Colic is one of the most well known terms used in reference to illness in horses. It refers to pain in the abdomen, used to refer to a variety of diseases where horses show signs of abdominal pain, as opposed to one particular disease.
Causes
Due to the range of conditions this can refer to, there are various causes. This could be caused by intestinal spasms (cramp), a blockage of the stomach caused by indigestible material such as sand (impaction), erosion of the intestinal lining (ulceration), a rupture (from an impaction or gas build up causing the stomach to dilate, or from a back up of fluid as horses are unable to vomit), or from tapeworms and parasites (wherein the intestine slides within itself, cutting off blood supply or causing a blockage; intussusception). These are just an example of a few of the causes.
"There are many (over 70) different intestinal problems that cause colic." [1]
The four most common causes of colic are listed below.
Excessive fluid or gas building up in the digestive tract causes the wall of the intestine to be stretched, stimulating nerves sensitive to stretching in the wall of the intestine. Strangulation or torsion; a twist in the colon or small intestine may result in the blood supply being cut off, resulting in ischemia (restriction in blood supply to tissues causing a shortage of oxygen and glucose) and necrotic (dead) tissue. Inflammation of the intestines; either Enteritis, of the whole intestinal wall, or Peritonitis, of the covering of the intestine, with both having various causes including viruses and bacteria. Excessive tension on the mesentery (a fold of tissue that attaches organs to the cell wall, in this case the small intestines to the abdominal wall) creating pain, which could occur with intestinal displacement.
Over 80% [2][3] of the reported cases of colic are Idiopathic (meaning they have no known cause)
Laminitis, ovarian problems and bladder stones may be identified as colic, due to similar symptoms. These can be known as 'false colic'.
Symptoms & Diagnosis
In mild cases, symptoms can include lip curling, restlessness, pawing at the ground, flank watching (turning the head to look at the abdomen), arching the neck, shifting of weight to hind limbs or decreased appetite. More serious cases may have symptoms ranging from kicking at the stomach, persistent movement, difficulty or frequently urinating or defecating, repeated lying down and getting back up, rolling, lying down for extended periods of time, with severe cases including profuse sweating, violent rolling (potentially causing other injuries) and rapid breathing.
Other symptoms may also be present, dependent on the horse, mainly those showing some form of distress or abdominal pain.
For diagnosis, a thorough examination should be made, due to the various potential diseases the horse could have. As there is a long list of diseases associated with colic, the treatments for the most likely one (determined by the horse's age, medical history, living conditions, information given by the owner, etcetera) is administered, before a more specific diagnosis is made so as to try and improve the prognosis (the outcome of the disease, particularly in terms of recovery).
"The history of the present colic episode and previous episodes, if any, must be considered to determine whether the horse has had repeated or similar problems or whether this episode is an isolated event. The duration of the present episode, the rate of deterioration of the horse's cardiovascular status, the severity of pain, whether faeces have been passed, and the response to any treatments are important pieces of information. It is also critical to determine the horse's deworming history (schedule, treatment dates, drugs used), when the teeth were floated last, if any changes in feed or water supply or amount have occurred, whether or not the horse is a "cribber," and whether the horse was at rest or exercising when the colic episode started." [4]
As the heart rate increases due to pain, a faster heart rate may indicate a more severe cause (such as strangulation), although not all those that require surgery are accompanied by faster heart rates.
"The most definitive part of the examination is the rectal examination. The veterinarian should develop a consistent method of palpating for the following: aorta, cranial mesenteric artery, cecal base and ventral cecal band, bladder, peritoneal surface, inguinal rings in stallions and geldings or the ovaries and uterus in mares, pelvic flexure, spleen, and left kidney. The intestine should be palpated for size, consistency of contents (gas, fluid, or impacted ingesta), distention, edematous walls, and pain on palpation. In healthy horses, the small intestine cannot be palpated; with small-intestinal obstruction, strangulating obstruction, or enteritis, the distended duodenum can be palpated dorsal to the base of the cecum on the right side of the abdomen, and distended loops of jejunum can be identified in the middle of the abdomen." [5]
Laboratory facilities and ultrasonography aid in determining the cause and correct treatment, differentiating between the different diseases.
Treatment
As colic may be life threatening, if seen exhibiting moderate or serious symptoms a veterinary surgeon should be notified immediately. For example, if the stomach is twisted, surgery may have to be performed. potentially at an equine hospital. While waiting for the vet the horse should be kept quiet and still if possible. If the horse is lying comfortably, it should be left. If it is rolling violently, or could potentially cause itself further injuries, try and slowly walk the horse until it calms, or will lay quietly.
If mild symptoms are shown, the horse should be gently walked for no more than ten minutes. If symptoms persist after thirty minutes or become more severe the vet should be contacted. In neither case should the horse be made to trot or canter.
The medical treatment required is based upon the cause and severity of the disease, ranging from surgery to pain relief (analgesia). Fluids can be given to clear any feed stuck (impacted) within the small intestine. Motility modifiers are drugs that can be given to alleviate cramps and spasms in the gut. Gentle exercise (under the watch of a veterinary surgeon) could be undertaken, which can aid in alleviating some causes of colic, such as colonic displacement.
Surgery may be a necessary treatment, based on the cost and potential prognosis. This occurs in an estimated 10% [6] of colic cases. To ensure the best chances of recovery and survival, if surgery is required it should be undertaken as soon as possible.
"The mean duration of illness before presentation was 4.2 hours for survivors and 6.2 hours for non-survivors." [7]
References - provided general understanding of the disease; including symptoms, causes and treatments
University of Liverpool - Equine Hospital - Diagnosis and Treatment
http://www.liv.ac.uk/equine/common-conditions/colic/diagnosing-colic/
- Quote, number of causes of colic [1]
- Data, percentage of colic cases resulting in surgery [6]
University of Liverpool - Equine Hospital - What is Colic?
http://www.liv.ac.uk/equine/common-conditions/colic/what-is-colic/
Colic In Horses: Types of Colic, Potential Causes and Reducing Risks
http://www.succeed-equine.com/equine-health/health-risks/colic-in-horses/
- Data, percentage of Idiopathic cases of colic [2]
Types of Equine Colic: Crusade Against Equine Colic
http://www.coliccrusade.com/what-is-equine-colic/types-of-equine-colic/
- Data, percentage of Idiopathic cases of colic [3]
Overview of Colic in Horses: Colic in Horses: Merck Veterinary Manual
http://www.merckmanuals.com/vet/digestive_system/colic_in_horses/overview_of_colic_in_horses.html
- Quote, history of the horse and colic episodes [4]
- Quote, rectal examination [5]
Colic: To Walk Or Not To Walk
http://www.thehorse.com/articles/10352/colic-to-walk-or-not-to-walk
- Quote, duration of illness between survivors and non-survivors of horses who had undergone surgery [7]
Charlotte O'Connor
Causes
Due to the range of conditions this can refer to, there are various causes. This could be caused by intestinal spasms (cramp), a blockage of the stomach caused by indigestible material such as sand (impaction), erosion of the intestinal lining (ulceration), a rupture (from an impaction or gas build up causing the stomach to dilate, or from a back up of fluid as horses are unable to vomit), or from tapeworms and parasites (wherein the intestine slides within itself, cutting off blood supply or causing a blockage; intussusception). These are just an example of a few of the causes.
"There are many (over 70) different intestinal problems that cause colic." [1]
The four most common causes of colic are listed below.
Excessive fluid or gas building up in the digestive tract causes the wall of the intestine to be stretched, stimulating nerves sensitive to stretching in the wall of the intestine. Strangulation or torsion; a twist in the colon or small intestine may result in the blood supply being cut off, resulting in ischemia (restriction in blood supply to tissues causing a shortage of oxygen and glucose) and necrotic (dead) tissue. Inflammation of the intestines; either Enteritis, of the whole intestinal wall, or Peritonitis, of the covering of the intestine, with both having various causes including viruses and bacteria. Excessive tension on the mesentery (a fold of tissue that attaches organs to the cell wall, in this case the small intestines to the abdominal wall) creating pain, which could occur with intestinal displacement.
Over 80% [2][3] of the reported cases of colic are Idiopathic (meaning they have no known cause)
Laminitis, ovarian problems and bladder stones may be identified as colic, due to similar symptoms. These can be known as 'false colic'.
Symptoms & Diagnosis
In mild cases, symptoms can include lip curling, restlessness, pawing at the ground, flank watching (turning the head to look at the abdomen), arching the neck, shifting of weight to hind limbs or decreased appetite. More serious cases may have symptoms ranging from kicking at the stomach, persistent movement, difficulty or frequently urinating or defecating, repeated lying down and getting back up, rolling, lying down for extended periods of time, with severe cases including profuse sweating, violent rolling (potentially causing other injuries) and rapid breathing.
Other symptoms may also be present, dependent on the horse, mainly those showing some form of distress or abdominal pain.
For diagnosis, a thorough examination should be made, due to the various potential diseases the horse could have. As there is a long list of diseases associated with colic, the treatments for the most likely one (determined by the horse's age, medical history, living conditions, information given by the owner, etcetera) is administered, before a more specific diagnosis is made so as to try and improve the prognosis (the outcome of the disease, particularly in terms of recovery).
"The history of the present colic episode and previous episodes, if any, must be considered to determine whether the horse has had repeated or similar problems or whether this episode is an isolated event. The duration of the present episode, the rate of deterioration of the horse's cardiovascular status, the severity of pain, whether faeces have been passed, and the response to any treatments are important pieces of information. It is also critical to determine the horse's deworming history (schedule, treatment dates, drugs used), when the teeth were floated last, if any changes in feed or water supply or amount have occurred, whether or not the horse is a "cribber," and whether the horse was at rest or exercising when the colic episode started." [4]
As the heart rate increases due to pain, a faster heart rate may indicate a more severe cause (such as strangulation), although not all those that require surgery are accompanied by faster heart rates.
"The most definitive part of the examination is the rectal examination. The veterinarian should develop a consistent method of palpating for the following: aorta, cranial mesenteric artery, cecal base and ventral cecal band, bladder, peritoneal surface, inguinal rings in stallions and geldings or the ovaries and uterus in mares, pelvic flexure, spleen, and left kidney. The intestine should be palpated for size, consistency of contents (gas, fluid, or impacted ingesta), distention, edematous walls, and pain on palpation. In healthy horses, the small intestine cannot be palpated; with small-intestinal obstruction, strangulating obstruction, or enteritis, the distended duodenum can be palpated dorsal to the base of the cecum on the right side of the abdomen, and distended loops of jejunum can be identified in the middle of the abdomen." [5]
Laboratory facilities and ultrasonography aid in determining the cause and correct treatment, differentiating between the different diseases.
Treatment
As colic may be life threatening, if seen exhibiting moderate or serious symptoms a veterinary surgeon should be notified immediately. For example, if the stomach is twisted, surgery may have to be performed. potentially at an equine hospital. While waiting for the vet the horse should be kept quiet and still if possible. If the horse is lying comfortably, it should be left. If it is rolling violently, or could potentially cause itself further injuries, try and slowly walk the horse until it calms, or will lay quietly.
If mild symptoms are shown, the horse should be gently walked for no more than ten minutes. If symptoms persist after thirty minutes or become more severe the vet should be contacted. In neither case should the horse be made to trot or canter.
The medical treatment required is based upon the cause and severity of the disease, ranging from surgery to pain relief (analgesia). Fluids can be given to clear any feed stuck (impacted) within the small intestine. Motility modifiers are drugs that can be given to alleviate cramps and spasms in the gut. Gentle exercise (under the watch of a veterinary surgeon) could be undertaken, which can aid in alleviating some causes of colic, such as colonic displacement.
Surgery may be a necessary treatment, based on the cost and potential prognosis. This occurs in an estimated 10% [6] of colic cases. To ensure the best chances of recovery and survival, if surgery is required it should be undertaken as soon as possible.
"The mean duration of illness before presentation was 4.2 hours for survivors and 6.2 hours for non-survivors." [7]
References - provided general understanding of the disease; including symptoms, causes and treatments
University of Liverpool - Equine Hospital - Diagnosis and Treatment
http://www.liv.ac.uk/equine/common-conditions/colic/diagnosing-colic/
- Quote, number of causes of colic [1]
- Data, percentage of colic cases resulting in surgery [6]
University of Liverpool - Equine Hospital - What is Colic?
http://www.liv.ac.uk/equine/common-conditions/colic/what-is-colic/
Colic In Horses: Types of Colic, Potential Causes and Reducing Risks
http://www.succeed-equine.com/equine-health/health-risks/colic-in-horses/
- Data, percentage of Idiopathic cases of colic [2]
Types of Equine Colic: Crusade Against Equine Colic
http://www.coliccrusade.com/what-is-equine-colic/types-of-equine-colic/
- Data, percentage of Idiopathic cases of colic [3]
Overview of Colic in Horses: Colic in Horses: Merck Veterinary Manual
http://www.merckmanuals.com/vet/digestive_system/colic_in_horses/overview_of_colic_in_horses.html
- Quote, history of the horse and colic episodes [4]
- Quote, rectal examination [5]
Colic: To Walk Or Not To Walk
http://www.thehorse.com/articles/10352/colic-to-walk-or-not-to-walk
- Quote, duration of illness between survivors and non-survivors of horses who had undergone surgery [7]
Charlotte O'Connor