There are a number of things that can send shivers of fear running up and down a horse owner's spine. You walk out to the pasture and see your favorite mount standing there three-legged lame, blood dripping from a gaping wound in the leg being held aloft. Serious injury. You walk into the stable and there in that comfortable box stall is a horse rocking back on its rear legs, front legs extended. The horse is in obvious, severe pain. Laminitis. You walk into barn or pasture and there on the ground lies your horse, writhing in agony, its eyes glazed with pain, its coat dirty from rolling. Colic.
How the horse owner reacts in the above three situations can be critical to the animal's survival. In two of them, the action taken by the owner is pretty clear-cut. In the third, colic, there is a good deal more confusion.
The first step, of course, is obvious. Immediately call a veterinarian. What one does while waiting for the veterinarian to show up can be a little confusing when dealing with colic. That is not the case when dealing with serious injury or laminitis. In those two instances, one wants to keep the horse quiet and not moving. In the case of a bleeding injury, one should staunch the flow of blood.
But what about colic? Should you walk the horse until the veterinarian arrives? Should you put it into a corral and use a whip to keep it at a trot? What if it wants to lie down and roll? Should that be permitted (can't horses twist their gut if they roll?), or should the horse be kept on its feet?
Unfortunately for the horse owner, there are no clear-cut answers to most of these questions, only some guidelines. The reason for the confusion is that colic is not a single affliction. The word is used to describe abdominal pain in the horse. There can be many reasons for the pain and, until one knows the cause, it is difficult to decide what approach to take until the veterinarian arrives. (See the cover story on colic in the August 1999 issue of The Horse.)
The universal remedy in years gone by was that the horse should be walked until the pain went away. There have been countless incidents where horse owners have walked and walked and walked. Then, they walked some more, until both they and the afflicted horse were ready to drop from exhaustion. Yet, the horse still suffered from colic.
The reasoning was that if the horse kept moving, it would aid in peristalsis --the movement of food through the animal's digestive system. Researchers are no longer quite so sure that this is true; walking might not be providing a digestive assist.
When food fails to move through the horse's digestive system, impaction colic often is the result. The causes can be many and varied. To understand how and why impaction occurs, we must understand the horse's digestive system and its eating habits.
The horse was designed by nature to exist on forage. It is a grazing animal. If left to its own devices on open range, the horse will eat a little food many times per day. It will graze leisurely until its hunger needs are satisfied, then will perhaps take a long drink, followed by a doze in the sun for an hour or two before leisurely grazing some more.
By eating in such a manner, the horse allows its digestive system to move continually and process the food that has been consumed. The prime area for processing forage is the large intestine. The digestive process involves a form of fermentation where fibers are broken down, nutrients extracted, and waste moved along preparatory to excretion.
It is not the most efficient of processes when compared to ruminants, where digestion of forage takes place in a large compartment of the stomach known as the rumen. The rumen is like a large fermentation vat, while the large intestine is a huge tube that is looped around inside the abdominal cavity.
As long as the horse's digestive system proceeds in a normal manner, all is well. During the process, gas and liquids are produced and are moved along through the system. By pressing your ear against a horse's side or using a stethoscope, you can eavesdrop on this process. When all is routine and normal within the digestive system, there will be a gentle gurgling and rumbling from within.
Unfortunately, things are not always well within the equine digestive system. One of the problems that can occur involves a halting of the food movement process. This is impaction, and it might occur at one of the bends in the large intestine. As the term implies, impaction occurs when a mass of partially digested food blocks an area of the large intestine, making it impossible for the food being processed behind it to continue moving. The result usually is colic.
There are many causes of impaction, but rarely are grass and leafy green hay involved. Forages that would be more apt to cause impaction would be those of high fiber content, such as straw or corn stalks, which the large intestine would have difficulty breaking down. Certain ground feeds that are ingested without adequate water intake also have been implicated. Impaction can be the result of ingested sand as well.
When impaction occurs, there is a cessation of gut sounds. When you press your ear against the animal's side, there will be silence or near silence instead of the normal gurgling and rumbling.
As with so many equine maladies, prevention is far better and often easier to accomplish than effecting a cure. The owner should make certain the horse has plenty of the right kind of roughage in its dietï¿½either leafy green hay or grassï¿½and that it has constant access to water. It stands to reason that if a horse eats small amounts of food frequently, it also should be ingesting water frequently. Concentrates should be fed in small amounts frequently, rather than in a large quantity once per day.
When impaction is suspected, one should call a veterinarian immediately. While waiting for medical help to arrive, one should walk the impacted horse quietly. The activity should do no harm and might help to take the horse's mind off its discomfort.
The veterinarian might administer mineral oil or other substances in an effort to free the blockage, but it would not be something the layman should attempt. Normally such fluids are administered via a stomach tube inserted through the nose. This method would require professional help.
The horse's digestive process also can get totally out of synch when the animal gets into the grain bin and ingests far more of the potentially volatile food than its digestive system can accommodate. This is another of those situations that send shivers of fear up and down the spine. You walk out to the barn in the morning and notice that the horse's stall door is ajar. Then, with a sinking feeling, you find the horse at an open grain container and realize that the animal has perhaps eaten a week's supply or more.
The stage is set for a form of colic, if it hasn't already occurred. If it hasn't, the horse owner's first move should be to call the veterinarian and not wait for the first signs of colic. Overeating of grain also can result in laminitis, so early treatment is imperative.
Waiting for the veterinarian to arrive might be the time when walking would be advised in the hope that it would assist in keeping the digestive processes working. Besides, it gives one something to do other than just sit idly and stare at the horse while waiting for the veterinarian.
What should not be administered at this point is water. That will hasten fermentation and compound the problem.
Several things happen when a horse ingests too much grain. The digestive process in a horse produces substantial quantities of gas and fluid. When gas and fluid are produced more rapidly than the body can eliminate them, there is distention of the stomach or intestine. Distention causes severe pain. The most serious distention is that caused by gas.
Ingestion of large amounts of grain also leads to the release of toxins from dying bacteria, and these toxins can cause a number of complications, including founder and even death.
Prevention of this form of colic, of course, is far better than any treatment. Stall doors should contain latches that the horse can't open and all grain containers should have covers that can be securely fastened.
Perhaps the most common colic is spasmodic colic, which is due to muscular spasms of the intestinal tract. It is similar to simple indigestion in people. However, it can be very painful to the horse and can be brought on by over-excitement which causes the release of hormones that can interfere with the normal function of the digestive tract.
Another anecdote. At one time we had a nice grade mare we used for a pack animal. The only problem was that she would colic after being unloaded from a trailer in the wake of a trip to a mountain trailhead.
The first time it occurred, we had traveled only about 100 miles from our home in Wyoming to a trailhead in the Bridge-Teton National Forest. It was to be a new experience. We arrived at the trailhead in the evening. There were a clear sky and a full moon, so we decided to ride to our first campsite, only a few hours' ride away, by moonlight.
The young mare stepped off the trailer and almost instantly cramped up. Colic. She didn't seem to be impacted, so we assumed it was a case of spasmodic colic. We walked her around a bit, but the pain seemed to get worse rather than lessen. We had some Banamine in our first-aid kit and administered it intravenously.
This procedure would not be recommended if you are at home waiting for the veterinarian to arrive. First, of all, he or she might decide it was not the appropriate drug under the circumstances and, second, it could mask symptoms and make it more difficult for the veterinarian to arrive at a correct diagnosis.
However, colic usually does not strike under the best of circumstances, and when that is the case, the horse owner must make use of options that are available.
In our case, the Banamine did the trick. The mare soon was standing quietly and shortly thereafter was cropping grass. By then, however, the moonlight ride didn't seem like such a good idea. What if the mare became ill again when the effects of the pain killer wore off? We were many miles from veterinary help as it was. We didn't want to compound the problem by riding into the wilderness. We camped overnight at the trailhead. The mare was fine the next morning and throughout the trip.
Unfortunately, the next time we hauled her, the same thing happened. Again, Banamine solved the problem, but by that time, we were worried that we were dealing with a chronic situation. At present the mare makes her home with folks who don't require that she travel.
One of the most insidious forms of colic is the twisted intestine. As already mentioned, this is a form of colic where no amount of walking will help. The only remedy is surgery, and even that must be performed quickly if the horse is to survive.
Although there has been a great deal of research on the subject, no one is quite sure exactly what causes a twist. For years, horse owners thought that it resulted from a horse's rolling on its back. Researchers have found that this is hardly ever the cause. Many horse owners have whipped their horses to their feet during bouts of colic, fearing that rolling will result in a twist. Research has shown that if a twist is involved, it usually has occurred before the horse ever lies down and rolls.
Nature didn't seem to do the horse any favors in designing the large intestine, which is actually a gigantic tube. In order to fit into the horse's abdomen, the large tube is folded into several sharp bends where food can become impacted and where the intestine can get out of place or twist.
One twist that is commonly encountered is known as large colon volvulus (LCV). It can be treated surgically. This was the subject of a report presented at the 1996 American Association of Equine Practitioners meeting by Rolf M. Embertson, DVM, Dipl. ACVS, of Rood and Riddle Equine Hospital in Kentucky.
Perhaps the point driven home most emphatically by Embertson was that early detection of the condition and immediate surgery are key in determining whether the horse will survive. In other words, if the condition occurred and the owner persisted in walking the horse for hours on end before seeking help, the outcome of surgical treatment would be severely compromised.
Embertson told his audience that medical records of horses requiring colic surgery at Rood and Riddle Equine Hospital from March of 1986 through February of 1995 were reviewed, and those of horses with LCV were closely examined. During that time frame, he said, 897 colic surgeries were performed on 828 horses. Seventy-one percent of these horses survived and were discharged. Broodmares comprised 79% of the total case load of surgical colics. (Broodmares are a large portion of the horse population in the area.)
Of the total number of colic surgeries performed, 238 surgeries on 204 horses were performed to correct large colon volvulus.
Embertson had this to say in his report:
"Eighty-three percent of horses requiring one surgery for LCV were discharged from our hospital. Eighty percent (28 of 35) horses with LCV that had an additional surgery for LCV or right dorsal displacement of the large colon survived the second surgery. One hundred percent (two of two horses) with LCV that had a third surgery survived the third surgery.
"The mean duration of illness before presentation was 4.2 hours for survivors and 6.2 hours for non-survivors. The volvulus (twist) was 360 degrees in 68% of the LCV patients, comprising 68% of both the survivor and non-survivor groups. The volvulus occurred most commonly at the base of the cecum when recorded, and 97% occurred in a counterclockwise direction as viewed from the ventrum."
When one studies the above figures, it becomes readily apparent that there is a narrow window of opportunity if a successful surgery is to be performed.
Embertson had this to say in conclusion:
"The shorter duration of clinical signs prior to surgery and an improved survival rate found in this study strongly support the necessity for immediate surgical intervention for LCV."
When foals are involved and surgery is necessary for colic, the prognosis becomes more guarded. Presenting a report at the same conference on the subject of colic surgeries on foals was N.J. Vatistas, BVSc, University of California, Davis. Vatistas reported on a study that involved 67 foals which underwent abdominal surgery for colic at the Davis veterinary hospital. The surgeries occurred between the years 1980 and 1992.
Overall, of the 67 foals in the study, 29 survived longer than two years. Thirty-two were euthanized or died, and six were lost to follow-up.
"Only 19% of the foals with strangulating intestinal lesions survived, in contrast to 69% with non-strangulating intestinal lesions," Vatistas reported. "In addition, younger foals appeared to have a poorer prognosis for survival than older foals."
Another study reported at that conference also indicated that older horses have a good chance for survival if the surgery is performed early. Presenting this report was Suzann A. Carson-Dunkerley, DVM, of the Auburn University College of Veterinary Medicine.
Examined in the study were the medical records from 104 horses of 17 years of age or more which were treated at the veterinary hospital for acute abdominal disease from December 1990 through February 1996.
Breed representation was as follows: 31 Quarter Horses, 19 Thoroughbreds, 17 Arabians, eight Tennessee Walking Horses, seven gaited horses, six ponies, five warmblood mixed-breed horses, four draft horses, three Morgans, and four of other breeds.
Carson-Dunkerley had this to say about treatment and its outcome:
"Fourteen of the horses were euthanized after examination without further therapy at the owner's request. In seven cases, the owner's presenting complaint of colic was not related to gastrointestinal pain. Diagnoses (for those cases) included thoracic neoplasia in two horses and one of each with liver disease, pharyngeal disease, choke, ruptured spleen, and uterine artery rupture.
"Surgery was performed on 32 horses. Eleven of these horses were euthanized during surgery because of necrotic or ruptured bowel. Twenty-one horses recovered from anesthesia. Of those recovered, 16 were discharged from the hospital. Of all 32 horses taken to surgery, including those euthanized on the table, 16 were discharged from the hospital."
So, Walk Or Not?
What the above studies tell us is that when colic surgery is required, there is a good chance for a successful outcome with mature horses if the animal is presented for surgery when the affliction is in its early stages. Thus, we come back to the point that getting a veterinarian on the scene early is imperative. A matter of only a couple of hours can be of utmost importance if surgery is required.
In other words, if the horse requires surgery and we insist on walking it for several hours before calling for medical help, we might literally be walking the horse to death.
When considering the question of whether to walk the horse or not to walk it, we might make the comparison with a person who has severe abdominal cramps. The last thing that person would want to do would be to walk about. Instead, he or she would try to find a bed to lie on and to assume a position that provides some degree of comfort.
In essence that is what the colicky horse is attempting. It is seeking a position where the pain is alleviated and there is a degree of comfort. What this means in practical terms is that if the horse with colic is lying quietly, whether on its side or sternally, it is best to let it be.
We must remember that some colics are of long duration with debilitating pain. This means that the horse will need all the strength and stamina at its disposal to fight its way through the affliction. Walking it endlessly can tire the horse and sap its energy.
On the other hand, if the horse is rolling about violently, that action might sap its energy even more than walking. Getting it on its feet and moving might actually result in conserving energy. In addition, when the horse is rolling, there always is the danger that it could injure itself by getting a leg caught in a fence or under a stall door.
Once the horse is on its feet and walking, there is no need for speed. Sending the horse careening around the arena or corral at a run doesn't help anything. It merely uses up the animal's energy more quickly. Walking the horse slowly and quietly is far better than forcing it to move at speed.
Dwight D. Bennett, DVM, Colorado State University, who has authored papers on colic, had this to say in one of his papers:
"Despite what has been passed down through the years, it is acceptable for a colicky horse to lie down. Furthermore, it is considered unlikely that the horse will twist the intestines by rolling. In fact, lying quietly may be good for a colicky horse, because the more energy he uses in kicking, pawing, and rolling, the more rapidly he may go into shock, which is a common cause of death in colicky horses. If the horse rolls violently, he should be walked very slowly. Do not beat the horse to keep him on his feet or keep him moving."
Earlier we mentioned that surgery often is successful in certain types of twists and displacements if the horse is presented for the operation during the early stages of the affliction. Unfortunately, there is another element involved.
Colic surgery is quite expensive because it is major surgery. The horse owner must often make an agonizing decision between surgery and euthanasia, with financial resources being part of the consideration.
So, this discussion concerning whether to walk the colicky horse has come full circle. There is no single, simple answer. It all depends on the circumstances. The only clear-cut conclusion is that veterinary help should immediately be sought when colic occurs or when an onset, because of undue grain ingestion, is believed to be imminent.
About the Author
Les Sellnow is a free-lance writer based near Riverton, Wyo. He specializes in articles on equine research, and operates a ranch where he raises horses and livestock. He has authored several fiction and non-fiction books, including Understanding Equine Lameness and Understanding The Young Horse, published by Eclipse Press and available at www.exclusivelyequine.com or by calling 800/582-5604.
POLL: Colic Surgery