Get to Know the Cecum

What is the cecum? This large, comma-shaped pouch is located at the junction of the small and large intestines; it takes up a large portion of the right side of a horse’s abdomen.

The organ is a blind pouch, meaning that the entrance and exit to the organ sit dorsally (to the back, nearer the anus); if gastrointestinal motility is in any way compromised, material passing through the intestine may settle to the bottom of the organ instead of being pushed through it, increasing the likelihood of material buildup and an impaction.

Between 4 and 5 feet long, the cecum acts as a storage area; it can hold roughly 8 gallons of material and water. It’s often referred to as part of the large intestine (along with the colon, into which it empties). The cecum assists in three things:

◆ Storage. The cecum stores electrolytes and water.

◆ Digestion. Bacteria in the cecum help ferment food passing into it from the small intestine.

◆ Fermentation. Enzymes in the cecum break down food.

With the ability to hold this much material and liquid, it’s easy to see why any slowdown of material moving through in this area could be significant. While a cecal impaction is not the most common cause of colic in horses, the mortality rate from such an impaction is shockingly high: between 25 and 57 percent.

These deaths are mainly attributed to cecal rupture, which can come on rapidly with minimal signs of onset. A horse’s digestive tract can still function (thought not as effectively) as a cecal impaction builds, so signs of impending impaction are easy to overlook.

Presentation of Cecal Impactions

Like other types of colic, early intervention is key to a favorable outcome. Cecal impactions can be particularly tricky to diagnose, as they often present very mildly. An affected horse may look slightly uncomfortable, trot around, or lie down with minimal fanfare; he may find relief with just a small dose of pain medication.

However, as the impaction grows, so does the horse’s pain. A horse with a cecal impaction may exhibit the following signs, but not necessarily over a consistent time period:

◆ Reduced manure output

◆ Pawing

◆ Pacing, rolling or stretching out

◆ Reduced intestinal sounds

◆ Increased heart rate

◆ Pale gums

◆ Sweating

It’s important to also remember that none of these signs may be pronounced.

“A lot of owners see ‘colic’ and think [the horse] has twisted his intestine,” explains Ann Andrews, DVM, of Park Equine Hospital in Lexington, Ky. “Then when they see their horse acting a bit more normal, if uncomfortable, they think they’re in the clear—but they may not be. Owners expect a violent, thrashing colic, but a cecal impaction may appear very mild.”

These mild signs in and of themselves don’t mean the issue isn’t important or doesn’t necessitate follow-up attention.

Cause: Dehydration

“A few things can cause a cecal impaction, but the most common is dehydration,” says Andrews.

Horses that live in hot, humid environments are more susceptible to this condition as they sweat, sometimes profusely, to cool themselves down. The ability to get out of direct sunlight, whether that means in a stall under fans, in a run-in shed, or in shade from trees, will prevent the horse from experiencing a spike in body temperature and an overabundance of sweat production, which could deplete his body’s store of electrolytes.

Additionally, it’s critical that you ensure your horse has fresh water, and that the water he has access to isn’t hot, says Andrews. This may mean extra work filling and refilling buckets and troughs, or making sure there are multiple areas from which your horse can drink (an automatic waterer and a trough, for example).

The even bigger part of having access to water is ensuring that the horse is actually drinking, Andrews says, though she notes that this can be hard if he lives in a herd.

The majority a horse’s water absorption (98 percent!) occurs in the cecum and distal colon, according to Andrews. This means that if a horse is dehydrated, his body tries to remove even more water from the material that is in the large intestine, causing the fecal matter to dry out and get firmer, making it difficult for it to pass around the pelvic flexure. She notes that this area is often where horses end up getting impactions.

Cause: Parasites

A horse with a heavy worm burden may also be susceptible to a cecal impaction. Tapeworms in particular appear to put horses at risk, as they tend to gather around the narrow junction between the large and small intestine, blocking the passage of food into the cecum. Tapeworm attachment at this junction can also irritate the intestine, leading to spasmodic colic.

Routine fecal egg counts, usually performed by your veterinarian, can help identify which parasites are affecting your horse and how heavy of a load he’s carrying. A deworming strategy created in conjunction with your vet can ensure that your horse is not negatively affected by a high worm load.

Cause: Age-Related Issues

Older horses with cancerous polyps in their gastrointestinal tracts may have slowed motility in the large intestine.

“Food and matter that sits in the cecum encourages the body to keep trying to pull out water,” says Andrews. At some point, there is no more water to pull.

Additionally, older horses with poor dentition, either from lack of routine care or because they no longer have teeth to chew their food well, are also candidates for cecal impactions.

“Their feed is not as broken up as it should be, and these larger balls of feed and matter can fluff up in the intestine,” she cautions.

Older horses may benefit from feed that is soaked or from a less-coarse feed that is more readily broken down in the digestive tract. Ongoing, quality dental care is critical during a horse’s golden years.

Treatment of a Cecal Impaction

There is no specific age or breed of horse that is most at-risk of a cecal impaction.

“I have seen cecal impactions across the board,” says Andrews. “They occur in a variety of ages [of horse], for a variety of reasons.” Early detection is key to the horse’s health.

Like other types of colic, cecal impactions can be treated medically or surgically based on the horse’s clinical signs, results of a physical exam, rectal palpation, health history, bloodwork results, and the horse’s response to medical management. Andrews will often ultrasound a horse’s abdomen to help determine if the horse is experiencing a cecal impaction.

Administration of fluids, both intravenously and orally, is the first line of defense to try to soften the mass in the horse’s cecum. Laxatives and pain relievers may also be administered.

Surgery, or euthanasia if surgery is not an option, must be considered if the impaction remains unchanged or enlarges, or if pain escalates, as this indicates that rupture is often imminent. Once the horse’s cecum ruptures, he may briefly appear more comfortable as he bleeds internally, which eventually causes death from blood loss or septicemia.

Because of this possible outcome, it’s important to know if surgery is an option—for a cecal impaction or other problem—long before the need arises, according to Andrews.

“If I can’t manage a cecal impaction medically, I don’t waste a lot of time before getting them on the table if surgery is an option, mainly so I can try to preserve the integrity of the GI tract,” she says.

Owners who know their horses well are cherished by their horse’s care team and offer solid ground for the veterinarian-client-patient relationship to flourish.

“I value the owners who look at their horses every day,” says Andrews. “When they say, ‘Something’s not right,’ I know that something truly isn’t right. Long-term, I know their horses as well as they do, and it helps me catch things really early and begin treatment.”

This article about cecal impaction colic appeared in the October 2024 issue of Horse Illustrated magazine. Click here to subscribe!

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A few weeks ago, my friend called me out of the blue. I thought it was odd since she usually texts. When I picked up, I knew instantly something was wrong. Her daughter’s horse had lain down to roll, but when she got up, she didn’t shake. That was the first red flag. And when she tried to lay down again to roll, she realized that the horse was colicking.

My friend is still relatively new to horse ownership, so she wasn’t sure what to do. Being a few hours away, I couldn’t be there to help, but I told her to keep the horse up and walking, and call the veterinarian. Thankfully, her horse came out of it, and they got some pretty funny videos of her after the vet administered some medication that made her woozy. She fell asleep standing up and snored with her tongue hanging out!

That ordeal made me realize that my own horse first aid kit needed to be upgraded. We had some basics, but it wasn’t complete. I started researching the most essential items, but also found some things I would have never thought of that could come in handy during an emergency. 

Below, find a list of items to keep in your horse first aid kit, broken down by different needs and circumstances. 

Horse First Aid Kit: Emergency & General Care

Horses are hardy animals, but more often than not, they manage to get themselves into some kind of scrape. While many injuries and illnesses can be treated at home, having the right tools on hand is essential. Here’s a list of emergency and general first aid items to keep stocked in both your barn and trailer.

Items Needed:

• Stethoscope: To check heart rate and gut sounds
• Gloves (disposable latex or nitrile): For clean handling of wounds and medications
• Twitch or sedation alternative: If handling an injured horse
• Headlamp or flashlight: For emergencies in low light
• Thermometer: To check temperature
• Syringes: To administer meds
• Needles: For injections
• Electrolyte paste or powder: To help with dehydration recovery
• Activated charcoal or Bio-Sponge: For toxin ingestion concerns
• Notebook or first aid log: To track treatments and vital signs
• Vet & emergency contact list: In case of urgent care needs

Horse First Aid Kit: Pain & Inflammation Management

According to the United States Department of Agriculture (USDA), colic is the most common cause of death in horses that are 1 to 20 years of age and the second most common cause of death for horses older than 20 years of age (USDA APHIS NAHMS 2015). Flunixin meglumine, often known under the name brand name “Banamine,” is a common NSAID used for equine inflammation and pain associated with injuries, but it’s also used to alleviate pain from colic. However, it is highly encouraged to only administer Banamine with a vet’s permission—or, better yet, by the vet themselves.

Phenylbutazone (more commonly known as “bute”) and dimethyl sulfoxide (DMSO) are also common NSAIDs, mainly for joint swelling and injuries, but they’re not great for colic. In fact, if DMSO is administered incorrectly, it can actually cause signs of colic in some horses.

Dormosedan Gel (frequently nicknamed “Dorm gel”) is another good addition. This is an oral sedative for calming a panicked or uncooperative horse in stressful situations.

Be sure to talk with your vet about directions for use and follow all medication guidelines. 

Items Needed:

• Bute: Pain relief, anti-inflammatory
• DMSO: Anti-inflammatory
• Dorm gel: Oral sedative
• Topical cooling gel or liniment: For muscle soreness

Horse First Aid Kit: Wound Care & Bandaging

If you are treating a wound, it’s important to inspect the wound for depth and infection. If the wound is too deep, it can lead to an abscess and it will require a call to the vet. Wounds on the eye also warrant an immediate call to the vet. 

When cleaning a wound, remove debris and wash with soap and water if possible. Avoid hydrogen peroxide or alcohol on open wounds as they can delay healing. Instead, use wound spray or antibiotic ointment.

Items Needed:

• Non-stick gauze: For wrapping wounds
• Cling gauze: Secures dressings without adhesive
• Gauze pads: Absorbs wound fluids
• Vet wrap: Self-adhesive bandage
• Elastikon: Strong adhesive tape
• Bandage scissors: For careful cutting of bandaging items
• Cast padding: Prevents pressure sores
• Duct tape: Secures hoof wraps
• Absorbine Silver Honey®: Antimicrobial wound care
• Triple antibiotic: Prevents infections
• Wound spray: Disinfects wounds
• Saline solution: Flushes wounds/eyes
• Hydrogen peroxide (3%): For cleaning tools, but not recommended for wounds
• Betadine (povidone-iodine solution or scrub): Antiseptic for cleaning wounds
• Cold packs or instant ice packs: For swelling and injuries

Horse First Aid Kit: Hoof Care

If your horse suddenly starts limping, chances are it’s a hoof abscess. Check for heat, swelling, tenderness, or drainage from the hoof. Treating an abscess often involves soaking the hoof in warm Epsom salt water or applying a poultice to draw out the infection. Wrapping the hoof or using a boot helps keep it clean and protected.

Items Needed:

• Bandaging items: See above
• Duct tape: Secures hoof wraps
• Soaking boot: Easy way to soak a hoof and keep out debris
• Epsom salt: Soaks abscesses and reduces swelling
• Animalintex: Poultice pad for infections
• Green poultice: Cooling clay poultice
• Magic Cushion®: Hoof packing for pain relief
• Hoof pick: To check for lodged objects and clean the hoof
• Diapers or sanitary pads: Great for hoof abscess wraps
• Soft-Ride Boots or hoof boots: If dealing with a hoof injury

Talk With Your Vet

Be sure to talk with your veterinarian about your first aid kit. They can recommend additional items tailored to your horse’s specific needs, explain best practices for administering medications and treating injuries, and may even offer pre-made first aid kits.

Emergencies and injuries are inevitable, but having a well-stocked equine first aid kit can make all the difference. Acting quickly gives your horse the best chance at a full recovery. While some situations will still require a vet, being prepared allows you to stabilize your horse until help arrives. When the unexpected happens, you’ll be glad you took the time to get ready.

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Consuming sand is not ideal for equine digestion because sand irritates and inflames the intestinal lining, disrupting the bowel’s efficiency in absorbing nutrients. Accidental ingestion of sand by horses may be harmless in many circumstances, but can also lead to the dangers of sand colic.

Some horses naturally pass ingested sand through their feces without any signs of discomfort. In other horses, the sand—which is heavier than grass or grain—sinks and accumulates in the large colon over time, leading to clinical signs of distress.

Though reported worldwide, a higher incidence of sand colic exists in parts of the United States, such as the desert Southwest, California, Florida, and Colorado.

Living in a dry environment isn’t the only source of sand ingestion, however. Grazing on dry lots or worn-down pastures, being fed forage on the ground, or trying to hunt out morsels of hay also present an opportunity for sand ingestion.

“Sand colic depends upon geographic location,” says Berkley Chesen, DVM, DACVS-LA, a veterinarian at Equine Comprehensive Wellness in Santa Fe, N.M. “Practicing in New Mexico, 10 to 20 percent of the colic cases I see have a sand component. In places where grass has been demolished and left bare, sand-covered ground, one might conclude that climate change has some effect on sand accumulation.”

Warning Signs of Sand Colic

While differences exist in geographical location, clinical signs of sand colic often mimic other forms of colic. A constant source of abdominal irritation, sand provokes a persistent inflammatory response and inevitably disrupts the bowel’s efficiency in absorbing nutrients.

When regular digestive movements are interrupted, signs such as watery diarrhea, unexplained or rapid weight loss, listlessness, loss of appetite, and evidence of sand in the stool serve as medical alerts. Increased heart and respiratory rates, sweating, pawing, and kicking at the abdomen are other signs of an impending colic episode.

Chesen notes that horses with frequent colic events, those that eat directly off the ground, and those that don’t receive enough hay in their diet are more likely to accumulate sand and experience abdominal pain.

If left undiscovered, sand accumulation may lead to impaction of the obstructing material. Bowel displacement can also occur, and requires surgery.

Too much sand can accumulate or the material clumps up in one area and blocks the intestine, causing an obstruction, according to Julie E. Dechant, DVM, MS, Dipl. ACVS and ACVECC with Equine Surgical Emergency and Critical Care at the UC Davis School of Veterinary Medicine.

As the horse emits gas, the blockage hardens like cement, and the intestines become distended with gas.

“The sand is so densely packed, it’s basically an impaction,” says Dechant.

Volume alone isn’t the only factor, however.

“Sometimes we’ll have horses with huge amounts of sand that we can manage medically,” she continues. “Others have smaller amounts of sand, but it’s clumped in one area and causes a blockage. Accumulation of sand with gas will also trigger the horse’s intestine to displace.”

Diagnostic Tests

In the field, veterinarians use standard tests for detecting sand in a horse’s abdomen or intestinal tract, partly due to convenience, but more often because of a lack of access to imaging equipment.

Auscultation, or using a stethoscope to listen for sounds that mimic waves washing over a beach, assumes that a quantity large enough to produce audible feedback is present. Dechant observes that the test, while accessible in the field, presents screening challenges.

“Often in the field, we’ll put our stethoscope on the lower, ventral part of the abdomen to listen for sand,” she says. “The intestines have to be moving, so if there are active colic signs, sometimes those intestines stop moving. You might not hear sand, even if it’s there.”

Fecal segmentation, another test familiar to most horse owners, requires a rectal sleeve or plastic bag. Chesen confirms the commonality of the test, but cautions against its limits: Fecal sand tests are only accurate in confirming that sand is passing through with the manure.

“Floating manure in a Ziploc bag of water with the corner pointing down is another good way to see if sand is passing through the digestive system,” says Chesen. “[Sometimes] sand is auscultated in the abdomen, but no sand is present on a float test. This is because it’s just sitting idle in the colon and not moving.”

Radiographs (X-rays) are considered the gold standard for confirming the presence of sand in the gut and the amount accumulated. However, access often requires travel to a referral hospital and may be cost-prohibitive for the average horse owner, according to Dechant.

“Abdominal X-rays are reliable and pick up even tiny amounts of sand, but aren’t readily available, especially in the field,” she says. “Other tests are accessible, but they have their limitations.”

Conventional Treatments

Approaches for treating a horse to resolve sand ingestion traditionally entail passing a nasogastric tube through the nose to administer psyllium mixed with water to the stomach.

Psyllium, a natural laxative, forms a gel that breaks up sand particles, allowing passage through the digestive system. Fluids increase intestinal mobility and rehydrate the horse. Pain medication alleviates inflammation.

Chesen prefers mixing the insoluble fiber with mineral oil to ease psyllium administration.

“I mix psyllium with mineral oil rather than water because it’s easier to pump,” she says. “With water, the psyllium turns into a congealed mess.”

Psyllium isn’t without controversy, however. According to Dechant, psyllium’s efficacy in treating sand colic is debatable.

“Some people feel it works; some don’t, especially in the acute, crisis, and long-term phases,” she says. “There’s not 100 percent consensus if psyllium is always needed. I would say that historically, I didn’t use much psyllium. [But] I have been using it more recently, and I’ve been pleasantly surprised by the results.”

The American Association of Equine Practitioners recommends adding psyllium one week out of every month in the feed for horses prone to sand exposure.

Emerging Treatments for Sand Colic

A randomized controlled study out of Finland in 2018 examined 246 horses to determine whether combining psyllium with magnesium sulfate proved more effective in clearing sand than using either ingredient separately.

The investigation of the treatment with psyllium and magnesium sulfate concluded that 75 percent of horses resolved colonic sand accumulation after four days using the combined treatment.

Chesen confirms the approach and study results.

“Adding magnesium sulfate—Epsom salt—to any fluid pumped into the stomach is common with colics, as it pulls liquid into the gut and flushes the sand out,” she says.

Researchers Diana M. Hassel, Allen Landes, Julie Funk, and A.E. Hill evaluated whether a mixture of probiotics, prebiotics, and psyllium enhanced sand clearance more effectively. Four days of treatment demonstrated an increase in sand clearance in clinically normal horses and may be effective in preventing sand enteropathy and sand colic. The supplement also reduced the likelihood of inflammation caused by sand irritation.

Environmental Management

Examining where and how your horse eats is the best way to minimize the risk of sand ingestion. This may require a multi-faceted approach and a dose of creativity.

Preventing a logjam of sand in the gut begins with halting its ingestion. Limiting access to sandy turnouts or feeding on rubber mats manages the amount of sand ingested.

Slow feeders reduce waste and provide a steady flow of forage, and access to forage around the clock helps the digestive tract remove buildup of sand or gravel.

Slow feeders with slotted tops help block a horse from pulling hay onto the ground, according to Chesen. Feeding in high-sided tubs and checking feces for sand are tactics all horse owners can take.

“Psyllium is easy, and that’s why it’s appealing,” says Dechant. “[But] environmental management is the tough part.”

This article about sand colic appeared in the June 2023 issue of Horse Illustrated magazine. Click here to subscribe!

These Horse Care Tips are presented by CareCredit.

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Many horse owners understand the term colic to mean abdominal pain in horses. Although there are several causes of colic, equine impaction colics are one of the most frequently encountered types. Let’s take a closer look at this common cause of abdominal pain to better understand early warning signs, treatment options, and prevention.

Impaction Causes

In basic terms, an impaction refers to an obstruction of the gastrointestinal tract. This is typically caused by a clump of ingesta (feed), but can also be made up of sand or other foreign material, such as hair or bailing twine, or rarely, a growth or tumor. Equine impaction colics most frequently occur in the portion of the horse’s large intestine called the large colon, but sometimes occur in the cecum or small colon.

Due to the length, complexity, and sheer volume of a horse’s digestive tract, an interruption in the flow of material through it can quickly become a very serious issue. A horse’s large colon is 10 to 12 feet long, and along with the cecum, can hold up to 30 gallons of fluid.

Fitting all this into the horse’s abdomen requires a few anatomic hairpin turns. One such turn is called the pelvic flexure, and this is a classic location for impaction because the diameter of the colon becomes narrower here.

Once a blockage occurs, this creates a backup of material behind it, which swells and stretches the gut. This understandably becomes increasingly painful for the horse.

But why would food become a dangerous clog in a horse’s digestive pipeline? Stress, a sudden change in diet, or an abrupt decrease in exercise (like a change from pasture to stall-bound) can result in a reduction in gut motility, which can predispose a horse to developing an impaction.

Hydration also plays a large role; if a horse is dehydrated, this can also slow the movement of digesta through the colon, sometimes ceasing movement altogether.

Equine impaction colics are often seen in the winter when horses are reluctant to drink icy water. This is a classic example of mild, chronic dehydration leading to this type of colic.

Clinical Signs

Equine impaction colic presents with the same clinical signs as other types of colic, although it may be milder at first and then progress in severity if not treated. An impacted horse may glance at his flank and prefer lying down or act like he can’t quite get comfortable. He may roll or stand at the trough and play in the water without drinking. Usually, impacted horses will not eat.

As time goes by, impaction colic worsens, and clinical signs may become more obvious. The horse’s heart rate will usually be elevated, and he’ll have decreased or absent gut sounds. His gums may become dry, tacky, and pale. If the horse is stalled, you will notice the absence of any manure.

If you notice these signs, have your veterinarian come out as soon as possible. After taking your horse’s temperature and pulse and listening to his gut, the vet will sedate the horse and conduct a rectal examination.

Fortunately, the pelvic flexure of the large colon hangs below the pelvis (hence its name), and an impaction at this location can usually be palpated during a rectal examination. This can help provide a quick definitive diagnosis. However, if the veterinarian cannot feel an impaction in this location, it does not completely rule impaction colic out.

Treatment

Rehydration is the cornerstone treatment for equine impaction colic. Softening up the impaction to get it to move is the goal. This is addressed in two primary ways. First, a nasogastic tube, which is a long rubber tube that is inserted in the nostril and fed down the esophagus into the stomach, is used to administer fluids as well as mineral oil, the ultimate laxative.

Second, an impacted horse is typically given large amounts of intravenous fluids. Pain medication and buscopan, an anti-spasmodic drug, are also sometimes given to help keep the horse comfortable.

A horse with an impaction should be kept off feed while the impaction is being treated; there’s no point in adding further material to bulk up the digestive tract. However, don’t limit water intake.

Additionally, keep the horse stalled, if possible. This allows you to monitor fecal output. If mineral oil has been given, look for it to pass in 12 to 24 hours. As it typically induces soft, oily stool, it is easy to observe when an impaction has passed.

Occasionally, an impaction is severe enough that it can’t be treated medically, making surgery the only option. During colic surgery, the impaction will be located and removed. Depending on the severity, the wall of the colon may be compromised.

If this is the case, a resection is performed where the damaged section of colon is removed and the two ends are rejoined. These types of surgeries can be complicated, and depending on the extent of the damage to the gut, can have a long recovery time.

Preventing Equine Impaction Colic

Avoiding any sudden and drastic changes in your horse’s diet will go a long way in helping prevent an impaction. Ideally, the majority of his diet should consist of forage, such as pasture or hay.

Consistency in diet and exercise are key. Good dental health is also important so that your horse can comfortably and efficiently chew his food. Annual dental exams will help ensure his teeth are in the best shape possible.

Perhaps the most vital tip for helping prevent impactions is to make sure your horse has access to clean water at all times. In the winter months, if you are in an area where temperatures fall below freezing, water heaters not only prevent icing, but also encourage the horse to drink when it’s cold out.

If your horse lives in a sandy climate, talk to your veterinarian about supplements that help prevent sand buildup in the gut (see “Sand Colic,” this page).
Common sense and good, practical horsemanship can go a long way in helping your horse avoid an impaction.

This article about equine impaction colic originally appeared in the September 2021 issue of Horse Illustrated magazine. Click here to subscribe!

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One vet’s crazy day reminds us how chaotic life can get. But when it matters, a life is saved.

The last thing I wanted to do was deal with my less-than-organized vet truck. My various assistants over the years did their best, but it was sometimes difficult to schedule time for cleaning and restocking, as we were usually out the door early and home fairly late. But today I finally had a slow day.

I sighed as I pulled a set of hair-encrusted clippers out from under the back seat where I’d shoved them during an earlier laceration repair. I located the carrying case perched on the center console and searched hopelessly for the clipper cleaning kit. No luck—probably because it was in my basement, since I tended to just buy new clipper blades when the old ones got dull. Somewhere in the basement lurked a bag of close to 40 used blades waiting to be sent out for re-sharpening.

My scrub kit was tipped on its side and had leaked its remaining surgical soap onto the carpeting on the floor of the truck.

In the back of the truck sat a plastic bag containing my used emasculators from that day’s castrations. I tucked the clippers and scrub kit under my arm and grabbed the bag, carrying them all to the basement, where I set them by the sink for cleaning and disinfecting.

I was returning to the truck, but realized I was hungry, so I set everything down and threw some leftovers into the oven. I set the timer, realized I’d forgotten bandaging material for the bandage box, then got distracted by a pile of bills on the counter.

When Everyone Needs Something During a Vet’s Chaotic Life

My phone rang with a client needing an approval on a prescription at some online pharmacy, and my teenage daughter wanted permission to go to a sleepover. And could I pretty please find her blue sleeping bag and suitcase and give her some money for a movie? I was beginning to think that life couldn’t get any more chaotic as a vet.

I returned to the basement to open my laptop and recheck the dose of the medication and locate the sleeping bag, then saw several new emails, two from clients with ongoing cases that I was managing. So I stopped and checked in with them, then realized I had an outstanding bill with one of my diagnostic labs, paid it, then saw the laundry piled by the stairs.

I was happily sorting darks and lights when the cat nudged my leg, so I opened a can of food. But her dish was dirty, so I washed it out, and then realized that the counter needed scrubbing. The paper towels and bleach spray were upstairs, but I hadn’t started the laundry.

And wasn’t I supposed to be bringing something else out to the truck? And where on earth was that dratted sleeping bag? I tried to go in four directions simultaneously and was twitching spastically in place when a voice called down the stairs.

“Courtney, is everything OK?” It was my neighbor.

“Yes, fine! Why?” I called back.

“Well, every door in your truck is open, there’s equipment all over the driveway, your front door is also wide open, your timer has been going off for about 10 minutes, and your kitchen is full of smoke!”

I tore up the stairs and looked sadly into the oven at the blackened mess that was supposed to be my lunch, started to yell for my daughter who could have been more helpful, and—right on cue—my phone rang with a colicking horse and a frantic owner.

I tore up the stairs and looked sadly into the oven at the blackened mess that was supposed to be my lunch, started to yell for my daughter who could have been more helpful, and—right on cue—my phone rang with a colicking horse and a frantic owner.

When I ran in, I opened a few windows to let the smoke out, started to leave again, and realized my stomach tube was sitting in disinfectant downstairs. I thundered down the stairs and grabbed it and finally hit the road.

When I ran in, I opened a few windows to let the smoke out, started to leave again, and realized my stomach tube was sitting in disinfectant downstairs. I thundered down the stairs and grabbed it and finally hit the road.

Shifting Gears

My brain was ticking off every possible scenario that I might run into with the sick horse and running mental checklists of supplies that I might need.

Thankfully, they were all in place. I had a fluid kit with catheters and drip sets, long-sleeved gloves, supplies for a belly tap, a clean bucket, a stomach tube and pump, and all of the medications that I use for colics.

I roared up to the farm, dust flying, and quickly located my patient. I examined her carefully, checked vitals and hydration status and listened to gut sounds. I lightly sedated her for a rectal exam. Within minutes, I’d found the problem—a firm impaction of the large colon. I threaded a catheter into her jugular vein and soon had a bag of IV fluids flowing, then passed a stomach tube and delivered a dose of my favorite impaction-relieving cocktail and some drugs to ease her pain. Soon she was feeling better and looking happier.

The young woman holding the mare was mostly silent, but as I was rinsing out my stomach tube and bucket, she turned to me with an adoring look on her face.

“Dr. Diehl, you’re always so calm and organized, and you always know just what to do. Your kids are so lucky to have a vet for a mother!”

My phone beeped just as she finished, and a capitalized text peppered with multiple angry-face emojis flashed ominously across the screen.

“MOM!!! WHERE ARE YOU? YOU FORGOT TO GET MY STUFF READY, AND YOU DIDN’T GIVE ME MONEY. GRRRRR!!!”

This Vet Adventures column on a vet’s chaotic life appeared in the March 2020 issue of Horse Illustrated magazine. Click here to subscribe!

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With many horses seeing their exercise schedules suddenly reduced or eliminated, questions have cropped up if this creates a higher risk of colic during the COVID-19 pandemic. The Canadian National Code of Practice for the Care and Handling of Equines is clear: Horses must have some form of exercise or turnout unless under stall rest for medical reasons or severe environmental conditions make this temporarily impossible. Equine Guelph encourages concerned horse owners and caretakers to assess their risk and adjust management practices to help reduce their chance of colic using a free online healthcare tool: The Colic Risk Rater.

One key to reducing the incidence of colic is making changes slowly. This includes exercise, feed changes, and more. Kristen Frederick, DVM, BSc, is just one veterinarian and equestrian providing helpful insight to keep everyone grounded during these rapidly changing times.

“The COVID-19 epidemic is a public health emergency,” says Frederick. “All small businesses are taking a serious hit with this pandemic, including riding instructors and owners of boarding and lesson facilities. I’d like to address a few points that have cropped up on the internet.

“Yes, horses need exercise, but they will get by if not ridden by their owner that is complying with social distancing,” she continues. “Access to turnout, longeing, and handwalking are all options that can continue to be provided while restricting barn access to essential personnel only. If your barn is well run, there is NO reason your colic rates should go up.

“Barns, like any public institution, involve multiple people touching the same gates, stall latches, grooming tools, tack, brooms etc.” continues Frederick. “Leather tack is difficult to disinfect. Disease will spread in a barn just as it will in any social environment. It’s worth bearing in mind that the longer we fail to comply with social distancing recommendations, the more damage the virus can do, and this will deepen the already profound economic effects.”

High-grain, low-forage diets and sudden changes in diet are two of the top risk factors for equine colic, whether during COVID-19 or not.

If you have concerns about your horse, call or e-mail your equine veterinarian for advice.

Another important task during these difficult times is to stay in touch with your hay supplier to ensure a consistent supply. You don’t want to run so low that you lose the ability to implement safe periods from one batch of hay to the next.

Check your colic risk with the interactive Colic Risk Rater tool linked above, kindly sponsored by CapriCMW. And remember, riding is not the only way your horse can receive the benefits of exercise. Be safe everyone!

Equine Guelph is the horse owners’ and caregivers’ Centre at the University of Guelph in Canada. It is a unique partnership dedicated to the health and well-being of horses, supported and overseen by equine industry groups. Equine Guelph is the epicentre for academia, industry and government—for the good of the equine industry as a whole. For further information, visit www.equineguelph.ca.

Complete COVID-19 Coverage

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Few problems can leave you feeling more scared and helpless than a colicky horse. Sometimes colic feels as unpredictable as lightening striking, and it’s frightening to wonder when and if it may happen to your horse. But what is colic in horses? And what can we do about it?

What is Colic in Horses?

It’s important for any horse owner to know what colic is. Colic is a fairly general term for a bellyache, and it can mean anything from a gas cramp to a more serious problem with the horse’s intestinal tract or other internal organs. Horses can develop stomach ulcers, have blockages in their intestines, or develop a twisted gut or an infection in the intestine, kidney or liver.

Parasites can cause colic, and so can overfeeding or the wrong kind of feed. Cancer is also a possible cause of colic. Because there are so many reasons for a horse to have a bellyache, there really isn’t a one-size-fits-all treatment, so it’s important to have a proper diagnosis of what is causing the pain before giving any sort of medicine.

What’s Wrong

Horses show pain in many different ways, and usually the first thing that an owner will notice is that their horse just isn’t “acting right.” He may be standing off by himself, refusing food, or standing over the water trough but not drinking.

Some horses will repeatedly stretch out as though they have to urinate. They may hold their tail cocked, look at their flanks, or curl their upper lip in the air. Pawing, lying down and rolling frequently are also signs of pain. Because the pain signs can vary so much, it’s important to know your horse’s normal behavior so that you can quickly recognize when something is off.

What to Do with Colic

The first thing to do is to get his vital signs. Take his temperature, pulse and respiration rate. Every horse owner should have a stethoscope. Practice taking vitals on your healthy horse and learn the normal ranges. Also listen to his belly and try to learn what healthy intestines sound like.

If your horse has been acting strangely for more than 15 minutes or the pain signs are worsening, it’s time to call the vet. She will ask you how long your horse has been feeling ill, questions about his diet and normal routine, his age and medical history, and his vital signs. If you can, have this information ready.

Don’t give your horse any medications without talking to the vet first. Someone at the barn may have a favorite colic remedy, but any drugs that you give the horse can interfere with the vet’s exam, and in some cases, they can make the horse worse if he is already dehydrated or has stomach ulcers. Again, until you know why the horse is sick, any treatment plan is only a guess and it may be the wrong guess.

It’s fine to take your horse for a short walk, but many horses that are in pain just want to lie down. It’s a myth that colicky horses must be kept walking or they’ll “twist a gut.” This is simply not true. Lying down and gently rocking can actually help work trapped gas through a crampy intestine.

If the horse is rolling, he’s telling you that his pain is getting worse. Don’t force him to his feet or force him to walk if he’s repeatedly going down. Just wait for the vet.

Treatment

The vet will probably sedate your horse and do a rectal exam to try to feel what the problem is. She may do an ultrasound of the belly if she needs more information. The vet will pass a stomach tube, and may give the horse medicine through the stomach tube.

She will probably give him some injectable medicine, draw some blood and take a manure sample for testing. Some horses have to be transported to a hospital for further care, and a low percentage may need surgery.

Prevention

An annual dental exam and float, a good deworming and vaccination program, and a diet appropriate for your horse may all help prevent colic. Regular turnout, socialization and grazing or frequent feedings help keep the gut healthy and minimize stress. Horses are designed to move and graze constantly, and the more their environment allows them to “just be horses,” the healthier and happier they will be.

This article about what is colic in horses originally appeared in the July/August 2019 issue of Young Rider magazine. Click here to subscribe!

The post In Case of Colic: What is Colic in Horses and How Do You Treat and Prevent It? appeared first on Horse Illustrated Magazine.

• Any horse can colic, even if they are otherwise healthy and receive good care.
• Modifying a horse’s diet, or feeding a diet that has too much starch or insufficient fiber, can increase a horse’s colic risk.
• Leaky gut in horses can lead to colic and other systemic problems ranging from dull coat and poor hoof quality to muscle wasting and laminitis.

It’s a helpless feeling to watch a horse experience abdominal pain while you await your veterinarian’s arrival. An often-asked question is, “Why is my horse colicking?”

Causes of Colic in Horses

Horses can develop colic even under the best of care, seemingly for no apparent reason. Intestinal pain occurs from a variety of causes, but some are related to management practices.

Modifying feeding routines significantly within a two-week period is known to contribute to intestinal crisis. Sudden feed changes alter the intestinal microbiome (collection of gut microorganisms), setting up conditions for intestinal upset.

While many horses are fortunately able to adapt to an altered diet with no ill effects, others have a more fragile intestinal system and experience impaction, gas distention, diarrhea or intestinal displacement, all of which can manifest as colic pain.

The objectives in dealing with colic in horses are: 1) prevention, and 2) quick recognition that your horse is having an intestinal problem. Have you ever counted how many manure piles a day your horse passes? On average, it should be eight to 12 per day, which represents normal intestinal digestion and motility.

What your horse ate three days ago is what passes through as today’s manure. Fewer than a normal number of manure piles means you should take note and monitor him carefully.

High-fiber diets of mainly forage (hay and/or pasture) are critical to your horse’s intestinal health. Studies show that eight to 10 percent of all colic cases in horses occur due to impaction, where digested feed forms a blockage in one or more portions of the large intestine.

Typically, a horse needs to drink a minimum of 7½ gallons of water for every 20 pounds of hay he consumes, and additional water intake is necessary in warm weather conditions and when exercising.

Rate of Passage

Exercise reduces intestinal activity by up to 85 percent as blood flow is diverted away from digestion and into working muscles. Additionally, water is pulled from the intestinal reserves to replace hydration lost in sweat.

Many other conditions reduce intestinal motility:

• Fasting between meals that are fed only twice a day.
• Large amounts fed at one time, especially only twice a day. Horses evolved to eat intermittently for about 18 hours a day, grazing small amounts frequently over a long period of time rather than consuming the daily allotment in two meals.
• Changes in routine or diet within the preceding two-week period increases colic risk.
• Feeding large amounts of grain slows intestinal passage time, particularly if a horse eats more than 5 pounds at a feeding.
• Inconsistent feeding intervals disrupt normal intestinal function.
• Stall confinement reduces fiber digestibility by 20 percent, resulting in delayed passage of food through the intestines. Fluid is absorbed out of digested material when transit is slowed. Stall confinement is responsible for as many as 54 percent of impaction colic cases.
• Non-steroidal anti-inflammatory drugs (NSAIDs) slow intestinal motility.

Sand Colic and Enteroliths

A horse may inadvertently consume sand or decomposed granite (DG) when fed on these surfaces. Accumulation of sand or DG in the large intestine often leads to intestinal irritation, diarrhea, impaction and/or colic pain.

High-fiber diets and psyllium supplementation not only help move sand through the digestive tract, but psyllium also acts as a prebiotic to encourage beneficial bacteria to populate the microbiome and improve digestion.

In the Southwest and on the West Coast, enteroliths in the colon may develop with alfalfa hay consumption. These intestinal stones are composed of magnesium-ammonium-phosphate mineral salts that form around a tiny pebble, wire or other small foreign object that a horse may have ingested. Large or multiple enteroliths can cause pain, and in cases where they are causing problems, they must be removed surgically to avoid blockage or damage to the intestine.

Leaky Gut

Because the intestines form a closed tube, the gut is cocooned away from the rest of the internal organs. The communication between the gut and bloodstream is through the intestinal lining, which forms a barrier to passage of unwanted microbes and biochemicals into the bloodstream. Anything that causes a breakdown of that barrier results in increased intestinal permeability, allowing toxic materials and bacteria to be absorbed into the bloodstream.

This results in systemic inflammation, which creates a number of significant health issues, including poor performance, behavioral and personality changes, lethargy, recurrent gastric ulcers, dull hair coat and poor hoof quality, allergies, hives, muscle wasting, and even serious conditions such as insulin dysfunction, equine metabolic syndrome, uterine infections, skin infections, pneumonia and laminitis.

Colic may also occur in our horses, but all these other systemic problems have their source in abnormal intestinal function and leaky gut.

Further Reading of Colic in Our Horses

• Preventing Colic on the Road
• Is There a Connection Between Grain and Colic?

This article originally appeared in the June 2019 issue of Horse Illustrated magazine. Click here to subscribe!

The post Colic Threat Level In Our Horses appeared first on Horse Illustrated Magazine.

Too Much Starch In Your Grain

If too much starch is fed in one meal, the small intestine can’t absorb all of it, so some spills over into the large intestine. This is not a good place for starch to be, since it leads to bacterial overgrowth and death of microorganisms that produce toxins that leach into the bloodstream when they die. These toxins are known to reduce intestinal motility.

Hydration Is Important

In addition, horses fed large grain meals are 15 percent less hydrated than horses fed a high-fiber diet; this adds to the possibility of impaction colic. Grains are also highly fermentable, generating more gas in the large intestine, which further slows intestinal motility. Distention (with gas or blockage) of the intestines leads to pain, cramping, and colic, and also the potential for intestinal displacements or twists.

Gastric ulcers—often resulting from high-grain diets—are the culprit of a variety of syndromes: behavioral changes, performance deficits, weight loss, and/or colic pain. (Tap here to learn more.)

When extra calories are needed, a high fat-and-fiber concentrate is much safer to feed than straight grains.

• Read more in Colic Threat Level >>

This article originally appeared in the June 2019 issue of Horse Illustrated magazine. Click here to subscribe!

The post Is There a Connection Between Grain and Colic? appeared first on Horse Illustrated Magazine.

Travel and competition are stressful events for horses. Here is a list of colic-causing problems in our horses that can be prevented while away from home:

• If your horse is used to being on pasture at home, a sudden change to dry hay can throw his digestive tract into a tailspin and can cause colic. Introduce grass hay a couple of weeks before travel to accustom him to drier feed.
• A horse used to a hay-only diet should be grazed sparingly when away from home. Suddenly eating/consuming pasture grass when he isn’t accustomed to it may result in excess fermentation and gas in the bowel, leading to painful colic.
• Pelleted complete feed products require a lot of intestinal water to digest. If you are feeding one of these, it helps to prepare it as a wet mash to improve water intake.
• Before offering large quantities of dry food (hay or complete feed products) after exercise, make sure your horse is well cooled down (a temperature of less than 102 degrees Fahrenheit). Otherwise, blood is diverted away from the intestines to the skin and muscles to dissipate heat. Reduced intestinal circulation leads to trouble.
• To improve water intake, incorporate it into the feed to make soupy mashes or pre-soaked hay.
• When away from home, don’t suddenly start feeding something your horse isn’t used to. Be conservative with any changes to the feed program and whether or not to offer new things. This includes not only grain products, but vitamins, minerals and other supplements.
• The final tip to prevent colic-causing problems while away from home is to prepare and condition your horse for the level of competition he will be asked to do. Proper conditioning improves your horse’s ability to cope with exercise stress and limits loss of hydration and electrolytes through the course of transportation and showing or other activities on the road.

The best way to keep your horse out of intestinal trouble is to keep things consistent. The KISS philosophy, i.e. Keep It Super Simple, is a useful mantra to use when feeding horses at home or away.

• Read more in Colic Threat Level >>

This article originally appeared in the June 2019 issue of Horse Illustrated magazine. Click here to subscribe!

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