Colic

Colic is a term that is used for “belly-ache” and it is a common disorder affecting the horse, but is not a specific condition.  A horse that has colic is one that displays any/all of the signs shown below, which most commonly mean it is suffering from abdominal pain.  This is usually due to pain from the gastro-intestinal tract, but can also be due to pain from any abdominal organs (e.g. kidneys, liver, ovaries).

Colic due to pain from these other organs is often known as “false colic”.

Occasionally, other conditions such as “tying up” (exertional rhabdomyolysis), and even laminitis, can cause similar signs to colic. Often horses that are ill with a high temperature will stop eating and lie down which may cause concern that the horse is colicking.

Colic is a potentially very serious condition, and if untreated can lead to death within a matter of hours.  It is imperative to call the vet at the first signs of any colicky behaviour.  However, the majority of colic cases are not serious, and can be treated medically.  The minority of horses that require surgery to treat their colic will have a far better prognosis the earlier this surgery is carried out.

Potential signs of colic are shown below, with the more frequently seen symptoms in bold:

• Pawing
• Stretching
• Frequent attempts to urinate
• Flank watching – turning of the head to watch the stomach and/or hind quarters
• Biting/nipping the stomach
• Pacing
• Repeated flehmen response
• Repeated lying down and rising
• Rolling
• Groaning
• Bruxism – grinding teeth
• Excess salivation
• Loss of appetite
• Decreased fecal output

What Should I Do?

If your horse is displaying any of the signs above, then contact us immediately on 0161 724 4503 – we have a vet on call 24 hours a day, 365 days a year.  The vet will take some details from you and then get on their way as soon as possible.

While waiting for the vet to arrive there are some simple things that can be done.  Firstly, you must decide whether it is safe to enter your horse’s stable – horses that have severe colic can be very dangerous and unpredictable, and a rolling horse can easily hit you with its foot.  If it’s safe to do so, then remove any food from the stable but leave water in there.  If your horse is fairly calm, then the best thing to do at this point is to step back and keep a close eye on things.  Keep a note of what your horse is doing – this can provide valuable information for your vet.

If your horse is violently rolling, then walking out in hand can sometimes be a distraction for them and reduce their pain.  It also removes them from a small, potentially hazardous environment.  There are a couple of notes of caution however; firstly, do not put yourself in danger entering the stable.  Secondly, a very painful horse may try to roll even while being walked, so do not walk your horse on concrete or near hard ground.  An ideal environment is a menage with soft ground. It is also important not to walk a colicking horse for longer than 5-10 minutes; walking for too long may exhaust and dehydrate them.

What Will The Vet Do?

1. History. When your vet arrives they will take a short history from you – this is likely to include your horse’s age and breed and relevant medical history.  They may also enquire about your worming routine, and your horse’s dentistry.  These questions can help give the vet a first impression of what might be causing the colic.

The vet will then ask about the current episode of colic – how long has your horse been colicking, has it improved or deteriorated, what signs have they been showing?  These questions cannot only help in determining a potential cause, but also in judging the severity of your horse’s condition.

1. Clinical examination. A thorough clinical examination will then be carried out, which will include examination of mucous membranes (gums), lymph nodes, jugular veins, arterial pulses, the heart rate and character, breathing rate and character, gut sounds and rectal temperature.  Your horse’s overall condition will also be assessed, for example, has he sweated up?  Is the abdomen bloated?
2. Rectal examination. The vet will then perform some further tests.  The first of these will be a rectal examination, which can be extremely valuable, and is carried out in all colic cases we see.  This allows the vet to directly feel certain parts of the GI tract, which can lead to early recognition of horses that require surgery, or a specific diagnosis (e.g. pelvic flexure impaction).  Rectal examination holds some small risks both to the vet and to the horse.  The risk to the vet is obvious – some horses will not enjoy this examination, and the vet is extremely close to the hind limbs.  The risk of being kicked is substantial.  The risk to the horse is far smaller, but there is the potential to cause a rectal tear.  The majority of rectal tears are treated fairly easily, and the potential benefit of the procedure is far greater than the small risk.
3. Sedation. This is commonly carried out to reduce the danger to both vet and horse.       It is also helpful and the risks are minimised by keeping the horse calm in a controlled environment.  Even the calmest, most amenable horse can become dangerous when suffering from abdominal pain.
4. Stomach Tubing. Nasogastric intubation (or stomach tubing) is a procedure where the vet passes a narrow tube up your horse’s nose, through its oesophagus and into the stomach.  This can be performed for either diagnostic or therapeutic reasons.  Diagnostically, the presence of large amounts of fluid in the stomach may indicate an obstruction in the small intestine, and a need for surgery.  Horses with large intestinal impactions are often treated with large volumes of water passed down a stomach tube.

Medical or Surgical?

Does this horse need surgery to treat its colic?  This is the main question your vet is trying to answer when examining a horse with colic.  Horses that need surgery need to be sent to a specialist surgical referral centre (we generally use The University of Liverpool’s Leahurst Hospital) as soon as possible.  Horses with medical colics can be treated, usually in their own stable.  The vet will be concerned that a horse may need surgery if any of the following signs are found:

• Heart rate above 60 or rising
• Severe pain
• Pain not responding to painkillers/analgesics
• Dark purple or brick red gums
• Specific rectal examination findings
• Large amount of fluid in stomach

Often, no specific signs are found on examination, and there are no indications that a horse needs surgery.  In this case your vet will administer a mild painkiller, and aspasmolytic (reduces spasms) drug.  The horse’s response to this treatment will then be assessed – the majority of horses will respond completely. However, it is important to monitor the horse’s progress closely over the following hours to ensure that there is no deterioration in the condition.