Colic

Colic is a symptom, not a disease.    The trick is figuring out which disease is causing the symptoms


Colic means abdominal pain.  That's all.  Abdominal pain is only a symptom, not a disease.  We all have had colic at one time or another.

The Signs     Horses with colic, or abdominal pain, show their discomfort in several ways.  Rolling, lying down, stamping, urinating frequently, not eating, tail wringing, and looking repeatedly at their flanks are all signs of colic.  Horses with colic are introverted, do not interact with people, do not look around at things in the environment, and may even have a painful expression.  They do not eat or drink, and they may or may not pass stool and/or gas.

If Colic is a Symptom, What is the Disease?    Diseases cause symptoms.  If colic is a symptom, what then is the disease?  The faint of heart will want to quit reading here, because what follows is neither short nor simple.  The answer is that there are hundreds of diseases that cause colic.

It is useful to spend a few minutes and think about abdominal pain in the species we all know the best, humans.  How many different causes of abdominal pain are there in people?  A list would look something like this:
upset stomach                                       pancreatitis                                       stomach cancer

gas cramps                                             gall stones                                          peritonitis

food poisioning                                     appendicitis                                       ovarian cycts

ulcers                                                      diverticulitis                                       kidney stones

Intestinal twists                                    splenic abcess                                    intestinal obstruction

and the list goes on.  All of these conditions cause colic, or abdominal pain,  in humans.  Some are serious and life-threatening, some not so serious.  There is a similar list for horses.   The point here is that many different diseases cause the symptom of colic.  Our goal is to identify the disease that is causing the symptom.
We start with a physical exam.  We measure heart rate, observe the color and texture of their mucous membranes, measure their capillary refill time, evaluate their hydration, listen to their GI sounds, take their temperature, percuss their abdomen, look at their stool, quantitize thier level of pain, listen to their heart, pass a nasogastric tube, perform rectal palpation, and sometimes we tap their abdomen.  Occasionally we do bloodwork.  All these parameters are considered together, and we make a working diagnosis.

To make a working diagnosis, we divide all the possible causes of colic pain into two groups, the obviously non-life-threatening diseases, and the obviously life-threatening diseases.  Sometimes we can't tell for sure, and so we make a third category called treat and observe.

Non-Life-Threatening Causes of Colic     In the non-life-threatening group, we find things like gas cramps, indigestion, and impactions.  These horse typically have mild to moderate pain, generally good vital signs, and hyperactive GI sounds.  They respond well to medication.

Obviously Life-Threatening Causes of Colic     In this group we find diseases like intestinal obstruction, intestinal twists, severe colitis, ruptured impactions, and advanced intestinal displacements.  These horses have severe, unrelenting pain, deteriorating vital signs, and no GI sounds.  They need surgery or to be put to sleep.

Treat and Observe    In this category we find survivable diseases like especially painful gas cramps as well as the life-threateniong diseases in their early stages.  These horses have signs that overlap, and do not give a clear indication as to the severity of the condition.  Here, we start medical treatment and observe closely for improvement or worsening.

Treatment for Colic        Just as there are different treatments for the different diseases that cause colic in humans, for instance gas cramps, gall stones, and appendicitis, so are there different treatments for the various diseases that cause colic in horses.  The treatment used on your horse will depend on the disease.  Treatment options include any of several different pain-killers, anti-spasmodics, mineral oil infusions, intravenous fluids, and occasionally antibiotics.

Some Horses with Colic Need Surgery       The surgery is exploratory surgery, where although we don't know for sure what the exact problem is, we have narrowed it down to a life-threatening problem that will take surgical treatment.  Colic surgery is something that is best done in referral centers, where they have excellent facilities and a trained surgical team lead by an experienced surgeon who does colic surgeries every week.

Colic surgeries can cost from $2,000 up to $10,000, depending on the nature and severity of the condition.  Survival rates vary, again depending on the nature and severity of the condition.  If I suspect that your horse has a condition that may require surgery, I will bring the possibility up early on.  It is important to know whether surgery is an option, because if it is we will do things differently than if surgery is not an option.

Most Horses with Colic recover with appropriate treatment.  It is my experience locally that probably 80% of the colicy horses that I see have non-surgical conditions.  However, each case is different, and I feel that it is important to evaluate each and every case.  Although many practitioners will prescribe medications over the phone or over the counter without even examining the patient, I will not.  I don't think that it is in the best interests of the horse or the owner to do things this way.