Everything Horse magazine Everything Horse UK Magazine, November 2014 | Page 18
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HEALTH: COLIC
Colic
What to do if you
suspect colic…
A bit of belly ache?
‘Colic’… is that word that fills horse owners with dread! However, colic is
actually a relatively common disorder affecting the horse and can occur at
any time for a plethora of reasons.
I
t is not a specific disorder but instead
a general term describing ‘abdominal
discomfort’. Although colic usually
occurs from discomfort originating from
the gastro-intestinal tract it can also be
due to pain from other abdominal organs
such as the kidney, liver or uterus, this
is termed ‘false colic’. In addition ‘tying
up’ (exertional rhabdomyolysis), laminitis
and even foot abscesses can incur similar
symptoms to colic.
Recognising colic
The following symptoms are not exhaustive
but cover the majority of the clinical signs
of colic that you may see; reduced faecal
output, lying down, groaning, rolling, biting
at abdomen, bruxism (teeth grinding),
pacing, flank watching, stretching, pawing
at the ground.
It is important to recognise these so you
can identify cases of colic in your horse and
seek veterinary help.
Types of colic
As discussed colic covers a number of
abdominal disturbances but it is often
discussed as either ‘medical’ i.e. that which
can be corrected without the need for
surgery, and ‘surgical’ that requires surgery
to correct.
Spasmodic/Idipathic: One of the most
common types of colics that we come
across in practice. Abnormal contractions
of the bowel, often described as ‘overactive
guts’ results in painful contractions. It can
be due to a number of factors including
diet alterations, changes in the grass,
recent worming and even things such as
weather or stressful situations. It usually
responds well to anti-spasmodic drugs such
as Hyoscine Butylbromide (‘Buscopan’)
sometimes in combination with a nonsteroidal anti-inflammatory such as
Phenylbutazone (‘Bute’).
Impactions: Usually, but not exclusively
affecting the large intestine, impactions
are firm blockages of food. They usually
result from horses eating bedding,
having a reduced fluid intake or reduced
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movement - therefore this is a type of
colic to look out for when horses are on
box rest but can also occur at other times.
Generally impactions can be corrected
medically by administration of fluids, either
via a nasogastric tube or intravenously
(‘dripping’) combined with pain relief.
However, more severe impactions can
require surgery.
Displacements, Torsions and
Strangulations: When a unit of bowel
travels to an abnormal location within
the abdomen we refer to it as displaced.
Torsions occur when the gut twists on itself
(often referred to as a ‘twisted gut) and
strangulation occurs if the blood supply
to a portion of gut gets cut off. These are
relatively uncommon types of colic but are
very serious. Occasionally displacements
can be corrected medically but severe
displacements, and all strangulations and
torsions require surgery to correct.
The vet’s role…
On arrival the vet will probably ask a lot
of questions, although you might think
these are irrelevant they are actually very
important and help to build an accurate
picture as to what is going on and how
best to treat your horse. Such questions
may include the following; age of horse,
how long has it been ‘colicking’ for and
what symptoms has it been displaying,
has it passed droppings and if so when,
any previous episodes of colic, has there
been any changes to diet or management
recently, if your mare pregnant, has the
horse had its teeth rasped and if so when?
The colic examination involves building
up a picture of a number of clinical
parameters and symptoms, providing vets
clues as to what type of colic is occurring.
A full clinical examination will be carried
out assessing everything from respiratory
rate to temperature as well as their general
demeanour and condition, however the
following observations are particularly
useful:-
1. Call your vet immediately
– colic is potentially very
serious, if left untreated it
can lead to death in a matter
of hours. Most cases are not
serious but those that do
require surgery have a far
better prognosis the earlier a
diagnosis is made.
2. Decide whether it is safe to
enter your horse’s stable.
Violently colicing horses can
be very unpredictable and
very dangerous and you
should not jeopardise your
safety.
3. If it’s safe to do so, remove
any food from the stable but
leave water available.
4. Observe your horse and keep
note of what your horse is
doing.
5. Walking your horse –this
reduces the likelihood of
horses potentially causing
themselves harm within their
stable, it also distracts them
from the pain of the episode.
Ideally a menage with soft
ground is the best place to
do so, failing that soft ground
such as a field.
refill time: By checking the colour,
moistness and the speed of blood refilling
when the gums are pressed, helps vets to
assess the horse’s hydration status and
blood perfusion. Normal gums are a pink
and moist with a refill time of less than 2
seconds. Concerning signs are alterations
in the colour to brick red, paleness, muddy
grey or purple and extended refill times.
Heart rate: A normal resting heart rate for
a horse is approximately 32-40 beats per
minute. Any elevations in heart rate can
indicate both pain and/or a compromised
cardiovascular system.
Skin tent: By pinching a section of skin,
often over the neck, and seeing how
quickly it returns to normal can indicate
the hydration status of the horse.
Mucus membranes (gums) and capillary
Everything Horse UK Magazine • Issue 14 • November 2014
Gut sounds: As well as listening to
the heart, your vet will also use their
stethoscope to determine how active the
abdominal contents are. We divide the
left and right sides of the abdomen into
upper and lower quadrants and group gut
sounds into increased, normal, decreased
or absent. Increased gut sounds tend to
occur with spasmodic colic and reduced
gut sounds with an impaction, complete
absence of gut sounds is a concerning sign
and can indicate a surgical colic.
Rectal examination: Abnormalities within
the abdomen (for example an impaction
or enlarged loops of bowel due to a twist)
if within reach, can be identified by rectal
examination. Such examinations do convey
a small amount of risk for both horse and
the vet. Resentment to the procedure by
the horse can result in kicking out and
hence injury to the attending vet. The risk
to the horse is much smaller but there is
potential for a rectal tear. However, the
potential benefit of rectal examination
is far greater than the small risk to your
horse. In order to minimise the danger to
both vet and horse we will sometimes use
sedation as even the calmest, most gentle
horse can become dangerous when it is
painful.
Nasogastric tubing: By passing a long
plastic tube via the nasal passage into the
oesophagus and then into the stomach
vets can both diagnose colic and also help
correct it. Horses are unable to vomit,
therefore if something stops the stomach
contents emptying into the intestines (for
example due to a blockage) fluid builds up
within the limited capacity of the stomach
and this is very painful and even runs the
November 2014 • Issue 14 • Everything Horse UK Magazine
risk of rupture. If gastric reflux (stomach
contents exciting the stomach via the tube)
occurs it is often an indication that the
colic could be surgical. Stomach tubing
is also used to help administer fluids to a
dehydrated horse or to help break down
and move impactions.
Abdominocentesis: In certain cases we
may perform abdominocentesis or a ‘belly
tap’. This is performed by placing a needle
into the abdomen to sample the fluid
that surrounds the abdominal contents.
By analysing the fluid it can give us an
indication to the condition of the bowel.
How is colic treated?
Depending on the clinical signs and
the type of colic suspected, treatment
generally involves the use of some or all of
the following:- pain relief, anti-spasmodic
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