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Colic—a general term for pain or discomfort in the equine abdomen—is one of the most common health problems for horses, even those that are very carefully managed. It’s also a leading cause of equine fatalities. It can strike any horse at any time, so all horse owners should be aware of the chief causes, preventive management steps, and most effective treatments for colic.

Fortunately, many colic cases resolve fairly quickly, with or without complicated treatment. Colic caused by gas or impaction can result in severe pain, but treatment is fairly straightforward and the horse usually feels better within a few hours. A veterinarian can examine the horse and administer medications or other treatments to ease the horse’s discomfort and anxiety. If the pain does not reappear when the medications wear off, the horse is usually in the clear. In these cases, owners can get instructions from the veterinarian as to how soon the horse can be allowed to resume eating hay and grain.

However, in other colic cases the cause is something that can’t be easily fixed and surgery is the only way to treat the condition. Examples are an intestine that is twisted so tightly that circulation has been cut off; entrapment of the displaced gastrointestinal tract by another organ; or rupture of some part of the tract, among others.

Colic surgery is costly, running into the thousands of dollars for routine procedures and tens of thousands or more if the horse’s condition is not straightforward or recovery is prolonged. Many colic surgeries go well and the horse makes an uneventful recovery, leaving the clinic in a few days and spending a month or so at stall restbefore slowly resuming limited grazing and hand-walking.

In some other cases, the horse dies or has to be euthanized within a few days because of complications. A common problem after abdominal surgery in horses is ileus, a condition in which the gut doesn’t regain motility, so ingested hay and feed won’t move through the tract. If measures to resolve this problem aren’t effective, the horse can’t survive.

What can horse owners do to be ready for a colic situation?

Before you have a colic incident, decide whether or not you would authorize colic surgery on each of your horses, understanding that in some cases, the only alternative will be to euthanize the animal. Base this decision on the horse’s monetary and emotional value, its other health conditions and age, and your financial status. Don’t wait until the colic occurs; make the decision for each horse at a time when you can consider it rationally. This is not the same as second-guessing the vet who may be recommending surgery for the colicking horse; it’s simply deciding whether you will choose surgery or euthanasia for a particular horse if the situation should necessitate that choice.

When a horse shows signs of colic, call your veterinarian. This person is the only one who can say for sure what’s causing the colic, what the best treatment is, and whether the horse is likely to need surgery. Waiting to see if the horse gets better on its own is risky; what seems at first like a mild case can sometimes quickly progress to the point where pain is extreme and no treatment can save the horse’s life.

After the horse has been treated, whether or not the treatment involved surgery, follow the veterinarian’s instructions for care and management. Review possible causes of the colic episode and take steps to change the horse’s care and feeding to prevent the problem from recurring.

For any horse, even one that may initially appear to need surgery, colic can often be resolved with medical therapy. Sending your horse to a referral practice ensures that the horse is in the best possible location to save its life if the colic continues to worsen. Waiting too long to send a horse often results in a horse that is down or unable to be transported easily, deterioration of the horse’s condition, or death. The intravenous fluids, analgesics, and continuous intensive care that a horse receives at a hospital give the horse its best chances and allow owners to have improved peace of mind.

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