Signs of colic are most commonly caused by problems in the gastrointestinal tract, and most frequently involve a form of obstruction. A successful outcome will depend on early diagnosis, the type of colic and rapid referral to the hospital. Our specialist surgeons carry out around 150 colic surgeries per annum, and we see many more non-surgical ‘medical colics’ in addition. Our medicine and surgical teams are available 24 hours a day, 365 days a year. With access to high quality ultrasound imaging, medical expertise and our in-house diagnostic laboratory, management decisions can often be established quickly.
It is important that all horses exhibiting signs of abdominal pain should be examined by a veterinary surgeon as a matter of urgency to allow a prompt diagnosis as some patients deteriorate rapidly. While the majority of colic cases can be treated with pain relief and other medication, some will require referral for more intensive treatment or emergency surgery.
Emergency Colic surgery
For cases requiring surgery, the surgical approach to the abdomen is almost always via a ventral midline incision (underside of the abdomen), and has to be performed under a general anaesthetic with the horse on their backs. All cases are given intravenous fluids, antibiotics, non-steroidal anti-inflammatory drugs and, often, intestinal stimulants. At surgery a variety of problems may be encountered, including ‘twists’, entrapment of intestines, intussusceptions (‘telescoping’ of one length of intestine into another), displacements, physical obstruction (impacted material or masses, such as tumours), or functional obstruction (e.g. in ‘grass sickness’ cases).
Most of these are amenable to correction, although some require removal of diseased intestine and joining ends of healthy intestine together.
Post-surgery intensive care
After surgery, the patients are allowed to recover from anaesthesia and then moved to a heated intensive care box where around the clock monitoring and intensive support is administered by our clinicians and nursing team. Most patients are not fed until normal intestinal function has returned (usually within 48 hours), although a small handful of grass often acts as an appetite stimulator and trigger to intestinal motility. It is necessary to encourage motility by medication, exercise, gastric decompression (passing a stomach tube to remove any fluid build up) and by controlling electrolyte levels, assessed by post-operative blood samples. Post-operative intestinal paralysis (ileus) is relatively common and our team are proactive in tackling this whenever it occurs.
Laparoscopic (keyhole) investigation of the abdomen can carried out using local anaesthesia and sedation. This can be useful for investigation of horses which suffer chronic and recurrent bouts of colic, as it allows inspection of a significant part of the abdomen without the need for a midline incision and full ‘colic surgery’ under general anaesthesia.
To refer a colic case, please contact the hospital on 01638 577754, or out of hours call the duty veterinary surgeon on 01638 663150.