Recent Colic…Now What?
By David Robertson, DVM - Information updated Sept 2022
Your horse has just been treated for COLIC by your veterinarian. Now what?
Oh, and in case you’re not exactly sure, “colic” just means abdominal pain from any reason.
After examining your horse for an episode of colic, your veterinarian may have performed one or more of the following common treatments: 1. Gave Banamine (pain control), 2. Gave sedation / opioids (for pain and relaxation), 3. Performed nasogastric intubation (NG tubed) with water, mineral oil, and/or electrolytes (to hydrate and help break up an impaction), and/or 4. Gave Buscopan (smooth muscle relaxer). Your vet may also have performed a rectal exam to help determine what is going on in the horse’s intestines. A rectal exam is mainly diagnostic, not therapeutic.
Here are some key points to remember:
1. Remember the 2 “Ps:” Poop and Pain. We want the first, not the second. You should clean your horse’s area so you will know if your horse passes manure. You may need to hang a sign on your horse’s area to let others know NOT TO FEED and NOT TO CLEAN the area. If your horse becomes painful again, CONTACT YOUR VET RIGHT AWAY!
2. Most of the time, you will want to withhold food for at least one, possibly more feedings. If your horse did not finish one or more of his feedings before you noticed him colicing, he may not produce as much manure as he normally would. Therefore, sometimes it is difficult to tell if the colic has resolved by looking for manure production alone.
3. After any sedation wears off, it’s OK to walk your horse for a while (10-30 minutes), but don’t walk your horse to exertion.
4. If your horse looks hungry, but has not yet passed manure, and is not painful, you can give some water mixed with either bran, hay pellets, senior feed, etc. to increase fluid intake. The idea is to give flavored water to encourage your horse to drink.
Here is more detailed information:
5. Your horse will feel immediately better if given sedation and/or opioids. This kind of treatment usually works fast (1 to 2 minutes) and lasts 5-30 minutes depending on the dose received. During this time your vet may have examined your horse rectally and performed NG tubing (to give water, etc.). If your horse gets painful after the vet has left, especially if given a sedative / opioid, CONTACT YOUR VET RIGHT AWAY. Your horse will most likely need to go to the hospital for further treatment.
6. Banamine takes a while to work to control pain (even if given IV). The oral type of banamine works just as good as the IV type but may not work as fast. Your horse should start feeling better from banamine anywhere from 45 to 90 minutes after it was given. If your horse feels better sooner than 30 minutes, it is most likely not from the banamine, but probably only from the sedative / opioid he received. Banamine gives 6-7 hours of strong pain control, and 8-12 hours of mild-moderate pain control. Banamine will relieve abdominal pain, which can help your horse to relax. Once relaxed, your horse’s intestines may start to move and produce manure again. If your horse becomes painful after the banamine has become effective, especially within the first 6 hours, you need to CONTACT YOUR VET RIGHT AWAY. Your horse is “breaking through” banamine’s strong pain control and will most likely need to go to the hospital for further treatment.
7. NG tubing (nasogastric intubation) is passing a tube through your horse’s nose into the stomach. This procedure helps your horse get rid of any unwanted liquid in the stomach that may be causing pain, and also adds water plus some other ingredients to your horse’s digestive tract to help hydrate your horse and to help relieve any areas of constipation (impaction). The movement of an impaction in the digestive tract may take from several hours to several days, depending on where the impaction is located. Hard, dry manure is the most common type of impaction, but enteroliths (stones), trichobezoar (hair), pellets, and other items may become impacted in any part of your horse’s digestive tract. Sometimes, when an impaction starts to move, your horse may become painful again. If no movement occurs (no manure is produced in 12 hours), or your horse becomes painful, your horse may need treatment again. Either way, CONTACT YOUR VET RIGHT AWAY to discuss the options. Sometimes giving another oral dose of banamine is enough. Some horses may need IV fluids to relieve a stubborn impaction which most likely means a trip to the hospital.
8. Watch for your horse to produce manure over the next 12 hours. Make sure your horse is in an area by itself, you have cleaned the area of any existing manure, and you have taken all the food away. Watch for any signs of pain. If your horse becomes painful again or does not produce manure in the next 12 hours, CONTACT YOUR VET RIGHT AWAY.
9. If your horse produces a good amount of manure within the next 12 hours, and is not painful, it is OK to start feeding again. It is best to give half the normal amount of your horse’s normal food for the first feeding. Then slowly increase the amount of food given over the next 12 hours. By the end of 24 hours, your horse should be passing manure and feeling hungry. If possible, don’t feed grain or sweet feed for the first 24 hours after a colic episode. Regular hay (or pellets or cubes) is best.
10. Not all impactions can be resolved with one treatment at home. Sometimes, a second treatment at home or a trip to the hospital for IV fluids (or even abdominal surgery) may be needed. If you think your horse may not have resolved the colic episode, CONTACT YOUR VET RIGHT AWAY!
11. Your horse may have “colic” from many different reasons. Not all types of colic may be resolved by treatment in the field. Some horses may need to go to the hospital for medical or surgical colic treatment. While many horses suffer from “impaction” or constipation colic, many other forms of colic exist. Here are some other types of colic: pain from gas with or without an impaction, spasm of the colon, mares in pain from a heat cycle, strangulating lipomas (fat tumors constricting the intestine), enteroliths (stones) usually in the large colon, volvulus (twisting of a part of the intestine which usually causes severe pain), displacement (part of the colon moves from its normal position in the abdomen), and many others. Your veterinarian will try to help figure out the type of colic your horse is suffering from but finding the exact reason in the field may be very difficult.
