What to expect during a Colic

Question: If your horse gets on the ground and begins to roll, shouldn't you try to get them back up on their feet and keep them walking? Also, is there medicine that each barn should have on hand in case a horse colics?

Answer: This is an excellent question. If your horse is rolling, it’s best to try to get him up and keep him walking. With that being said though, if your horse is violently colicking, rolling, throwing itself against the stall wall, and any other sort of self-destructive behavior in an effort to relieve its pain, you should stay away to avoid getting hurt. Those situations are not common, but they do happen and it is best to wait until a veterinarian is on site with strong sedation to avoid anyone being seriously hurt. Bute (phenylbutazone) or Banamine (Flunixin Meglumine) are two non-steroidal anti-inflammatory medications that work similarly and most barns or horse owners will have them in their emergency kit for situations such as this. It is wise to contact your veterinarian about your horse’s colic BEFORE you give ANY medication as it may affect the examination.

Question: I have been told that many horses suffering from colic also suffer from an elevated blood glucose level, which can worsen the condition and chances of a quick recovery. If a horse is showing signs of colic, do you think it makes sense to test the blood glucose? Are there any other blood tests worth carrying out?

Answer: While it is true that horses may have an elevation in their blood glucose, this is a RESULT of the colic and not a CAUSE for the colic. Glucose (or “blood sugar”) is made and released by the liver and is necessary for the normal function of all cells in the body. When a horse colics, the stress of the colic causes the release of glucose by the liver to increase, making the level of glucose in the blood increase. It has no effect on severity of the colic. With that being said, serum chemistry profiles are routinely done on horses with vague or chronic colic signs at our hospital. Since colic is a general term for pain in the abdomen, it doesn’t necessarily need to occur because of a dysfunction of the gastrointestinal tract. Colic can be caused by kidney or liver problems, bladder stones, cancer within any abdominal organ, or a generalized infection of the abdominal cavity (peritonitis). And while blood glucose levels may not be very diagnostic in this situation, a blood test to evaluate function of the abdominal organs can certainly have diagnostic value.

Question: How do gastric ulcers contribute to colic and how does feeding a twice daily dose of ranitidine help?

Answer: While we’ve always recognized the fact that gastric ulcers can certainly cause a horse abdominal discomfort, what we’ve recently discovered is that ulcers are more prevalent than originally thought. What a horse does for a living (racing, showing, broodmare, etc.) can have an influence on the presence and severity of ulcers. Studies have shown that up to 94 percent of Thoroughbred horses in active race training and over 50 percent of show horses have some degree of ulceration. So why do horses get ulcers? There are many different factors that go into the equation, but they can include level of stress, alterations in the amount and acidity of acid produced by the stomach, alterations in natural protective barriers and some medications. Stomach ulcers in horses, termed Equine Gastric Ulcer Syndrome (EGUS), are scored according to their severity. A Grade 0 means that there is no ulceration present. The most severe grade is a Grade 4 and occurs when the ulcer is very deep. In rare instances, the ulcer will perforate (or rupture through) the stomach causing peritonitis (an infection of the abdomen) and can lead to death. Ulcers that have a higher grade and those located in certain areas of the stomach can cause colic. There is no way of knowing if colic is a result of a stomach ulcer without visualizing the stomach with an endoscope. This procedure is performed under sedation and a long flexible camera is passed up the horse’s nasal passage, down the esophagus and into the stomach. After determining that your horse has ulcers, there are many different treatments available. Most medications for ulcers have an effect on the amount and/or the pH of the acid produced by the stomach through different mechanisms.

This question asks about Ranitidine specifically. Ranitidine (Zantac in human medicine) is in a class of drugs that act to decrease the amount of acid produced by the stomach and increase the acidity of the acid that is present to allow the ulcer to heal. While Ranitidine is used most commonly in foals, it has been shown in certain studies to be effective in adult horses as well. In adults, the number of tablets that need to be used per dose and the variability in how it is absorbed, as well as the availability of other products that have a more consistent efficacy (Omeprazole or Gastrogard), make Ranitidine a less popular choice for treatment.

Reprinted with permission from AAEP. To view the entire article please visit www.aaep.org/ask_the_vet.php