If you work, breath and live horses, or even if you don’t, you’ve probably heard the word ‘colic’ spoken with fear, distress and emotion. Colic is a term that means abdominal pain, its not a diagnosis, it is a symptom. This article will go over a few of the situations that can cause colic, some serious, some not and what they can mean in terms of prognosis and severity.
- Loss of interest in food or water
- Absence or difficulty having bowel movements
- Absence of gut sounds
- Abnormal posturing or behaviour (especially in foals)
- Distress or uneasiness
Many things can cause colic, but sometimes colic can occur with no cause as well. When this happens it is termed idiopathic colic meaning the cause is unknown and may not be figured out unless further diagnostics and tests are performed.
- High grain/low forage diets
- Moldy or tainted feed
- Dental problems
- Ingestion of sand
- Lack of water consumption
- Abrupt changes in feed
- Parasite infestation
Colic can be broadly divided into a few categories:
1.Gas colic – excessive gas accumulation in the intestines (often referred to as a ‘fart turned sideways’). Gas can also lead to spasms of the intestines creating excessive mobility, cramping and gut sounds. This causes abdominal distention and discomfort usually leading to a visible bloating. The danger with this type of colic is if the colon collects enough gas it can rise and twist causing a colonic torsion which is life threatening and can only be corrected with surgical intervention.
2. Simple obstruction – material has blocked the pathway through the intestines. Usually this is feed material or a foreign body the horse has ingested. Fluid will back up from the obstruction to the stomach causing distention of these areas. The distension triggers the stretch receptors within the intestines and stomach and this is what causes the pain. Because horses cannot vomit, the intestines or stomach can distend so large they rupture which is fatal. These horses often need to be hospitalized and that fluid removed until the obstruction can be relieved. A key feature to treating these horses is IV fluids; ironically, having fluid retention in the stomach dehydrates the horse and causes the intestines to shrivel around the obstruction even more.
3. Strangulating obstruction – something has caused a physical blockage by strangling the intestines. This type of obstruction is similar to a simple obstruction except that usually it is a twist in the intestines or a hole in the body that the intestines get trapped in like a hernia. This type of colic progresses faster than a simple obstruction because the blood flow to the trapped intestine is quite quickly cut off and the tissue begins to die from lack of blood flow. This is another form of colic which surgical intervention is the only way to correct the issue, and time is very important because if too much of the intestines die, the chances of survival are minimal.
4. Non-strangulating infarction – a portion of the intestines has died and become non-functional. This type of colic is similar to strangulating obstruction in the sense that the blood flow to the intestines is compromised or blocked. The intestines begin to die and must be resected if we hope to save the horse. Often parasites and larvae are the culprit by situating themselves in major arteries or veins occluding the blood flow.
5. Inflammation of the intestinal tract – colitis for the large intestine, enteritis for the small intestine and peritonitis for the space between the intestines in the abdomen. Inflammation causes the natural movement of the intestines (called peristalsis) to stop causing ileus. Ileus, the lack of movement of feed material and fluids through the intestines, causes accumulation of fluid in the intestines and stomach. Instead of a physical obstruction, inflammation causes a mechanical obstruction and is caused by infection, toxin, trauma or certain drugs. Just like in humans, if symptoms are treated early hospitalization usually can be avoided but if a severe case presents itself, hospitalization and aggressive treatment is necessary.
6. Ulcerations – the lining of either the stomach, intestines or colon is damaged. Many horse owners are familiar with stomach ulcers which are usually non-life threatening but can be very uncomfortable. The life threatening type of ulcers is the kind that develops in the right dorsal colon as this interferes with several functions of the colon and can lead to endotoxemia which is a blood infection which can be fatal.
Treatment: Because colic symptoms are broad and each individual horse may show different signs and have different levels of pain tolerance, it is impossible to determine the cause of colic without a medical examination by a veterinarian. The severity of colic signs aren’t always indicative of severity of colic. To determine the best course of treatment, the underlying cause needs to be established. Occasionally it cannot be determined with one veterinary visit and multiple visits with different diagnostics will be necessary. Medicine isn’t black and white so sometimes to identify a surgical colic, symptoms need to progress and your veterinarian will gain clues with each visit. While you are waiting for your veterinarian, you should:
- Watch your horse, monitor vital signs and note any feces passed. Remove access to all feed because if there is a blockage this will only make the issue worse.
- Let the horse rest. It is not necessary to walk the horse unless they are trying to roll or endangering themselves or other people.
- DO NOT administer any medications without direction from your veterinarian. Some medications work better than others for certain kinds of pain and giving the wrong one will only prevent your veterinarian from being able to administer the correct drug: certain drugs cannot be given at the same time as together they cause internal damage. For example, Phenylbutazone (Bute) and Flunixin (Banamine) together can cause serious kidney damage and stomach ulcers. Flunixin is far superior for intestinal pain than Bute and if an owner gives Bute when the horse colics it may not treat the pain adequately and the veterinarian will not be able to safely give Flunixin for at least 12 hours.
Prevention: Once the cause of colic is determined, such as too high grain and not enough forage. That can be corrected and further colic prevented. When the cause is unknown it isn’t always easy to try prevent further episodes but here are some things that help:
- Feed your horse on a regular schedule including weekends.
- Avoid sudden changes in diet.
- Have teeth checked frequently for dental issues that can cause chewing issues.
- Provide adequate exercise.
- Clean fresh water should always be available.
- Keep feed boxed and hay racks along with feed as free of mold/dust as possible.
- feed an appropriate amount of forage (at least 50% of total diet).
- Keep feed off the ground to avoid sand accumulation or parasite infestation.
- Practice an effective parasite prevention/control program.
And as always, if you have any questions or concerns. Call your local veterinarian.