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How To Spot Colic In Horses

Colic.  The one word that equally elicits fear amongst those involved with horses.  It doesn’t matter if you are the greenest horse owner or the most seasoned horseman, when you discover your horse is colicing, a pit forms in your stomach.  Unfortunately, colic doesn’t discriminate.  In the blink of an eye, the most well-cared for horse can go from seemingly healthy to experiencing an acute bout of colic.  
Colic is the term used to describe abdominal pain in the horse.  Cases can range from mild discomfort treated at the farm, to serious cases requiring surgery and even death.  As the number one killer of horses, it’s essential for anyone involved with the daily care or riding of horses to know the signs and symptoms associated with colic. 

Signs & Symptoms of Colic
Horses experiencing abdominal pain may exhibit one or more of the following signs:

  • Change in temperament (depressed or excited)
  • Pawing at the ground with a front leg
  • Flank watching (turning head toward flank)
  • Stretching out, as if to urinate
  • Kicking at abdomen
  • Lying down (may stay down or repeatedly gets up then goes back down)
  • Rolling or thrashing around
  • Constantly shifting weight on hind legs
  • Standing against a wall to support their stomach
  • Lip curling
  • Profuse sweating

You may also notice that the horse hasn’t touched its hay or grain.  Additionally, check the horse’s stall for the presence of manure or lack thereof.  If there is manure in the stall, examine it to see if it appears normal. 
Remember each horse will exhibit slightly different signs to indicate they are experiencing colic.  Some will let you know right away they are in distress, while others may be stoic regardless of the level of abdominal pain they are experiencing.  This is why it’s imperative for you as a horse owner to know your horse’s normal behavior and recognize when they aren’t quite acting like themselves. 

Types of Colic
Colic can be broken down into two categories idiopathic and non-idiopathic.  The vast majority of colic episodes (over 80%) fall into the idiopathic category.  Idiopathic means no root cause is determined. These types of colic are often resolved relatively easily.  However, if left untreated the colic can escalate in severity and become life threatening.  Types of idiopathic colic include gas and impaction. 

Gas Colic - Also known as spasmodic colic, occurs when excess gas builds up creating pressure within the digestive tract of a horse.  The gas may cause the colon to contract or spasm.  Horses who experience gas colic typically recover fully after simple treatment with a painkiller.

Impaction Colic – Impactions happen when feed (typically dried–out), dirt, sand or other material that isn’t digestible causes an intestinal blockage.  This blockage makes it difficult, if not impossible, to pass manure.  Impactions are typically resolved after the horse is administered a painkiller and laxative.  However, larger impactions may require surgery. 
Types of non-idiopathic colic include strangulation/displacement, intussusception and enteritis. Although their cause is still not 100% known, these colics are diagnosed a bit easier than the idiopathic ones.

Strangulation/Displacement – This occurs when the intestines get twisted and distended, resulting in the blood supply to be cut off.  Once the blood supply is cut off, necrotic tissue will develop requiring that portion of intestine to be removed via surgery.  This is one of the deadliest types of colic.  Prognosis is dependent upon how quickly the horse is able to get into surgery. 

Intussusception – As with strangulation, intussusception can be deadly if not treated early.  Intussusception is when the intestine slides back into itself, causing a blockage.  This blockage will cause blood supply to be cut off (partially or fully), thus resulting in necrotic tissue.  Like strangulation, surgery will be required to remove the necrotic tissue. 

Enteritis – Simply put, enteritis is an inflammation in the intestines typically caused by an infection, bacteria or virus.   The veterinarian will use an ultrasound to try and observe the inflammation in the intestine.  Treatment will often include anti-inflammatory medications, antibiotics and intravenous fluids. Surgery used to be the go to treatment option, however today research has shown enteritis can be treated successfully through the administration of medication.

When to call the vet?
If you notice your horse is experiencing any of the potential colic signs above, it’s important to know and check your horse’s vital signs (heart rate, mucous membrane color, temperature, gut sounds).   Lack of gut sounds, elevated respiration rate and heart rate are all signs it’s time to call your veterinarian. This information will help your veterinarian make decisions about the treatment plan.
Don’t delay in calling the veterinarian if you suspect your horse is experiencing colic.  This is one time your veterinarian will not mind an overly cautious or worried owner calling for treatment advice or requesting a farm call.  Your veterinarian would much rather examine your horse and find nothing wrong, than be called at the eleventh hour when the horse is deep in the throes of colic. The sooner your veterinarian can get out to the farm to start treating your horse, the better chance your horse has at surviving the colic episode and resuming a healthy life. 
Depending on the status of your horse, the vet may ask you to walk it some prior to them arriving.  Walking not only helps take the horse’s mind off of the pain, but can potentially help relieve some gas colics.  If you choose to walk, do not walk the horse to the point of exhaustion. 
Based on the severity of symptoms and when your veterinarian will arrive, they may suggest you administer a non-steroid inflammatory drug like banamine.  Banamine paste is a great addition to your barn’s first aid kit. However, do not administer medication without your vet’s approval as that could potentially mask symptoms upon their arrival. 

When the vet arrives
Once your veterinarian arrives, he or she will get to work performing diagnostic procedures to confirm the colic episode and determine its severity.  Even if you have previously checked them, the vet will check the vital signs and listen for gut sounds. The vet will likely ask you if there have been any recent changes to diet, exercise, behavior, any questions to pinpoint why the horse isn’t feeling well. 
Depending on the temperament of your horse, the vet may decide to sedate your horse to perform some more invasive diagnostic procedures.  Typically, a rectal exam follows.  This allows the vet to see if there is any intestine distension, misplaced organs, if the colon is twisted and more. Following the rectal, the vet may insert a nastrogastic tube through the horse’s nostril, down its esophagus into the stomach.  The vet will look to see if there is any reflux or gas built up in the horse’s stomach.  If there is no reflux, they may choose to administer fluids into the stomach (mineral oil, electrolytes or water) to help treat the colic.  After conducting these diagnostics, the vet will be able to determine if your horse can be treated at the farm or if he needs to be transported to a hospital for further treatment.

Going to the hospital
If your vet suggests taking your horse to the hospital, stay calm.  Although this is a stressful time, you are taking your horse to a facility where your horse can get the best possible treatment.  If possible have an emergency plan in place, should this need arise (either have a trailer available for transport or know who you can contact should you need to go to the hospital). 
If it starts to look like you will need to transport your horse, take any dividers or partitions out of your trailer as well as any hay.  A very painful horse may try to go down on the ride to the hospital.  You don’t want the horse to get stuck in the trailer should they go down during transport.  Likewise, refrain from tying your horse’s head up in case he decides to go down. 
When you arrive at the hospital, especially a teaching hospital, do NOT be alarmed if there are a lot of people there to greet your horse.  That doesn’t necessarily indicate the severity of the problem, there may just be students interested in learning more about colic.  The referring veterinarian will have called the hospital with details about you horse, however you may have to update them on the status.  The hospital team will perform the same diagnostic tests as were done at the farm and develop a game plan on how to proceed, whether medically or surgically.  Depending on the type of colic, the trailer ride to the hospital can potentially help your horse work through the incident.

Post Colic Incident
Regardless of whether your horse was treated medically or surgically, it’s critical to have a discussion with your vet on how specifically to care for your horse following the colic.  A horse who underwent colic surgery will be kept in the hospital until it is back on feed. Although, the horse is back to eating, you will need to follow a regimented recovery plan to slowly reintroduce your horse to turnout and work. 
Make sure you follow all of your vet’s recommendations to give your horse the best recovery possible.  You may need to reevaluate your feeding program with the help of your veterinarian.  Don’t be afraid to ask them how you can reduce the chances of another colic episode occurring.

Colic Prevention Tips

If your horse colics, don’t blame yourself! Horses are predisposed to colic based on their poor gastrointestinal design.  Although it can’t always be prevented, the following dos and don’ts can help reduce the occurrence of colic in your horse:

DO store all feeds or grains behind closed doors. You don’t want to find a horse that snuck out for a midnight snack, colicing in the barn aisle the next morning.

DON’T allow horses to consume spoiled or moldy hay or grain.

DO feed horses at the same time every day. Horses are creatures of digestive habit, disturbing their feed routine even by an hour or two, may be enough for some to colic.

DON’T feed too much grain at a single feeding.  Research shows a direct correlation between larger amount of grain and higher incidence of colic, as the horse has a limited ability to digest starch in the small intestine.

DO deworm horses regularly.  A good parasite control program can help control several types of colic caused by parasites.

DON’T keep your horse in a stall 24 hours a day.  Research has proven that horses who are stabled 24 hours a day have a higher colic incidence than those with a regular turnout or exercise program.

Takeaways
If you’re around horses long enough, you will need to assist a horse during a colic episode.  Thankfully, if you’re proactive colic doesn’t have to be a death sentence, even if your horse has to have surgery.  A quick response to colic is your best key to success. 

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