Colic in Horses

Colic. It’s a word that all horse owners dread, and rightfully so. Widely known as the most prevalent killer of horses worldwide, this disease can strike at any time and has claimed the lives of countless young and healthy horses. Yet there is much that can be done in order to prevent and treat colic, and many horses can recover fully even from serious colic if correctly managed.

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The term “colic” is not really applicable to any single disease. Instead, it’s simply an encompassing term for any kind of abdominal pain. As such, there are many different types of colic, each being a different and separate disease from the other. Some of the different types of colics include:

• Spasmodic colic: What stomach cramps are to people, spasmodic colic is to horses. This can be caused by a reaction to medication or even by drinking too much cold water in one go. Spasmodic colics can vary from very mild to serious.

• Gas colic: The horse’s digestive system relies fairly heavily on a process known as hindgut fermentation. This takes place in the horse’s colon or large intestine with the aid of beneficial bacteria. A by-product of fermentation, however, is gas. When the bacteria produce too much gas, it fills the horse’s intestine, giving it an uncomfortable and bloated feeling that may cause significant pain. While often easily relieved by a trot around the lunge ring, gas colic can cause a displacement of the bowel, which can be fatal.

• Impaction colic: An impaction is a blockage anywhere in the horse’s intestine. This blockage could be caused by food, foreign objects, or even worms, and results in the intestine swelling up and ceasing its normal movement. It is intensely painful and can be extremely dangerous: unresolved impactions invariably lead to perforation or torsion and, eventually, death.

• Displacement of the bowel: The deadliest colics occur when the intestinal tissue’s blood supply is cut off, causing parts of the intestine to die and rot inside your horse. This could be caused by the intestine folding, telescoping, moving to the wrong place, or twisting (a deadly form of colic known as torsion).

• Perforation or rupture of the bowel: In extreme impactions, the intestinal wall could rip (rupture) or develop holes (perforate). Intestinal contents will leak into the horse’s abdominal cavity. This disease is excruciatingly painful and the horse must be euthanized, as there is no way of repairing the bowel. Even if there was, the amount of intestinal contents leaking into the abdominal cavity will cause sepsis and, eventually, death.

Colic signs are generally the same for all types of colic, which is what makes them so dangerous. Your horse may look just like your friend’s horse that farted once and then was just fine, but he could easily have torsion or perforation. While more severe colics usually result in more severe pain, this is not always the case. Colic signs are always an emergency.

First, it’s important to know what’s normal for your horse. What time of day does he usually lie down? Many a colic has been spotted early by a diligent groom who saw a minor deviation in the horse’s daily routine. Some grooms can spot something as simple as an inward look or a minor shifting of the weight.

Your horse’s vital signs may also change during colic. Pain will often cause a slightly elevated heart rate and respiratory rate, although this is not always present in milder colics. Severe colic will present with a highly elevated temperature, pulse, and respiratory rate. Advanced colic that has resulted in shock will cause changes in the color of the horse’s mucus membranes as well, causing them to become pale or brick red.

Thermometer

A key component in identifying the type and severity of colic is your horse’s gut sounds. Placing your ear (or a stethoscope) on the horse’s side in the hollow between the last rib and the point of the hip will allow you to listen to his intestines. They should continuously make a rumbling, gurgling noise. Gassy sounds can indicate gas colic, while an absence of gut sounds is the most dangerous sign of all, indicating an impaction or worse.

Stethoscope

The easiest way to identify a colic, however, is by your horse’s behavior. Horses use a wide range of behaviors to tell us that their stomach is hurting. Some examples include:

• Lying down at uncharacteristic times of the day

• Lying down and getting up repeatedly

• Repeatedly rolling, especially rolling and then getting up without shaking themselves off

• Pawing the ground obsessively

• Looking around, kicking or biting the flanks

• Stretching repeatedly

• Standing in an unusual twisted position

• Throwing themselves violently on the floor

• Constant pacing

• Lack of appetite

• Lethargy

• General anxiety, distress, or depression

One major fact about colic cannot be stressed enough: colic is always an emergency. I repeat, colic is always an emergency! It is practically impossible to tell without at the very least rectal palpation (an internal exam conducted through the horse’s anus) or, preferably, an ultrasound, whether the horse is having minor gas colic or a potentially life-threatening displacement. The layperson certainly cannot tell the difference in the majority of cases.

Should you suspect your horse is colicking, calling the vet is imperative. Failing to call the vet for colic may result in the death of your horse. Some very experienced horse owners and stable managers may be able to start treatment on their own, but even the most experienced horseman should at least alert the vet to the situation so that they are ready to come over should the horse’s condition deteriorate.

Once the vet has been called, here’s what you can do in the meantime.

• Contact your horse’s insurer if he has one.

• Ensure that you have transport to the animal hospital available – arrange for a trailer, or if you have a trailer, check its tires and the fuel in the towing vehicle.

• Remove access to food. Adding food into a malfunctioning gastrointestinal tract could make the condition worse.

• Offer the horse cool, fresh water – do NOT attempt to force the horse to drink it. Your vet may advise you to remove the water if the colic is particularly severe, but minor impactions may benefit from some water intake. A severely colicking horse is unlikely to drink anyway.

• Prevent the horse from injuring itself by violent rolling or throwing itself to the floor. Recent research indicates that rolling is unlikely to cause a torsion, but many panicking horses can hurt themselves by rolling furiously and smacking legs or head against a wall or fence.

• Encourage the horse to move around. Easy hand walking can be very beneficial to help the gut get moving, particularly up and down some small and gentle slopes. A gentle trot on the lunge line can also be of assistance, but avoid tiring the horse out.

lunge line

Avoid doing any of the following:

• Giving the horse anything orally, including water or oil. Oil is unlikely to lubricate an impaction; instead, it may actually coat it and make it more difficult to dissolve. Worse, drenching the horse is not an easy skill, and you could end up pouring some foreign liquid into the horse’s lungs.

• Administering a painkiller, sedative, or antispasmodic. As much as this might bring the horse some relief, it will prevent the vet from being able to accurately examine the horse and assess his pain level. These drugs should only be given by qualified and experienced horse people on the advice of a vet, and then only if there is going to be a long wait for the vet to arrive.

• Exercising the horse too much. The horse is already in pain and his system is taking the strain – overwork will only make his situation worse.

• Giving the horse an enema. This is a very dangerous practice that may rupture the horse’s bowel.

Once the vet arrives, he will be able to assess the horse and put a good treatment plan in place. Many colics can effectively be treated at home. Others will be better off in an equine hospital, even if the horse doesn’t require surgery. A colicky horse should never be left alone – nursing a very sick one can take a terrible strain on the owner, and is better done by the staff in equine hospitals. At least they have shifts! Some of the treatments available for colic include: • Nasogastric (stomach) tube (commonly called “tubing”) – One of the first lines of defense against impaction colic, tubing is a skill that horse vets can perform at home. The vet will pass a long tube through the horse’s nose and into his stomach, then pour water (sometimes with electrolytes) directly into the tube. This can dissolve the impaction and cause it to clear up quite easily. Once the tube is in, adding more water is a relatively easy task, and the vet might leave the tube in for the owner to repeat the drench. The horse will need to be sedated for the tube to be inserted; it’s an uncomfortable, but generally painless, procedure.

• Various drugs – While there’s no magic injection that will relieve colic, there are medicines that can remove the horse’s pain and stop his stomach from cramping. The latter, known as antispasmodics, are often very effective in treating mild gas or impaction colic. In any form of colic, the vet will give the horse something for pain in order to keep it comfortable while it’s being treated. Pain control is a priority. If the colic is caused by an ulcer, your vet can recommend a chronic medication to help.

• Intravenous fluids – Severe colics may need supportive care in the form of a drip. Flooding the horse’s system with fluids can also help to loosen an impaction, as the excess fluids will go into the stomach and intestines. Fluids keep the horse hydrated and help him to feel better. This is usually done in a veterinary hospital.

• Cecal trocharization – Severe gas colics that don’t respond to normal treatments can be relieved by a cecal trochar. This is a large needle that goes through the horse’s skin and into his cecum (the first part of his large intestine), allowing gas to escape. The procedure is generally not recommended as it has a risk of infection, but when colic surgery is not an option, it can be life-saving.

• Colic surgery – The dreaded colic surgery is the last resort in treating displacements, severe impactions, and torsions. It is a highly effective treatment, but the recuperation is fairly harsh on the horse, and the surgery is extremely expensive. Surgery is usually only performed on very valuable horses or horses whose owners have had the foresight to insure them. Many horses recover well from colic surgery and go on to return to normal, active lives. Treatment options for colic can vary from cheap and easy to very expensive and involving long-term recovery. Your vet will be able to discuss the options with you according to your individual situation.

The most tragic thing about colic is that this dreadful illness, claiming many thousands of equine lives every year, is extremely preventable. While all horses are at risk of colic, there are many steps that can be taken in order to minimize this risk. The most important thing to keep in mind is the horse’s natural diet and lifestyle – trickle feeding on roughage while moving across large spaces. Some of these tips may help boost your horse’s digestive health:

• Feed concentrates with care, giving multiple small meals instead of a single, larger one.

• Make changes to the diet slowly.

• Avoid allowing the horse to get hungry and then gorge himself. Roughage available ad lib will cause the horse to eat more slowly.

• Allow for plenty of roughage (such as hay and grass). Grazing is the best food available for horses, but free choice hay is almost as good. Use a slow feeder if your horse is overweight, and soak the hay if he is prone to laminitis.

slow feeder

• Allow for plenty of movement and turnout time.

Colic is a scary disease that strikes fear into the hearts of all horsemen. However, there are many treatment options available to save our horses. Prevention and early identification is key to your horse’s digestive and overall health.