Colic

\"Colic1\"The simplest definition of colic in the horse is abdominal pain. The horse has a single, relatively small stomach (monogastric), small intestine that is comparatively long and a hindgut (caecum) where fibre and insoluble starch are digested.

This arrangement of the horse\’s digestive system together with the type of management regime that many horses are subject to means that they may suffer several bouts of colic during the course of their lives.

Minor colics often go unnoticed.
There are a number of different types of colic that the horse is susceptible to. Management and diet play an important role.

1. Biliary colic caused by growths or parasites that block the bile duct.
2. Renal colic due to enteroliths or calculi in the kidneys or ureters.
3. Alimentary colic that is the result of gastro-intestinal tympany (gas retention), impaction and obstruction, spasmodic colic and intestinal catastrophy (twists, rotations and intussusception). These may be caused by irregular meals, the wrong type of feed or diet, inadequate time allowed for digestion prior to work or exercise, inappropriate watering, stress and tension, worm infestation and damage to the gut.

Grass sickness may result in an Impactive colic. This disease affects horses and ponies at grass and is associated with cold dry conditions and is therefore most likely to occur in geographic regions that experience these weather conditions. It is not known what causes the condition, though its considered that it is most likely that a fungus is implicated. Affected horses are constipated, usually as a result of an impacted colon and the most usual presenting feature for the owner of the horse are signs of colic.
Most horses that contract the disease die or are humanely destroyed dependent upon the form the disease takes i.e. acute, sub acute or chronic.
Stomach rupture may be a sequel to Impactive colic. Horses that have been reacting violently to abdominal pain, become quiet, go into shock and death follows shortly.
Sand colic is also an Impactive colic due to an accumulation of sand in the caecum.

Tympany is a gaseous accumulation in the stomach, caecum or colon. Gaseous distension can occur in front of an impaction or when the flow of digesta is prevented due to a twist or torsion of the intestines. It may also occur when food ferments within the stomach and intestines after too much grain has been ingested. This results in rapid lowering of pH within the gut, fermentation and the production of gas.

Intestinal catastrophy / twisted gut: This is a twisting of the intestine, a rotation of the intestine around its mesentery or a length of intestine telescoped into another length of intestine (intussusception). The blood flow is interrupted and gangrene may set in.

In older horses, lipomas (fat tumours) may twist round the intestine producing the signs of a twisted gut. Stomach rupture can be a sequel to an intestinal twist.

Horses that have been reacting violently to abdominal pain, become quiet, go into shock and death follows shortly.
Diaphragm rupture: This may occur in brood mares following foaling or in horses that have been involved in major accidents.

Hernia: The most common sites for  hernia are at the navel and the inguinal ring into the groin. A loop of small intestine or fat becomes entrapped through a natural or acquired hole in the abdominal wall and this cuts off the blood supply to the intestine resulting in colic.

Abdominal abscess may occur in horses of all ages but is usually seen in young foals.

The signs of colic indicate pain and discomfort that is the result of stretching and inflammation of the peritoneum that has many pain receptors and spasm of the muscle in the gut wall. The deg ree of the pain is dependent to an extent upon the cause.

Typical signs of colic are anxiety with the horse looking towards its flanks, a horse that lies down and gets up frequently, (the healthy horse gives itself a good shake when rising after lying down).
It may roll, and in the case of tympany and twists; violently.
It may also paw at the ground or kick out at its sides. It may be sweating and pass few droppings or in a spasmodic colic there may be diarrhea. Intestinal sounds may or may not be heard. The horse may be inappetant, have a raised temperature and pulse rates and may attempt to urinate.

Early veterinary supervision or intervention is essential.

Diagnosis is made on the symptoms that the horse exhibits and absent or increased gut sounds. Rectal examination can help to determine the type of colic

In the past it was recommended that a horse showing the signs of colic is walked in-hand until the symptoms passed. If the horse rolled, it was prevented and restrained. It is now considered inappropriate to walk a horse that is in severe discomfort and it should only be restrained if its behaviour is so violent as to cause itself injury. In some cases, rolling may actually effect a recovery.

Impactive colics are treated with large volumes of water or saline and a gut stimulant via stomach tube may be administered.
In all types of colic pain is relieved with analgesics, anti-spasmodic, anti inflammatory drugs and sedatives as appropriate.

Most of the colic cases admitted for surgery are due to high grain or concentrated diets, leading to rapid lowering of pH in the gut with death of specific gut flora and fauna and causing endotoxaemia.

Other colics requiring surgical intervention are hernia, malignant tumours and lipomas. Diaphragm rupture usually requires exploratory surgery for a definitive diagnosis, but the prognosis is generally poor.

It is a good idea for a horse owner to have a clear idea as to what they propose to do in the event of catastrophic colic in order that they can make a rational decision when under stress. Are the necessary surgical facilities available if required? Is the horse of particularly high sentimental or monitory value?

After a colic incident Equilibrate BB (probiotic) is useful for helping to reestablish the normal gut population and digestive health.

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