Colic is a general term that refers to a horse’s abdominal pain. The range of pain can be anywhere from mild to extreme, and the horse must always be examined and treated quickly. Signs of mild pain may include lifting the upper lip or kicking the hind legs up toward the abdomen, whereas signs of severe pain may include violently rolling onto its back or throwing itself down on the ground.
Often, the sooner an animal owner seeks veterinary care for a horse with colic, the better the outcome will be for the animal.
Veterinarians have many different diagnostic tests available to help identify the cause of equine colic, but the most important distinction to make is whether the condition should be managed medically or surgically. Survival rates are improved by quick recognition of colic and immediate surgical referral – rather than waiting for signs of improvement – which may result in rapid deterioration of the horse. Surgical intervention can return most horses to the same level of performance that was achieved prior to surgery.
How bad is it?
When a horse has colic, an animal owner will see changes in the horse’s personality, as well as signs that indicate levels of pain. Upon such observation, the owner should immediately consult with a primary care veterinarian and discuss the need for a referral to a board-certified veterinary surgeon.
The signs of colic distress include:
- Lack of appetite
- Looking at the flank
- Lying down more than usual or at different times than normal (Figure 1)
- Lying down, getting up, circling, laying down again repeatedly
- Curling/lifting the upper lip
- Kicking up at the abdomen with hind legs
- Rolling onto back
- Stretching out
- Increased heart rate (normal is 28–44 beats per minute)
- Visible abdominal distention (appearance of being bloated)
- Less than normal-to-no manure production
- Foals may roll on their backs or grind their teeth and salivate excessively
In addition to asking for the owner’s observations of colic signs, a veterinarian will likely ask the animal owner the following questions:
- Has the horse traveled recently?
- Have there been any changes in feed or routine?
- Is the horse taking any medications?
- What is the horse’s deworming/vaccination schedule?
A physical examination may include:
- Heart rate
- Respiratory rate
- Rectal temperature
- Listening for presence or absence of gastrointestinal sounds
- Abnormal color of mucous membranes (gums; Figure 4 shows gums that are too dark)
- Skin turgor (a sign of fluid loss or dehydration)
- Digital pulses of the hooves
- Abdominal distention
Depending upon the results of the physical examination, the veterinarian may recommend some or all of the following procedures:
- Blood work
- Rectal examination
- Passing of a nasogastric tube to check for reflux (accumulation of fluid in the stomach)
- Abdominocentesis (obtaining a sample of the fluid that surrounds the intestines from the abdomen)
- Ultrasound examination of the abdomen
- Gastroscopy to evaluate the stomach for ulcers
- Radiographs to look for sand or enteroliths (stone-like formations in the horse’s colon)
Surgical intervention is not automatically required with equine colic.
The majority of horses with colic will respond to medical treatment. If the horse remains uncomfortable, prompt re-examination by the veterinarian and possible referral to a surgical facility should be considered.
Medical treatment generally consists of:
- Analgesia given intravenously (Banamine or sedation)
- Laxatives administered directly into the stomach via nasogastric tube (mineral oil or magnesium sulfate/Epsom salts)
- Re-hydration with oral or IV fluids
Horses treated medically will typically be withheld from hay/grain until signs of colic have diminished. Once the colic signs have resolved, feeding will resume gradually. Depending on the suspected cause of colic, preventative measures such as having the horse’s teeth floated, instituting a farm specific/appropriate deworming strategy or changing the type of feed or method of feeding may be recommended.
When Surgery is Required
Surgical treatment should be considered if the horse remains uncomfortable despite medical treatment or if there are specific indicators that were found by the veterinarian during medical workup that would indicate a surgical problem. Surgical success rates have improved dramatically over the years due to early referral and prompt surgical intervention.
Surgical procedures may sound ominous to an animal owner, but under the care of a board-certified large animal surgeon, the animal will be in good hands. Board-certified veterinary surgeons are qualified by the American College of Veterinary Surgeons (ACVS) and the ACVS designation is earned only after numerous credentials are met, including advanced training, completion of a residency program, and passing specialty certification examinations. The ACVS specialist can provide the horse’s owner with a comprehensive understanding of the surgical options and recovery expectations.
Surgical exploration by an ACVS board-certified large animal surgeon is performed at a surgical facility after placing the horse under general anesthesia with an incision made on the ventral midline. Many causes of surgical colic can be corrected; however, there are certain causes of colic that despite the most aggressive surgical approach and treatment, survival is guarded.
What to Expect After Surgery
The horse’s prognosis varies greatly depending on the cause of the colic, how systemically compromised the horse was at the time of surgery, and if there were any postoperative complications. However, horses treated surgically that did not require removal of any portion of the intestine have a good prognosis.
For additional information on this topic, visit the ACVS website.
If your horse shows signs of colic and you need to locate a board-certified large animal surgeon, use the VetSpecialists.com search tool on the website’s homepage. The tool allows you to search for a veterinary surgeon, then select large animal along with your location by zipcode or city name. Contact the hospital of your choice to discuss your horse’s signs and to review whether there is a need for a referral from your primary care veterinarian.