While a rose is a rose is a rose, a colic is not a colic is not a colic! The old saying implies that when all is said and done, a thing is what it is, but colic in horses isn’t really just one thing. Colic is a catch-all term for abdominal pain, but a number of issues might be going on in that dark mysterious place that is your horse’s belly. While the outward signs can look similar (rolling, pawing, lack of interest in food, etc.) it takes some detective work in my doc’s examination to determine the cause of your horse’s colic.

Depending on what the actual problem is, the treatment can be very different. It can be confusing to horse owners that the remedy that worked on their horse before isn’t the right choice for the colic they’re dealing with now. I’ve written several blogs filled with my cat wisdom on how to prevent colic, but today let’s talk about the different kinds of colic so you can have a better understanding of what my doc is describing if a colic happens.

There are a few broad categories of colic – non-strangulating obstructions, strangulating obstructions, inflammatory conditions, and “other stuff” that doesn’t really fit into those other categories. There are about 100 feet of intestine in your horse’s belly, so unfortunately there’s a lot that can go wrong. I won’t describe every possible abdominal problem your horse could think up, because frankly we’d be here all day and I have a clinic to supervise!

Non-Strangulating Obstructions

This is the largest category of colic my docs see. In these types of obstructions, something is blocking the passage of feed material through the GI tract. Because the blood supply to the gut isn’t cut off (aka strangled), the intestinal tissue isn’t badly damaged (at least not immediately). Non-strangulating colic can often be managed medically, meaning that with appropriate care such as pain medications, oral or intravenous fluids, and laxatives, many can get better without surgery.

The type of non-strangulating obstruction you’re probably most familiar with is a feed impaction. It’s basically constipation. Food gets lodged somewhere in the GI tract – frequently the large colon or a part of the small intestine called the ileum. We see impactions a lot when the horse isn’t drinking enough water and gets dehydrated, when he’s not chewing his feed well, or with certain types of feed (cough-cough coastal hay cough) Most of the time, if my docs can rehydrate your horse and soften the impaction, she can get him un-impacted and feeling better.

Also very common are large colon displacements. The not-so-brilliant design of the horse GI tract includes a 12-foot-long large colon that basically has a single attachment point to the upper body wall. Why is that a problem? Because it allows the colon to move around the abdomen. Sometimes the colon turns in such a way that it kinks off the passage of feed material and gas or gets trapped against other organs. We call this a right dorsal displacement or a left dorsal displacement (aka nephrosplenic entrapment), depending on what direction the colon has moved. Some of these can be treated medically, but sometimes the colon will fill up with food and gas and get really wedged. It can get bad enough that the gut becomes damaged, and the horse won’t survive without surgery.

Other kinds of non-strangulating obstructions include sand impactions, which is ingested sand that accumulates in the large colon, and enteroliths, which are mineral stones that develop in the colon and grow large enough to cause a blockage. Enteroliths can require surgery to remove if they get large enough to cause a problem. Young horses that aren’t dewormed properly can even develop an obstruction made of ascarid parasites.

Strangulating Obstructions

Thankfully, strangulating obstructions aren’t as common as the non-strangulating types, but when they do happen, you have to move fast to save the horse’s life. These colics occur when part of the GI tract gets twisted or trapped in a way that cuts off the blood supply to the gut. Strangulating colics are much more serious and always require surgery to treat.

Signs of pain often come on quite suddenly and can be quite severe, with a very high heart rate and violent rolling. It’s usually difficult or impossible to control the horse’s pain with medications. The bowel begins to die quickly once the blood supply is cut off, so there’s no time to lose and your horse will need to be on his way into surgery quickly. Yet another reason to contact your vet immediately if your horse is showing signs of colic.

There are several types of strangulating colic. A “volvulus” of the large or small intestine occurs when the piece of bowel twists on its own axis and tightens down. Because of the long attachments and the ability of the bowel to move around the abdomen, volvulus can occur as an “accident” for no known reason. Large colon volvulus also tends to occur in broodmares shortly after foaling.

Another common strangulating lesion, especially in older horses in their later teens and 20’s, is a lipoma. A lipoma is a benign fatty tumor growing from the mesentery (the tissue that connects the intestine). The lipoma itself isn’t the problem, it’s the fact that the lipoma grows suspended from a thin rope of tissue like a stalk. Lipomas can exist in the abdomen for years without causing an issue, but if they get wrapped around the intestine, they will quickly cause the tissue to die. The treatment is surgical removal of the dead intestine and suturing the healthy ends of intestine together.

Entrapment colic occurs when small intestine gets stuck in a place where it’s not supposed to be. Epiploic foramen entrapment is when the intestine wiggles itself into a narrow opening between organs in the front of the abdomen, called the epiploic foramen. The foramen is a normal part of the horse’s anatomy, but the intestine isn’t meant to get in there. Another way entrapments happen is through an abnormal tear in the mesentery (a mesenteric rent) or in the gastrosplenic ligament. In both cases, there is an abnormal opening where there isn’t supposed to be one, and the intestine finds its way in there and gets stuck.

An intussusception is a weird type of colic where a piece of intestine telescopes inside the adjacent intestine and gets stuck. It’s an infrequent cause of colic and tends to affect young horses. Eventually, like all strangulations, the blood supply is cut off and the bowel starts to die.

The prognosis for a strangulating colic depends on how long the colic has been going on, how much intestine is involved, and how quickly the horse is operated on. While strangulating colics are invariably very serious situations, if treatment is performed fast, many will make it through surgery and be discharged home.

Inflammatory

Inflammatory colics are usually caused by infection by bacteria, viruses, or mold. Sometimes it’s possible to find the specific microorganism causing the problem, like salmonella or clostridium, but frequently the exact cause can’t be identified. Inflammatory colics can involve the large colon (colitis), small intestine (enteritis), or the peritoneal space inside the abdomen that contains the organs (peritonitis). Unlike most of the other types of colic we’ve discussed, inflammatory colics may have a fever.

They can all range from relatively mild to extremely severe. The inflammation of the colon in a colitis case usually results in diarrhea. Enteritis causes inflammation of the small intestine and a painful fluid backup in the stomach and small intestine. Peritonitis cases might show obvious colic signs, or just depression and a lack of appetite. Depending on what kind of inflammatory colic you’re dealing with, the treatment might be intravenous fluids, antibiotics, decompression of the stomach by nasogastric tube, or lavage of the peritoneal space. Prognosis depends on the amount of inflammation and how sick the horse is.

Other Stuff

There are a few other types of colic that don’t fit easily into one of the categories above. And it’s not that they’re uncommon! Gas colic, sometimes called spasmodic colic, is one of the most common causes of abdominal pain in horses. Gas buildup in the intestine can be caused by changes in diet or activity level, though many times a specific reason can’t be identified. While many gas colics will feel better once the gas moves through, it’s possible for an untreated gas colic to progress into a more serious colon displacement or twist.

Gastric ulcers, or sores in the lining of the horse’s stomach, don’t always show obvious outward signs – they may just have poor body condition, lack of appetite, or attitude changes. More serious cases can show colic signs like laying down and grinding their teeth. They can affect any horse at any age, but they’re most likely to occur in athletes like race or show horses.

As you can see, there are a whole bunch of different ways your horse can colic! It’s not possible to tell the type of colic just by looking at it, so make sure to get my docs involved right away. That’s why they go to school for years and years!

I’m going to give you a Pro Tip from a cat in the know: I see people who are trying to avoid spending $500 on a vet bill when their horse is showing signs of colic, so they try to wait it out. The first few hours that the horse is sick is when it’s the cheapest and easiest to treat him. After that, it gets more expensive, and the chances of a good outcome drop significantly, because most of these things we’ve talked about get worse if left alone, not better. So do your horse (and your wallet) a favor and call sooner rather than later.

Until next week,

~ Tony

P.S. Now that I’ve whetted your appetite with some serious horse knowledge, you should listen to an episode of Straight from the Horse Doctor’s Mouth, which is my podcast. Well, I have people that do that stuff, just to be clear, but I still claim it. Dr. Lacher is willing to spend way more time talking about this than I am (hey, a cat’s got to sleep, and eat, and there’s only so many hours in the day). She has several very in-depth episodes on colic that will really clog your brain up with next-level facts. You can check it out over on the Podcast Page, or subscribe on Apple Podcasts, Spotify, or wherever you get your podcasts.          

If you missed the first half of my blog on how to help your vet manage a colic, click here to read it first! Don’t worry, I’ll wait. Wake me up when you get back and we’ll go on to Part 2.

While Your Vet is Examining Your Horse

My doc may start by asking you some questions about what’s been going on, or, if your horse is really painful, she may need to start working on him immediately. A typical colic exam includes these things: a physical exam, passing a nasogastric tube through your horse’s nose and down into his stomach, an ultrasound of his abdomen, palpation per rectum to feel his internal organs, and bloodwork.

These are all pieces of the puzzle to determine what is causing the colic and how best to treat it. Some types of colic can be treated on the farm with pain control medications and laxatives. Some need to be brought into a hospital for IV fluids and more involved medical treatment, and some kinds of colic can’t be resolved without surgery. Listen carefully to what my doc tells you is going on and her instructions.

After the Vet Visit

• You’ll want to continue monitoring your horse frequently. Exactly how frequently will depend on what my doc finds – at least every few hours in a very mild case. Colic signs can worsen quickly, so you won’t want to miss anything. Yes, you may have to miss work or lose some sleep during the night. Trust me; as a cat, I know what I’m asking for on losing sleep. That’s how important this is.
• Check for manure production. You’ll want to keep your horse somewhere you can see when he passes a new pile of manure. Pick out a stall or a small paddock so you can tell new piles from old. Don’t turn him out in the back 40 where you’ll have no idea if he’s pooping enough.
• Follow my doc’s re-feeding instructions. This will probably mean a gradual reintroduction to feed to ensure the colic doesn’t start again. Yes, your horse will look at you like he is staaarving and you are cruel, but remember, it’s just tough love and it’s what is best for him.

The DON’Ts (and the NEVER EVERs in a million years)

• Don’t give your horse banamine without talking to my doc first. Banamine is a pain medication that will mask some signs of colic. This can make it hard for my doc to get an accurate assessment of the severity of the colic. Banamine can also have a toxic effect on the kidneys if your horse is dehydrated, so it is best to let her make the decision if it is appropriate to give. Also, don’t give extra banamine after the first dose if your horse is still painful. If your horse still isn’t comfortable, it’s a sign of a more serious colic, and more banamine won’t do anything to help that.
• Never give banamine in the muscle! It can cause a horrible infection if injected into the muscle. While it doesn’t happen every time, it is definitely not worth the risk! Trust me, I have seen the disgusting result. If my doc instructs you to give banamine, you can give it by mouth, even if what you have is the injectable liquid.
• Don’t walk your horse to exhaustion. While a little walking is good for gut motility (5-10 minutes every hour or so), there is no need to walk for hours, and it can end up dehydrating your horse further
• This is a big one – NEVER attempt to put a hose anywhere, either down his throat or by rectum. This is a sure-fire way to injure your horse. Don’t give your horse an enema – the horse’s rectal tissue is delicate and at risk for a rectal tear, which can be fatal. An enema will almost never even reach the location of the colic in an adult horse anyway. Don’t try to syringe water or oil into your horse’s mouth either. You could end up aspirating some into the horse’s lungs, which could lead to a fatal pneumonia. Sadly, I have seen these awful conditions caused by well-meaning, but misguided owners. JUST DON’T DO IT.
• If you have to trailer your horse to the hospital, don’t ride in the horse compartment with him. A rolling colic can be dangerous in confined quarters, and there isn’t anything you can do to help him while enroute.
• If your horse goes down in the trailer on the way to the hospital, don’t stop. I know it’s scary but keep driving to the hospital – that’s where my docs can help him. While we’re on the trailer topic: don’t tie them in the trailer! If they do go down, being tied can put them in a really bad way, and can make it much harder to get them out at the hospital.
• Don’t discount colic surgery if my doc says your horse needs it. Many horses go on to have long, healthy lives after colic surgery, so don’t think there is no hope. There are often no restrictions on future athletics. Horses that have had colic surgery have gone on to compete in the Olympics, or in 100-mile-long endurance rides like the Tevis Cup.

If you are not sure what to do, just phone one of my docs. They are always there to help you. Working together and intervening early are the best ways to give your horse the best possible outcome.

Until next week,

~Tony

P.S. Have you seen the latest video over on my YouTube Channel? If you aren’t subscribed to that (as well as this blog, of course) you might be missing out on some great stuff! While my cat blog is far superior to everything else, of course, the humans work pretty hard on giving you lots of amazing doctory info in both their videos and their Podcast. Just click on the blue words to check out each of these amazing free resources. And you’re welcome, as always. Now, back to my nap.

I see a lot of stuff as the Springhill Equine Clinic Cat, and it seems to me there are few things that strike more fear into the heart of a horse owner than colic. Colic is a catch-all term for abdominal pain and can be caused by a variety of different things in your horse’s belly, ranging from a mild gas colic to a serious lesion that requires surgery.  I’m not sure why horses don’t just puke on the carpet (or a keyboard, I love puking on keyboards, very satisfying) like I do whenever they start to feel colicy, but my docs say that’s not how it works. Colic will never be a fun time, but here are some ways to help your horse (and my docs!) so things go as smoothly as possible.

Be Prepared

• Know how to recognize the signs of colic – Rolling, pawing, looking at the flank, and laying down are the most common signs, but horses can also show more subtle signs such as not wanting to eat, kicking at the stomach, restlessness, stretching out as if to urinate, increased respiratory rate, and reduced manure production. If you notice any of these things, give my doc a heads up so she can advise you what to do next.
• Call my doc! Even if you aren’t sure she needs to come out yet, it’s best to discuss what’s going on. If you wait too long, it could turn a mild problem into a severe one. Generally, colic is much more easily (and economically) treated if you can catch it early. A severe colic may have no chance of survival if you don’t pursue treatment immediately.
• Get yourself an inexpensive stethoscope and learn how to listen to your horse’s heart and gut sounds. You can find one for as little as $20 and my doc can show you how to use it! Practice ahead of time, don’t wait for an emergency to happen. When you call my doc, it’s very helpful to tell her what the heart rate is – it helps to determine how serious the colic is. A horse’s normal heart rate is around 26-46 beats per minute (much slower than yours, and waaay slower than my thrillingly fast kitty heartrate of 170 beats per minute) You can hear it best on the left side, just behind his elbow, about where the girth rests. A high heart rate is often a sign of a more serious colic. His gut sounds can be heard on both sides of his belly, high and low, in front of his hips. A normal horse has active rumbles all over his belly, and you shouldn’t have to listen for much longer than 15 seconds to hear some. Again, practice ahead of time to get used to his normal sounds. Keep a thermometer around, too. Practicing ahead of time will also help you keep track of what your horse’s normal temperature is, so you’ll be more likely to notice a problem. Normal temperature is usually between 98.5 – 100.5 degrees F.
• Have a transport plan. If your horse needs to get to the hospital for surgery or medical treatment, who is going to trailer him there? If you have a trailer, can it be hooked up quickly and ready to go? Are the tires and lights good? You don’t want to have to worry about these things when the colic is happening, trust me.
• Consider a major medical insurance policy for your horse. Colic surgery can be very expensive, around the mid to high 4 figures in north central Florida. Insurance can be surprisingly affordable, especially compared to the cost of treating a colic. It’s a very sad thing to have to euthanize a horse that could have been treated. When your horse is sick, the financial part is the last thing you’ll want to have to worry about. There are also colic programs from Platinum Performance and SmartPak that will cover a significant chunk of the surgery cost if your horse is enrolled.
• Be familiar with the idea of colic surgery. While hopefully you never have to use this option, you should make sure you don’t have any misconceptions about surgery. Decades and decades ago, colic surgery was less common than it is now. Some people still have the idea that colic surgery doesn’t have a great success rate. But the truth is, the survival rate for colic surgery is about 90%. Most horses can go back to athletic careers a few months after. Another misconception is that older horses can’t handle surgery well. Studies have shown that postoperative survival rates for older horses are about the same as younger horses.

 While You’re Waiting for the Vet

• Give my doc good driving instructions or an accurate GPS address to find your barn. The importance of well-marked street numbers visible from the road can’t be overstated! Keep your phone close in case she needs to contact you. If the house might be hard to find, especially at night, get someone to stand by the driveway or meet at a landmark to help direct her to where your horse is.
• Have a well-lit area available for my doc to examine your horse. It should be a safe place to work and free of obstructions. Have a clean water source available in case she needs to pass a nasogastric tube into your horse’s stomach. It helps to have a power source available to plug in equipment. Also, this feline thinks you ought to put the dogs away so there are less slobbery distractions.
• Take away your horse’s food until after my doc has examined him. This includes grass, too. It’s okay to leave him water, though a colicky horse usually won’t be interested in drinking.
• Keep an eye out for manure. The amount of manure your horse has passed, and whether it’s a normal consistency, is useful info for my doc. If possible, collect some of the manure for her to inspect, as it might offer a clue about the cause of the colic. But, a common misconception is that if a horse is passing manure, the colic has to be getting better. That’s not always the case, since there are about 100 feet of gut inside your horse. The manure could be further back than the site of the problem or obstruction.
• You don’t have to continuously walk your horse, especially not for hours and hours! That can do more harm than good. A little walking (5 or 10 minutes at a time) can help to improve the activity of the intestines. But it’s okay to let him rest calmly. Laying down isn’t going to cause a twisted gut – that’s an old wives’ tale. If your horse is rolling violently and you can’t keep him up, your own safety is the priority, so it may be best to put him in a safe place and stay back until the vet arrives.
• Think about possible causes. Do you have a new batch of hay? Has your pasture changed recently? Anything else different in your horse’s lifestyle?

In Part 2, we’ll go over what will happen while my doc is examining your horse, and what to do after the vet visit, so keep an eye out for that one!

Until next week,

~Tony

P.S. Are you subscribed to my blog? Don’t rely on Facebook to let you know it’s here. Be a good human and scroll down to the purple box. You can do it, just a little more. As a reward, I’ll email you my blog every Monday, a day early!