A Case for Colic, Part 2
Last week we looked at colic, the scourge of the equine abdomen. As we delved into the signs of abdominal pain in horses and its general causes, I just got so carried away that I suddenly realized colic would take two blogs, not one. So here’s the second helping.
This week we get to talk about the good side of colic — how to treat it. Remember last week when I mentioned sticking a long hose up the horse’s nostril and down his esophagus to see if there’s excess fluid that needed to be siphoned off? Well, that’s a good place to start. You see, if no fluid comes back out of the nasogastric tube (meaning no horrible twist or impaction so bad that nothing can get by), I will use this chance to put things down the tube. If I believe the colic to be caused by an impaction, I’ll pour mineral oil mixed with water down the tube. The goal of this treatment is pure lubrication – whatever’s stuck in the gut needs to be slimed up to come out and mineral oil’s an easy, non-toxic, practical option. You can also use Epsom salts for this, as these salts pull water into the digestive tract, thereby helping to lubricate the ingesta. If the horse is dehydrated (which they usually are by the time I get called out), I’ll also use the nasogastric tube to administer electrolytes directly to the gastrointestinal tract.
After the fun of balancing a funnel on the end of the tube and holding it up in the air like the Statue of Liberty, trying my best to not spill mineral oil down my arm or slosh it into my hair (been there, done that about a million times), I’ll slowly and carefully remove the tube from the horse’s nostril. Remember last week how I mentioned that horses could get bloody noses from nasogastric tubes when you put them in? They can also get them at the last minute when you pull the tube out. Also been there, done that.
After tube removal (and bloody nose cleanup, if need be), I will administer IV pain medication, usually flunixin meglumine, the NSAID of choice for horses. Sometimes, if the horse is very dehydrated, I’ll administer IV fluids as well. Occasionally, other medications like anti-spasmodics, if it is a gaseous colic, can be used. The variations on colic treatment depend on the cause, the condition of the horse, and even the vet. But the basics are as follows: alleviate the pain, keep the horse hydrated and out of shock, and fix the cause of the stinkin’ problem in the first place.
Of course, each vet has his or her own collection of favorite colic remedies. In my bag of tricks I sometimes see the need to pull out the ole’ Dr. Anna’s Manure Dance. You see, with impaction colics, all you want is for the silly horse to poop. That’s all. You have no idea how desperate you get waiting for a horse to poop until you’ve have one of these cases that draws out for days. Sometimes, owners understandably get tense. They wake in the morning — no poop. At lunch — no poop. And at bedtime? You guessed it — no poop. I have found that sometimes a little veterinary humor helps. So we all gather around the horse’s stall and do a little jig, waving our arms, and hiking up our boots. Honestly, every time I’ve done this, within the next 24 hours, the poop gods have answered and the owner is rewarded with cleanup duty. I’m not saying I’ll be publishing these results in any scientific journals any time soon … I’m just saying.
Now, if the cause of the colic is a twisted intestine, all bets for treating it at the farm are off. This quickly becomes a surgical case and time is of the essence, as blood flow to the gut becomes constricted and the parts that are twisted begin to die.Usually you can’t tell right away if there’s a twist, but generally if the horse continues to deteriorate despite the treatments discussed above, you’re probably looking at a twist.
Colic surgery is a major event. Only performed at equine surgical facilities, colic surgery requires special skilled surgeons (as in, not me), and a whole team of technicians and anesthesiologists. I’ve seen my share of these procedures at vet school and can tell you a few things:
- Not one colic surgery is the same.
- They can take hours.
- Horse colon is heavy, so try not to volunteer to hold any of it.
- Sometimes the surgeries are successful and sometimes they aren’t.
- The horse’s cecum is called Sparky.
I swear I didn’t make number five up. If a horse’s guts haven’t shifted and twisted horribly, the first thing to pop out (because it is filled with gas) as the horse is on his back being opened up for abdominal surgery should be the cecum. And it’s called Sparky. And sometimes the surgeon will yell, "There’s Sparky!" and everyone reacts as if this is a perfectly normal thing to say. Except for the vet students, who giggle. But they giggle at everything, so that in itself, I guess, is perfectly normal too.
So that, folks, is colic in a nutshell; hopefully I’ve shed some light on this common equine ailment. And I encourage you to try a Manure Dance.It’s pretty fun.
Dr. Anna O’Brien