How Can We Diagnose and Treat Colic?
So let's start with the warning signs; what do we look for that will tell us that our horse is colicking?
The one definite symptom that every colicking horse exhibits is:
It will stop pooping. The horse may also exhibit one or more of the classic signs which are:
The horse will go off its feed
It will start to sweat
It will lay down and get up and be very restless
The horse will bite or kick at its stomach
The horse will stand and hang its head low with dull eyes
Additional signs are:
Elevated respiration (normal respiration is 8 to 15 breaths per minute) The respiration rate will be elevated during hot weather but it should never exceed the pulse rate. If it does, call the vet immediately.
Elevated heart rate/pulse (normal heart rate for an adult horse at rest is 30 to 40 beats per minute). A heart rate above 50 should be cause to call the vet.
Elevated or depressed temperature (normal temperature is 99 to 101 degrees Fahrenheit). If the temperature is below 98 or above 102, call your vet.
Lack of gut sounds. You should always be able to hear food moving through the horse's gut. Whereas for us humans, we are embarrassed by the gurgling that sometimes comes from our stomachs. For a horse however, the lack of these noises is a cause for concern because it means the food has stopped moving.
The horse will be gassy. My mare will actually gas colic where the only problem is the buildup of gas. I short session on the longe line which will be jet propelled with every stride will soon clear that!
The horse may paw the ground
Some other signs I have experienced but in very rare instances are:
The horse will fall down when tacked up
The horse will stand backwards in a corner, propping itself up between the converging walls
The horse may throw itself into the walls to try to relive the pain in the gut
Of course there are a million different signs and the best way to recognize the symptoms is to know your horse and to be able to detect when he is "off"
Let's just run through how to check the vital signs:
Respiration:
o If you don't have a stethoscope you can lay your hand on the rib cage
o Count each expansion and contraction of the rib cage as "1"
o Make sure you count for a full minute
o If you do have a stethoscope, place it on the front of the horse's neck on the windpipe
o Listen again to the inhale and exhale and count each pair as "1"
Heart Rate / Pulse:
o Without a stethoscope place your forefinger (never your thumb your own pulse runs through there) under the left jawbone and feel for the prominent artery that runs there
o Hold the finger there for 15 seconds and count the pairs of "bloop-BLOOP" as "1"
o Multiply the count by 4 to get the 1 minute heart rate
o If you have a stethoscope, place it behind the left elbow.
o Be sure to count each "bloop-BLOOP" as 1
o Count for 15 seconds and multiple by 4 as for checking with your finger
Temperature:
o For this you will need a thermometer with a length of string attached to the end
I would recommend a digital thermometer since they are easier to read
If you use a mercury thermometer make sure you shake the mercury down before using it
o Lubricate the thermometer with petroleum jelly (Vaseline)
o Hold the horse's tail to the side
o Insert the thermometer, sensor end first into the horse's rectum.
This is where the string comes into its own many horses will contract the rectum and the net result is that the thermometer will be sucked into the horse. Having the string in place will eliminate the need for an exploratory expedition to retrieve the thermometer ;o))
o When using the digital thermometer, listen for the beep that tells you the reading is completed
o If using a mercury thermometer leave it in place for at least 3 minutes
o Remove the thermometer gently and check the temperature
Gut sounds:
o Press your ear to the horse's barrel just behind the last rib or place a stethoscope in the same location
o You should hear gurgling and swishing
o Check both sides of the horse to determine if all sounds are absent or only one side
An additional set of vital signs that you might want to check to give additional information to your vet are:
Pinch Test for Dehydration:
o Pinch
o Take a fold of skin from the horse's neck and pinch it between the thumb and forefinger.
o Hold the fold for a couple of seconds
o Release the fold
o The fold should flatten out in less than a second
o If it takes more than 1 second, make sure you make a note of how long it takes because this will give your vet a good indication of how severe the dehydration is
Capillary Refill Time (CRT)
o This test will give an indication of how long it takes for blood vessels to refill, thus indicating the efficiency of the circulatory system
o Lift the horse's upper lip
o Press your thumb into the horse's top gum for at least 2 seconds, making a white spot on the gum
o The gum should return to a nice healthy pink within 1 to 2 seconds
o If it takes longer than this, it might mean that your horse is going into shock and should trigger the call to the vet
So now we have all these things that are telling us that our horse is colicking. What do we do now?
Of course the "what" depends on how severely the horse is colicking and unless you are experienced at diagnosing colic, I would definitely recommend calling the vet. The earlier you call the vet the better chance you have of having a successful outcome.
In mild cases of colic or gas colic, where there is no major obstruction, the best treatment is fluid and exercise.
Give your horse clean fresh water. If they don't drink try adding Gatorade (for electrolytes) or apple juice to make the water more appetizing. Take the horse out of the stall and, if possible longe them for a short while to get things moving. You can expect a fair amount of gas to be passed during this process so don't worry about that.
Keep the horse moving for at least 15 minutes and then check the vial signs and gut noises again. Make sure the horse has the opportunity to drink after each exercise session.
Repeat this cycle until the horse either poops (this is the best result we can hope for) or the vital signs return to normal. If, after more than an hour nothing has changed, or if at any time the vital signs deteriorate, it is time to move on to "Plan B".
The next level of treatment involves the administration of Banamine. Banamine is the trade name of the substance "flunixin meglumine". It is a non-steroidal anti-inflammatory substance in the same category as aspirin or bute. Although known as an effective remedy for colic because it reduces the inflammation and thus allows the gut to offer a larger orifice for the passage of the food. However Banamine has a few side effects that should be noted. The pain suppression properties of Banamine may provide initial relief for the horse but the colic may continue developing into something more serious without being detected. Make sure the horse is monitored for vital signs and gut sounds even though it appears to be quieter and more relaxed.
Remember, what we are really looking for is for the horse to poop. Until that happens the danger of colic is still very high.
The most effective form of Banamine is the injectable form which is administered intravenously. The next most effective form is the intramuscular injection. Banamine also comes in a paste form but that is the least effective form. Think about it if nothing is moving through the gut, how is the paste going to get to where it needs to be?
Unless you are very experienced giving intravenous injections, do not attempt to do so. The dosage for Banamine should also be recommended by a vet. If you do not have experience in administering the drug, make sure you consult with a vet first. My advice is not to wait until you have a colic to try to understand the administration of Banamine. Talk to your vet; find out about the dosage; lean how to give at least an intramuscular and preferably an intravenous injection; ask the vet if you can help with the spring or fall shots under his supervision so you can practice in a low stress environment.
Certainly never administer Banamine to a colt under the age of 2 without the approval of a vet.
Continue to monitor the horse and, in most cases, their system will return to normal and they will be pooping within the hour.
If there is no relief in the vital signs an hour after administering Banamine, it is time for "Plan C".
Plan C is not negotiable. If a horse has not responded to water, exercise and Banamine, it is time for the vet. A vet will assess the situation and may recommend a variety of treatments. The most common of these is the administration of mineral oil.
The vet will insert a tube through the horse's nostril and down into the stomach. Once there the vet will pour a quantity of mineral oil through the tube to lubricate the gut directly. If the vet attempts to use a stirrup pump to push the oil down the tube, insist that he stop. The oil should flow down the tube under its own weight. I have known rare occasions where the vet has pushed too much oil into the gut because he is unable to feel the pressure mounting through the pump. The result of this has been the rupturing of the gut when the volume of oil meets the immovable obstruction, resulting in death.
If the vet suspects the obstruction has resulted in an immovable impaction or even a twist in the gut, the vet will recommend surgery. This is the last resort. It is expensive and is fraught with risk for the horse. Before approving surgery, you must evaluate the possibility of success including the age of the horse, the history of colic, and the vet's prognosis for a full recovery. As difficult as the decision can be, it may be better to let your aged horse with a history of colic go than to put them at risk of a painful death as a result of the anesthetic or weeks of painful recovery only to have to make the ultimate decision anyway.
With careful management and early diagnosis, colic can be no more than a temporary discomfort which can be quickly and easily dealt with. Procrastination and lack of knowledge can be fatal!