Colic is the most common, troubling and nerve racking disease for horse owners and veterinarians. More disturbing than the horse that occasionally goes through a bout of colic is the horse that colicks on a regular basis. Veterinary practitioners cannot diagnose what is causing each repetitive colic episode. Once a horse has colicked several times the list of causes most commonly thought to be responsible becomes rather short. Causes for recurrent colic are:
- Gastric ulcers
- Abdominal adhesions (in cases where the horse has had a prior surgery for colic)
- Internal parasites (for most horses this cause is ruled out early in the evaluation process)
- Colonic inflammation with or without ulceration
- Colonic sand accumulation
- Enterolith formation (intestinal stones)
- Dental abnormalities (this is easy to diagnose and most often ruled out early in the evaluation)
- Metabolic abnormalities such as liver disease, renal disease or hormonal imbalances in a mare
- Feeding issues such as poor feeding practices and lack of water
- Stress
Many of the common causes of repetitive colic are easy to rule out by monitoring responses to therapy or a change in management. Causes of colic which are due to management problems include dental abnormalities, internal parasites, poor feeding and watering practices and colonic sand accumulation. Although possibly not as obvious, colic caused by gastric ulcers, colonic inflammation or ulceration and stress are often related to management. Of the ten common reasons for repetitive colic, only two are not management related. They are abdominal adhesions due to prior colic surgery and metabolic abnormalities.
In clinical veterinary practice, it is relatively easy to help owners to eliminate many of the contributing factors leading to colic. Even for the horse having had prior colic surgery, the diagnosis of adhesions cannot be assumed until many, if not all, of the other common causes of repetitive colic are eliminated. The first items to be investigated and adjusted are those related to feeding, internal parasites and dentistry. Once these three management concerns are evaluated, gastric ulcers, colonic ulcers, stress, sand accumulation and enteroliths can then be considered. Stress caused by travel, changes in environment and routine work can lead to both gastric and or colonic inflammation and ulceration and both
of these conditions can lead to hindgut motility disturbances that are the hallmark of colic. Even without gastric or colonic irritation and ulceration, stress can lead to colonic motility disturbance that by itself can lead to colic.
How does sand relate to motility disturbances and colonic irritation? Although sand does not typically accumulate in the stomach, sand, dirt and silt passing through the intestinal tract and colon can increase inflammation and ulceration. Both the inflammation caused by irritation and the sheer weight of the sand, can be the cause of decreased motility leading to diarrhea at times and even colic. Irritation and inflammation hinders the normal activities of the gastro-intestinal lining and can work to significantly alter the balance of beneficial bacteria that populate the colon, and are critical to the normal digestion and function of the digestive system. In cases of recurrent colic the role of sand, although not fully understood, has been hypothesized at times to be intermittent in nature. The sand and dirt that can accumulate in the colon is not usually stagnant and variability in the quantity and the distribution of sand within the colon can account for the intermittent and variable nature of its effects. This is often displayed by an irregular pattern when sand is a component of factors leading to repetitive colics. On the other hand, once a large quantity of sand has accumulated in the colon the frequency and severity of diarrhea and colic can accelerate until the signs are continuous.
Diagnosing and eliminating gastric ulcers can be accomplished by the veterinarian either by scoping or by trial drug therapy. It is preferable that the stomach be examined via a gastroscope. At times, trial therapy is recommended and in these cases the horse's response to the therapy acts as the diagnostic tool for determining ulcers. When working to diagnose colonic irritation and ulceration the veterinary practitioner does not have a reliable diagnostic tool readily available and the diagnosis is usually a presumption. In the first wide scale study looking at the incidence of both gastric and colonic ulcers, the study group was determined to have an incidence of gastric ulcers that was greater than 90% and the same group had a 64% incidence of colonic ulcers. This study of approximately 180 horses was a high stress group, which makes it valuable evidence and support for the relationship between stress, gastric ulcers and the incidence of colonic ulceration and disturbance. This study has also heightened the awareness of the relatively high rate of colonic disturbance in the general equine population.
What does "life on the edge" really mean for the horse owner? Studies have shown that the vast majority of colic cases are caused by a primary gastrointestinal disturbance. Yet the factors leading to the G.I. disturbance is often unknown. Consider the fact that your horse has a digestive system that was not designed for intermittent feeding, high grain and carbohydrate diets and drug therapies. Then, add the negative influence of a managed environment and the many stressors that it includes…it doesn't take much for any horse to colic. But "life on the edge" means more than just colic; digestive disturbance and
inefficiencies can be a major cause of additional health problems prior to colic. Digestive disturbances and inefficiencies have been shown to contribute to poor attitude, less than optimal physical condition and poor performance.
How do we solve the problems related to "life on the edge?" The solution starts with improvements in management: feeding programs, stress reduction from environmental issues and health maintenance programs are crucial. These are the easiest and best ways to get a head start on proper digestion. For many horses improvement in these areas is not enough to keep them from the brink of digestive upset. Digestive maintenance can be enhanced by colonic cleansing and conditioning that promote removal of all dirt, sand and silt and re-establishment of the normal or beneficial microflora.
ASSURE PLUS® and the ASSURE® line of digestive aids have been shown in both clinical studies and field trials to clean the hindgut of debris and sand and support the normal bacterial population thereby stabilizing colonic motility. In my clinical application experience The ASSURE SYSTEM® of daily digestive aids has proven itself to support normal digestion in all diagnosed cases of sand colic and most cases of chronic undiagnosed colic. If your horse is living "life on the edge" or you want your horse to experience the best in gastrointestinal motility and health, consider adding these cost effective digestive aids to your management program. If your horse is currently experiencing colic consult with your veterinarian for specific diagnostics and treatment.
Jay Altman, DVM
Arenus Technical Service Veterinarian