Treating Colic: Recognizing the Signs & Acting Fast

Colic can be more common in winter, when horses fed grain and hay are increased and exercise less, and prone to dehydration.

By Debbie Elliot

Colic is every horse owner’s worst nightmare. If you have been around horses for a significant amount of time, you will have at least one scary colic story that impacted either you or a barn mate. Colic can range from mild to fatal, and it is the most common cause of death in horses age one to 20, according to the United States Department of Agriculture Equine 2015 study.

Colic is not actually a disease itself, but rather a symptom of an underlying condition inside the horse that causes abdominal upset and pain. This can range from mild gas to a twisted colon.

While colic can strike at any time of the year, it is more prevalent in winter due to dehydration, diet changes, and reduced movement. Horses commonly drink less water in cold weather, which means the food in the gut is drier and the risk of impaction colic is higher. They also eat more dry hay as opposed to the fresh grass of summer, and this can upset gut bacteria and cause gas colic. In addition, horses may be stalled for long periods of time and exercised less frequently due to bad weather, which slows down gut motility.

“The influences that can cause colic are highly variable,” said Dr. Chad S. Davis, DVM, Davis Equine, LLC, who is based in The Plains, Va. “The key to prevention is to identify factors such as poor diet, dehydration, and lack of exercise.”

Prevention

What you feed your horse is highly instrumental in the prevention of colic, and simulating a natural diet of “forage first” is the best way to support intestinal motility and gut health. Horses are hindgut fermenters, which means they have a single-chambered stomach and rely on their cecum and large colon (the hindgut) to ferment plant material. If they don’t have fiber moving through the hindgut, the microbial population (biome) gets disrupted, which can lead to colic and other ailments. Green grass is therefore often the perfect food for motility, and if pasture time is not available, high-quality hay is the best alternative option. Blending hay types is a great way to make sure all the nutritional boxes are ticked, such as a combination of Timothy, orchardgrass, and alfalfa.

Symptoms

The most common signs of colic are:

• Loss of appetite and not drinking

• Restlessness

• Less or drier manure

• Pawing at the ground

• Repeatedly laying down, rolling, or refusing to get up

• Kicking or biting at their abdomen

• Sweating and/or elevated heart rate

Dr. Davis warned that many owners confuse other ailments with colic, as it is often used as a catch-all term. If a horse has certain types of gastric disease, then it would act more ulcerative than colicky, he explained.

“Once you start sleuthing it out, you can determine if it is colic or something else. I recently examined a horse with colic symptoms, and we discovered that it had tannin toxicity from eating too many acorns, which led to colitis and liver disease,” he said.

A diet that relies heavily on grain can contain high starch and sugar levels, which may be a factor in causing colic. When feeding grain, choose a lower non-structural carbohydrate feed. Look for products with a beet pulp or alfalfa meal base, as opposed to those made with high-starch ingredients like corn, oats, wheat, barley, etc. Spacing feed out in smaller amounts throughout the day allows the small intestine to digest the starch fully and reduces the chance of it escaping into the colon to be fermented. Feeding hay before grain will slow down the passage time through the stomach and small intestine, and allow the small intestine enzymes time to break down and absorb starch. When making any diet changes, be sure to do it slowly and gradually, ideally over a two-week period, to avoid gastrointestinal issues.

Dr. Davis recommends horses are given a prebiotic, and/or a probiotic, or even a postbiotic, to promote normal intestinal activity and help maintain a healthy gut biome.

“Platinum Performance GI and Platinum Performance CJ or DJ are also incredibly beneficial, especially for older horses,” he stated.

Regular exercise is essential for gastrointestinal health and gut motility, whereas a sedentary lifestyle can cause gas build up or impaction. Therefore, it is important to turn your horse out in winter when the weather permits. If it is too cold to ride outside, look for alternative ways to get your horse moving such as lunging, hand walking, or turn outs in an indoor arena. In addition, adding salt to their feed may encourage them to drink more water and reduce dehydration.

Treatment

Once colic has been diagnosed, most often the vet will visit the barn to treat the horse at home. The vet’s first step is to learn the horse’s health history, check their temperature, and monitor their behavior.

“If the horse is uncomfortable, you need to act quickly to resolve that discomfort,” said Dr. Davis. “Sedation in the early phases can be helpful, especially if the horse is agitated, and getting up and down a lot.”

Performing a transabdominal ultrasound will assess the size, motility, and wall thickness of the gastrointestinal tract, and indicate the severity of impaction as well as displacements of the colon. A Serum Amyloid A test can show the level of inflammation and identify possible bacterial or viral causative infection.

There are scenarios where a nasogastric tube is used to evaluate how much reflux or excess fluid there is in the stomach, however, Dr. Davis warned that it can be a difficult procedure as the tube is passed through the nostril, but it is often a necessary diagnostic tool.

“It can be dangerous for the horse, and it can be dangerous for the clinician,” he said, adding that many veterinarians wear helmets for their own safety.

Once the initial examination is conducted, and if severe colic is diagnosed, Dr. Davis will often advise the horse be taken to a nearby equine hospital to meet with the surgical team to avoid wasting valuable time.

“I don't try to be anybody's hero by delaying, sitting on or watching cases because time is always of the essence. I’d rather not linger,” he said. “It's going to cost the owner the same amount to get fluids at the barn as it would in the clinic, where they will have the opportunity to have 24 hours of observation. Should the horse have to go onto the surgical table, at least we're not trying to get them there while they struggle to keep standing.”

There are multiple factors in play when deciding whether to opt for colic surgery, and while the welfare of the horse should always be first and foremost, the financial aspect is also a consideration, explained Dr. Davis. A coverage plan such as Platinum Colic Coverage®,a complimentary program that reimburses you for the cost of the surgery up to $15,000 following qualifying purchases, can ease the stress of that decision.

Recovery

If your horse has recovered from colic, slow, forage-first feeding will aid their gut recovery once they are able to eat again. Dr. Davis advises feeding alfalfa mashes and steamed hay, to reduce fungal bacterial pathogens. Pasture grazing is the ideal option, but if they are in a stall, then use a slow feeder to mimic grazing patterns.

The Surgery Dilemma

When a horse arrives at an equine hospital, the surgical team will perform full diagnostics such as blood work, a rectal exam, examine perfusion, and hydration parameters (to see how well the blood is circulating), and perform an abdominal ultrasound.

Dr. Jackie Hill, DVM, DACVS-LA, a Veterinary Surgeon at Littleton Equine Medical Center in Colorado, said a key indicator as to whether a horse needs surgery is their pain level.

“We ascertain that by looking at vital parameters such as heart rate, and also how they respond to sedation,” said Dr. Hill.

How much sedation they need and how long it lasts can show how much pain a horse is in. Another sign is if they are dropping to the ground and trying to roll, versus standing and simply looking at their side.

“There really isn’t one test that will show if a horse needs to go for surgery,” Dr. Hill explained. “It is about all the pieces fitting together.”

If surgery is determined to be the best treatment option, the horse will be anesthetized and laid on their back while an incision is made in their belly.

“We always explore the abdomen first to determine what the problem is, and which section of the bowel is affected,” said Dr. Hill. “Based on that, we can decide what needs to be done to correct the issue, such as untwist the colon and put it back in place or remove a section of the small intestine and reconnect the healthy ends.”

Many owners are concerned about putting their horse under anesthesia in case they fatally injure themself waking up, however Dr. Hill said that only happens in one percent of cases. “We have them in head and tail ropes, and on a padded mattress in a stall with padded walls to ensure their safety as they wake,” she explained.

However, in cases where the horse is very severely bloated and their blood is circulating poorly, the risks of anesthesia are significant. Sadly, in those circumstances their chances of survival are also slim if surgery isn’t performed, and an anesthetized horse does not feel pain, so euthanasia is often the most humane option.

The horse’s age, overall health, temperament (as some horses do not tolerate stall rest), and cost all factor into whether to perform surgery or not. Decision-making is influenced not only by clinical factors but also by the owner’s apprehensions, priorities, and expectations.

“If someone has had a bad experience with colic previously or if their friend at the barn had a bad experience, they may be tainted by that and reluctant to opt for surgery,” Dr. Hill said, stressing that every case of colic is different and every horse is unique. “We can fix a lot of horses with surgery nowadays and there are great success stories. Colic surgery doesn't have to be a death sentence, and many horses go back to the same level of performance afterwards.”

Following successful surgery, the horse will stay at the hospital for five to seven days, receiving fluids, antibiotics, and pain medication. Once home, it is a three-month recovery plan: a month of stall rest and hand walking, access to a small turnout for a month, followed by pasture turnout and walking under saddle for a month. Dr. Hill recommends waiting until the four-month mark before jumping or major exertion, while always conferring with your vet throughout the rehab period.

Owners are understandably stressed and panicked when faced with a colic emergency, but the situation can be eased by research and pre-planning.

• Know which hospital to go to in an emergency, and the best routes to get there

• Have access to a trailer and ensure your horse will load

• Find out what your insurance coverage limits are, plus any exclusions

• Delegate an emergency contact in case you are not available

Photos: Leslie Potter/US Equestrian