Week 6 of HITS Thermal started off with a bang!
We were up four nights in a row with colic after colic after colic. Four horses were referred to the surgical facility two hours from Thermal, and the rest were managed medically at the show grounds, including one horrendous impaction that was lucky to survive (referral was not an option).
Saturday morning I did get to see a gorgeous sunrise at the show grounds, after pulling my last all-nighter.
It can be so pretty out here.
Since we have seen about 10 colics in the last week, my PSA for you today is about colicking horses at the show grounds.
Horse Show Colics: the Good, the Bad, and the Ugly
When a veterinarian, rider, trainer, or other equine observer says that a horse is “colicking”, this simply refers to a horse showing signs of abdominal pain. Most colics fit into five main categories:
Impactions can occur anywhere in the GI tract from the stomach to the small colon. The most common type of impactions we see at horse shows are large colon impactions. We also occasionally see gastric, ileal, pelvic flexure, cecal, and small colon impactions. Most of these cases are only mildly to moderately painful and can be managed medically with a combination of oral and IV fluids, and Banamine. Some impactions are firm enough that the horse may require sedation or additional pain management to stay comfortable, and a few may require surgery if their pain is unmanageable or they are in danger of rupturing.
Strangulating lesions can involve any area of the GI tract from the small intestine to the large colon. There are different types of strangulating lesions as well, with the word “strangulating” indicating a decrease or total absence of circulation to the affected part of the GI tract. Strangulations are some of the most painful and violent types of colics we see on the show grounds. The most common types of strangulating lesions we see in show horses are small intestinal volvulus or strangulating lipomas, with lipomas being more common in older horses. Other types of strangulations include large colon torsion or volvulus, epiploic foramen entrapment, and mesenteric rent entrapment. Almost all strangulating lesions require surgical correction within 4 to 6 hours for the best prognosis, after that time period the horse may become shocky (if it isn’t already) and the affected portion of the GI tract is likely to be too devitalized to be salvaged. Resections of devitalized tissue significantly negatively impact the prognosis post-surgery.
Gas and/or spasmodic colics are quite common out at the show grounds. Most of these horses are mildly to moderately painful, and are simply managed with oral and/or IV fluids, Banamine and Buscopan. Some diarrhea cases can also be included in this category as well, since these horses often have fairly severe spasming along with the passage of liquid manure.
Sand colics are relatively uncommon back home in Kentucky, but tend to be fairly common here in California. Most sand colics are mild, with only the occasional one requiring surgery. These horses are usually treated with fluids (notice a theme here?), Banamine, and psyllium, a soluble fiber that helps to force the sand out of the colon.
Other common colics in show horses include displacements, gastric ulcers, and non-GI related abdominal pain, such as testicular torsions. The most common displacement we see are nephrosplenic entrapments, where the horse’s colon displaces to the left side of their abdomen and becomes trapped between the spleen and the left kidney. These cases can usually be medically managed with fluids, banamine, and phenylephrine, a drug which helps to shrink the spleen and allow the colon to slide back into place. After administering the phenylephrine, the horse is jogged for about 20 minutes to try to shake the colon loose from it’s displaced position. Gastric ulcers are a huge problem in show horses due to the constant chronic stresses placed upon them. Although gastric endoscopy is the only way to definitively diagnose gastric ulcers, most horses will compete on GastroGard as needed for their comfort without ever having an endoscopic exam. The final type of colic we’ll discuss is in show stallions, testicular torsion. While not related to the GI tract, testicular torsions are extremely painful and may initially appear as a severe colic. These horses require immediate surgical intervention to preserve their chance of reproducing in the future.
So, why did we go through all of these types of colic? Because now you understand the treatments required in most of these cases. At a horse show, we are severely limited as to what treatments we are allowed to do that will still allow the horse to compete. Most horses that we see are already being given Banamine or Bute (phenylbutazone) as part of their daily regimen. I prefer using Banamine for colics, because in my experience it works better for treating soft tissue pain. If the horse has already been given Bute and I give it Banamine, under USEF rules the horse is not allowed to show for three days. In the majority of cases I see, the ability of the horse to continue to show is the top priority. In these cases I give the horse Bute for its pain, even though I don’t think it works quite as well.
We’re also not equipped to deal with surgical colics when we’re at horse shows. At HITS Thermal, we are 2.5 hours from the nearest surgical facility, which means we don’t have very much time to get a horse on the table for surgery if it has a strangulating lesion. This makes me quick to refer painful cases, since I want to give the horses the best chance at a favorable outcome. I always end up having horses who make the trip and probably would have been fine staying at the show grounds, but I still think they are always better off safe than sorry.
If you’ve hung in there with me for this much, I really appreciate it. The final, and most important topic on horse show colics is prevention. How do you keep your gorgeous, expensive show horse from colicking at competitions? Here are my biggest rules:
- DO NOT change anything at a horse show. Don’t buy new hay at the show, bring your own hay from home that your horse is used to eating. Don’t add in new supplements or change their dose (unless prescribed by your veterinarian) that might put him off his feed or upset his stomach. Please do continue to offer plenty of fresh, clean water, since the number one problem we see with colicking show horses is dehydration.
- PAY ATTENTION. Maybe your horse isn’t quite cleaning up his feed like he usually does, or you think he hasn’t passed as much manure as normal. Are his gums a little tacky? Is he drinking fewer buckets of water than usual? If so, call the vet and have him checked out. The worst impaction we’ve seen was in a horse who continued to show even though he hadn’t eaten for two days. He pulled through, but I would have given the horse 50/50 odds at best.
- GastroGard. I honestly believe GastroGard is worth its weight in gold. I know it’s expensive, but it is a fantastic product and a full course (28 days) will cure ulcers. I have seen several horses with minor colics that have ended up being from painful gastric ulcers, and to be honest your horse isn’t going to show as well if his tummy hurts as he will if he feels good. Many show horses benefit from being on a maintenance (1/4 tube) dose of GastroGard throughout the year, or at the very least during the show season.
Has your horse ever colicked at a horse show? Do you think there are things you could have done differently to prevent the colic in the first place? Feel free to share your experiences in the comments section.