Colic
The definition of colic in horses is ‘abdominal pain’. The term ‘colic’ is therefore a broad one as it encompasses all forms of abdominal pain, even those that do not involve the gastrointestinal tract. However, the most common forms of colic are caused by a gastrointestinal disorder, most specifically a disorder of the colon. Among domesticated horses, colic is the leading cause of premature death. The incidence of colic in the general horse population is estimated to be between 4% and 10% over the course of their lifetime.
Knowing the signs
Due to the fact that the condition is so common, most horse owners are well versed in the signs of colic in horses. Some of these signs include pawing, rolling, bloating, sweating, disinterest in food and water, reduced or absent gut sounds, and general signs of distress.
In most instances of colic, a diagnosis of the specific problem is never achieved, because the abdominal pain resolves with minimal intervention. In fact, of all the episodes of colic pain that occur, an estimated 80% to 90% will resolve without major intervention. Therefore, although colic is a serious concern, it does not mean that every horse who colics is destined for surgery.
Treatment
The initial approach of a vet usually involves simple diagnostic and physical examinations, control of the pain, rehydration, control of food intake, and an evaluation of the response to therapy.
If the colic resolves with this therapy, as it usually does, the vet is unlikely to have a conclusive diagnosis as they have not been able to evaluate the abdomen and specifically the intestines in any meaningful way.
A rectal examination examines only a limited portion (maximum 40% in a small horse with a vet who has long arms) of the intestine, and unless the pathology is in this area (and in some cases, even if it is), a definitive diagnosis cannot be provided.
Having said this, the importance of veterinary attention for even apparently mild cases of colic is as follows:
- To evaluate the overall health and hydration status of the horse.
- To perform the physical examination and other diagnostics that may yield a specific diagnosis.
- To help control the pain.
- To determine if the horse should be referred for further evaluation or treatment.
Many horses who recover quickly from colic symptoms may have become uncomfortable due to various intestinal upsets that can cause impaired or disorganised intestinal motility, intestinal gas accumulation, intestinal clogging with dry faecal matter, or other temporary dysfunctions.
These episodes may be considered as similar to the cramping or abdominal bloating that occurs in humans.
Thus, while they may induce significant discomfort for some time, they are unlikely to require major intervention in the long term.
In such situations, the passage of stool and/or gas can improve the situation dramatically.
When a vet arrives, it is essential to report if the patient has passed gas and/or stool.
When surgery is needed
In surgical cases, an experienced vet is a necessity, as the earlier the need to operate is established, and the surgery started, the greater the chance of success.
Generally, horses requiring surgery do not respond to pain medications, and nasogastric tubing and rectal examination provide little to no relief.
The pain tends to appear more quickly, be more severe, escalate more quickly and is not completely relieved with even the strongest pain relief.
In the most obvious cases, horses will keep throwing themselves down on the floor in pain, rolling and will refuse to get up even once drugs have been administered.
Getting these horses into surgery before permanent damage is done to the intestine, or they become completely overwhelmed with pain, is essential.
Surgical cases can result from many different causes, but the common factor is that the surgical cases are those where the blockage of the intestine cannot be resolved without opening the abdomen and physically intervening.
On rare occasions when a horse who colics cannot be transported for surgical or medical treatment, reasons being age, poor prognosis, or instability of condition, the vet who attends is essential for assessment, pain management, prognostication and advice.
As seen above, there are certainly conditions that cause significant abdominal pain from which a horse can recover without surgery.
However, prolonged pain and increasing instability of the horse are indications that recovery may not be feasible without more intensive intervention.
In the event of severe colic without other management and treatment alternatives, euthanasia may be the most humane option.