Browsing tag: pain

Ireland is living in the past: it’s about to become legal for members of public to dock puppies’ tails.

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Tail docking is a illogical, nonsensical form of puppy torture, and it looks set to become legal in Ireland.  The procedure is brutal: a pair of scissors, a sharp knife or a tight ring are used to chop off a young puppy’s tail. There is no anaesthetic, and it clearly hurts a lot (they squeal loudly), but the pups are too small and helpless to do anything about it. The pup above was brought to me for treatment after the amateur tail docking job had resulted in a chronic non-healing wound.

Tail docking has been banned in the UK since 2007: it’s completely illegal in Scotland, and in England and Wales, it’s only allowed for a small number of working dogs or when the procedure is needed for medical purposes under theAnimal Welfare Act 2006 or the Welfare of Animals Act (Northern Ireland) 2011. It’s also illegal to show dogs that had their tails docked after 2007.  The subject has been debated in detail elsewhere, but the evidence is clear: tail docking causes pain to puppies, and it does not reduce the incidence of tail injuries in adult dogs, even in working animals.

Tail docking is also illegal in most European countries: the fact that it has not yet been banned in Ireland is the only reason why Ireland is unable to become the 23rd European state to ratify the Council of Europe’s European Convention for the Protection of Pet Animals. (In fact, the UK is also unable to ratify this convention because of the illogical “working dog” exemption on tail docking in England and Wales).

Until last week, it seemed that tail docking was about to be phased out in Ireland. Suddenly, this has changed.

A new Animal Health and Welfare Act is due to be brought in by the Irish Minister of Agriculture Simon Coveney in the next few weeks. The new law has been carefully drafted in conjunction with veterinary bodies and animal welfare groups, all of whom are strongly anti-docking. The Act specifically prohibits “surgical procedures for cosmetic reasons” and it also bans  ”mutilated” dogs from being exhibited in the show ring. These clauses were introduced to stop old-fashioned and unnecessary procedures such as tail docking.

So far so good. So it was a bombshell when it was made known last week that the Minister intends to allow tail docking by members of the public, by listing it in a Regulation under procedures that may be performed without the use of anaesthetics or pain relief. The other activities under this section are mostly agricultural tasks, such as ear tagging cattle, castrating sheep and removing piglets tails: these have been allowed to permit such traditional aspects of agriculture to continue (even though it can be argued that, logically, they too should be restricted).

The official bodies representing animal welfare in Ireland are incensed at this news: it’s worth reading the open letter that has been written to the Minister by Veterinary Ireland, the ISPCA and Dogs Trust. An online petition has been launched to gather public support against the new Regulation: you can sign it here. The petition was started on 10th November, and already has over 5000 signatures.

It isn’t too late to change the future for Irish puppies: the government must surely be listening to common sense and the voice of the people.

Lost in translation – do you know what your cat is really trying to tell you?

‘Miaow!’  One simple word, so many possible meanings.  Is she happy?  Is she hungry?  Is she scared?  It’s all in the tone in which it’s delivered.  And that’s just the miaow – researchers have documented 19 different vocal patterns in domestic cats ranging from purrs to chirps to growls, along with countless body language cues.  Do you really know how to interpret them?  Test your feline language skills below…

A deep, rhythmic purr

We’ll start with an easy one – a purr means she’s happy, right?  Possibly, but that may not always be the case.  In fact, cats purr for many reasons.  Young kittens and mother cats purr during nursing, possibly as a way of maintaining contact and communicating contentment.  Adult cats purr when they’re in the company of other cats or humans that they are friendly with, especially during grooming or petting or resting together.  And as most cat owners probably already know, they also purr when they want something.  This ‘solicitation’ purr contains some of the high frequency peaks also found in a human baby’s cry, and it is commonly thought that cats use this to their advantage when asking for food at 5am.  But what many people don’t know is that cats will sometimes also purr when they are nervous or even painful.  We don’t know exactly why they do it, but the important thing to remember is that purring doesn’t necessarily mean that a cat is happy, you need to look at the rest of their body language for clues.  Think of it like a human smile – we do it when we’re happy, but also when we want something or when we’re nervous.

Blinking, half-closed eyes

If you said this is a sign of contentment, you would be absolutely right.  A cat who stares without blinking is alert and confrontational, while a cat with half closed eyes is relaxed and feels safe in their environment.  Interestingly, this is one of the few ways that we can truly speak their language.  I use it all the time whilst consulting – before starting my exam, I catch their eye briefly and then blink slowly as if to say ‘It’s ok, you’re safe here’.  They almost always respond by blinking back, and are then much more likely to relax while I do what I need to do.  But even this isn’t always the case, as a cat in pain can also have squinty eyes, but the rest of their body language will be very different.

The tail flick

This is a really useful one to know as it can save you a scratch or two!  If you are petting your cat and notice that they start to flick their tail quickly from side to side, I’d suggest you take a break because it probably either means that they’re getting fed up with what you’re doing or they’re getting playful and are ready to pounce!  Often accompanied with a widening of the eyes which may help you recognise their increasing level of alertness.

Wee on the carpet

This may not seem like a method of communication, or at least you probably won’t be thinking rationally enough to see it as such at the time, but cats frequently use urine and even faeces as a way of getting their point across.  One of the first words that comes to mind when you discover such an incident is probably ‘spite’, but try not to take it personally and instead try to figure out why it may have occurred.  It may be that they are painful and need to see the vet, or that they are unhappy with your neighbour’s cat who keeps peering in on them from the window.  If the culprit is an intact male cat, talk to your vet about castration because there is a good chance that the underlying reason is territorial.

Grooming

Although this is usually associated with relaxed, friendly cats or members of the same family, grooming may serve another purpose.  Like the nervous purr, cats sometimes groom each other’s heads and necks when they’re feeling intimidated or antagonistic, possibly as an attempt to avoid overt aggression.  Chances are they’re feeling pretty comfortable when they start grooming you, although I have on occasion had a ‘nervous licker’ during an exam and even known a few cats to lick forcefully before they bite.

Chirping

It’s a funny sound, almost like a very excited miaow but broken and muted at times.  Often associated with a tail twitch and very wide eyes, it is a sign of extreme interest.  My cat regularly ‘chirps’ when looking out the window at the birds on the feeder.  An amusing, hopeful sound indeed!

Scratching on your new leather sofa

Again, try not to push human emotions onto your cat and assume that they’re doing it to get back at you for going out to dinner instead of spending time with them the night before.  In actual fact, cats have scent glands on the bottoms of their feet and between their toes so scratching (including the visual signs that are left behind) is another method of letting other cats know that this is their territory.  Make an effort to find out the underlying cause, or at least be sure to provide them plenty of other more suitable places to ‘sharpen their claws’.

Hissssssssss!

No surprises here, if you hear this sound, back off.  Cats are instinctively tuned into this sound and are therefore easily frightened by any noise that resembles a hiss such as aerosol spray cans or our own frantic ‘psssssssst!’ when we catch them up on the kitchen counter.  If their hiss escalates to a spit, don’t just back off, turn and walk away.  Quickly.

If you were surprised by some of the answers above, spend some time observing your cat over the next few weeks.  You’ll be amazed by what you find when you know what to look for!  Even those fluent in ‘felinese’ can learn something new from their cats every day.  The more you understand what your cat is trying to tell you, the better your relationship will be so it’s definitely worth the effort.

Do you know when your pets are poorly?

It may seem like a silly question, of course you would know when your pets are sick wouldn’t you? They share your life, your home and you know them really well, just as you do other members of your family. However, what many people don’t realise is that our animals are extremely adept at masking signs of illness and often by the time we realise there is a problem, they have been struggling for a while.

This blog was inspired by a cat I saw last week. She was owned by some lovely clients; regulars with their other pets and they definitely have their best interests at heart. I didn’t blame them for not noticing sooner this one was poorly because a) felines are notoriously good at hiding illness and b), you know, I’m a vet, so really I should be quite good at spotting when animals are sick but I don’t expect others to be.

However, I think they may have realised they had left it a little long to bring her; several times during the consultation the husband mentioned that they had waited because she didn’t seem in ‘distress’ and here in lies the nub of the matter for this cat, and for many of the pets I see.

Animals are very, very good at hiding when they aren’t feeling well or are in pain. You could say they are made of much sterner stuff than us humans, and they probably are, but in the main this characteristic comes from millennia of evolution; in the wild sick creatures are soon picked off by predators. This means that even when they feel dreadful animals will do their level best to behave as normally as possible or they may simply go off and sit quietly in a corner or curl up and sleep much more than usual. What they won’t do it moan or groan (or winge and demand tea and sympathy!), the most we might get is a reduced appetite or a limp. This is especially true of problems like arthritis, cancer or kidney failure, all of which are common in older pets.

Sadly this little cat had the latter of these and I will tell you how this tale ends now; blood tests showed her renal function was so damaged the kindest thing was to put her to sleep. Many people would think it almost impossible to not notice a pet was so sick they were near death but this is not the first time I have dealt with a case like this and it won’t be the last.

Obviously you don’t want to be dashing down to the surgery every 5 minutes when a pet isn’t quite themselves but neither do you want to leave things too long. So what is best to do? My advice would be to always be aware of how your pets are and if they have seemed ‘off’ for more than a day, ring your practice for a chat. A good clinic should take the time to speak to you and help you decide whether there is really a problem or not or use the symptom checker on this website!

Cat Henstridge BVSc MRCVS – Read more of her blogs at catthevet.com

Ask a vet online – Why is my staffy rubbing his bum on carpet after his glands were done? – Anal gland problems in dogs.

Question from Jo Padfield

Why is my staffy rubbing his bum on carpet after his glands were done. Pls

Answer from Shanika Winters (online vet)

Hi Jo and thank you for your question about your dog’s anal glands. I will explain a little about what anal glands are, where they are and why dogs have them followed by a discussion of what can go wrong with them and how these conditions are treated.

What are anal glands?

The anal sacs (commonly called the anal glands) are a pair of sacs found either side of the anus (bottom); they are around 1cm across and open via a duct (tube) in the anus. As with your dog the anal sacs often become blocked and or infected and this is called anal sacculitis. The substance inside the anal sacs is produced by glands that line the inside of the sacs, this smelly substance should be passed each time your dog does a poo, and leaves a scent marker to other dogs.

What goes wrong with the anal sacs?

Diseases of the anal sacs include anal sacculitis as mentioned and less often tumours. Other conditions around the bottom include anal adenoma (small non-cancerous lumps around the anus), anal furunculosis (cracked infected skin around the anus usually found in German Shepherd Dogs) and perianal hernia (where muscles weaken and separate either side of the anus allowing pelvic and abdominal contents to push through, seen in older uncastrated male dogs).
It is really important to have your dog thoroughly examined by your vet to make sure that the condition has been diagnosed correctly so that the correct treatment can be given.

How are blocked anal sacs treated?

We usually treat blocked anal sacs by manually emptying them out, this can be done by inserting a gloved finger into the anus and gently squeezing on the sac to empty the contents into a piece of tissue paper. The anal sacs can be emptied from the outside but this does not allow the anatomy of the sacs to be examined as thoroughly. Some owners feel confident that they can learn to empty their dog’s anal sacs, this is something to discuss with your vet who can show you how to do this.
If there is infection in the anal sacs then your vet might give your dog antibiotics, this can be given orally or put directly into the anal sacs after they have been flushed out. If the anal sacs are going to be flushed out, most dogs will need sedation or general anaesthesia to allow this to be performed, a small cannula (plastic tube) is passed into the anal sac via the opening of the duct on the anus and saline is then flushed in and the glands then emptied, the process is repeated until the glands appear clean. Antibiotic and anti-inflammatory preparations can then be put into the anal sac. Sometimes steroids may also be given to ease the irritation caused by anal sacculitis.

Anal sacs sometimes are not properly emptied if your dog has soft poo or diarrhoea; this usually improves once your dog’s poo is firm again and can be helped by a change in diet.

When is surgical removal of the anal sacs an option?

If there are severe repeated anal gland infections and the dog does not tolerate medical treatment and manual emptying of the anal sacs then surgical removal is considered. The procedure is performed under general anaesthesia and does carry a small risk of disturbance to the dog’s ability to control passing poo. In most cases the lack of control when pooing is temporary but due the closeness of the nerves controlling continence to the anal sacs themselves there is this risk of them being damaged. Remember that your vet will discuss the pros and cons of a procedure with you so that a joint and informed decision can be made by you with the help of your vet.

I hope that this answer has been helpful for you and that your dog starts to feel more comfortable soon.

Shanika Winter MRCVS (Online Vet)

If your dog has a problem with its anal glands please book an appointment to see your vet, or use our online symptom checker

The Drugs Don’t Work – Or Do They?

Today I put to sleep a lovely old Collie owned by a lovely man. It was definitely the right decision, the dog was really struggling on his legs and had become very depressed and withdrawn. This is a common scenario and very often the way that arthritic pets come to their end. In fact, a very similar thing happened to our beloved family Labrador, Molly, a few years ago and although she was still trying to get about and clearly happy to be with us, she was obviously in a lot of pain which could no longer be controlled. Euthanasia in these situations is a true kindness and although still desperately upsetting, is by far the best thing for the pet.

However, just as I was discussing the euthanasia of this dog with his owner, he said something that stopped me in my tracks.

‘Well, we did try him on some of your arthritis medication a few months ago but to be honest it didn’t seem to be doing anything more than the Asprin I was giving him, so we stopped it’

Now, at this stage in the process there was no point in me making any comment on this statement (or my thoughts on giving pets human medications!) and you may think it sounds like quite a reasonable thing to say but to be honest, I really had to bite my tongue.

Arthritis is a very common problem in older pets but it is also very under-diagnosed because the signs can be difficult to spot, mainly because our animals are so stoical in the face of chronic pain. Even just a bit of stiffness after rest can indicate a significant problem. The medications we have to treat it are extremely effective but often, and especially in the older pets with more advanced arthritis, just one drug on it’s own doesn’t completely combat the problem and they need a combination of medicines to really keep them comfortable. (Anyone with an older relative will probably be familiar with this concept; my granny seems to be on hundreds of tablets!)

Our darling Molly was practically rattling in her last few months I had her on so many medications and supplements These kept her comfortable but eventually, they could no longer control her pain and give her the strength to get around, so the kindest thing was to let her go.

My message is, if you have an older pet, firstly, don’t assume that them slowing down and stiffening up is a ‘normal’ part of aging (well, in a way it is but that doesn’t mean we can’t do something about it!) and if the medicines your vet gives you don’t make much difference at first, don’t assume that that is because there isn’t a problem or that nothing else can be done, it may just be they need different tablets or combination therapy to give them their bounce back! This is far preferable to leaving them to struggle in silence and although, in the end, their arthritis may mean they need to be put to sleep, it will certainly give them more time and mean their final months with you are pain free and comfortable.

And finally, please don’t give your pets ANY human medications without talking to your vet about it first. Drugs often work very differently in animals than they do in people and some can be actually harmful.

Competition Vetting

Horse Jumping, photo by EDWARD McCABE

Horse Jumping, photo by EDWARD McCABE

Like everyone I know, I was glued to the Olympics – great job Team GB, especially our first Dressage and Show Jumping medals for a long time!
However, I wonder how many people think about the infrastructure and planning that go into keeping the horses fit, safe and healthy when they compete?
I’ve been a treating vet at a lot of competitions over the years, including Endurance events, local, regional and National Championship Pony Club events (where the standard is often as high as at many BE competitions!) and the International Show Jumping at Sheffield Hallam Arena. I was also on the vet team as a student at Badminton back when they still had roads and tracks before the cross country.

The vets that people most often seen are those on the Ground Jury at competitions – the notorious “Trot Up” before the competition starts, and again (in eventing) before the horses go forwards to the show jumping phase. At Badminton and most other big events, there are two vets – one on the Ground Jury, along with two or three other worthies – and one in the Hold Box. If there is a question over a horse’s fitness to compete, they get sent to the hold box, where the second vet examines them to see if there is a medical problem rendering the horse unfit. This is a very contentious area – I’ve never yet been at an event where the Ground Jury and the vets didn’t come in for a barrage of criticism over their decisions. However, it’s important to realise that they have to balance several factors:

Firstly, if a horse is unlevel on the trot up, it may be truly lame, or it may have a “mechanical lameness” – in other words, an abnormal gait that is non painful, and does not render it unfit (on welfare grounds) or unsafe to compete. To help them decide, they trot the horse up before the competition, and then note down any anomalies of gait or stride.
Secondly, there are some horses with minor injuries who can appear far more badly injured than they actually are. This is the reason for the Hold Box – a horse with a mild lameness due to a stone in it’s hoof (yes, it does happen, I’ve seen it!) will probably trot up sound once the offending pebble has been removed; likewise, I once saw a hopping lame (7/10 at trot, for anyone interested) horse go 100% sound after a misfitting stud was removed.
Thirdly, of course, the Ground Jury and the vets have to watch the riders or grooms who are trotting up the horse. It’s an old joke in the profession that the shorter the skirt and tighter the top of a woman competitor, the more carefully you have to check the horse, because she’s trying to distract your attention from something!

The role of the vet as a judge of fitness is of course expanded in Endurance competitions, where every horse has to be checked at various points along the track to ensure it is fit to continue, and that its heart rate drops enough to be permitted to go on. Different events have different requirements for judging, but as a general rule, the horse has to trot up sound and well hydrated, and have a heart rate below a certain value (e.g. 80 beats per minute). I was at one big competition once where there was a dispute over whether the (leading, international competitor’s) horse was sound or not. The decision was passed to a panel of 3 vets, none of us having seen the horse before that day, and its soundness or otherwise put to a secret ballot.

This used to be standard practice at two- and three day events, when there was a roads and tracks phase before the cross country. In these competitions (and there are still a few ongoing, regional Two Day Events in various corners of the country), the vet is present simply to determine whether the horse is fit and safe to continue. I once had to pull a horse because it was obviously “not right” – not an easy decision for a vet student at a CCI 3*! The rider appealed the decision – and while we were waiting, it tied up completely, and had to be recovered by the horse ambulance. I still shudder to think how badly it might have been injured if we had allowed it to run cross country.

At these events, riders, trainers etc can be very keen for the vet to pass a suspect horse as sound (although strangely, it doesn’t seem to be such a problem at Pony Club) – however, we’re really not trying to ruin your day (honest, and no, we don’t get paid to “fail” some competitors horses either), we’re just trying to make sure that an injury doesn’t ruin your horse’s week, month or season!

Of course, that brings me on to the treating vets at an event. Any equestrian competition will have a vet either on call or – especially at big events – on site. Some events (like the Pony Club Championships, Badminton or the International Show Jumping) will have the horses stabled on site. At these, there will usually be some vets assigned to the stables area, and others out on the course or at the arena.
Nowadays, we also have access to Equine Ambulances and their fantastic staff. They may look like normal horse trailers, but inside they have slings, winches, padded walls and often lowering floors – everything you need, in fact, to quickly and safely evacuate an injured horse.
The job of the course/arena vets is to be first on the scene and assess the state of the injured horse. They will give first aid, stabilise any strained tendons or suspicious fractures, and then decide where to send the horse. The big decision to make is whether it’s best to send the horse back to the stables (and if so, on foot or in the ambulance?), or refer them directly to a hospital facility. Fortunately, injuries that need immediate referral are rare; and most cases will be sent back to the stables. While assessing the horse, I like to have screens available – it doesn’t mean I’m preparing to put the horse down, but it does mean I can examine them in a calmer, more private environment. If we do need to put a horse down, we’ll usually try and move it off the track or away from the arena in the ambulance, to get some privacy.

While the course vets have to perform in the blaze of publicity, the stables vets are equally important. During the competition, the stables vets will keep in touch with their colleagues on the course, either by phone or (usually) radio. Quite often we’ll listen in on official channels as well so we can be leaning the right way if there is an incident! It’s the stables vets who will deal with most injuries and accidents during the competition, and it can get pretty hectic, stitching up rows of horses in succession…
At many competitions, there will only be a couple of us, looking after several hundred horses, 24 hours a day. I remember one memorable competition several years back where the night after the cross country phase, I got about an hour’s sleep – the rest of the night I was up treating the colicing, the sprained and strained, and the just “not quite right”. Most of my patients that week were mildly dehydrated – it’s amazing how much more horses need to drink after competing in hot weather! That’s the only time I can remember when I had to ring up a local practice to borrow more electrolyte salts, because I’d used up everything I took with me… (And the next year, when I took boxes and boxes of the stuff, they competed in gales and torrential rain, and I actually had cases of rain scald to treat… Well, that’s the English summer for you!).

If you are concerned about your horse, talk to your vet or try our Interactive Horse Symptom Guide to see how urgent it might be.

Part 3: Surgical Colic

As we saw in the previous part of this series, Medical colics are those which can be managed medically, usually on the yard. However, about 1 in 10 cases of colic require emergency referral to an equine hospital for surgery.

This is what most horse owners are terrified of. The general indicators that a horse has a surgical colic are:

1) Heart rate over 60 that isn’t relieved by injectable painkillers.
2) Dilated loops of small intestine on rectal exam.
3) Positive stomach reflux from the stomach tube.
4) A definite rectal diagnosis of a surgical problem.
5) “Toxic rings” – dark red or purple gums, that indicate that the horse is going into toxic shock.

Of course, it varies between horses, and the vet has to make a judgment call based on all the evidence available.

We also have to talk to the (by now usually frantic) owners about costs. Colic surgery usually costs between £4000 and £5000, but can easily be a lot more. Even if the horse is insured, it is important to check how much the insurance company will cover – there are a couple of companies out there who will only cover part of the costs of emergency surgery. If in doubt, always call your insurer’s helpline.

However, colic surgery is one of the most genuine emergency operations there is – and it can be truly life-saving.

So, what causes a surgical colic? Probably the most common are:

1) Twisted bowel. If a length of bowel twists around itself, it can cut off the circulation. At this point, the gut begins to die, and unless it can be removed by surgery, and quickly, the horse will go into toxic shock and die. This commonly happens in the small intestine or occasionally the colon, but there’s also a condition where the caecum gets turned partially inside out (an intussusception).

2) Small intestinal blockages. Horses rarely eat things that get stuck in the small intestine (although it can happen). More commonly, a really heavy worm burden can simply block up the bowel; with the bowel overfull, the blood supply starts to fail, and the gut, again, can die. I once had a patient who was a little foal with a severe colic; we removed two gallons of worms from her small intestine!

3) Strangulating Lipomas. These are really common in older horses and ponies. A small, benign, fatty tumour forms somewhere in the abdomen, causing no harm at all. However, it grows on a stalk, and eventually, the stalk gets wrapped around a length of gut, cutting off the blood supply… This results in the bowel dying, as if it had twisted. Fortunately, these are usually really simple surgical procedures; unfortunately, older horses and ponies are less likely to be insured for surgery.

There are also a number of medical conditions that can mimic those requiring surgery – particularly peritonitis and anterior (or proximal) enteritis. Horses with these conditions are often referred for possible surgery because it’s very hard for the vet in the field or on the yard to be 100% certain they’re not surgical. I think that most of us would say it makes a lot more sense to have the horse at the hospital, with a surgeon on call, to make the definitive diagnosis, rather than waste time in the stable, and risk having to then decide it needs surgery when it’s still an hour or more away in travelling time from the hospital!

So, what happens when the vet decides that a colic case isn’t suitable for medical management?

Firstly, they’ll talk to you about the options. If a horse isn’t insured, or there’s no money for treatment, it is a perfectly respectable and responsible decision to decide, sadly, to put the horse to sleep rather than prolong its suffering.

Hopefully, of course, that won’t be the case. Once you and the vet have decided that referral is the way forward, your vet will get in contact with a referral hospital. If you’re very lucky, it will be one run by your vet’s practice, but in most cases, it will be a specialist referral hospital. I must say here that not every centre with surgical facilities is able to cope with emergency colic surgery – they need not only to have the facilities (knock-down box, operating theatre, recovery box etc), but also the staff (not only a surgeon, but also enough vets and nurses to take care of your horse in the vital recovery period). Your vet will have a list of suitable referral hospitals – generally, its best to send the horse to the closest one with the shortest transport time, but your vet will be able to advise you.

Making an emergency referral is simple – but only your vet can do it. A referral hospital will not accept referrals from the horse’s owner! Once you’ve made the decision to refer, your vet will call them and speak to the veterinary team on call, who will be available 24/7/365 (when I was part of one such team, we ALWAYS seemed to get our referrals at about 10pm!). They’ll let him or her know what they want done during transport – generally, they’ll describe what painkillers they want given, and what samples they want taken (don’t be surprised if your vet gives you a couple of blood tubes to take up and give to the referral team). In addition, they’ll sometimes ask the vet to put in a stomach tube and tie it in for the journey – this is to prevent the stomach from getting over-full and bursting if there’s an obstruction in the small intestine. Don’t forget your horse’s passport – legally, they do need it even when being rushed to emergency surgery.

Your vet will generally give you directions and a contact number for the hospital, and send you on your way. Remember, they can’t normally go with you, because your horse’s colic, while devastating, is probably only one of several cases they’ll have to deal with.

If there’s a problem (e.g. your horse getting distressed) in transit, call your vet or the referral number you were given – but if at all possible don’t stop unless they tell you to! Remember, you’re on your way to the best equipped help available.

On arrival at the hospital, you can expect to be met by the veterinary and nursing team. Your horse will be rushed to an assessment area, and you’ll probably be given a lot of scary-looking paperwork to sign. Generally, this comes into 2 parts – firstly, you’re signing to give consent for whatever they need to do (and remember, a lot of drugs aren’t technically licensed for use in horses, because the manufacturers haven’t paid for an official license for that drug in horses. It doesn’t mean a drug is dangerous or experimental, it’s probably used on a daily basis by the hospital. You’ll have to sign consent to use unlicensed medication – it’s absolutely routine, and nothing to worry about). Most hospitals will also ask to see your passport – if you haven’t got it, or it isn’t signed to mark the horse as “not intended for human consumption”, legally the hospital can refuse treatment (although they rarely do).

The second set of paperwork you’ll sign is a bit more pedestrian – you’ll be signing to say that you will pay for any treatment!

While you’re contemplating the paperwork, your horse will be undergoing another examination by the veterinary team. This is to establish what’s going on, and what’s changed since your vet examined him back on the yard. They may well repeat some tests – most colic conditions are dynamic (i.e. constantly changing), and sometimes the change is more useful in working out what’s going on than a one-off test. Other tests they may wheel out include ultrasound – the powerful ultrasound systems available in a hospital environment can give the vets a lot more information about what’s going on. The vets will then make a decision about what to do – don’t be disappointed or worried if they don’t rush immediately to surgery! They may decide to try a course of medical treatment first (remember, they don’t have to rush as much as your vet does – if your horse’s situation deteriorates, they can operate at a moment’s notice).

In many cases, however, they will decide to take the horse straight to theatre. If so, you normally won’t be able to follow, so I’m going to describe what happens once you’ve been gently steered in the direction of a waiting room.

To begin with, the horse will have an intravenous catheter fitted, to allow easy access for fluids and drugs. A horse with colic is systemically weakened, so will almost invariably be given intravenous fluids during surgery. He’ll then be given a premed – this is a sedative, designed to make induction into anaesthesia gentler. It will usually contain the drug acepromazine, because the use of this before surgery has been demonstrated to reduce the risks of anaesthetics.

He’ll then be led into a knock-down box: this is a special padded room, designed to make induction of anaesthesia safer. Then he’ll be anaesthetised with an injection containing (usually) a mixture of 2 anaesthetic agents, ketamine (no, it’s not a tranquilizer, it’s an anaesthetic) and diazepam or a similar drug. Shortly after the injection, he’ll go wobbly, and then quickly lie down.

Once he’s asleep, the team will swing into action: a tube will be passed down his throat to help him breathe and he’ll be moved into the operating theatre. While this was going on, the surgeon(s) will have been scrubbing up, ready to start.

Once he’s in theatre and safely ensconced on a well cushioned table (to prevent pressure sores etc), he’ll be put onto anaesthetic gas to keep him asleep.

Colic3 - SurgeryThe surgery involves a long incision down the midline of the belly. The surgeons can then have a good look through all the intestines, to find the problem. This is the exciting, sexy bit, but it’s actually pretty simple in principle: “if in doubt, cut it out”. In other words, removing devitalized (dead) bowel, emptying out anything in the bowel that shouldn’t be there (e.g. a caecal impaction), replacing anything that’s got stuck in the wrong place (e.g. an entrapment) and untwisting anything that’s tied up. There are usually at least 2 surgeons, because one person is needed to hold loops of intestines (and they don’t stay still – sometimes they wriggle around in your arms)! Meanwhile, the anaesthetist will be carefully monitoring all sorts of parameters (heart rate, blood pressure, ECG, reflexes, breathing and blood gasses can all be monitored at many hospitals) and adjusting the anaesthetic and any other drugs to give the safest and most effective anaesthetic.

Once whatever the problem was has been found and (hopefully) sorted out, your horse will be returned to the recovery room. In many ways, this is the most dangerous part of the procedure. Horses are very prone to breaking things when they wake up, so everything is done to keep it as calm and quiet as possible. Sometimes, the veterinary team will help the horse to rise, using hoists and lifts; other times, it works out better to let him get up in his own time. In either case, he will be moved into a padded room, and left in dim light, as quietly as possible, so he wakes up slowly.

Once awake, and steady on his feet, he’ll be moved to an intensive care box; he’ll almost certainly be on a drip to keep him hydrated. At regular intervals through the next 24 hours (or longer) he’ll be checked by vets and nurses. In some cases, the guts don’t start working properly on their own, and medication may be needed to encourage motility (e.g. a lidocaine drip). Although everyone gets excited about the surgery, it is this recovery period that is in many ways the most important in getting a good long-term prognosis.

As time goes on, the vets and nurses will try and tempt the horse to eat – normally, we’ll try and get him eating fresh grass as soon as possible. As soon as he is stable enough and eating on his own, he’ll be sent home – most horses do better in their own home environment, so as soon as they no longer require advanced medical intervention, they can go home. Once home, it’s important that the discharge instructions from the hospital are followed – it can be tempting to try and speed things up, but don’t rush it! Major abdominal surgery takes time to recover from.

Colic is a worrying condition to have to deal with as an owner, especially as it often seems to come out of the blue. However, if you ever have to go through it, I hope that having read these blogs, you’ll have some idea of what’s being done, and why. Remember, our aim as vets is to help your horse and, if at all possible, send him home to you fit and well.

If you are worried your horse or pony may be suffering from colic, talk to your vet, or check the symptoms using our Interactive Equine Symptom Guide to help assess how urgent the problem may be.

But can’t he just die in his sleep…..?

This week my Granny died, which was sad for us all but she was very old, had had a wonderful life and her family was with her at the end. She had been in a home for some time and was cared for very well. When she became sick and bedbound, the doctors and nurses worked together to keep her comfortable and pain free, until she slipped away in her sleep. I am lucky in that she was the first person I knew well who has died and this experience has made me understand why many people hope this is how their pets will go. However, to die in their sleep is rarely a pleasant or pain free experience for our animals.

Domino sleepingAlthough, just like people, our pets are living longer and healthier lives, inevitably there comes a time when their age catches up with them and illnesses develop. Advances in veterinary care mean we can do a lot for them but eventually we won’t be able to keep up with their problems. If they were people we would put them in wheelchairs or place them in a home where their needs could be catered for, for example being assisted to the toilet or spoon fed but this isn’t practical, or in most cases fair, to a pet who won’t understand what is happening (there are many people who would argue this is no kind of life for a person either but that is a whole other debate). For a pet, when they can no longer get up and out to do their toilet or feed themselves properly, or when their illnesses or pain can no longer be controlled with medication, this is the time as owners we should objectively assess their quality of life and decide whether it is fair to let them continue. Also, just as important is your quality of life, it is hard work caring for any pet, let alone an elderly one who may be incontinent or senile.

The vast majority of pets who reach the end of their natural lives are euthanased by their vet. This is inevitably a sad experience for their owners (and us) but is far preferable than allowing them to slip away on their own. Many people hope this will happen, having probably experienced death this way with people as I recently did myself, but it is very different for animals. Bodies are designed for living and will go on doing so regardless of how painful or unpleasant it becomes for the individual. When people die in their sleep they are usually heavily medicated and cared for to ensure they are not in any pain or dehydrated but this doesn’t happen for our pets. If an animal dies this way, they have usually suffered to a large extent; likely being dehydrated, malnourished and in pain. Although from the outside they might look peaceful, they are anything but; it is simply all their exhausted body can manage.

This is why when our pets become infirm and their quality of life declines to a point where living is a struggle and not the joy it should be, by far the kindest and most humane thing we can do as owners and vets is to euthanase them in a painless and peaceful way. I often say it is the one big advantages we have over human medicine; we can stop the suffering before it becomes too great. Although it may seem daunting your vet will talk you through the procedure and make sure you are happy with the process and your decision. You will be able to stay with your pet if you want to and most vets will come to your home if your request it. Euthanasia means ‘a peaceful death’ and as a pet owner it is the final act of kindness you can bestow upon your companion.

If you are worried that your pet may be ill, talk to your vet. Try our Interactive Symptom Guide to check any symptoms they are displaying and help decide how soon you’ll need to visit your vet.

Colic: Part 2: Medical Colics

In my last piece, I looked at how the vet will examine a horse with colic. Following this, and using all the information from the history and workup, he or she has to decide if the colic is Medical or Surgical. The terms are more or less self-explanatory: a medical colic can be managed with drugs, while a surgical colic needs emergency surgery.

As a rule of thumb, 9/10 colics are medical, and can almost always be managed on the yard.

So, here are the common causes of colic that we see in the UK1 :

1) Spasmodic Colic. This is probably the commonest, and perhaps the least understood; I estimate about 80% of Medical colics are Spasmodic. Spasmodic colic can be caused by a stressful event, mild dehydration, or be genuinely idiopathic (i.e. we don’t know what causes it!). It can also be caused by severe tapeworm burdens. In a Spasmodic Colic, a section of the gut goes into a spasm, preventing anything from moving past it. It can be acutely painful, but usually responds really well to management with drugs. For any horse that has two or more bouts of spasmodic colic, I’d always recommend a tapeworm blood test to make sure it isn’t part of the problem!

2) Impaction Colic. This is more common in some management systems – it is pretty rare, for example, in horses who live on grass. In these cases, the food in the large intestine dries out a bit too much, and turns into a putty-like material. It then gets stuck, typically at one of the 180- degree turns in the Large Colon. It’s also strongly associated with moderate dehydration – as a horse gets dehydrated, he will move water out of the gut in order to keep up his circulating blood volume. This is a clever trick, meaning a horse can survive levels of dehydration that would kill a human. However, if the water isn’t replaced, and he’s been eating dry hay, his gut contents can become so dry they cause an impaction. This is why, many years ago, bran mash and Epsom salts were fed after hard work – both are good ways of rehydrating the colon and Caecum contents.

3) Gut displacements and entraptions. These are a bit of a mixture – some are medical, some are surgical, some look surgical but aren’t, and some can be fixed medically but keep coming back so surgery is eventually needed. What many people don’t realise is that the guts are in constant motion. Occasionally, a loop of intestine goes “wandering around” inside the abdomen, and gets stuck behind something else (for example, into a little gap between the spleen and the kidney). These can often only be diagnosed by rectal exam, and can feel really confusing, where nothing seems to be exactly where it should be! Each case has to be treated on its merits, and many can be resolved by lunging – presumably because jiggling everything around helps the intestines to fall back into their proper places! Personally, however, my inclination is generally to refer the horse as a possible surgical case, because it’s amazing how often a trip in the box fixes a displacement or entraption. Of course, if they can’t be rapidly resolved, they need to have surgery to put everything back, before any permanent damage is done.

4) Sand colic – I’ve only rarely seen these; they’re normally caused by the horse drinking from sandy water. Over time, sand builds up in the intestines, causing irritation and sometimes an impaction. Management usually revolves around maintaining gut motion with laxatives and pain relief; however, surgery is sometimes needed to evacuate the sand and debris from the gut.

5) Inflammatory diseases, e.g. peritonitis or anterior enteritis. I’m including these here because they’re not strictly surgical. However, they can be really hard to differentiate from surgical cases, and they’re usually only diagnosed after referral, with the advanced techniques available at a referral hospital.

6) Other medical causes, e.g. diarrhoea, or stomach ulcers, can also cause a “Medical” colic; however, these cases require the underlying disease to be treated, at which point the colic symptoms will resolve themselves.

Treatment for medical colics is focused around pain relief and maintaining hydration. Spasmodic colics especially respond very well to a mixture of hyoscine and a pain-killer, which relaxes the spasming gut segment, allowing normal gut movement to be re-established.

Using a painkiller (e.g. injectable bute) can also be a really useful diagnostic test for whether a horse needs surgery – one of the standard guidelines is that a horse with a heart rate over 60 beats per minutes, 30 minutes after intravenous bute, is usually a surgical case. The other painkiller (flunixin meglumine) is almost never used, unless surgery is definitely not an option. This is because it is too powerful! Even horses with dead bowel can look bright, healthy and well, until the flunixin wears off. At that point, they crash, and are often too far gone to be saved.

Equipment for the medical treatment of colic

Equipment for the medical treatment of colic

For impactions, rehydrating the gut contents is vital, but pain relief is also really important. In these cases, Epsom salts and water by stomach tube are really useful. There is some controversy over the use of liquid paraffin in impaction colics. If the horse later has to go to surgery, the presence of liquid paraffin in the gut can cause major headaches for the surgeons; on the other hand, it can be a marvellous lubricant to help move things along. Personally, I tend to give any impaction colic a bucket by stomach tube containing a mixture of water, electrolytes and Epsom salts; and if I’m sure it’s not surgical, I’ll add in a litre or two of liquid paraffin as well. Liquid paraffin is horrible stuff to work with, and if all you’ve got to give it with is cold water, it’s not easy to mix in; I like to mix the water and electrolyte tablets or sachets together first in a bucket, then add the paraffin.

The tube is passed down the nose and (hopefully first time!) into the gullet (if it goes into the wind pipe, start again…), and down all the way into the stomach. To check it’s in the right place, I always feel for it passing down the throat, listen for air moving as the horse breathes, and then suck on it to see if I get lots of air back (means I’m in the airways) or nothing (means I’m in the gullet) or, worst of all, a mouthful of stomach contents. This means the tube is in the stomach, which is great, but it tastes truly vile! Once I’ve carried out all those tests, I’ll pour in a tiny amount of clean water, just to be sure – if the horse coughs, it means the tube is in the windpipe despite all my tests, but it’s not the disaster it would be if I’d poured in a couple of gallons of liquid…

To get this lot into a horse, some people use stirrup pumps – they’re a bit like bicycle pumps, and attach to the end of the stomach tube. This is used to pump fluid from the bucket down the tube – they’re great if you’ve got them, although you have to be careful not to overfill the stomach. However, most of us still use syphons and funnels. The tallest person present (usually me…) attaches a funnel to the top of the tube, then fills the funnel from the bucket. They then hold the funnel as high as they can, so the liquid runs down the tube into the horse’s stomach. You then repeat this until either the bucket is empty or the funnel stops running, which normally means the stomach is full. It’s messy, and can be physically pretty hard work, but it’s a vital part of treating an impaction colic. Personally, I quite often use it to rehydrate the gut of any severe medical colic, because anything that causes gut stasis can lead to a secondary impaction if you’re not careful.

I’d normally treat a definitely diagnosed impaction with injectable bute for pain relief. There is some evidence to suggest that the use of anti-spasm drugs like Buscopan can help to encourage normal gut action, even though they are designed to work as gut relaxants, but I think that particular debate is still open.

To maintain hydration, some vets also like to start a drip line for intravenous fluids. This won’t help the gut (any excess fluid will be excreted by the kidneys before it gets there), but it can help to support the circulation of the horse. Personally, my thinking is that most colics that are so severely dehydrated that they need a drip are either surgical or have another, underlying disease; however, there are always exceptions!

Chronic, ongoing colics can be a nightmare to manage – they’re typically low grade, spasmodic colics, or mild impactions. In these cases, a more thorough examination (including blood tests) is indicated, to try and rule out any underlying disease. Chronic impaction problems tend to be management related, and can usually be resolved with minor tweaks to management. However, your vet will often want to check your horse’s teeth – this is because dental problems can result in poorly chewed food, which can make impactions more likely.

My experience with the chronic spasmodic colics is that if there’s no other underlying cause found, they can occasionally respond nicely to a course of probiotics. I had an incredibly frustrating case once of a horse that had repeated bouts of colic, that we never got to the bottom of. I was being called out every few weeks (and the yard was nearly thirty miles from the practice, which made each visit something of a nightmare!). Eventually I suggested we try a month’s course of probiotics… and the next time I saw the horse was nine months later for annual vaccination. Any further colic episodes, I asked? No, they replied – nothing since we started the probiotics. Although it isn’t a cure-all, it can apparently help in some cases!

Of course, not all colics are medical – about 10% require surgical management. In the third and final piece of this series, I will look at the indications for surgery, the types of colic needing surgery, and then I’ll go through what happens when your horse is referred to an equine hospital for emergency surgery.

1 This is based on my clinical experience in the Midlands, Wales and the South West of England. In some parts of the country, other causes will be more common – for example, on the South Coast, Sand Colic is more common. However, it seems to be fairly rare in most areas, so I’m not going to cover it in great detail.

If you are worried your horse or pony may be suffering from colic, talk to your vet, or check the symptoms using our Interactive Equine Symptom Guide to help assess how urgent the problem may be.

Colic: Part 1: Diagnosis and Workup

Horse colic examination and anatomy
When talking about colic, it’s important to have some idea of what the various parts of the equine gut are… So, here we go:
Stomach – quite small, and hidden away deep up in the ribcage.
Small intestine - this is very long, but quite narrow (perhaps 1 or 2 inches across). It is all coiled up throughout the abdomen.
Large intestine – this is divided into three parts:
The Caecum is a large sac perhaps four or five feet long, pointing forward, and can be heard on the right flank. Generally, it makes a loud gurgling noise every 20 to 30 seconds in a normal, healthy horse.
The Large Colon makes up a double U shape, lying on the bottom of the abdomen. It can be up to a foot across, but at each end is a sharp 180-degree bend; the bend near the pelvis (the pelvic flexure) is especially narrow.
The Small Colon runs from the large colon down to the rectum, along the top of the abdominal space.

It’s something all horse owners dread – colic. However, colic is a symptom, not a disease in its own right, and has a wide range of different causes. This is the first in a three-part series where I’ll be looking at colic in horses – its diagnosis and treatment, and what happens if your horse has to be referred for surgery.

Put simply, all colic is, is abdominal pain. However, before you’re tempted to dismiss it as a stomach ache, it’s worth remembering that the horse’s intestines are as complicated as a major chemical factory! Anything that causes disruption to their function is potentially life-threatening.

Occasionally, colic pain comes from a non-intestinal source, e.g. Liver disease (think ragwort poisoning, or liver fluke), or a kidney issue. In mares, it can also be caused by certain disorders of the reproductive tract. However, the vast majority are due to disease, damage or malfunction of the intestines.

If you call your vet and tell them that your horse has colic, they’ll treat it as an emergency, because it can be. They’ll generally take a bit of history from you, a quick description of what the horse is doing at the moment, and then they’ll head out to examine the horse. Most vets will also give instructions for what to do while you’re waiting; it’s important to do what they say, not what someone else on the yard suggests. This is because they may have an idea what sort of colic your horse has, and will try to tailor their instructions to the specific case. For example, some forms of colic respond well to being trotted around on the lunge; however, that can worsen other types.

When they arrive, the vet will want to establish three things:
Firstly, does the horse actually have colic? I’ve been called out to “colic” cases that proved to be laminitis; to a mare foaling down; once even to a tired (but perfectly healthy) horse sleeping in his stable!
Secondly, assuming it is a colic, is it a Medical or a Surgical Colic? (I’ll talk more about this distinction in a minute).
Third and finally, can they make a specific diagnosis of what kind of colic it is?

Every vet will have their own routine, but my workup goes something like this:

What’s the horse’s behaviour like? Is he alert, or dull and unresponsive? Is he thrashing about, or just looking at his flanks occasionally? Generally, a quieter horse is likely to have a milder colic, unless he or she is so toxic that they are depressed or spaced out. One exception is that some spasmodic colics are incredibly painful – however, the pain usually comes in waves.

Are there any droppings in the stable? Hard, dry lumps of faeces is suggestive of an impaction, or blockage; while very runny faeces or diarrhoea may suggest colic secondary to an infection, e.g. Salmonella.

Then I’ll start my examination:

Mucous membranes (gums are usually most accessible and reliable) – what colour are they, what is the refill time, are they tacky?
The normal colour is described as being “salmon pink”, and if you press with a finger for a moment, the colour should fade to white, then return within 2 seconds. They should also be nice and moist to the touch. If they are red, or purple, or the colour doesn’t fade, it is highly suggestive of toxic shock (like septicaemia). This is a marker of a really, really severe injury to the gut wall, that’s allowing bacterial toxins to enter the circulation. If the refill time is greater than 2 seconds, or the membranes are tacky or dry, it suggests dehydration and/or shock.

Heart rate - how fast, is the rhythm good? As a (very rough and ready!) general rule, a heart rate under 60 beats per minute implies a Medical colic, while over 80 suggests a Surgical case. If there’s an abnormality in the rhythm, it can mean heart disease as well, or severe toxic shock.

Gut sounds - what do the guts sound like in all 4 quadrants?
This is where you’ll see your vet putting a stethoscope to the horse’s flanks, listening to the guts. The normal, healthy gut makes a wide range of bubbling, gurgling noises (the sort that anywhere else you would associate with really cheap plumbing!). The bottom left is the left Large Colon, bottom right is the right Large Colon and perhaps some Caecum, the top right is the base of the Caecum, and the top left is mainly small intestine. This is one of the most useful tests we can do – reduced sounds mean the guts are “slowing down” – this can mean an impaction or blockage, but it can also mean a serious disease e.g. a twisted gut. Increased sounds is generally a good sign, as it usually means a Spasmodic colic.

Finally, I’d want to take the temperature (a horse with a fever is likely to have another disease, e.g. Salmonella, that is the underlying cause of the colic), and then, if at all possible, do a rectal exam. People get very excited about this, and it’s one of the standard jokes about vets, but I’d like to go on record and say that I doubt anyone actually enjoys rectalling a horse! Apart from anything else, it’s dangerous to the vet, and uncomfortable to the horse… However, it can provide more information than almost any other test. What we’re feeling for is anything unusual: is the large colon a normal size and texture? How about the Caecum? Can you feel the small intestine? Usually, the small intestine is almost impossible to feel – it just slithers out of the way. If, however, you can feel thick, swollen loops of intestines (they feel a bit like black pudding, or really thick, soft sausages, if you’re interested!), it is an indication of a complete blockage in the small intestine, which needs emergency colic surgery. On the other hand, if you feel a doughy, squishy mass in the colon, that means the horse has an impaction.

Sometimes, if there is doubt about whether food is passing from the stomach or not, the vet will pass a stomach tube and see how full the stomach is. This looks really easy in theory – you pass a tube up the horse’s nose, he swallows it, and then you syphon out the stomach. If you get lots, it’s too full, if not, it’s fine. However, not all horses are quite so easy! Some horses are really difficult to get to swallow the tube, and it can take several attempts to make sure it’s not in the windpipe (which would be a disaster). Also, the equine stomach is, as one equine surgeon I know once put it, “a fantastic organ – it can be completely dilated (full), and you’ll get nothing out of it until you move the tube half an inch, then it all comes spurting out”. However, if there’s any doubt, it can be a great tool to ensure that there isn’t a rapidly life- threatening blockage; it can also be emergency first aid to prevent the horse’s stomach rupturing in a severe surgical colic.

The vet will also sometimes take blood samples – we tend to hold onto these in case they’re needed, but the main things we’re looking for are:
1) Evidence of dehydration – the blood tests will allow us to quantify the degree of dehydration, making it easier to plan a course of treatment.
2) Evidence of infection – if the white cell count is significantly abnormal, it suggests there may be something else causing the colic that we might need to look into.
3) Liver and kidney function – sometimes liver or kidney disease can present as colic
4) MOST IMPORTANTLY – Fibrinogen levels. Fibrinogen is a substance that can be used to assess inflammation and tissue damage – a high Fib level in a colic case is very suggestive that the gut integrity is damaged, and that surgical intervention may be needed.

There’s one other sample that can be very useful, especially as a “rule out” test if the clinical findings are contradictory or unclear. This is a peritoneal tap. This test carries some risk, but sometimes it’s the best way to find out what’s going on inside the abdomen. The belly of the horse is clipped, and prepared so make it as sterile as possible – we don’t want to risk introducing infection. The area is numbed with local anaesthetic, and then either a small incision is made with a scalpel and a blunt cannula inserted or (more usually) a small sterile needle is VERY CAREFULY inserted through the abdominal wall. The fluid that comes out is collected in a sterile sample pot for examination. The risk, of course, is that damage is done to the intestines; however, we’re very careful to avoid them as far as possible, and instead to collect the fluid that surrounds the intestines, the peritoneal fluid. In the lab, the numbers of cells can be counted to assess if there’s infection in the belly (peritonitis); however, in the field we can tell three things:
1) The tap fluid is clear (you can read text through it) yellowish – this suggests that the abdomen is basically OK, and means that in the absence of any other findings, the case can be managed medically.
2) The tap is cloudy, reddish or umber in colour - this means severe damage to the gut walls and/or peritonitis (infection in the abdominal cavity). This horse needs urgent referral for investigation at a hospital.
3) The tap contains gut contents (green or brown, lumpy) – sadly, this means that the intestines have ruptured; the horse is highly unlikely to survive. Alternatively, this may mean that the needle has gone into a part of the intestines, so if I get this, I’ll usually repeat the tap a few inches away, to make sure. If the needle has damaged the intestine, it’s not a disaster, but it is something to be avoided if possible.

So, using all the information from our history and workup, the vet has to decide if the colic is Medical or Surgical.

The terms are more or less self-explanatory: a medical colic can be managed with drugs, while a surgical colic needs emergency surgery.

As a rule of thumb, 9/10 colics are medical, and can almost always be managed on the yard. In my next blog, I’ll be looking at these Medical colics, their causes and treatment.

If you are worried your horse or pony may be suffering from colic, talk to your vet, or check the symptoms using our Interactive Equine Symptom Guide to help assess how urgent the problem may be.

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