What is Colic?Colic is a broad veterinary term used to describe any form of abdominal pain. It is a non-specific term as there are multiple causes of colic; most of these are gastrointestinal in nature but occasionally colic can be the result of cardiovascular, musculo-skeletal, or urogenital systems and even some severe respiratory disease can present as colic. A horse's gastrointestinal system is complex in structure and function, and virtually any aspect of the gastrointestinal tract can be affected.
Colic episodes can occur suddenly or can be mild and relatively self-limiting, waxing and waning over the course of several hours or even days. Signs of colic in horses are variable and often depend on the severity, location, and cause of the pain. As colic can progress quickly and even a mild case can turn serious, if you suspect your horse has colic, the vet should be contacted immediately.
Typical signs of ColicKnowing and recognising the signs of colic is very important for horse owners as this will allow early recognition of colic and therefore early veterinary intervention. Signs to look out for include:
- Repeatedly getting up and lying down;
- Rolling or thrashing;
- Flank watching;
- Pawing the ground;
- Kicking or biting the abdomen;
- Decreased faecal output or diarrhoea;
- Sweating, anxiety, trembling;
- Inappetance and depression; and
- Standing stretched out as if to urinate.
Causes/Types of ColicAs mentioned previously, there are many different reasons for colic and often we are never really quite sure why a horse has shown colic signs. The vast majority of these are due to some sort of gastrointestinal problem. Some of the more common causes of colic include stomach ulcers, distensions, strangulations, displacements, tumours, and impactions.
The following outlines some of the more common causes and their typical locations:
Spasmodic colic is probably the most common type of colic we see. It occurs the gastro-Intestinal tract contracts in such a hyper-active abnormal way that it causes painful spasms. The majority of these colic cases respond to simple medical treatment administered on the farm.
Impaction colic refers to abdominal pain as a result of a blockage in part of the gastro- intestinal tract. The majority of impactions occur in the large intestine, and frequently in the Pelvic flexure (an anatomical U-bend). These are fairly common and can often be resolved on the farm with medical treatment and the administration of fluids via a stomach tube. If they are larger and more severe than surgical correction may be required.
Displacements, Distension, Torsions & Strangulations.
The horse's gastro-intestinal tract is complex (and badly designed!) due to the fact that large sections are either, suspended in place by loose lengths of tissue, as is the case for the small intestine, or completely unattached to the body wall, as is the case for the large intestine. The gastrointestinal tracts freedom of movement within the abdomen predisposes the horse to displacements and torsions. Strangulations and displacements are intestinal accidents that are uncommon, but are very serious in nature. Displacements occur when part of the gastrointestinal tract moves to an abnormal position within the abdomen. Torsions occur when abnormal movement of the gastro-intestinal tract results in it twisting on itself, cutting off the blood supply.
Strangulation of the gastrointestinal tract by other structures (pedunculated lipomas) also results in cutting off the blood supply. A few displacements can be treated by starving and medical treatment but many displacements and all strangulations and torsions require immediate surgery to correct the problem. The early stages of strangulating or displacement colic often show signs very similar to the more common, less life-threatening forms of colic. It is therefore important to take all colic episodes seriously and call the vet at the earliest signs of abdominal pain.
If your horse is colicking
- Call the Vet immediately. Colic is a true veterinary emergency and rapid veterinary intervention is essential for the best possible outcome.
- Place your horse in a safe environment in case it rolls, such as a manege or well bedded stable to allow for easy and close observation.
- Remove all feed from your horse.
- Do not administer any medication without veterinary permission.
- If your horse is rolling violently try gently walking them around a safe area, such as a manege or small paddock, to prevent self-trauma. DO NOT put yourself in danger trying to help your horse.
What wll the vet do?On arrival the vet will perform a complex clinical examination to evaluate of a multitude of interacting factors.
The clinical examination may include some of the following;
- Heart Rate: A normal resting heart rate is around 24-44 beats per minute. An increased heart rate is usually a good indicator of pain and can often be an indicator of severity of colic.
- Mucous Membranes and Capillary Refill Time: Normal gums should be salmon pink in colour, moist with a capillary refill time of less than 2 seconds. Mucous membrane colour, moistness and capillary refill time help to assess your horse's hydration status and are good indicators of blood perfusion. The colour of the gums can be an indicator of severity of colic.
- Gut Sounds: In a normal horse these sounds are heard in 4 quadrants of the abdomen. By listening to the gut sounds the vet can get a good indication of how much activity is occurring inside the abdomen.
- Skin Tent: A well hydrated horse's skin when pinched will spring back to its normal position as hydration is closely related to skin elasticity. A sluggish return to normal can be suggestive of dehydration.
- Rectal Examination: Internal examination of the abdomen via the rectum is a vital part of the colic diagnostic process. It allows the vet to feel what is occurring inside the abdomen to assess if there are any major abnormalities present such as an impaction or distended loops of bowel due to a twist. Not all areas of the abdomen can be reached using this technique but it is an invaluable examination.
- Passing a Nasogastric (Stomach) Tube: Passing a tube up your horse's nose and down into its stomach is both diagnostic and therapeutic. Firstly this will allow the vet to determine if there is any excess fluid in the stomach, "Gastric reflux", which occurs when there is a blockage in the small intestine that causes the build-up of fluid in front of it. Unlike other species the horse cannot vomit and the stomach can rupture due to build-up of fluid. The presence of gastric reflux is often a major indicator for surgery. Secondly, if gastric reflux is not present, your vet may decide to administer some fluids down the tube to help treat an impaction colic.
TreatmentAfter assessing your horse an appropriate course of treatment will be started. The majority of colic cases can be successfully managed on the yard. This will include intravenous administration of analgesics (pain relief) and gut relaxants. If an impaction is diagnosed then a stomach tube will be passed to administer fluids/electrolytes into the stomach.
If colic signs persist then it is vital that you contact the vet. Recurring pain could be due to an impaction needing further fluid therapy. Or a horse that is still painful despite pain relieving drugs may need to be referred to a hospital for further investigation and possible surgery.
It is essential to determine whether the horse can be managed medically or if it requires specialist care/surgery. The vast majority of colic cases do not require surgery and respond well to on-farm treatment but if the vet feels that your horse needs referral to hospital for possible surgery, time is of the essence.
The decision to take your horse to surgery can often be very difficult and unfortunately, due to the nature of colic, a rapid decision is required. Many factors are involved in making this decision but the vet will be able to help you make the right decision for you and your horse.
PreventionNot all cases of colic can be prevented, but consistent and appropriate husbandry will help reduce the chances of colic.
- Maintain a regular level of exercise.
- Ensure free access to water - in winter break any ice on top. Keep field water topped up in summer.
- Keep a consistent feeding schedule - introduce any changes to diet or routine gradually over time.
- Keep up to date with worming.
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