A Case for Colic, Part 1
For all but the most novice horse owners, the word "colic" sends shivers down the spine. This word is like "shark" for divers, or "oops" to a skydiver — well, maybe not that dramatic, but you get the point. Being a horse owner means that at some point during your horse owning tenure, you will encounter colic.
Firstly, let’s get some terminology straight. The word "colic" simply means abdominal pain. A horse that is acting colicky is having abdominal pain, which may be caused by a myriad of things. Not one case of colic is ever created equal and although the word colic is thrown around as a diagnosis, it’s really truly just a clinical sign. But to be practical — on the farm, to the horse, to the owner, and to the vet (me) — colic is colic.
Horses demonstrate some pretty distinct signs when they are having abdominal pain. One of the classic signs of colic is rolling; the horse will get up and down, act restless and roll, sometimes violently. I’ve heard of horses ramming themselves into walls as they roll. I remember one patient of mine in vet school, a gorgeous gray Quarter Horse stallion named Corona, that came in for colic surgery — he had rolled so violently that one of his eyes was swollen shut (don’t worry, he recovered!).
In addition to rolling, horses will often paw the ground and splash in their water buckets. It’s like they’re trying to say: I know something’s wrong but I don’t know what to do. They will also look at their flanks and may even bite at themselves. Usually the horse will not want to eat and won’t pass any manure.
Before we get much farther, let’s take a minute to discuss the general causes of colic. A horse can have gut pain because there is a blockage in the intestine, usually dry manure — this is called impaction colic. This can happen when the horse isn’t drinking enough water (like in the winter), or when the horse doesn’t have enough roughage in his diet, or even when he ingests sand, something more frequent in the southwestern U.S. A horse can also have a spastic colic from excessive gas build up (haven’t we all been there!). This tends to happen more in the spring, with the diet change to lush pasture. Lastly, and worst of all, a horse can have a twist, meaning a portion of the intestine has physically twisted over itself, causing constriction of blood vessels and buildup of fluid and gas. Many times, there’s no explanation for why this happens. Luckily, this last scenario is not as common as the other two.
So, now that we know how to identify colic and understand the basis of what causes it, what the heck can we do to treat it? Here’s where I come in. When I get a colic call, I have some very specific things I do. After an initial physical exam and thorough history from the owner, I get out the following: sedation, long gloves and a long plastic tube. Doesn’t this sound like fun?
After sedating the horse, I do a rectal exam (hence the looonnnggg glove). This allows me to actually feel part of the horse’s colon, telling me if there’s excessive gas or fluid buildup. If there’s an impaction, sometimes you can actually feel that too. After this, I grab my long plastic tube, also called a nasogastric tube. I carefully stick this up the horse’s nostril (and I mean carefully, because if you inadvertently bump the horse’s sinuses, they bleed like a stuck pig, erm, horse), and feed it down the esophagus into the top of the stomach. Then I wait. I’m waiting for gastric reflux. If there’s fluid that comes back out of the tube, we’re in trouble. This means the horse’s gut is so backed up that fluid is pooling in the stomach. Because horses can’t vomit, their stomachs can actually rupture. (It’s tough being a horse sometimes.)
After these things are done, I’ve formed a pretty good idea of what might be causing the colic (impaction versus twist versus gas) and how to begin to manage the case. Visit next week for Part 2 when I’ll discuss treatment options. Until then, I’ll leave you in suspense by offering these two sneak peaks: I’ll describe Dr. Anna’s Manure Dance and introduce you to something on the surgical floor known as "Sparky" (I’ll bet you ten bucks it’s not what you think!).
Dr. Anna O’Brien