Colic is a very broad term, describing signs of abdominal pain in the horse. If you are somewhat unsure of what colic truly means, you are certainly not alone! Colic has a number of different causes, and each cause of colic comes with varying treatment options, and varying prognosis. In this blog post, we will dive into the details of colic. We will start with the basics of recognizing colic signs in your horse, and walk through different types of colic, their causes, and their treatments.
Recognizing signs of colic promptly is one of the most important steps in getting necessary veterinary care and to have the best outcome for your horse. Each horse shows signs of pain differently, and they may show any number of the following signs:
- Inappetence
- Pawing
- Laying down more than usual or repeatedly
- Rolling
- Flank-watching
- Lip-curling
- Parking out and stretching
- Sweating
- Increased breathing rate and effort
If you notice any combination of these signs, you should call the veterinarian immediately. Until the veterinarian arrives, only give medications as instructed by the veterinarian coming to see your horse. If you horse wants to stand or lay quietly, you may let them. If they want to roll and may get themselves cast or injured, get them up and take them for a brief hand-walk. Take care not to over-walk your horse and cause them to be sweaty, dehydrated, and tired.
Now your veterinarian has arrived. They will want to ask you some history questions, so be prepared to provide information such as:
- The age of your horse
- What signs of pain the horse is showing
- How long the horse has been painful
- When was the horse last seen normal
- How much manure and urine has been passed and when
- Vaccination, dental, and deworming history
- Regular diet of the horse
- Has the horse colicked ever in the past
- If yes, what was the diagnosis, treatment, and did the problem resolve
The colic exam includes a physical examination paying extra close attention to mucus membrane color, vital signs, and GI sounds. A rectal examination is performed, along with passing a nasogastric tube. Depending on the case, abdominal ultrasound and/or abdominocentesis (taking a sterile sample of abdominal fluid) may be performed. All of these items together help provide as much information as possible so that the veterinarian can make the most accurate diagnosis and determine the best course of treatment.
At this time, your veterinarian will likely have a tentative diagnosis, and will also likely have an idea if your horse’s colic is “medical” or possibly “surgical”. Let’s dive into more detail on some of those diagnoses, and what that means for your horse.
“Medical” vs. “Surgical”
These are not specific diagnoses, but terms that divide colic into two general types. A “medical” colic is one that the veterinarian feels will be able to resolve with medical treatment. This can range from treatment on the farm to more advanced treatment and fluid therapy in a hospital setting. A “surgical” colic is one that the veterinarian feels or knows will not be able to resolve without colic surgery. If your veterinarian feels that a colic is surgical, time is of the essence! Getting your horse to a referral hospital that can perform colic surgery as quickly as possible will provide the best outcome for your horse.
Gas or spasmodic colic
Spasmodic colic occurs when a portion of the intestine becomes overactive, creating acute cramping pain for your horse. The cause of colic may not be readily apparent. This type of colic is incredibly common, and luckily most respond to simple medical treatment.
Impaction colic
Impaction colic is when a portion of the GI tract, usually the large intestine, has become full and obstructed with a large amount of firm ingesta. Horses that are drinking less than usual and become dehydrated are prone to developing an impaction. Treating an impaction is most importantly through hydration. Treatment with oral fluids via the nasogastric tube will be performed, and may include electrolytes, Epsom salts, and/or mineral oil. Depending on the extent of the impaction, repeat treatments via nasogastric tube may be required. Severe cases may be helped by IV fluid therapy, and occasional cases refractory to treatment may be taken to colic surgery.
Displacement and torsion colic
The large intestine of the horse has many segments that rest in specific locations in the abdomen. Occasionally, the large intestine can move, or displace, to a different area of the abdomen. This causes pain, can cause obstruction or gas build-up, or potentially lead to a torsion. A torsion happens when the large intestine twists on itself. This cuts off the blood supply to the intestine, and can lead to the entire twisted portion dying. Displacements can resolve with mild medical treatment, or require hospitalization to correct. If the displacement leads to a torsion, immediate colic surgery is necessary. When caught early, prognosis for these surgeries is good.
Strangulating or obstructive colic
Most commonly seen in geriatric horses, strangulation and obstruction of the small intestines can occur from benign fatty tumors called lipomas that develop within the abdomen. These tumors are harmless on their own, but potentially can wrap around a segment of the small intestine. When this happens, the intestine is cut off of its blood supply and it becomes obstructed. In a relatively short period of time, the strangulated portion of small intestine dies, and fluids builds up in the small intestine and stomach. These horses often show severe signs of pain. Strangulating small intestinal colic always requires colic surgery to repair. Complications following this type of colic surgery are common, and recovery may be more difficult.
While these diagnoses are not necessarily “one size fits all”, we hope that this has provided valuable information to help you feel better prepared if you encounter colic in your horses. All colic episodes should be taken seriously, though fortunately most cases of colic respond well to medical treatment on the farm.