Colic
Colic means abdominal pain - it usually suggests a problem in the digestive tract, but can involve other organs in the abdomen. The good news is that around 90% of colic cases respond to medical treatment (antispasmodics and pain relief) or resolve on their own, but around 7-10% of cases are serious and require surgery or hospitalization. The sooner the need for surgery is diagnosed and performed, the better the outcome is likely to be.
Signs of colic include:
Change in behaviour
Restlessness
Pawing at the ground
Refusing food
Sweating
Increased heart rate and respiration rate
Kicking at the stomach
Looking round at the abdomen
Stretching out as if to urinate
Rolling or trying to roll, or lying down unusually
Change in mucous membrane colour - gums should be pale pink, any change in colour towards red or purple may indicate endotoxaemia and dehydration associated with a severe colic.
To reduce the risk of and help prevent colic:
Make all changes to feed as gradually as possible. Even changing to new but similar hay should be done over 2 to 3 weeks if possible. Feeds can be removed abruptly from the diet, but should never be added in large quantities abruptly, as any change in the diet will cause the gut microbiome to change.
Keep concentrate bucket feeds small, and keep the amount of starch in a feed as small as possible. Apart from intensely working horses, many horses do well on a fibre diet with a balancer to ensure adequate protein, minerals and vitamins.
Do not feed anything with dubious hygienic quality - NEVER risk feeding anything with signs of mould or feed that has been damaged in any way (e.g. become wet). Horses are very susceptible to mycotoxins and moulds in feed. Discard any feed that could contain hazards such as plastic, string, needles.
Feed at least 1.5% of a horse's ideal bodyweight in forage. Although straw can be fed, many experts recommend that straw should make up no more than 25% of the diet, teeth must be functioning well and straw must be introduced very gradually, to reduce the risk of impaction colic.
Ensure clean water is always available. In cold weather, offer moist feeds and warm water. Not drinking enough in cold weather is a high risk for impaction colic.
Ensure teeth are functioning well - have adult horses checked by a qualified EDT or specialist vet at least every year, youngsters and aged horses every 6 months.
Ensure worm burdens are not significantly high - although now recommendations are not to remove all worms, worm egg count frequently to ensure worm burdens stay within acceptable ranges. A saliva test is available for tapeworms, but currently (2021) there is still no test for encysted small redworms, so worming once a year (between November and February) with Equest (moxidectin) may be sensible.
Monitor horses closely after stress or change, e.g. hard exercise if not sufficiently conditioned or after eating, travelling, change of routine or environment, loss of a companion, any change to exercise or diet. Impaction colic is often seen when horses are put on box rest.
Movement helps gut motility - try to give regular exercise and turnout.
Avoid grazing on sandy soils. If horses live on sandy soil, try to avoid short grass, feed plenty of forage (hay may be as good as psyllium for clearing sand from the gut), do not feed directly from the ground, use psyllium regularly to help remove sand from the gut.
Never allow horses to eat mown grass cuttings, or anything that has fermented. Do not soak hay or sugar beet for long in hot weather, feed soon after soaking and remove uneaten food before it can ferment.
Know your horse's usual heart rate, respiration rate, temperature, capillary refill time, mucous membrane colour and feel (how slippery the gums are).
What to do if your horse has colic
Phone the vet - colic should always be treated as an emergency.
Ideally check heart rate, respiration rate, temperature, mouth mucous membrane colour (normal membranes are pale pink and moist) and feel and report these and the clinical signs you are seeing to your vet - this helps them to know how quickly they must get to you and to recommend anything you can do in the meantime.
Remove feed and hay from the horse (and water until a vet says it is ok to allow access to water).
Put the horse in a safe area.
Do not stop the horse from rolling. Keep yourself safe.
If signs are not too severe, walking a horse may help clear gas, but check with your vet first, and do not walk a horse to exhaustion.
What your vet might do
Your vet will try to identify the cause of the colic, which part of the gut is affected and whether there is part or complete obstruction of the gut. An examination will usually involve:
Treatment
If there are no indications that surgery is needed, the vet will usually give short acting pain relief and assess again in 2 hours. After re-examination at 2 hours, if there is no improvement, a vet may either give pain relief and re-assess after a further 2 hours, or refer for surgery. If no improvement after 4 hours, a horse may be referred for surgery, as even though it may not have a surgical colic, there may be a risk of endotoxaemia.
Increased severity of pain, degree of abdominal distention and frequency of gut sounds can be used to evaluate how serious the colic is. Moderate to severe colic signs, persistent colic that doesn't respond to medical treatment, and return of colic signs following pain relief are all associated with the need for surgery.
Horses should be given pain relief before traveling to a clinic.
Severe colic can lead to dehydration, hypovolemia and shock. Signs of moderate dehydration and hypovolemia: quiet but alert and responsive, heart rate 62-76 bpm, mucous membranes variable colour, sticky to dry, capillary refill >2 seconds, extremities start to become cooler, slow jugular refill and variable pulse quality. Signs of severe dehydration and shock: dull, heart rate >80 bpm, mucous membranes dry and red/purple or pale, capillar refill time >3 seconds, cool extremities, poor jugular refill, peripheral pulses difficult to feel.
Colic: prevention and management - Blue Cross
Colic types and causes - University of Liverpool Equine Hospital
Colic means abdominal pain - it usually suggests a problem in the digestive tract, but can involve other organs in the abdomen. The good news is that around 90% of colic cases respond to medical treatment (antispasmodics and pain relief) or resolve on their own, but around 7-10% of cases are serious and require surgery or hospitalization. The sooner the need for surgery is diagnosed and performed, the better the outcome is likely to be.
Signs of colic include:
Change in behaviour
Restlessness
Pawing at the ground
Refusing food
Sweating
Increased heart rate and respiration rate
Kicking at the stomach
Looking round at the abdomen
Stretching out as if to urinate
Rolling or trying to roll, or lying down unusually
Change in mucous membrane colour - gums should be pale pink, any change in colour towards red or purple may indicate endotoxaemia and dehydration associated with a severe colic.
To reduce the risk of and help prevent colic:
Make all changes to feed as gradually as possible. Even changing to new but similar hay should be done over 2 to 3 weeks if possible. Feeds can be removed abruptly from the diet, but should never be added in large quantities abruptly, as any change in the diet will cause the gut microbiome to change.
Keep concentrate bucket feeds small, and keep the amount of starch in a feed as small as possible. Apart from intensely working horses, many horses do well on a fibre diet with a balancer to ensure adequate protein, minerals and vitamins.
Do not feed anything with dubious hygienic quality - NEVER risk feeding anything with signs of mould or feed that has been damaged in any way (e.g. become wet). Horses are very susceptible to mycotoxins and moulds in feed. Discard any feed that could contain hazards such as plastic, string, needles.
Feed at least 1.5% of a horse's ideal bodyweight in forage. Although straw can be fed, many experts recommend that straw should make up no more than 25% of the diet, teeth must be functioning well and straw must be introduced very gradually, to reduce the risk of impaction colic.
Ensure clean water is always available. In cold weather, offer moist feeds and warm water. Not drinking enough in cold weather is a high risk for impaction colic.
Ensure teeth are functioning well - have adult horses checked by a qualified EDT or specialist vet at least every year, youngsters and aged horses every 6 months.
Ensure worm burdens are not significantly high - although now recommendations are not to remove all worms, worm egg count frequently to ensure worm burdens stay within acceptable ranges. A saliva test is available for tapeworms, but currently (2021) there is still no test for encysted small redworms, so worming once a year (between November and February) with Equest (moxidectin) may be sensible.
Monitor horses closely after stress or change, e.g. hard exercise if not sufficiently conditioned or after eating, travelling, change of routine or environment, loss of a companion, any change to exercise or diet. Impaction colic is often seen when horses are put on box rest.
Movement helps gut motility - try to give regular exercise and turnout.
Avoid grazing on sandy soils. If horses live on sandy soil, try to avoid short grass, feed plenty of forage (hay may be as good as psyllium for clearing sand from the gut), do not feed directly from the ground, use psyllium regularly to help remove sand from the gut.
Never allow horses to eat mown grass cuttings, or anything that has fermented. Do not soak hay or sugar beet for long in hot weather, feed soon after soaking and remove uneaten food before it can ferment.
Know your horse's usual heart rate, respiration rate, temperature, capillary refill time, mucous membrane colour and feel (how slippery the gums are).
What to do if your horse has colic
Phone the vet - colic should always be treated as an emergency.
Ideally check heart rate, respiration rate, temperature, mouth mucous membrane colour (normal membranes are pale pink and moist) and feel and report these and the clinical signs you are seeing to your vet - this helps them to know how quickly they must get to you and to recommend anything you can do in the meantime.
Remove feed and hay from the horse (and water until a vet says it is ok to allow access to water).
Put the horse in a safe area.
Do not stop the horse from rolling. Keep yourself safe.
If signs are not too severe, walking a horse may help clear gas, but check with your vet first, and do not walk a horse to exhaustion.
What your vet might do
Your vet will try to identify the cause of the colic, which part of the gut is affected and whether there is part or complete obstruction of the gut. An examination will usually involve:
- physical examination & review of history - heart rate, respiration rate, temperature, capillary refill time, oral mucous membrane colour & moistness, is the horse alert or dull, what signs of pain is the horse showing (looking at the abdomen, pawing, lying down, rolling). NB a horse with a heart rate >60 bpm should have a naso-gastric tube inserted immediately as this can be a sign of pending fatal gastric rupture. If the heart rate is >70 bpm the horse is likely to have some degree of shock.
- listening to gut sounds - are they normal, more/less than normal, on one or both sides
- looking for distention of the abdomen (the horse should be standing square)
- considering when dung was last passed and whether there are faeces in the rectum
- naso-gastric reflux
- rectal exam - only the back 1/3 of the abdomen can be examined and often changes can only be detected when they become quite marked. Carries a risk of tearing the gut wall. The horse must be adequately restrained and sedated if necessary.
- ultrasound - may be used instead of (particularly in small breeds/foals) or as well as a rectal exam
- blood tests - PCV (to assess hydration), lactate, creatinine
- examining peritoneal fluid for colour and assaying red and white blood cells, lactate and protein
- gastroscopy
Treatment
If there are no indications that surgery is needed, the vet will usually give short acting pain relief and assess again in 2 hours. After re-examination at 2 hours, if there is no improvement, a vet may either give pain relief and re-assess after a further 2 hours, or refer for surgery. If no improvement after 4 hours, a horse may be referred for surgery, as even though it may not have a surgical colic, there may be a risk of endotoxaemia.
Increased severity of pain, degree of abdominal distention and frequency of gut sounds can be used to evaluate how serious the colic is. Moderate to severe colic signs, persistent colic that doesn't respond to medical treatment, and return of colic signs following pain relief are all associated with the need for surgery.
Horses should be given pain relief before traveling to a clinic.
Severe colic can lead to dehydration, hypovolemia and shock. Signs of moderate dehydration and hypovolemia: quiet but alert and responsive, heart rate 62-76 bpm, mucous membranes variable colour, sticky to dry, capillary refill >2 seconds, extremities start to become cooler, slow jugular refill and variable pulse quality. Signs of severe dehydration and shock: dull, heart rate >80 bpm, mucous membranes dry and red/purple or pale, capillar refill time >3 seconds, cool extremities, poor jugular refill, peripheral pulses difficult to feel.
Colic: prevention and management - Blue Cross
Colic types and causes - University of Liverpool Equine Hospital