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Q When does colic become serious?
:I have a question about colic. I always thought that it was imperative to keep a horse suffering from colic from lying down and rolling, But recently I’ve read that this is no longer considered important.
A horse I am leasing is apparently ‘prone’ to bouts of mild colic. Can you tell me what the reason for this is, is there anything I can do to prevent these bouts, and how best do I care for him when they happen? At what point does ‘mild’ colic become serious and require surgery?
Rumble, Taupo
A
:Colic is a term which is used to describe any abdominal pain or discomfort. In the horse there are a huge number of possible causes – some serious and life-threatening, some of only mild concern, and a lot somewhere in-between.
The pain may be caused by :
any stretching or inflammation of the gut or abdomen
any traction (or pull) on any structure in the abdomen
any area of compromised blood supply
So some causes are minor, like a mild impaction, a spasmodic or overactive gut, and some are serious, like a bowel twist or rupture, and intussusception (when the gut telescopes on itself).
Because there are a large number of possible causes, it is difficult to be too specific about your best plan of attack in home treatment before the vet arrives.
First of all, you must ensure the horse does not cause any harm to his handlers, or further harm to himself.
Generally, walking is considered helpful in a lot of mild cases, as it can help the horse relax, and also stimulate gut peristalsis, which may help alleviate any mild impaction.
A lot of colics are classified as spasmodic colics. These can be brought on by stress and anxiety, and can abate when the horse is encouraged to relax.
Prolonged colic is very exhausting for the horse, and it is understandable that he will want to rest.
I do not consider that resting with the occasional roll is harmful. However, when the horse is vigorously rolling and throwing himself around, he does run the risk of further damaging himself or his handlers.
There has been the belief that the horse must be walked continuously, and sometimes this is done to the point of exhaustion (horse and handlers!). This can be harmful to the horse, as it depletes his energy reserves which may be vital later if surgery does become necessary.
Possible causes for a recurrent colic that you may be able to help with include:
i. poor teeth – if he is unable or unwilling to chew his food properly this can cause impaction. So ensure his teeth are checked regularly.
ii. parasitism – worms are a common cause of colic through gut irritation and blood supply disruption. So parasite control is so important. This does not just mean regular worming – you need to ensure the pasture he is on is as free as possible from contamination. That is, all the herd needs to be wormed, the dung picked up, paddocks rested and rotated.
iii. feed issues – flatulent colic can be caused by too much easily fermentable green feed (new fresh grass). Poor quality grass and insufficient water consumption can lead to impaction. Make sure there is always a source of good clean water. Make sure any change in feed type or volume is done slowly over a week or so.
iv. Gastric ulcers – pain may be present soon after feeding.
Then there are numerous causes that are more difficult to help with, including:
i. a tumour
ii. an enterolith (a mass of accumulated material inside the gut – often forming around twine, plastic or something similar)
iii. Scar tissue and adhesions from previous surgery or damage.
If the colic is a surgical colic, then the decision needs to be made as soon as possible to give the horse the best chance of survival.
The decision is often not easy to make. Obviously, the last thing the horse or the owner needs is an operation to be done when it is not absolutely necessary.
The decision is made based on a number of factors, including the degree and duration of pain, and whether pain relief is effective, the heart rate – generally the higher this is, the more likely that surgery will be needed, and the colour of the membranes and the CRT (the capillary refill time). These give a good idea of the level of shock.
Other factors your vet will consider are the gut sounds, what is palpated during a rectal examination, and what is revealed with a ‘peritoneal tap’ - where a needle is introduced into the peritoneal cavity.
Q Preventing proud flesh
:My horse has a bad injury to his hind leg, sustained in a wire fence. He was on 24-hour box rest to start with, and it appears to be healing well.
The cut was deep (I could see the tendon and bone) but it appears the tendon has not been affected. We’re past the worst now (the wound was stitched) but I’m just after any suggestions on how best to keep caring for it, especially how to deal with proud flesh.
JL, Auckland
A
:Proud flesh is always a concern with deep and extensive limb injuries, particularly to the lower limb, where there is very little soft tissue between the skin and bone.
This is particularly the case below the knee and hock.
Wounds heal with granulation tissue forming to “fill the spaces” and to try and reattach skin edges.
Where there is excessive movement of the tissues, these attachments break down and more granulation tissue is formed. This process can repeat itself over and over, to the point where a large amount of granulation tissue (or proud flesh) is formed before the wound edges become stabilised.
The best way to prevent proud flesh forming is to minimise movement of the tissues while healing is taking place.
This is best achieved by:
having the wound sutured (not always possible)
Firmly bandaging to minimise any swelling and movement of tissue while healing takes place. This is essential to have any chance of your sutures holding
Confining your horse to minimise his movement
It does sound like you have done these things JL, so hopefully everything works out well.
Sutures are normally left in for about two weeks – longer sometimes for added security.
Support bandages should be kept on for at least 1-2 weeks after suture removal – the same goes for the confinement.
You are best to strictly follow your vet’s advice on these issues, as these wounds can be quite variable in severity and aftercare.
Often, however, the wound cannot be fully closed by suturing or the wound breaks down either partially or fully.
Then it needs to repair by secondary intention or granulation.
This is when proud flesh is most likely to form. If it does form, then the two options you have are:
i. to have it trimmed off. This normally gives the best result and is easily done as there are no nerves in the proud flesh. Trimming is done to as close as possible to skin level – this enables the skin to grow across the wound (epithelialization). It may be necessary to trim it back a number of times as it can be persistent. Note it is very vascular, so will bleed readily – this is easily controlled by bandaging.
ii. To apply a caustic substance that “eats away” at the excess tissue. The problem with this is that sometimes healthy tissue is damaged along with the proud flesh.This may delay healing. There is a huge range of products used for this purpose – including copper sulphate, potassium permanganate, bleach and so on.
Once the proud flesh is removed, it may be appropriate to use a cortisone cream. Cortisone can inhibit the further production of proud flesh without delaying epithelialization.
Q A career as a horse vet
:I am interested in being an equine vet. I know that I will have to go to Massey University to get a veterinary science degree, but I am wondering what I need to do in order to specialise in treating horses. How did you get started?
Logan, Wanganui
A
:I went to vet school with the intention of working with horses.
Back then, the five-year vet course did not allow for any option-taking at all.
Everyone, including those that knew they only wanted to see small animals and those that only wanted to see horses, all did exactly the same course.
Now, in the final year, students can choose an option. Whilst the majority of the year is still spent learning about all the species in general, students can choose a track and bias their study towards small animals, production animals, mixed animals, equine or others (as approved).
Then, basically, once you have graduated you have two options:
to do more study in the equine field. This would usually be done in conjunction with working in a veterinary university somewhere around the world.
to gain more experience by working in a veterinary practice that has a significant equine caseload. This is the path I followed.
