Colic 101 - What Your Veterinarian Wants You to Know About Colic

Colic. It's something no horse owner wants to face, but if you have horses, you'll likely have to deal with colic at some point. It can strike any age or breed.

Colic remains the leading cause of premature death in horses. Out of an estimated 920,000 reported cases each year, approximately 64,000 of those are life threatening.

One of the most frustrating aspects of colic is that there are multiple causes. Among the most common are:

• Obstruction/impaction
• Disruption of blood supply (caused by torsion/twist)
• Gastrointestinal distension due to gas build up
• Inflammation of bowel wall
• Parasite infection
• Lack of dental care/improperly chewed food
• Confinement/restricted mobility
• Poor quality hay
• Inadequate water consumption
• Poor management practices
• Inconsistent feeding times/amounts

Is It Colic?

Good horsemanship and observation skills make all the difference in caring for horses, especially if you're concerned it might be colic. The astute horse owner pays close attention to the animal's attitude, activities, eating, water consumption and bowel habits on a regular basis. When you are extremely familiar with what's normal for your horse, any change can be a sign something's not right.

Symptoms of colic may include:

• Lack of interest in eating/drinking
• Pawing
• Lying down
• Rolling
• Biting at side or swinging head around to side
• Bloated belly
• Separation from other horses
• Decreased or lack of gut sounds
• Abnormal temperature (higher or lower than normal)
• Increased heart rate
• Increased respiration rate
• Slowed capillary refill time
• Gums any color other than "bubblegum" pink

It's important that every horse owner know how to take his/her horse's vital signs. You should do this often enough to know what's normal and what's not for your particular horse. Once you have this knowledge, you can make an informed assessment if you think your horse is colicking. It only takes a few minutes and you can gather enough information to relay to your veterinarian who can quickly determine if your horse needs medical attention.

Check those Vitals

Most colics can be identified with a thermometer and stethoscope by the horse owner, observes Chris Morrow, DVM, of Mobile Veterinary Practice in Amarillo, Texas.

Check your horse's vitals so you can relay the results when you call your veterinarian.

"With a $20 stethoscope you can take your horse's heart rate and see if he has gut sounds," says Morrow, who has been a practicing veterinarian since 1997.

"Thirty beats per minute is normal," Morrow notes, adding that a heart rate greater than 60 is not good, because it can indicate the horse is in distress. A horse suffering from colic will typically have a markedly increased heart rate. (Obviously, we're not talking about increased heart rate due to exercise.)

While you have the stethoscope handy, listen for gut sounds in the horse's upper and lower flank area on both sides. When digestion is normal, the equine gut is typically noisy, with gurgles, rumblings, pings and similar sounds audible regularly, often multiple times in a minute. Absence of gut sounds is not a good sign.

Check respiration and count your horse's breaths per minute. About ten breaths per minute is normal (when a horse is not exercising), so anything greater than 20 may be considered a negative predictor.

Take the horse's temperature using a digital rectal thermometer. Depending on the weather and his activity level, about 101ºF is normal.

Lift your horse's lip and observe the color of his gums, which should be pink under normal conditions. If they are pale, this is a sign of cardiovascular compromise. Dark color or purple is a sign of toxicity.

Now press your thumb firmly against his upper gum above left incisor. Hold a few seconds and then release. One to two seconds is the normal amount of time it should take to "pink up" where your thumb was. Anything longer than three seconds indicates cardiovascular compromise.

In addition to doing a thorough check of vital signs, observe the horse overall so you can describe his appearance and actions to your veterinarian.

This includes looking at how your horse is standing and his posture. Is he lying down and if so, is he lying flat on his side or propped up on his sternum/chest. Is he rolling?

Look closely at his eyes. Does he look frightened, in distress or even detached and distant?

How is he acting? When a horse is engaging in self-trauma, this is an indicator of significant distress. This includes biting at himself (typically his hips/flank area) or pushing his head against something solid, such as the stall wall.

"If a horse is self-traumatizing, we must intervene with analgesics/sedatives," notes Morrow.

Also consider the animal's age. Colic in foals is not common, but should always be considered an emergency when it does occur, because the causes are often life threatening.

Make the Call

As soon as you've assessed your horse's condition, call your veterinarian and give him/her the details of your horse's appearance, actions and vital signs. Then follow whatever instructions your veterinarian gives until he/she arrives.

In some cases, it helps to walk the horse slowly. Morrow emphasizes that the priority is staying safe and managing the situation to avoid injury to people and to the animal. A colicky horse is not thinking clearly and can fall into you or drop suddenly to roll, so be alert at all times.

In the case of a gas colic, sometimes it helps to put the horse in a round pen or small corral with soft footing. Often, the horse will lay down and find a comfortable position and the gas obstruction will pass.

Many colic episodes "self resolve," meaning they will pass without human intervention. The problem is you cannot know this from the outset, so you should always err on the side of caution and contact your veterinarian as soon as you detect signs of colic.

Medical vs. Surgical Colic

An experienced veterinarian can examine the horse and determine whether you're dealing with a medical colic, meaning it can most likely be treated and resolved through medications, or a surgical colic, in which the situation is more serious and surgery is advised to save the animal.

While methods for treating colic have not changed significantly in recent years, veterinarians' ability to diagnose and treat it have improved.

For example, the veterinarian may draw blood and run lab tests to check specific blood chemistry. This can indicate systemic compromise and also check specific organ parameters, all of which can indicate how compromised the horse is at that point and help make a decision as to how successful surgery may or may not be. In some cases, veterinary ultrasound may be used to get a better idea of what is happening internally.

Once the veterinarian has these results and discusses them with the horse owner, it's up to the owner to decide whether or not to send the horse to the clinic for colic surgery.

"You also need to think about the definition of 'successful' surgery. Is a live horse good enough or do you need the horse to be exactly the same as he was before the colic? This should be considered before surgery," Morrow gently adds.

This also brings up the old "cure" of taking colicky horse for a trailer ride so that the bumps and jarring of the trailer may help resolve the colic.

"Trailer rides are like hand walking," says Morrow. "If it is safe to put the horse in a trailer, I am in favor of it, but not if the horse wants to get down and roll. Some of the horses we see after a trailer ride are more comfortable, but this is probably due to time and the colic self resolving."

It's worth noting that if your horse is insured, you should be familiar with all policy requirements in case of colic before an incident occurs.

Recovery After Colic

There is no "one size fits all" time frame for a horse's recovery from colic.

"Recovery is dependent on the individual horse and his sensitivity to pain, any previous surgery he may have had, as well as the owner's awareness and management of the horse," Morrow notes.

With a medical colic, you should typically allow four times the length of the colic for the horse to return to normal. For example, if Morrow has a horse overnight in the clinic (not for surgery), he doesn't expect that horse to be his normal self until about four days.

"Recovery depends on the cause of the colic and its duration," he says. "Longer, more complicated cases are also more likely to relapse."

In the case of a surgical colic without complications, the horse may be back to eating normally in 72 hours, but he will need high quality, easily-digested feed, given in small, frequent meals.

Exercise can usually resume in about three months, but it can take up to six months for a horse to return to full work after colic surgery, and this is also dependent upon discipline.

"In the case of a complicated colic, the horse may always be on a special diet and may not go back to work," adds Morrow. 

Preventive Measures

The ability to properly assess your horse's vital signs cannot be underestimated, emphasizes Morrow. You should include your veterinarian in this process if you have any questions or need instruction.

During a regular exam or visit for vaccination, your veterinarian should be happily willing to show you how to use a stethoscope to check your horse's heart rate and gut sounds. (For example, each “lub-dub” sound is ONE heart beat, not two.) Then you can practice so you get familiar with your horse's "normal" over time.

"I teach all my clients how to give IV shots so they know how to do so in an emergency," says Morrow. "We veterinarians need to be educators. Nothing makes me happier as a veterinarian than when my clients know more about their horses after our interaction than they did before. I want them to leave with more knowledge than they came with.

"Any time we can promote the bond between owner and animal, and owner and vet, the horse will benefit," states Morrow.

Tip #1: Engage Your Veterinarian                                                                                                                                                                                                                                         It's important to maintain an ongoing relationship with a veterinarian so you're not "cold calling" when there's an emergency. Even if you only need him/her to come by once or twice a year for vaccinations and a basic exam, this is still helpful interaction, and gives the veterinarian a chance to see your horse under normal circumstances. If you don't feel comfortable asking questions or this person consistently acts too busy or disinterested in answering them, you may be using the wrong veterinarian. Just as with human doctors, we want not only a competent professional, but someone we feel comfortable around. It may just be a matter of switching vets in the same practice, or asking your local horse friends which veterinarians they use and trust.

Tip #2: Normal or Not?                                                                                                                                                                                                                                                        Do you know your horse's resting heart beat or how long it takes his respiration rate to return to normal after exercise? How about his normal temperature? If your answer is "no," it's going to be difficult to call your veterinarian and give any detailed feedback in an emergency, such as a colic. Learn what’s normal for your horse by taking his vital signs at home periodically in his regular environment. Because each horse is an individual, "normal" can vary slightly from horse to horse. The important thing is knowing what's normal for your horse! Post these normal numbers in a chart by the stall or in a readily accessible spot in the barn so you don't have to try to remember in case of an emergency.