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By Dr Ben Pratt  BVSc MANZCVS (Equine Practice)

Intro 

‘Colic’ is one of those words that can make a horse owner’s heart skip a beat. The reality of finding a much-loved family horse experiencing colic can be even scarier. As a horse owner, I’m familiar with the panic and anxiety that sets in when our horse is unwell; however, as a veterinarian, I know that a logical and rational approach is required to help make them feel better. Understanding and demystifying ‘colic’ is the first step to calming these anxieties, allowing for the correct steps to be taken promptly. This leads to a greater chance of successful, cost-effective, faster recoveries for our horses.

Definition 

Colic in the horse is defined as the expression of abdominal pain, making it a symptom, not a diagnosis in itself. You might wonder why this is an important distinction to make. Well, a broad range of diseases present with ‘colic’ as a symptom, meaning each horse with colic-like signs should be seen on a case-by-case basis.

Colic-like signs often arise from diseases affecting the abdomen or gastrointestinal tract. Examples include abdominal cavity inflammation, gut blockages (impactions), gut spasms, or in severe cases, twisting or displacement of the guts. Horses, unable to communicate clearly to owners where the pain is located, may also experience disease elsewhere (such as in the chest) that also presents with colic-like signs. With this many diseases causing colic-like symptoms, we must try to diagnose the suspected causative disease in a colicing horse. This allows for a more targeted and informed therapeutic approach.

We’ve all heard stories of colicing horses, often from friends or neighbours, or perhaps even experienced them ourselves. Given the fact ‘colic’ is a symptom, not a disease, horse owners shouldn’t rely on these stories to guide the expected progression or required treatments for their own colicing horse.

Horse owners role

Horse owners are often the best judges of their horse’s normal behaviour and can regularly detect when something isn’t quite right with their horse (even in the early stages). Horses experiencing colic-like symptoms often display signs such as:

-Rolling

-pawing

-kicking or biting at belly/flanks

-sweating

-inappetence

-dullness and lethargy

The exact signs displayed by horses experiencing colic-like symptoms vary on a case-by-case basis and may be any combination of the above. These signs can also range from mild and occasional to severe and continuous.

Unfortunately, how our horses display these signs is not an accurate indicator of the underlying disease process causing colic episodes. For example, a horse with mild symptoms may still be at risk of life-threatening disease if not treated promptly.

So what do I need to do if I think my horse is experiencing an episode of colic? Firstly don’t panic! The next thing we should be doing after we’ve calmed ourselves is to give our veterinary clinic that treats horses. Some diseases that cause colic episodes can progress very quickly and cause lasting damage to our horses if not addressed promptly. That’s why it’s best to involve your veterinarian in the early stages without delay.

It is helpful to get to know the services of your local veterinary clinic before you even need them. It’s essential to check whether they can provide 24/7 emergency services or whether you will need to call another veterinary clinic outside of regular business hours. Having these phone numbers saved in an easy-to-access location will make getting in contact with help faster in a time of need.

Trained veterinary staff field calls like this consistently, and we love to help you and your horses (we’ve dedicated our lives to it). When contacted, we will often ask you a few phone questions to help us understand what’s going on and calmly guide you through the following steps.

While waiting for the veterinarian to arrive, moving the horse to a clean, safe location to be examined upon arrival is useful. If it is unsafe to do so, identifying and removing hazards in the area around the horse will help to keep yourself, the veterinarian and the horse safe from harm.

Unless your veterinarian directs, you should not administer any medication (or home remedy) to your colicing horse. Doing so may complicate the timely and accurate assessment of the horse and in some cases, may complicate treatment (or even cause harm).

Veterinarians role 

Veterinarians are highly trained and experienced in the diagnosis and treatment of diseases. This includes those that cause colic-like signs. We adopt a systematic approach to examining your horse to collect valuable information and ensure that everything is noticed. This will help us to establish a suspect diagnosis of the disease responsible and implement an appropriate therapeutic plan.

On arrival, your veterinarian will often continue to ask further questions to get a better idea of your horse’s medical history and the progression of this particular colic episode. Try to remain calm, to answer these as accurately as possible. Little details that may seem insignificant can be significant to your veterinarian.

The veterinarian will perform a thorough clinical examination on the horse. Veterinarians often listen to a horse’s heart, examining the horse from nose to tail. We will take note of details such as gums, lung and gut sounds and temperature along the way. It is not uncommon for a veterinarian to ask to examine a horse experiencing colic from afar and unrestrained at some point during the examination. This is often the best view of a horse’s true behaviour. This allows the veterinarian to gather crucial information about your horse that guides our further investigation and helps to formulate our suspected disease diagnosis.

Once your veterinarian has completed their examinations and diagnostic tests, they will discuss appropriate treatment options for your horse based on their suspected diagnosis. Once again, with colic being a symptom and not a disease, it’s not abnormal for treatment options to differ from how you may have seen previous colic episodes treated. It’s not a one size fits all approach to colic.

Some common initial treatment options often include;

-medications to provide pain relief: helping to make your horse feel comfortable whilst the underlying disease is corrected

-fluid therapy: to help rehydrate your horse and its gut contents. This often involves passing a tube through your horse’s nose and into its stomach. We call this nasogastric intubation. It can look uncomfortable and strange but is therapeutic and diagnostic in colic episodes.

-medication to change and reduce inflammation

-medication to change how the horse’s guts are moving

Before your veterinarian leaves, they will also discuss signs to look out for to indicate the horse is improving or signs you will need to give them another call.

Referral 

Most horses with colic-like signs, seen by a veterinarian, will respond to initial treatment. Before you know it, they’ll be back to normal and acting like it never happened. A small number of horses experiencing colic episodes will require more advanced diagnostic testing and intensive therapeutic options before they get to this point.

Inside a well-equipped veterinary hospital, veterinarians have the facilities to provide advanced diagnostic and therapeutic options that are not always possible at home. It allows us to provide a high standard of care, ensuring your horse is well looked after, and critically helps establish a more definitive diagnosis of the underlying disease. Although some diseases causing colic episodes will require surgery, many advanced medical options are available for other underlying diseases. Veterinarians at these hospitals will keep you updated every step of the way, ensuring you are well-informed of the decisions you will be asked to make.

Transporting a horse experiencing colic, often to an unfamiliar location, can be daunting for horse owners. Although daunting, this can be the best option for the horse’s ongoing care. Your veterinarian can help make your horse safe and comfortable for transport. Horse owners need to consider transport options and ensure they are available when required. It’s best to plan this well in advance, ideally before the horse is unwell or at the time of the initial veterinary visit. This way, you won’t be stuck in a time of need, and the horse can get the care it requires as soon as possible (leading to better outcomes).

Prevention 

Veterinarians like to say that “prevention is better than a cure”. Although not all causes of colic are preventable, many are. At your horse’s next health check, ask your veterinarian how you can best manage your horse to help keep them happy and healthy. We have lots of handy tips about how to feed, water and house your horse that will prevent an emergency call in the future.

Conclusion 

With “colic” now a little more demystified, you’ll be more prepared to act confidently in the unlikely event that it occurs in your horse – and I’m sure