Recognizing and treating colic

By Robert N. Oglesby, DVM
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Symptoms: You have just come in to feed your horse, Plugly, and he looked a little off. He plays around in his tub and decides he is not interested in what is usually the focus of his life; his feed. Perhaps he occasionally looks at his sides and paws the ground. Some horses seem to get relief by parking out like a Saddlebred. As the pain worsens he lays down and rolls gently on to his side and then back up again. If the pain is very bad he will roll violently. These are all signs of colic. Colic simply means the horse has abdominal pain.

Causes: A recent study (1995) at Texas A&M of 821 cases of colic and 821 horses with no history of colic identified 3 management factors that increase in incidence of colic:

1. Recent changes in diet.
2. Recent changes in stabling.
3. Recent changes in activity.

This is not surprising, but underlines the need to make changes in a horses diet and environment slowly.

Many people make the mistake of looking upon colic as a single disease, but the symptoms we describe as colic occur in hundreds of different diseases. Most of these are easily treatable problems; some require expensive treatment or surgery to fix. Another common misconception is that serious (surgical) colic is what happens when a treatable colic goes on too long or a horse is allowed to roll. More often, serious colics just look mild early and early medical treatment just puts off the inevitable.

Veterinarians attempt to determine whether a colic is a medical or surgical disease, on the initial physical exam. Surgical colics are displaced (twisted) segments of bowel or hard impactions and they require abdominal surgery to fix them. Medical colics are usually caused by migrating worm larvae, recent changes in feed, gas, fecal impactions, and occasionally inflammatory bowel diseases. Medical colics will respond to lubricants and pain relievers. Occasionally medical colics will require oral or IV fluids.

Surgical colics: Surgical diseases will mimic medical colic in the early stages and temporarily improve with treatment, only to have pain return within the next few hours. Some of the criterion a veterinarian will use are painfulness, heart rate, rectal exam, appearance of abdominal fluid and response to treatment. A horse that is scraping himself up by rolling on the ground or has a heart rate greater than 60 early in the disease is a possible surgical candidate. Another early clue is the horse that does not respond completely to treatment with Banamine.

Foals can present extra challenges to get an early diagnosis. A recent report on retrograde contrast radiography (xrays) to help illuminate the colon on radiographs was successful at identifying problems in the colon, a frequent location for surgical problems in foals with colic. (JAVMA, v207, n6, p734.)

If surgery is an option for your horse, it is important to get an early diagnosis since the horse's ability to survive surgery lessens rapidly as he becomes sicker. The prognosis for surgery is much improved by early referral. Treating the horse with pain relievers before the vet sees the horse may delay a diagnosis of surgical disease and delay referral. Currently 60% of colic surgical cases which were performed at our educational veterinary hospitals are alive one year later. Early referral will improve these odds greatly.

You must first decide if you would have your horse taken to surgery if necessary. You treat the surgical candidate differently. A good time to make this decision is before the horse becomes ill. Surgery for colic is always expensive (a $3000 minimum in my area), has frequent complications associated with it, and only a fair prognosis, though this is greatly influenced by how early in the disease the horse is operated on. Let your veterinarian or barn manager know your wishes in case you are not reachable when your horse gets ill, this happens all the time.

Medical treatment: Fortunately most (90% or more) colics are treatable with pain relievers and intestinal lubricants. Banamine is an unparalleled choice for pain relief of medical colics. It is quick, effective and very safe. The only down side is that it may do too good of a job and hide a surgical disease until too late when used at the recommended rate. For those horses for whom surgery is an option, it has been recommended that a reduced dosage of 6cc's per 1000 pounds be given to prevent hiding a serious disease. Personally I have found this lower dose not very effective for relieving pain even in medical colics.

There are other drugs available to relieve pain, but the only other effective pain relievers are potent sedatives. Rompun (TM) is a fair choice for pain relief without the downside of Banamine. Dormosedan is even more potent than Banamine at relieving pain. It has been very useful in serious colics that are not surgical candidates. But I find it will hinder an early diagnosis of surgical disease. Horses on Dormosedan will maintain a lowered heart rate past the safe surgery time.

If surgery is not an option for your horse use the high dose Banamine and whatever else it takes to make him comfortable and try not to worry. If surgery is an option, I still use the regular dose of Banamine and then watch them like a hawk and if there is any indication of a return of pain or that the pain is not rapidly and completely relieved, I refer them. Mineral oil is a popular intestinal lubricant, but I have found water is much better at breaking down fecal impactions. It has the advantage of also keeping the horse hydrated cheaply as horses with impactions frequently do not drink enough water. Mineral oil still has its place to help slow down microbial fermentation and toxin absorption, particularly in grain overloads.

First aid: If you come in to find your horse displaying signs of colic what to do depends on how severe the signs.

If the signs are mild:

1. Take away all his feed, small amounts of water are OK.
2. The next step is to take his temperature; if he has a fever (above 101) call the vet.
3. Put a lead rope on him and walk; or lunge him at a trot for about 10 to 20 minutes or go for a trailer ride for 20 min. Many mild colics will improve with either of these treatments.
4. Then put him back in the stall and watch him. If you are unsure about his condition ,offer a small handful of feed and see if he will eat it. A colicky horse as a rule will not chew and swallow feed, though he may play with it.
5. If he is over his bout of colic, continue to check him frequently for 4 to 5 hrs. to make sure the pain does not return. He should not be fed for 6 hours after his appetite returns completely. He should be allowed water free choice.
6. If he remains painful or you are unsure about his condition call the vet.

Even if Old Faithful gets over his pain, talk with your vet about possible causes and prevention.

If your horse is very painful you are going to need help:

1. The first priority is to call the vet.
2. You would like to prevent the horse from hurting himself and one of the best ways of doing that is to walk him. If the horse is so violent that he is dangerous stay away, otherwise halter him and walk him until the vet arrives.
3. If the horse insists on lying down, that is OK so long as he does not roll. Lately many colic specialists have questioned whether rolling causes bowel twists, but until the jury is in, try to prevent it.