryan Rothenbuhler DVM, MSHead of SurgeryConley and Koontz Equine Hospital