A Word on Colic

I promised I'd be doing more informational posts in addition to bragging about how awesome Stella is. Since I've had a fair bit of experience with colic, at least the more mild kinds, I'd like to share a bit of what I've learned as well as some preventative bits. Colic is a pretty complex topic but every horseowner should have a basic, working knowledge of what it is, how it can happen and what they can do to prevent it.

This will be a two-part series: the first will cover signs, symptoms, and the initial "diagnosing" period. The second will cover the aftermath and prevention tips.

A word to the wise: colic is not something to mess with. I was very fortunate in that Stella's colic stayed mild until I finally decided to try the Gastroguard regimen, but I was VERY lucky they didn't get worse. It was almost a year of more or less frequent mild colics before I bit the bullet and did this: I would have done it much sooner had I known then what I know now, and I don't suggest anyone wait as long as I did.

Colic, colic, what's in thy name?

From the World English dictionary:

"Colic: noun, a condition characterized by acute spasmodic abdominal pain, especially that caused by inflammation, distention, etc of the gastrointestinal tract"

Sounds familiar, right? However, it would probably surprise a lot of people to know that colic in and of itself is a clinical sign. It's NOT a diagnosis. Colic is a catch-all term for abdominal pain, just as the definition suggests. But there is always a cause for the abdominal pain, so colic is merely a sign of something awry.

That brings us to the question, what causes a horse to colic? Here's the bigguns':

• Pelvic flexure impaction: this is your typical impaction colic, AKA big wad o' food gets stuck in the hindgut (most often where the left colon takes a 180 degree turn and narrows) and blocks traffic. Ileal colic (last part of the small intestine) is also a fairly common but is usually attributed to parasites. Impactions can also be caused by sand ingestion and enteroliths, large mineral deposit balls that build up as a result of ingestion of dirt, sand, etc.
• Speaking of bugs: a heavy parasite load can cause a blockage in the gut and thus cause colic. This usually happens when a very wormy horse is suddenly hit with a ton of anthelmintics (dewormers). Otherwise, large parasite infestations usually cut off bloodflow, and cause colic in this way
• Gas colic/spasmodic colic: this is caused by (usually) mild gas build-up in the gut. Usually the least severe and very response to basic treatment
• Ulcers. Probably the biggest cause of all colics, IMHO.
• Torsion, AKA intestines manage to flip over on themselves, causing a twist, cutting off blood flow and blocking the passage of feed. This is usually a bigger problem in mares that have just foaled, as the suddenly increased intra-abdominal room makes it easier for stuff to get tangled up

Now, those are the big ones. There are plenty of others, but most involve intestines doing things they shouldn't do, falling through spaces that shouldn't be there, etc. If you'd like to know more about these, look up keywords like strangulating lipoma, epiploic foramen entrapment, mesenteric rent entrapment, or intussusception. Please take note, though, that these are all pretty rare, and shouldn't be the primary concern of your average horse owner.

911, We Have An Emergency!

The biggest and possibly most important decision you'll have to make if you think a horse is colicking is whether or not to call the vet. I always call, because this allows me to alert them in case I need to have them drive out. Either way, do not hesitate to pick up the phone. HOWEVER, do your homework first, and be able to describe symptoms and give vital signs. Be a proactive, knowledgeable horse owner and learn what is A) normal for the average horse, but more importantly, B) what is normal for YOUR horse. In all of my dealings with Stella's colics, I learned she runs warmer than your average horse all the time, by as much as a whole degree. This is important information to know!

In general, these are the things to look for if you suspect a horse is colicky:

• repeated rising/laying down, rolling or thrashing
• kicking or nipping at gut, repeatedly looking at side
• pawing
• attempts to urinate or stretching as if to urinate
• groaning
• excessive salivation
• blatant lack of interest in food or water
• heavy breathing/blowing (may be shallow) and/or sweating

I'd like to note here that Stella only ever did the following: refused food, and then laid down and got up repeatedly. She showed no other observational symptoms like those listed above (with the exception of the blowing/sweating: I did find her doing this once). This is where it's important to know your horse.

The next series of physical symptoms are ones you need to actually physically check on the horse.

• Temperature: the average horse runs somewhere between 99F and 101F. Remember, know your horse. Stella averages around 101.3F. This would indicate a fever in many other horses but is normal for her. A temp over 102F should be called in to a vet immediately, however.
• Pulse. 30-40 BPM is normal for an adult horse at rest (any horse over 2 is considered "adult" where pulse is concerned). You can take pulse near the front of the left jawbone. Anything over 50 usually indicates distress.
• Respiration: average for a resting horse is 8-15 breaths per minute and increases with exercise or pain. Watch for the rise and fall of the horse's side.
• Gum color: moist pink is normal. Pale pink indicates fever, anemia or blood loss. Bright red is toxic shock, grey/blueish is severe shock, yellow is jaundice and means liver failure. You also check the gums for capillary refill: lift the horse's top lip and press your thumb on the gum for 2 seconds, then release. The gum color should turn from white back to normal in 1-2 seconds. A greater time means dehydration. You can also do the skin pinch test on the horse's neck to test for dehydration, but I think the gum test is easier to see.
• Gut sounds. None or few are usually more indicative of colic than lots, but lots aren't always good either. Ideally, you should here a gurgle every 2-4 seconds. You can check gut sounds with a stethoscope, holding it flat and pressing slightly in the belly. There are several quadrants in which you can listen that correspond to the different parts of the digestive system.

What's Up Now, Doc?

So, your horse is colicking. I'd first recommend calling your vet. Even if it seems mild, do it. It puts them on alert and you can check in with them every hour or more often if necessary to get more guidance.

Always have some sort of fast-acting pain medication on hand, either in liquid or paste form. Banamine is the first choice, and you can get the cheaper generic form (years ago Banamine was the only brand name of the actual drug, called flunixin meglumine, and has since stuck). Banamine primarily works (and thus is great for colic) by breaking the pain-dysfunction cycle in the gut, allowing it to start to function normally. Don't bother with Bute: it takes too long to work into the system and it's intended for musculoskeletal disorders.

Banamine is admistered on a weight basis, so know you horse's weight. Once you confirm colic, administer either orally, IM (intra-muscular) or IV (intra-venous). I don't highly recommend IM, though. You can give IV Banamine orally, just remove the needle from the syringe after you draw it from the jar and squirt it in the horse's mouth. IM administration can irritate muscle tissue and in severe cases cause serious muscle damage and bacterial infection. Don't attempt to give any drug IV unless you are trained to do so. Orally is your best option.

Once you've given a pain medication, take away all food (I leave water). You can walk the horse, but this isn't necessary if the horse is otherwise quiet and not thrashing. In some cases, walking can actually tire the horse and make things worse. I like to leave them alone and just keep watch, which is what I usually did with Stella. This is the less-intensive part, but probably the most important. Do NOT just leave the horse if they start to get better. Remember, colic is not a diagnosis, but a symptom of something bigger. Many a horse gets better once given pain medication and then lapses a few hours to a day later, and often worse than they did initially.

I won't go into the specifics of the vet work-up, but if your vet does come out, chances are he/she will go through all the same tests you did for vital signs, as well as do a rectal exam. They may pump your horse with fluids via the nasal passage directly into the gut to diagnose impaction. They may also, in severe cases, do a gut tap, called an abdominocentesis, to check the fluid in the peritoneum and thus diagnose the state of the intestines. The steps are generally the same for most vets, but the timeline may differ dramatically, and last as long as several days. The good news is most horses recover without needing surgery or any drastic measures. The bad news is that once your horse is in the clear short-term, you've got some investigating to do to figure out what caused the colic in the first place. That's almost always the hard part but I'll provide a pretty solid step-by-step guide for what to try first and why.

That's it for now, stay tuned for Part II! The 2nd installment will cover the aftermath of a colic episode, and what you can do to treat the real source of the colic and prevent colic altogether.