It’s been a long, wonderful fall with lots of relatively warm days until this past week when Old Man Winter suddenly made an appearance with a cold front coming through causing the temperature to drop by a whopping 20 degrees from 45 daytime highs to 25 degrees and colder still at night with a stiff wind out of the north. The mud has frozen in what now appears to be a lava field of jagged rocks that your horses are convinced will cripple them if the walk on it. They aren’t completely wrong. So they are huddled around the hay feeder, only moving off occasionally to venture over to the water tank for a drink. No one is moving about freely, playing in their usual fashion. But, wait, one of them is off to the side, pawing at the ground, sweating despite the cold weather. Now he is lying down, stretched flat on his side…what is going on here? He gets up, moves a few feet and flops back down again, clearly unhappy. What to do next?
What is Colic?
Colic is what horsemen and veterinarians refer to when a horse is experiencing abdominal pain. Colic is a clinical sign of abdominal pain. As such, it can be due to a wide range of abnormalities typically within the abdominal cavity. Most of the time, it is related to an issue involving the digestive tract – stomach, small intestines, cecum, large colon or small colon. It can involve any of the other organs within the abdomen such as the liver, kidneys, bladder or spleen, as well as the abdominal space itself or the peritoneal cavity. Colic is manifested in many ways by a horse – pawing, lying down and getting up repeatedly, rolling, stretching as if to urinate but not, refusing to eat, lethargy, sweating, and breathing heavily are all clinical signs that can be seen together or separately. Each horse’s individual level of pain tolerance will play a part in how they exhibit colic. Additionally, different problems within their abdomen, or the cause of colic, are associated with the demonstration of more or less severe pain. For instance, a large colon impaction, or constipation, is typically less painful than a large colon torsion or twisted large colon. Thus, the horse’s level of pain exhibited can give you and your veterinarian information about the underlying problem.
How can I Help my Horse?
Now that you’ve noticed your horse is uncomfortable and exhibiting signs of colic – what do you do next? Try to remain calm and don’t panic. A large portion of mild to moderate colic cases are due to gas build up in the intestines. This may be described as gas colic, hypermotile or crampy intestines, or spasmodic colic. Horses suffering from these forms of colic will typically resolve the issue on their own without requiring veterinarian intervention. Often times, just getting this horse up, walking them for a bit or lunging them for a few minutes will help them sort things out. Most of these cases resolve within 30 to 90 minutes or so. You should expect to start to see them relax, stop exhibiting the behavior that alerted you to the problem initially, and eventually show interest in eating again. If your horse is not responding in this time frame or if they appear to be getting more painful, it is time to contact your veterinarian.
Take Vitals and Prepare for the Veterinarian
Prior to calling the veterinarian, if you can do so safely, try to collect some physical exam findings or vitals from your horse. Take his temperature rectally with a digital or mercury thermometer that can be purchased from any drugstore. The temperature should be between 98 to 100.5 typically. Be sure to remember to take the temperature before giving any of the nonsteroidal anti-inflammatory drugs (NSAIDs) you may have on hand such as phenylbutazone (bute), flunixine meglumine (Banamine) or firoxicib (Equioxx) as all of these drugs will lower a fever. Knowing whether or not the horse had a fever will help your veterinarian in determining the diagnosis. Try to take a heart rate and respiratory rate. The normal range for heart rate is typically 28 to 48 beats per minute and the respiratory rate is typically 8 to 12 breaths per minute. It is not critical that you get this information, but having it, along with an assessment of your horse’s level of pain, will help your veterinarian over the phone if he or she needs to triage their incoming emergency calls. It also gives them a baseline and comparison point if the vitals have changed by the time they arrive to assess the horse themselves. Has the horse been passing any manure or gas? What is the consistency, volume or frequency of the bowel movements? Once you have what information you can collect, give your veterinarian a call to discuss the situation. Have the address of your farm or boarding facility available, and give clear information and concise directions if needed. Your veterinarian can’t help you if they can’t find you or get to you in a timely fashion.
Okay, so now you have contacted your veterinarian and they are on their way. What now? Follow any instructions they may have given you regarding giving or withholding administration of bute, Banamine or Equioxx. Most veterinarians would prefer to see the patient before any pain medication is given so that the level of pain can be used to determine the diagnosis and whether the horse needs referral to a hospital for further treatment or surgery. If the horse is simply lying down, not rolling, it’s okay to let them rest. If they are rolling frequently and you are not alone, try to get them on their feet and walking to prevent them from injuring themselves. If you are alone and can’t handle the horse safely without getting hurt yourself, don’t get in their way. Try to contain them in a stall, arena or other enclosed area that is safe. Horses in severe pain can become quite violent and may hurt you while throwing themselves to the ground. Pay attention to what they are doing and if they appear to be getting more or less comfortable as time goes by. If they seem to be getting more comfortable, are they interested in a little hay or grass? Drinking? Have they passed any manure and if so, is it of normal consistency and volume? Have they been passing any gas?
Think about Referral/Surgical Options
Use this time to think again about what you will do if the condition they are experiencing is one of the kinds of colic that requires surgery to correct and save their life. Is this an option for you and your horse? Do you have the ability to cover this cost (typically somewhere between $4000-$8000 or more depending on the condition involved, size of your horse, and where you live)? Most surgical facilities require a down payment or deposit of half the estimate at the time of admission and full payment at the time of discharge. Cash, check, Care Credit or credit cards are routinely accepted. If referral is an option for your horse, is the horse insured? If so, let your veterinarian know when they arrive as the insurance company will need to be notified either if the horse needs to be referred or if they can’t be saved.
Do you have a trailer and truck readily available to haul the horse? If not, do you know someone that can do this for you and are they available right now?
We ask that all of our clients fill out an emergency consent form when you first begin a relationship with us. When your horse is colicking, everyone is emotional, upset, and scared. It’s not a great time to think about financial restrictions, trailer availability, etc. Plan ahead and fill out an emergency consent form when you have time to think clearly about it.
Plan your Treatment Area
Think about the area your veterinarian will have to work with your horse once they arrive – is it out of the weather; does it have adequate lighting; is it spacious enough to accommodate an uncomfortable horse; is the footing soft enough to handle a down horse without further injury? These are all things your veterinarian will be looking for once they arrive so if you have it scoped out prior to their arrival, they can get to work quicker. They may require warm water as well for stomach tubing and rehydrating the horse.
Veterinary Assessment and Treatment
Once your veterinarian arrives, they will assess the horse’s pain level and decide how to proceed with pain management, a rectal exam, nasogastric intubation or stomach tubing, administration of fluids/electrolytes and laxatives, and abdominal ultrasound if needed. They may also run some stall side laboratory blood tests such as a lactate level, packed cell volume and total protein. Once this information is gathered, they will discuss the different treatment options for whatever type of colic they feel your horse is suffering from – whether it likely can be treated successfully on the farm or if it would be better handled at a referral hospital for further observation, assessment, medical management or surgical intervention.
What would lead your veterinarian to recommend referral to a hospital? This decision is reached by putting all the pieces of the puzzle together. Persistent or unmanageable pain in combination with various physical, rectal, and possibly ultrasound findings that suggest a surgery will be needed is the primary reason for referral. Persistent pain is reason enough for referral for further evaluation and possible surgery because if the pain can’t be managed, the horse likely has a surgical problem. Other reasons for referral would include the need for further diagnostics and treatment or monitoring that can’t be administered on the farm, such as high volume intravenous fluids, abdominal radiographs, STAT blood work or round the clock observation and care.
After all is said and done, the majority of colic cases that we see as veterinarians can be treated successfully on the home farm. Working with an experienced, well-equipped equine veterinarian will improve your horse’s chances of getting an early, accurate diagnosis and appropriate treatment, which will optimize their chances of survival and return to full function.
If you have any questions, reach out to your veterinarian to discuss what tools you should have on hand and what signs you should be prepared to identify. You can also comment below with any additional questions you have, or topics we didn’t cover.
Dr. Lisa Nesson