The term colic can encompass all forms of gastrointestinal (GI) conditions which cause pain as well as other causes of abdominal pain not involving the GI tract. However, the most common forms of colic are GI in nature.
Broadly speaking colic is often placed into one of two categories; medical or surgical. When a vet is assessing a horse with signs of colic, we are trying to determine first what is causing the colic signs, and secondly how do we treat the colic? Does it need surgery? Can we treat this horse with pain relief and fluid therapy alone?
When your horse is admitted to the Sussex Equine Hospital the vet will perform a repeat clinical examination and further investigations to help determine what type of colic your horse has and how best to treat it.
The following is a brief overview of what we will assess and some of the procedures that may be performed.
Heart Rate: An increased heart rate is an indicator of pain and can often be an indicator of severity of colic. A normal resting heart rate is around 30-40 beats per minute.
Mucous Membranes (gums): Mucous membrane colour, how moist they are and their capillary refill time can help us to assess the horse’s hydration status and provide an indicator of circulation. Normal gums should be pink and moist with a capillary refill time of less than 2 seconds.
Gut Sounds: By listening to the gut sounds we can get a good indication of how much activity is occurring inside the abdomen. Gut sounds are broadly grouped into 4 categories; increased, normal, decreased and absent.
Rectal Examination: Horses will usually be sedated and have a drug to relax the gut before a rectal examination is performed. We will be able to assess any major abnormalities present such as an impaction and sometimes distended small intestine or displacements of the large colon can be felt.
Nasogastric Tube: A tube will be passed into the horse’s stomach. We do this to assess whether there is any excess fluid in the stomach. This will give us some indication as to whether your horse has an obstruction requiring surgery.
Ultrasound Examination: We will perform an ultrasound examination of your horse’s abdomen. Again, this is to help us ascertain whether or not your horse has a surgical or medical colic. We are looking for any abnormalities of the intestines, whether they are distended or not.
Peritoneal Tap: A sample of fluid from the abdomen will be taken and evaluated. This will give us an indication of damage to the intestines.
Blood Sample: A sample of blood will be taken and analysed. This will give us an indication of your horse’s hydration and again, if there is suggestion of damage to the intestines.
If your horse is being treated for a medial colic, they may have a catheter placed into the vein on the neck and intravenous fluid therapy started. Your horse will be monitored closely for change in any of the measurements mentioned above and treated appropriately.
If your horse is diagnosed with an impaction, we will pass fluids orally through the day and night, to try and break down the impaction.
Once your horse has recovered from the initial colic we will then start to “re-feed” your horse. This will start with picks of grass and then be followed on by bran mashes.
For medical colic, your horse will be in the hospital on average for between 2 and 5 days depending on the type of medical colic and response to treatment.
When your horse is discharged we will write discharge instructions with a detailed plan of how to manage your horse after his/her stay in hospital.
Once the decision has been made to take a horse to surgery, their abdomen will be clipped, an intravenous catheter placed and antibiotics started along with pain relief.
The horse will be placed on the surgical table on his/her back and an incision made down the middle of the abdomen.
There are many different types of surgical colic; some will require the small intestines to be removed, some the colon emptied and others require the colon or small intestines to be repositioned into the correct place.
After surgery your horse will remain on an intravenous drip, an abdominal bandage will be placed around the abdomen to help protect the surgical incision. Your horse will be monitored closely post operatively.
If response to surgery is good then “re-feeding” will start 12 – 48 hours post operatively to help stimulate the intestines. For a surgical colic your horse will be in the hospital on average for between 5 and 7 days depending on the type of colic and response to treatment.
When your horse is discharged we will write discharge instructions with a detailed plan of how to manage your horse after his/her stay in hospital. There will be a feeding plan, and your horse will still have an abdominal bandage in place. Staples will be removed 14 days post surgery.