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My Horse University and eXtension’s HorseQuest welcome you to this live Webcast.

Equine Colic:Understanding

the BasicsElizabeth A. Carr DVM, PhD

Equine MedicineLarge Animal Clinical Sciences

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Meet our presenter:

Elizabeth A. Carr DVM, PhDDip ACVIM & ACVECC

Equine MedicineLarge Animal Clinical Sciences

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What is Colic?Colic = abdominal pain– **Gastro-intestinal tract**– Referred pain:

• Kidneys

• Bladder

• Liver

• Orthopedic pain?

• Reproductive– Uterine torsion

– Testicular Trauma

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Does My Horse Have Colic?Know what is normal!

Temperature (rectal)• 99°F – 101.5 °F

Heart Rate or Pulse• 30 - 45 bpm

• Left elbow

• Bottom of jaw

Respiratory Rate• 12 - 36 bpm

• Watch nostrils

• Chest excursion

Intestinal Sounds

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Does my horse have colic?Interpreting the signs:

Mild signs• Kicking at belly

• Pawing

• Laying down

• Looking at sides

• Curling lip (Flehmen response)

• Playing in water

• Grinding teeth

• Refusing feed

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Mucous membranesNormal• Pink, and moist, with <2 sec

capillary refill

Abnormal• Color - red, bluish,

blanched• Prolonged refill

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More obvious signs:Down and rollingEvidence the horse has rolledBreathing hardSweatingAbdominal distention (bloating)

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Making the call:What does your vet need to

know?Breed, age, gender

Duration of colic signs?

What are the colic signs?• Degree of pain?

Last time the horse passed manure?

Has the horse been eating & drinking normally?

Any medications given and the horses response

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Predisposing Factors for Colic:Change in Feed / Environment

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Predisposing Factors for Colic:Water availability and consumption• Clean• Frost-free

– Heaters versus insulated containers

• Temperature– Warm, especially for older horses

with sensitive teeth

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Predisposing Factors for Colic:Ginseng – Parasites• Ascarids - young, immune problems• Small strongles (cyanthostomes)• All ages• Resistance

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Predisposing Factors for Colic:Sand• A concern in all of Michigan• Feeding on the ground

– Sand in stalls or run-ins

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Predisposing Factors for Colic:Poor Dental Health

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Predisposing Factors for Colic:Use of NSAIDS• Bute / Banamine sensitivity

• Gastric / colonic ulcers

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Other Predisposing Factors for Colic:

Foreign bodies– Rubber fence

– Twine

Uterine torsion

Recently foaled mare– Large colon torsion

Older horse– Lipomas (fatty tumor)

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Decreasing the risk factors:Make feed changes slowly• Gradually introduce new feeds / hays as the old feed is phased

out• Newly harvested hay needs to cure before feeding

• Pasture - introduce gradually

• Sweet feed / concentrate feed can predispose colic symptoms• Excessive Gas production

• Decreased gastric pH--ulcers

• Amount fed and order of feeding

• Complete / pelleted feeds• Easily digestible fiber with C. Fiver > 16%

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Decreasing the risk factors:Always provide fresh water• Change / clean out bucket and tanks regularly

• Provide non-frozen in winter months• Heated tanks offer warm water daily

Provide electrolyte source year-round• Salt block

• Traveling / showing• If you add electrolytes to water, always provide a water source

without electrolytes as well

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Decreasing the risk factors:Parasites / Infectious DiseaseGood management practices• Good hygiene / sanitation, feeders

Fecal egg countsAlternating products• 3-4 times per year (or more) based on population density of

horses

Once a year, after first frost, TAPEWORMS• Praxiquantel

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Decreasing the risk factors: Parasites / Infectious Disease Good management practices

Good hygiene/sanitation, feeders Fecal egg counts Alternating products

3-4 times a year (or more) based on population density of horses

Once a year, after first frost, TAPEWORMS

Praziquantel

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Decreasing the risk factors: Good dental health:

ANNUAL EXAM – FLOAT? As horses age, may require dental exam more than

once a year Horses with problems

Dental abnormalities Minis, parrot mouth, trauma

An “equine dentist” is not necessarily a dentist that is a veterinarian

A DVM/dentist will provide a good physical exam of the horse and the mouth

Knows how to use drugs

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Decreasing the risk factors: Prevent sand ingestion Feed off the ground

Place mats/carpet beneath feeders Prevent ingestion during

“clean-up” Psyllium –effective?

Binds sand? / increases motility? One week per month

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Decreasing the risk factors: Judicious use of NSAIDs (Bute/Banamine) Horses may develop sensitivity during therapy or

have a pre-existing sensitivity. Warning signs:

decreased appetite mild colic signs after eating refusing grain weight loss mild swelling under chin, between front legs or

along belly, sheath/mammary tissue. Vicious circle – “pain >> drug >> damage >> pain

>> drug”

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Colic Treatment Recognize problems early Leads to a better outcome May be able to correct problem by

management changes Impaction (decreased appetite and fecal

production changes) >> increase water consumption

Sand – make management changes

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Initial Colic Treatment Rule of thumb: Less than 20% of all horses that colic, actually require surgery Good physical exam Rectal exam Pass stomach tube Medications Pain medication – NSAID, Xylazine, Detomidine, Torbugesic Oral fluids – water with electrolytes, mineral oil

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Colic Treatment Most colics require only 1-2 visits by your veterinarian What do you do if your horse is still not responding Continue to treat at home Referral to a facility with surgical expertise Make you decisions NOW before a problem arises! Euthanasia – don’t let your horse suffer!

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At the referral hospital:• Repeat diagnostics

Rectal Exam

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Naso-gastric Reflux Where does the

fluid originate? Why does it

accumulate? Horses cannot

vomit Stomach distention

is life-threatening.

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Abdominal ultrasound

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Abdominocentesis (belly tap)

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IV catheterization• Provide fluid therapy

• Intravenous route of drug administration

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Abdominal Radiographs

Foal / Mini

Adult horse

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Medical Colic Many horses that present to referral

facilities do not go to surgery Dehydration Mild impactions

Feed / Sand Gastric / colonic ulcers Gas / spasmodic colic Therapeutic trailer ride?

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Referred Medical Colic Average costs for medical therapy? $1200 -- $2500 3 – 4 day hospitalization IV and oral fluids Pain control Prior to discharge:

return to normal feed,

normal water intake,

normal fecal output

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Does you horse need surgery? The #1 reason is

PAIN. Pain that is

non-responsive

to analgesia

(pain medication)

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Strong indicators your horse may need surgery:

Violent pain -- unrelenting Large colon gas distention / bloat Distended loops of small intestine Naso-gastric reflux Persistent pain (several days

duration)

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Abdominal Surgery

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Large Colon Lesions Volvulus (twist)

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FecalithMiniature Horses /

Foals

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EnterolithsWestern horses -California & Texas horses

Michigan Horses

“Stones” in the GI tract

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Sand impactation that does not respond to medical treatment

All Michigan horses are susceptible

High risk are:

•Over-weight horses

•Vacuum-cleaner horses

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Small Intestinal Lesions

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Strangulating Lipoma•Older

horses

•Fatty tumor

•Risks increasewith age & size of lipoma

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Surgery Costs: $3000 -- $7500 Small intestinal lesions greater expense

Length of Stay: 5-7 days without complications

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Peri-operative Complications: Anesthesia Recovery Post-operative ileus Endotoxemia Thrombophlebitis

(infected vein) Incisional infection Laminitis (founder) Adhesions (long-term) Hernias

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Prognosis for recovery? Large colon lesions = 95%

Small intestinal lesions Uncomplicated, with/without resection (dead intestine) = ~70-80% Patients with a resection/anastomosis have a greater incidence of

post-operative complications.

Unfortunately, true diagnosis / prognosis difficult to make without surgical exploration

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Minimize your STRESS:• Equine Insurance• Mortality vs. Medical vs. Surgical policies• The cost of insurance is much cheaper than medical therapy and/or

cost of surgical procedures

• Set aside a “Medical Fund”

• Out-of-town?• Make a plan for your horse• What to do in case of emergency• Appropriate phone numbers, insurance, etc.

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Questions?

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Upcoming Webcasts

Horse Health Series• Respiratory Disease: Diagnosis, Treatment and

Prevention | Feb. 16• Lameness in the Performance Horse | March 16• Rehabilitating the Lame Horse | March 23• Equine Emergency First Aid | April 20

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