Colic in horses

Colic – what it is and how to treat it

Colic, the very word strikes fear into the hearts of horse owners everywhere but what is colic and how can it be both managed and prevented?

The definition of colic

Colic is a generic description of abdominal pain and is not confined purely to horses.  Other mammals and humans can also suffer from colic. However, in equines, it does have a specific connotation and is never something to be ignored.  Across the equine population, anywhere from between 4%-10% of horses can suffer at least one colic episode. There are different types of colic:-

·         Spasmodic Colic – literally muscle spasms or cramps in the intestine

·         Impaction Colic – a blockage usually caused by food material which has been only partially chewed through inadequate mastication or digestion and causes a physical obstruction at some point along the intestinal tract.  The horse will not usually pass any droppings

·         Gas Colic – a build-up of gas in the gut which can be caused by eating inappropriate food, for example, gorging on lush grass.  The gut will be very noisy and there will be a lot of flatulence

·         Sand Colic – this colic is caused by the ingestion of sand from the soil which builds up over a period of time, often due to inadequate grazing.  The sand accumulates eventually resulting in a troublesome blockage

·         Parasitic Colic – caused by a heavy worm burden particularly tapeworms and small redworms

·         Strangulation Colic- occurs when the blood supply to a portion of the intestine is restricted or cut off totally hence the name.  Strangulation colic is fairly rare but very serious

·         Twisted Gut – it used to be thought that this occurred due to the horse rolling repeatedly, twisting a portion of the intestine in on itself – a torsion – or where a section of intestine inverts into itself – intussuception

Why is colic so frightening for horse owners?

Colic is so worrying for horse owners because it can strike unexpectedly even with the best management routines and it can be fatal.

Colic must always be treated as a veterinary emergency.  Not every horse will succumb to colic but it is impossible to tell without veterinary intervention which type of colic your horse has.  Time is of the essence.

The symptoms of colic

Horses can exhibit a range of symptoms just prior to and during a colic episode.  Some horses may show some signs but not others. These can include:-

·         Unexpected restlessness which does not have any other obvious cause

·         A withdrawn, depressed demeanour

·         Box walking

·         Pawing the ground

·         Lying down and getting up repeatedly

·         Agitation including tail swishing, kicking up or out with the hind leg, swinging the head and neck around to stare at the flanks

·         Rolling

·         Lying on their back

·         Elevated respiration

·         Sweating

Colic attacks when they are in full swing can be violent and traumatic but often these bouts are preceded by a subtle change in the horse when they may appear dull and listless and just not quite right.  Any alteration in characteristic behaviour should always be closely monitored as this may just give you the requisite warning to make an early and prompt intervention. This could make the difference between a successful outcome and an unhappy ending.

Decisions on colic surgery are not to be taken lightly but must be taken quickly.  Studies have shown that early treatment from vets gives the horse the best chance of recovery.  If you are contemplating travelling a horse for surgery then you will need to do this before the colic becomes so severe that the horse is in too much pain and distress to be travelled safely.

Immediate First Aid

Contact your vet without delay.  Even if the colic looks really mild, it is helpful for the practice to know that you may have a potential issue and they can ensure someone remains nearby in your area, on hand when they are needed.

If the horse will remain in the stable then observe him.  Remove hay and any feed – if the horse has an impaction then this will only make it worse as food matter has nowhere to go.  Check for droppings and keep a note of the horse’s behaviour and whether he passes any more dung. Walking in hand can help certain types of colic – remember you don’t know which type your horse may have just by looking.  Mobility can help with gut motility and can ease discomfort in horses which are continually going down to roll.

What information does the vet need?

It is very easy to panic when presented with a colicking horse but it is important to remember that the vet needs clear information.  The type of things the vet will need to know include:-

·         How long the horse has been colicking for – you may have only just discovered the horse but the bedding may be disturbed and you should be able to tell the last time you saw the horse and it was well

·         What behaviour is the horse exhibiting?  Is he just uncomfortable and getting up and down occasionally or is he really in a lot of pain?

·         If you are able to provide heart rate and respiration this is useful

·         Can you hear any gut noises if you place your head against the side of the horse?  Check both sides

·         Is the number of droppings in the stable normal both in terms of number and appearance?

·         Is there anything that you may be aware of which has caused the episode – for instance, the horse broke into the feed room and has consumed pellets which are designed to be fed soaked or was discovered in a far-flung field on rich grazing so he has gorged himself.  This can give the vet a head start on what type of colic he may be dealing with

Veterinary treatment

Vets will treat colic as an emergency and prioritise your call.  Whilst you wait for the vet, you might wish to organise a few things.  Do you have transport available if required or do you need someone on standby?  Do you need a friend to travel with you if need be? If you have other horses that require attention in your absence, is there anyone who can do this for you if you have to travel the horse to a hospital quickly.

Upon arrival, the vet will examine your horse in one of a number of ways.  As well as listening to your account of events to understand the timeline, the vet will check the following:-

·         The colour of the mucous membranes in the mouth, nostrils and eyes

·         Check the hydration status of the horse

·         Heart rate

·         Respiration

·         Gut sounds

Depending on presentation and evaluation of symptoms, the vet may perform a rectal examination, nasogastric intubation, abdominal ultrasound or belly tap.  Treatment options will depend on the severity of the colic and the type of colic. Treatment options will include:-

1.    Pain Relief  – administered intravenously, for instance, Phenylbutazone or bute

2.    Antispasmodics – these are really effective with spasmodic or gas colic and calm down the muscle spasm that causes the intense pain

3.    Fluids or electrolyte therapy – usually administered via a drip, this can be done at home if necessary

4.    Laxative – most commonly, liquid paraffin which is used in the case of blockages of impactions and administered via a stomach tube

5.    Surgery – often the only option for some horses in the case of strangulation or twisted gut or blockages which cannot be moved via other means

Colic Surgery

Not for the fainthearted and really should only be contemplated in the case of early colic in an otherwise fit and healthy horse.  Colic surgery is far more commonplace than it used to be but that is because surgery has advanced so much in terms of technique, anaesthetics and post-operative recovery.  Colic surgery does however still present unique challenges and survival rates are now past 50% but this increasingly upward trend may be more a reflection of which horses are being presented for surgery in the first place.

Colic surgery is expensive.  Know if you are covered for surgery under your insurance policy and what is the limit on the claim.  It is not the time to be discussing this when your horse is down on the floor and rolling. Costs for colic surgery in Australia are heading north of $8,000 as a minimum so expect your vet to ask the question if you are contemplating opting for surgical intervention.

Colic prevention

Despite the best management routines, colic is sometimes unavoidable.  However, it is always worth eliminating or certainly reducing some obvious causes so that the risk can be minimised as much as possible.  Here are some points to consider:-

·         Manage your horse’s worm burden through appropriate treatments and faecal egg counts.  Worm infestation is known to increase the risk of colic

·         Introduce dietary changes very gradually so the gut flora can acclimatise.  This includes a move onto new pasture particularly in springtime, any hard feed alterations and even different hay.  The change should take place over a period of around ten days

·         Ensure dentition is in good order.  Poor mastication can mean that food is not adequately chewed before it is passed down the oesophagus increasing the chances of a blockage or impaction

·         Some horses struggle to process coarser fiber or straw even when their teeth are in good order.  Always make sure that your fiber source is suitable for your horse

·         Follow the principles of good feeding, feed little and often and never more than 5kg of concentrates in any one feed

·         Mimic the horse’s natural lifestyle as much as possible.  A higher percentage of colic cases occur in stable kept rather than grass kept horses.  One of the reasons for this difference is thought to be the constant movement of the horse when he is grazing in the field.  Good gut motility is linked to the horse’s mobility

·         Reduced exercise unsurprisingly also has an impact on the incidence of colic so horses suddenly confined on box rest due to injury or illnesses will need a review of their diet if they have been receiving a lot of hard feed

·         Horses which crib bite demonstrate increased susceptibility to colic

·         Stress through competition or traveling can cause colic.  Whilst it can be impossible to remove stress totally from the horse’s life, it is possible to manage it and minimise it with forethought and careful planning

A simple understanding of the complexities of the horses gut and the anatomy of his intestine will demonstrate quite clearly why they are prone to colic as a species. 

Good management practices will always promote the best health for the horse and reduce the likelihood of colic occurring.  Colic is no more or less common than it used to be but its fearsome reputation can cause undue worry amongst owners. Colic does not have to mean the end as some cases can respond quickly and successfully to veterinary assistance.  Always give your horse the best possible chance of a good outcome by seeking professional help quickly.