“Colic” is the broad term we use to define abdominal pain in our patients. Abdominal pain can be caused from a variety of ailments, although it is commonly due to gastrointestinal disease of some degree. Colic can, however, refer to diseases not affecting the gastrointestinal tract such as urinary tract stone(s), choke, uterine torsion, laminitis, tying up or rhabdomyolysis, pleuropneumonia, and reproductive causes (dystocia, abortion). Significant advances have been made in regard to diagnosis, medical treatment, surgical techniques and postoperative care in horses. In spite of all these advances equine veterinary medicine has made in the last decade, colic unfortunately, has remained the leading cause of premature death in our adult horse population.
Signs your horse may be colicing:
- Lethargy, anxiety or depression
- Pawing at the ground
- Looking at the flank
- Kicking or biting at the abdomen
- Flehmen, (repeated lifting of upper lip)
- Repeated lying down and rising
- Playing in the water bucket but not drinking
- Decreased fecal output, or change in consistency of manure
- Lack of appetite
- Pacing or constant shifting of weight while standing
- Excessive sweating
- Abnormally high heart rate (over 45 beats per minute) or respiratory rate (over 20 breaths per minute)
- Lack of or decreased normal gut sounds
- Frequent attempts to urinate, stretching out
- Bruxism (grinding teeth)
- Abdominal distention
Research has shown that a large portion of our colics are a result of feeding and care practices. As a result, some of our colics can be prevented with proper management.
Ways to Reduce the Risk of Colic
1. Always have fresh, clean water available
A typical horse at rest in a moderate environment will drink anywhere from 8 to 12 gallons of water a day. The need for water will increase with an increase in ambient temperature, humidity, activity and/or a change in physiological condition such as exercise or lactation. Horses have been shown to prefer to drink out of buckets compared to automatic waterers. Horses prefer warm water in the winter as opposed to cold water. Adding hot water to the buckets to achieve a more tepid temperature in cold weather is desirable. Horses without water for as little as 1-2 hours, are at an increased risk of colic.
2. Feed high quality roughage
Most mature horses should be fed 1.5 to 2.5% of their body weight in forages each day. Hay should be provided in tubs or hay racks to minimize the horse eating directly off the ground where it would potentially consume sand. Rubber mats or catch pans can be placed underneath racks to enable horses to finish hay without getting sand. Hay should not be elevated too high as it creates the possibility for respiratory disease and can increases intake of molds and dust. Feeding from round bales increased the risk of colic. Feeding coastal hay increases the risk of colic due to the association with ileal impactions and coastal bermuda grass.
3. Minimize concentrates and feed in smaller frequent meals
A horse’s natural diet is made up of strictly forage, yet because of the performance demands put on today’s horses, they are often fed processed grains and sweet feeds that are high in carbohydrates. Horses eating pelleted feeds and sweet feeds are at increased risk for colic compared to horses on a 100% hay diet. Colic risk can increase 70% for each pound increase in whole grain or corn fed in some studies. When more energy than can be supplied via forages is needed and concentrate diets are fed the risk of colic increases. Recent research has shown that diets that are lower in starch and higher in fat are healthier for most horses. Various feeds are available to meet the individual needs of the horse. Try and feed smaller but more frequent meals, this allows starches to digest before reaching the equine hindgut, preventing minimizing hindgut acidosis. Automatic feeders such as the iFEED are excellent choices when concentrates are required.
4. Establish a strict daily feeding, exercise and turnout routine
Strict attention to establishing a daily routine for your horse is very important in minimizing the risk for colic. Colic risk increases during the two weeks that follow changes. Changing the batch of hay can increase the risk of colic. Make only gradual changes in diet, turnout, and exercise whenever possible. To make changes in feed, mix ¼ new with ¾ old for about seven days, then increase the percent of new feed to ½ new and ½ old for 7 days, then gradually increase the remaining new to old ratio over the next week. Changes in intensity and duration of exercise should be made slowly if possible. Try and provide exercise and/or turnout daily. Horses that have access to pastures have been shown to have a lower colic risk than those without pasture access. If your horse is on stall rest for management or medicals reasons, daily hand walking is usually allowed although it is good to consult your veterinarian.
5. Float horses teeth annual or biannual
Horse’s teeth erupt continually through their lifetime, they are constantly being worn down by the grinding action associated with chewing of feedstuffs, especially forages. Over time sharp points will form on the upper and lower teeth as they are just slightly offset. If not filed down or “floated,” the points on the teeth can cause lacerations on the inside of the cheek, this in turn can cause pain and interfere with how the feed is chewed. Routine floating ensures the horse’s ability to properly and thoroughly chew hay and concentrates.
6. Parasite control
Horses on a daily wormer or horses regularly dewormed are less likely to colic. More information on deworming is available under Performance Equine Vets Parasite Guidelines.
7. Limit medications to minimize risk
Administration of certain medications can predispose horses to gastrointestinal problems. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as phenylbutazone (Bute) and flunixin meglumine (Banamine) when administered at or even below normal recommended dosages can have side effects on the gastrointestinal tract. NSAIDs can cause ulceration of the mucosal lining of the gastrointestinal tract, this in turn can cause pain and colic. Although important for the treatment of a variety of conditions, antibiotics carry some degree of risk and therefore careful consideration is put into the decisions to administer antibiotics and the choice of antibiotic to treat our patients. The equine hindgut contains billions of bacteria, fungi, and protozoa that serve in a symbiotic relationship with the horse. These microflora enable the horse to digest cellulose and other fibrous materials in the feed that would otherwise not be utilized. Some antibiotics can cause the disruption of the hindgut microflora, which permits proliferation of pathogenic microbes and resulting colitis or “colic”.
What should you do if you suspect colic?
Colic can be life-threatening and needs to be addressed immediately. Awareness in what is normal for your horse will allow you to discern subtle signs that there may be a problem. Early signs of impaction colic may include dry fecal balls, fecal balls that are smaller than usual or less frequent fecal output. Some horses with impactions may go slightly off feed or decrease water intake during the early stages of colic. If your horse does colic, appropriate and timely care can make a profound difference in the outcome.
Early diagnosis and surgical treatment of more serious cases of colic remains one of the most important factors in giving horses the best chance of survival following colic surgery. Please seek veterinary attention if you determine there is a problem with your horse.
What should you expect from a referral hospital?
1. Physical Examination
A thorough and accurate history should be provided to the veterinarian. Information such as diet, travel history, exercise or turnout schedule, recent deworming, medications administered, previous colic episodes, as well as any other pertinent medical information should be conveyed to the veterinarian. Risk factors as well as underlying disease can then be discovered and assist the clinician in determining the type of colic your horse may be encountering. A temperature, pulse rate and respiratory rate will be taken. Mucous membranes in the oral cavity will be assessed for color, hydration status, and capillary refill time. Auscultation of the respiratory tract as well as the abdomen will be performed. The pain level of your horse will also be evaluated as will the horses response to any medications administered.
2. Nasogastric intubation
A tube passed through the nasal passages into the esophagus and then into the stomach will allow the clinician to evaluate the patient for evidence of excess fluid on the stomach, “reflux”. The equine patient does not possess the ability to vomit. As a result any fluid accumulation in the stomach potentially can apply too much pressure to the stomach wall and subsequently the stomach may rupture (although this is relatively rare). If no fluid is obtained, the veterinarian typically administers replacement fluids, electrolytes and lubrication into the stomach to help resolve the colic.
3. Rectal palpation
Rectal palpation is an important factor in determining the type of colic present. Roughly twenty-five to forty percent of the abdomen can be reached on a rectal examination. Critical information can be obtained to determine the type of colic and therefore the appropriate treatment required. Determinations are made on small intestine vs large intestinal involvement, gas, impaction, displacements, abnormal masses, or fluid distention.
4. Abdominal ultrasound
We perform abdominal ultrasound examinations on most of our patients. A full evaluation of the respiratory system as well as the abdominal cavity is performed. Fluid accumulation in the pleural space or roughening of the pulmonary surface can indicate respiratory disease. Evaluations of the abdominal cavity can reveal gastric or intestinal distention, increased intestinal wall thickness, increased amount or abnormal character to the abdominal fluid, evidence of displacement of intestine, lack of or decreased motility, presence of strangulating lesions, presence of sand, and diagnosis of herniation.
5. Laboratory blood analysis
Valuable data can be obtained with laboratory analysis of the blood. Assessment of cardiovascular status, hydration, presence of infection, organ abnormalities (liver, kidney), presence of endotoxemia, as well as electrolyte abnormalities. Overall condition of the horse can be evaluated to determine if there is systemic compromise and to help dictate a specific, detailed therapeutic treatment plan. Information obtained from the laboratory analysis can also assist in limiting potential complications.
Abdominocentesis is a procedure to evaluate the fluid in the horses abdominal cavity. The veterinarian performs the procedure by placing a blunt ended catheter into the abdominal cavity, typically using the assistance of an ultrasound. The color, quantity, and character of the fluid is observed visually as well as analyzed in the laboratory for cellular characteristics. This fluid, if abnormal, can provide valuable information as to the degree of the severity of the colic as well as the prognosis for the patient. Often times the abdominocentesis or “belly tap” is done to determine the need for surgical intervention or to dictate a change in the course of therapy provided.
Gastroscopic evaluation is performed by passing a thin tube with a small camera into the horse’s stomach. This allows the clinician the ability to visualize the gastric mucosa and diagnosis gastric or duodenal ulceration if present. Some colic episodes are attributable to gastric ulcers, other times the colic episode is worsened by the presence of gastric ulceration.
Every equine patient that undergoes a colic episode is unique. Each horse will respond differently to treatment and therapies provided. After a full evaluation is completed, the veterinarian will review the information and determine the best treatment options for your horse. If the veterinarian feels your horse is a surgical candidate, our team will quickly prepare the horse for surgical intervention. Performance Equine Vets is here to minimize the stress associated with this time for you and your horse. Our goals are to communicate promptly and effectively to both the owner as well as the trainer and to provide the best possible care to your horse.
We are always available for a consultation.
If you have any questions and would like to speak to a Veterinarian, please give us a call. 803-641-0644