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COLIC FIRST AID

Horse owners that have never seen a colicky horse first-hand should probably consider themselves lucky! Colic is one of the most common emergencies we see as veterinarians, and often has the potential to be the most life-threatening. There are a few things everyone should know about colic, and some important tips to help keep yours under control.

WHAT IS COLIC?

Colic is a term used to describe any sort of gastrointestinal problem that causes your horse pain or discomfort. There are many different types of colic and these are caused by a number of different problems. The horse’s digestive system is quite complex and very sensitive, and it is complicated by the fact that they are unable to vomit in order to expel noxious substances from their stomach. Some common words you may here when you are dealing with colic are as follows:

Displacement – this is where a piece of the large intestine moves to a place in the abdomen it is not supposed to be (often due to gas build-up or the horse rolling vigorously)

A “Twist” or Volvulus – this is where a piece of the large intestine rotates around itself and causes a blockage. The twisting of intestine can also compromise blood flow to the tissues and cause it to die.

“Gas colic” – caused by a build up of gas in the intestines, often making the horse very uncomfortable or crampy. Sometimes caused by eating a lot of grass, exposure to a new pasture, or getting into grain.

Intussuception - where one piece of intestine ‘telescopes’ into another, essentially causing a blockage

Colitis – inflammation of the colon wall, usually causing diarrhea. This form of colic can also make a horse very uncomfortable.

Impaction – this is where a large firm mass of fecal material builds up in the large colon and gets trapped (usually where the large colon narrows at the pelvic flexure)

SYMPTOMS

Many people know that a horse laying down and rolling can be a sign of colic. This is often the most recognizable sign, but it can be accompanied by others. Horses suffering from a bout of colic may be sweaty, paw at the ground, appear anxious, stall walk, have an increased respiratory rate, or lift their upper lips (Flehmen’s response) in response to pain.

WHAT TO DO IF YOU SEE THESE SIGNS…

If you are inexperienced with colic – call your veterinarian for advice immediately. Even if your horse does not warrant a farm visit with examination, your vet can offer you some advice about how to proceed. They will often ask you for a bit of history on the phone and advise you to handwalk your horse in a safe location until they can get out to your farm. During this time, it is important to monitor your horse for the passage of any manure (and make note of it’s consistency) and not to feed it anything. Access to water during this time is fine.

If you have dealt with colic before, you may have some medications on hand to treat your horse with. If you decide to treat your horse first (before calling the vet) it’s important to remember that giving these medications can change some important parameters the vet will use to evaluate your horse’s condition – such as temperature, heart rate, and respiratory rate. It is useful if you are able to write down this information prior to giving any medication AND the time and route that the medication was given, so that we have an idea of how the horse was initially.

If you administer medication the most important thing to remember is that things like banamine (flunixin) and bute (phenylbutasone) may mask the signs of pain, but they do not necessarily correct the problem. During the first 3-4 hours after administration, horses should be kept off feed (although they often want to eat) and monitored for manure production. The rule of thumb is that after a colicky episode, we want to see manure being produced before we start feeding again. After 3-4 hours, most medications will have worn off in a severely colicky horse – if this happens and they become uncomfortable, they likely need treatment by a veterinarian. If the horse remains quiet and comfortable after 3-4 hours, you may choose to start feeding the horse small amounts of hay (1/4 flake every hour) or a soupy bran mash - and monitoring for any discomfort as well as manure production.

IF YOUR VETERINARIAN COMES OUT…

The first thing we will want to do is get a history from you – when you found the horse, what was it doing when you found it, was it inside or on pasture, have there been any changes to the feeding program, deworming history, etc. Next we will perform a physical exam to determine the severity of the colic. This will often include listening to the heart, lungs and gut, taking a temperature, evaluating the colour of the horse’s mucous membranes and capillary refill time.

After the physical exam, we generally will perform a transrectal palpation – where we can evaluate how the intestines are placed in the abdomen. Large abnormalities such as a displacement, or torsion, or impaction can often be felt during this examination. As well, a nasogastric intubation will usually be performed, which involves passing a tube up the horse’s nose and into the stomach. “Tubing” a horse allows us to evaluate the contents of the horse’s stomach (gas, feed material, etc) and also to relieve some of the pressure that may be building up inside. We will sometimes administer medications directly into the stomach via this tube such as “anti-gas” to help with gas breakdown in the intestines, electrolytes to help rehydrate the body, mineral oil to help lubricate impacted feed material, and good old water to help move things along.

If a horse is dehydrated, we will often offer intravenous fluid therapy. This involves placing an intravenous catheter in the horse’s jugular vein, and hanging somewhere between 10-20L of a balanced electrolyte solution to drip into the vein. The idea is to restore the horse’s normal hydration status, as this can negatively affect blood pressure, kidney function and gut motility if it is poor. Running 10L of IV fluids into a horse usually takes around 2 hours, and it involves having someone in the barn to monitor the horse during this time.

After treatment, we will generally advise that the horse be exercised (either at a brisk walk, or a slow jog or trot on the lunge line) for 15-20 minutes to help restore gut motility. Provided the horse remains comfortable, periodic exercise of this type is usually advisable to keep the GI tract moving.

Monitoring the horse for manure production and continued comfort will usually be necessary for a 6-12 hour period, providing the colic resolves after initial treatment. Occasionally a second treatment by a veterinarian is needed. Some colics may be deemed ‘surgical’ at this point and referral to a surgical facility offered. Only around 5% of the colics we see are surgical candidates, but it is still important to treat every colic as though it could be. Giving them the best and most immediate treatment possible is the best insurance against a colic becoming surgical.