Thal Equine, LLC
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www.thalequine.com
PO Box 608, Ranchos de Taos, NM 87557
Understanding and Preventing Colic - Synopsis
By Doug Thal, DVM
What is Colic?
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Colic is not a disease, but a symptom of disease
It is the horse’s unique way of showing abdominal pain.
The pain usually results from intestinal dysfunction, but can result from problems with other
organs.
#1 cause of death in the equine industry worldwide. A common problem.
Costs the equine industry $115,000,000 annually.
2nd only to lameness in terms of economic loss and loss of use.
Causes great pain and suffering for horses and humans.
Recent study shows incidence of 4-5 out of 100 horses being affected on an annual basis.
Other studies have suggested up to 15 horses/100.
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The Horse’s Stomach
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Small capacity: 2-4 gallons. Made for small meals eaten frequently.
Produces acid and some digestive enzymes.
Horses cannot vomit.
Can become impacted.
Site of gastric ulcers.
The Small Intestine
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70 feet long x2-3 inches in diameter. Snakes and slides around the abdomen.
Involved in absorption of readily digestible feeds.
Involved in digestion.
Can become twisted, trapped in places, blocked by a foreign body, strangulated by fatty tumor,
trapped in scrotum in stallions and other disasters.
The Cecum
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A 3 foot long, 10 gallon, comma shaped organ.
Involved in water uptake and mixing of feed material and digestive juices. Also site of some
fermentation.
Can become impacted, distended with gas or twisted.
The Large Colon
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About 12 feet long and as big around as a tire.
Full, it weighs hundreds of pounds.
Bacterial cells here outnumber total cell number in body.
More than 1/2 the weight of manure is bacteria.
Can become impacted, displaced, or twisted.
The Small Colon
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About 10 feet long and 2.5” diameter.
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Makes fecal balls out of waste from large colon.
Squeezes out water.
Can become impacted.
Equine Intestinal Function
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Motility- responsible for mixing contents of gut and moving it along the intestine
Water uptake.
Digestion or breakdown of feed through fermentation and other processes.
Absorption - uptake of the smaller molecules (protein, carbs, fat, etc) that can be used by the
body.
In process of fermentation, huge numbers of bacteria produce gas far from an exit.
Modern housing limits exercise.
Modern feeds high in starch, more gas.
Leads to increased incidence of problems.
Signs of Colic Pain
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A group of signs which can be mild, moderate or severe. If untreated, generally the signs
progress.
A horse may show one sign, more than one, or all of these.
How severe the signs are may or may not relate to the severity of the problem.
Each horse is an individual- breed, age, etc.
The Horse with Mild Colic
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Poor performance.
Appetite is decreased.
Attitude is different.
Lies down more than usual.
Occasionally grinds teeth.
Curls upper lip (flehmen).
Cocks tail to one side.
Occasionally stretches or looks at side.
The Horse with Moderate Colic
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No appetite.
Wants to lie down.
Looks at side more frequently.
Paws.
Kicks at belly.
Swishes tail.
Stretches.
Not interested in surroundings.
The Horse with Severe Colic
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May be dangerous!
Frequent pawing or kicking at belly.
Desperately wants to lie down and may roll repeatedly and violently.
Violently kicking at belly or biting at side.
Can be difficult to keep up or get up.
Colic Pain Comes From
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Tension on attachments of the gut to the body wall (mesentery).
Over-filling (distension) of part of the intestine. Example: gas accumulation.
Irritation to inner surface of intestine. Example: gastric ulcer.
Colic Pain is a Cycle
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Gas causes stretch of wall.
Stretch causes pain.
Pain causes sympathetic nervous system to discharge.
This shuts down intestinal movement.
This means more gas accumulation.
And more stretch and more pain.
And the cycle continues until it is broken.
Pain Goes Away When
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The intestine regains function.
Drugs are given which blunt or mask pain.
The bowel is decompressed. Gas is relieved with stomach tube or trocar through the flank.
Surgery is performed and problem fixed.
The intestine ruptures, which releases pressure. This would be followed by death in a few hours.
Non-Intestinal Causes of Colic
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Tying up
Founder (Laminitis)
Pneumonia-Pleuritis
Ruptured bladder in foals
Uterine twist
Heart failure
Urinary stones
Foaling
Bean
Other
Most Colic Cases are Simple
80
70
60
50
40
30
20
10
0
Simple colic
Severe Colic
Surgical Colic
Simple Functional Colic
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Spasmodic or gas colic.
The most common intestinal cause of colic pain.
Mild to severe pain.
Generally responds well to medication.
Simple Obstruction
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Material cannot move down the digestive tract due to obstruction
Examples: Feed impaction; Round Worm impaction; Enterolith (stones); Sand; Foreign body twine, etc.
Gastric Ulcers
 Diagnosis often based on clinical signs
 Evaluating stomach
 Response to treatment
Signs of Gastric Ulcers in Adult Horses
 Poor appetite
 Recurrent colic
 Poor body condition
 Intermittent diarrhea
 Performance?
Severe Forms of Intestinal Colic
Small Intestinal Strangulation
 Strangulating lipoma
 Volvulus
 Mesenteric rent
How Can We Tell What’s Going on in There?
 Requires training, experience with many horses and an interest in keeping up with the latest
diagnostic techniques.
 Both an art and science.
 A quick and correct diagnosis will often make the difference between life and death!
 Sometimes not sure until look in abdomen surgically.
Oh, No – My Horse Has Colic!
What should you do?
 Call the vet - even if it seems mild!
 Withhold feed or give reduced amounts, depending on the advice of your vet.
 Hand walk – Hand walking itself is never detrimental; it helps increase gut motility and helps
take your horse’s mind off the pain.
 It is ok to allow your horse to lay down as along as he does not roll or thrash; if he is laying
quietly, let him be.
 Don’t walk your horse to exhaustion; let him rest.
The Owner’s Role
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Understand “normal”
Temperature = 99 – 101 degrees
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Heart rate = 35 – 45 bpm
Respiratory rate = 10 – 20 rpm
Keep your vet informed! Even if we don’t need to come out, keep in touch.
Continued monitoring at home
Have a plan! The Plan
Have a trailer or access to one for an emergency
Leave detailed instructions for an emergency if you go out of town
Have a plan for each horse:
How far would I go…Vet call? Hospitalization and intensive care? Surgery?
Costs Associated with Colic
 Vet call $150-$275
 Hospitalization (IV fluids, monitoring) $500-$1000+
 Colic Surgery $3,000 to $5,000+. Includes average 10-day hospital stay
Banamine
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Banamine is a drug that is commonly given to colicky horses
It is a potent pain reliever
Can help stop the cycle of pain in a gas or spasmodic colic
Can mask signs of a serious colic and delay treatment
Does NOT cure colic!!
Some owners request to have it on hand at home to use in an emergency
Can be a recipe for disaster if used improperly
Never give your horse banamine and then assume he is OK because he looks OK!!
Use only AFTER consulting with your vet!
Banamine can make accurate evaluation of your horse difficult
Can make him look better than he really is
Banamine does NOT cure colic, it only masks signs of pain
Is often given by injection
Intramuscular
Risk of “clostridial myositis” a serious infection of the muscle that can require hospitalization
Intravenous
Risk of accidental injection into the carotid artery which runs along side of the jugular vein - can
result in seizures or death
Questions Your Vet May Ask
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How long has this been going on?
When was the last time you saw your horse acting normally?
Any recent changes in feed or management?
What signs is the horse showing?
Observe him for a few minutes
Worming/Vaccination/Dentistry history
The Vet’s Role
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Assess and control pain
Stabilize both the patient and the owner
Diagnose as quickly and completely as possible the cause of the colic
Communicate with the owner effectively
Institute appropriate treatment and recommendations
Diagnosis
Physical exam
Gut Motility
Rectal Exam
Bloodwork
Ultrasound
History &
Management
Response to
Treatment
Nasogastric
Intubation
Abdominocentesis
(Belly Tap)
Radiographs
Diagnosis
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It is often not possible to reach a definitive diagnosis
The veterinarian uses all aspects of their examination to determine the cause of the colic as
specifically as possible
Medical Treatment of Colic
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IV Fluid therapy
Impactions
Systemic support
Trocarization (decompression)
Other:
 Anti-ulcer medications
 Psyllium (sand colic)
 Changes in management
Colic Surgery
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The ultimate diagnostic tool
Indicated when pain is uncontrollable, or when diagnostic tests indicate that it is necessary
Manually correct intestinal displacements or torsions
Remove dead or damaged sections of intestine
Depends on many factors
Cause of colic, duration, systemic condition
Average about 70 - 80% survival rate
Small intestinal resection 50 - 65%
Colon Torsion 60 - 80%
Large Colon Displacement up to 80 - 95%
Why Is Surgery So Expensive?
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Anesthesia
IV fluids
Special anesthetic supportive drugs
Personnel
Trained in anesthesia
Trained in surgery
Emergency (2 a.m.!!) compensation
Equipment
EKG
Blood pressure
Anesthesia machine
Overhead
Surgery facility
Induction & recovery room
Hoist
Intensive aftercare
Life After Colic Surgery
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Approximately 4-month recovery period
1 month stall rest with hand walking
1 month small paddock turnout
1 month unlimited turnout
Then back to work!
 Complications
The first 10 days after surgery are critical
How Do We Differentiate
(Knowing which treatment to use or if surgery is required)
 History- breed, age, sex, colic history, care, worming history.
 Physical exam- pain level and duration, temperature, heart rate, gut motility
 Passage of nasogastric tube- anything back?
 Rectal exam- can feel the back 1/3 of the abdomen
 Belly tap - analysis of fluid from abdomen
 Response to pain relief?
 Ultrasound, x-ray.
 Still can’t tell… medical therapy not working. Horse still in pain – SURGERY
When is Surgery Required?
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Diagnosis
Prognosis
Correction?
Uncontrollable Pain
Physical exam suggests
Rectal findings are suggestive
Abdominal tap
Colic Surgery
Preparation
 Involves stabilization of patient
 Preoperative medications
 Clipping
Anesthesia – a big deal
 “Induction”
 Anesthesia- requires specialized equipment for very large animal.
 Monitoring during anesthesia critical
 Recovery
 Unique because of size
of the horse
 Blood pressure and ventilation
 Complications include:
Muscle, nerve damage
Injuries in recovery
Surgery involves
 12” -18” incision lowest belly “Linea Alba”
 Exploration of abdomen
 Diagnosis of problem
 Correction
 Repair of abdominal incision and skin closure
 Drain?
Recovery
 Can be difficult after long surgery
 Padded room
 Injuries possible
Post-Operative Care
Hospital
 Usually 7 days
 Difficult and costly
 Massive amounts IV fluids, medications
 24-hour monitoring and nursing care
 Decisions…..
Home
 12’x12’ stall confinement necessary for 4 months
 Hand walking
 Careful monitoring
Success of Colic Surgery
 Timing is absolutely critical
 Good anesthesia and patient support
 Surgical skill and speed
 Requires proper facility and trained colic surgery team, available 24/7
Good Management Reduces the Risk of Colic
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The horse’s gastrointestinal system was designed for “snacking” – eating small quantities of feed
(grass) almost continuously
Their GI system is poorly adapted to the lifestyle we impose on them
Often just 2 meals per day
High concentrate/low roughage diet
The closer a horse’s management is to their natural state, the lower their risk of colic
Stabled horses have a higher incidence of colic than horses at pasture
The more grain a horse is fed, the higher their risk of colic
Risk Factors for Colic
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Recent change in type of hay
Recent change in diet
Previous colic surgery
History of previous colic
Recent change in weather
Recent change in stabling
Failure to receive regular deworming
Recent deworming
Stabled
Older than 10 years
What Can You Do?
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Try to mimic your horse’s natural feeding habits as closely as possible
Feed small, frequent meals
Use pasture or hay as the base of the diet
Think of grain as a supplement
Provide as much turnout as possible
Keep fresh water available at all times - hated to avoid freezing in winter
Maintain regular worming schedule
Regular dental exams
Bad teeth can result in poorly chewed food, leading to impactions
Introduce new feed or hay gradually
Alfalfa hay can predispose some horses to gas colic
Pfizer’s PreventiCare Program
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Use the daily dewormer Strongid C
Two vet visits per year for full health care:
Routine vaccinations
Deworming
Overall exam and dental exam
Pfizer will reimburse client up to $5,000 if surgery is required for colic
For more information, feel free to contact us at:
info@thalequine.com
See our web site – www.thalequine.com –
Articles page for other articles on colic by Dr. Thal