Although many colic cases are mild in nature, others can imperil your horse’s life and career and can require surgery. Today, because of advancements and innovations in the diagnosis and treatment of colic, the chances of survival and return to normal activity following colic surgery have never been better.
Colic signs should always be taken seriously, and although early symptomatic treatment will resolve many mild cases, if a horse fails to respond, it should be considered an emergency. The biggest controllable determinant for a successful surgical outcome is minimizing the duration of clinical signs before surgical intervention. Early correction of twisted intestines can obviate the need for costly resections (removal of sections of intestines). In addition, timely intervention can limit the collateral damage to the intestine, which can lead to serious disruptions in propulsive motility requiring lengthy hospital stays, increased cost and complications such as adhesions.
We are much better today at utilizing ultrasound and hematologic parameters to identify the cause and severity of the crisis, which enables us to give a good estimate of cost, and expected recovery before going to surgery. Innovations involving stapling equipment, intestinal viability assessment and bypass procedures offer more intra-operative options and surgical efficiency, decreasing surgical time and improving prognosis. With careful attention to post-operative pain management, control of inflammation, antibiotics, nutrition and exceptional nursing care, we not only improve patient comfort, but also reduce devastating complications such as infection, diarrhea and laminitis. In addition, protection of the surgical incision with a belly bandage has reduced the likelihood of incisional complications and hernias, which have delayed the return to exercise in the past.
Clearly, there is a need for rapid correction of surgical conditions, and postoperative care plays a significant role in successful outcomes. However, what about horses with colic that do not need colic surgery? How do they benefit from emergency and critical medical care?
Whenever possible, if your horse is not responsive to medical therapy administered on the farm, referral to a hospital should occur without delay. Immediate evaluation of your horse, including ultrasound examination and comprehensive laboratory testing of blood and abdominal fluid (available 24/7 in a hospital), can help determine the likely cause of the colic and the most appropriate therapy.
Common causes of medical colic include; gas distension or impaction of the large intestine, impending diarrhea (colitis), small intestinal inflammation (enteritis), and gastric ulceration. Other diseases that may present clinical signs mimicking colic are also important to recognize and may include myositis (tying-up), liver or urinary tract disease, and some neurological diseases. Because different diseases require different treatments, access to comprehensive diagnostic capabilities found in a 24/7 hospital benefit the equine patient tremendously. Fluid therapy to correct dehydration and electrolyte abnormalities, antibiotic therapy if infection is suspected, anti-inflammatory therapy, and pain management are mainstay treatments. When indicated, prokinetic medications to promote gastrointestinal motility and measures to reduce the risk of laminitis and other potential complications are employed. Other medical conditions that resemble colic, but require different therapies, can be identified and treated accordingly.
Critically ill horses benefit from a rapid and accurate diagnosis and specific treatment of the underlying disease. Colic has long been a dreaded condition that strikes fear in horse owners. Today, with innovations in diagnosis and advancements in surgical procedures, in concert with the critical supportive care component, the potential for a successful outcome following colic surgery is greatly enhanced.
- Norris Adams, DVM Diplomate ACVS, Diplomate ACVSMR
Clinical Assistant Professor of Equine Surgery
Krista Estell, DVM, Diplomate ACVIM
Clinical Assistant Professor of Equine Medicine