I played a lot of horse games on the computer growing up, most of them focused on eventing (the act of jumping or a piaffe reduced to pressing a single button on the keyboard). While this was fine, my main interest was drawn to the care parts of the simulators — dragging a curry comb over the side of a homogeneously dirty pixelated horse and watching the dirt be wicked away in great rectangular swaths (it was the early 2000s, computer graphics were not focused on realism). In one game, you could not only brush your horse, but scoop grain for them as well, preparing a bucket to the specifications of a white board list: two scoops oats, one scoop bran.

Back then my knowledge was as rudimentary as the game’s graphics. Horses should be fed, watered, and brushed, but the nuances therein were not made clear to me until much later (and in all honesty, some still exist in blurry 8‑bit, waiting for further clarity).

 

This is a post about a recent colic that Otto had. I bring up these games because I wonder where “colic simulator” is. Press A to call the vet. Press B to remove hay. Here’s a mini game; listen for gut sounds, all 4 quadrants.

I’m not trying to make light of it – colic is never a fun situation, and can be ultimately tragic. Oh horses, why do your GI tracts have to work the way they do? But I’m thinking about how it would have been nice to have some kind of ingrained framework for what to do when the first signs appear.

 

When we talk about colic in our volunteer meetings, one of the most common questions is, ‘how will we know?’ I had the same question in the early days of my job, watching over each horse with the worried eye of a new mother, searching for anything even remotely out of place. There’s a laminated sheet of paper in our barn aisle, ‘signs of colic,’ listing out the common behaviors a colicing horse might exhibit: looking at their side, kicking at their stomach, rolling. But sometimes when there are flies buzzing around, or a sudden itch, there could be a stamp or a bite that seems unprovoked. If you’re the anxious sort, it could be enough to make you question things.

 

But now, having experienced more than a few colics, my answer to the question of ‘how will we know?’ is simple: ‘you’ll know.’ There’s something so off about a colicing horse, it’s nearly impossible to miss.

 

For Otto, it began with lethargy earlier in the day. He’s a young horse, and despite his gentle disposition, he is altogether a lively guy. So a dullness in his eyes was the first sign, and I’d say perhaps the easiest to miss, especially if you’re not familiar with his personality or mannerisms.

But then, when volunteers went out to his paddock a little past feeding time, they caught him lying down. It is not atypical for horses to rest, but it is not normal for a horse to take a nap when there’s food in front of them. The warning bells were ringing, and we swiftly took action.

 

We always call our vets at the first signs of colic, typically immediately after taking vitals to better inform them about the situation. Some colics are worse than others, and the conversation to the vet is less of ‘how should we proceed’ and more ‘when can you get here.’ Luckily, Otto’s was more of the former, with just traces of the latter.

Otto’s vitals were mostly normal, though his gut sounds were decreased. A heart rate within normal range told us he was likely not in a massive amount of pain, and he was not running a fever.

 

We led Otto out of his paddock to better monitor him inside. On his way into the barn, he had a very loose pile of manure. Passing manure, good. That manure being only liquid, not as good. He also was attempting to roll as we walked through the sand arena, another tell-tale sign. Our vets have said it is OK to allow a colicing horse to lie quietly, but generally speaking if they are trying to roll repeatedly, it is better to keep them up and moving.  And so we walked Otto around as we waited for the vet to arrive – the information we had given her about him was enough for her to want to check him out in person.

 

Other signs of colic, in case what I’ve mentioned hasn’t already made it clear: Otto was pawing. Kicking a hind leg up towards his belly. Looking repeatedly at his side as if answering the question ‘show me where it hurts.’ He was reluctant to move, standing parked out, generally looking very uncomfortable.

How do you know?” people ask. You’ll know.

 

Our vet arrived, and we all breathed a sigh to know relief was likely in Otto’s future. Dr Lewis gave Otto an IV dose of banamine, and sedated him to perform a rectal exam. Upon examination, Dr Lewis palpated an impaction on Otto’s right side. It is apparently not very common horses get impactions on their rights – what can sometimes happen is that an impaction on the left can get large enough that it migrates over, but given that Otto did not seem to have a very high pain level as evidenced by his vitals, Dr Lewis did not feel this was the case.

 

Otto’s rectal exam also revealed a crucial piece of the puzzle – the manure that Dr Lewis extracted had a good deal of sand mixed in with it.

 

The first step in dealing with Otto’s impaction would be to hydrate him with the hope he could pass it on his own. The word ‘surgery’ fluttered in the back of our minds, but we kept our fingers crossed it would not come to that. Dr Lewis intubated Otto, and gave him a fluid cocktail of electrolytes for rehydration, and epsom salts and mineral oil to act as a laxative.

 

By now, it was early evening. Dr Lewis penciled us in for first thing in the morning to come and check on our sweet boy, but told us to call if anything happened in the meantime. Our fingers remained crossed for a quiet night. We set Otto up in a stall with a camera so we could monitor him overnight, and offered him sweet water after sweet water to try and get as much liquid into him as we could. He did a very good job of drinking, which made us all feel a little better.

 

Our vets will also often suggest we move the horse out in intervals every few hours to help get their system moving. There is something mildly heartbreaking about making a horse with a stomach ache trot around for 10 minutes, but the feel-bads are quickly replaced by relief with each offering of manure or gas they produce. Never have I been happier to see a horse poop than when they’re colicing.

 

Otto’s mostly liquid stool was also explained by the impaction – his body was trying to pass, but there was a blockage in the way preventing much solid from leaving.

 

Overnight, we checked the cameras on the hour to monitor our sweet Otto, and moved him out several times to the tune of several small, mostly liquid piles of manure. But overall he did well through the night, and when Dr Lewis returned at 7am the next morning, we were all delighted to hear that the impaction had decreased in size, clearly breaking down. Otto got more banamine, more fluids, as well as a slow return to food – a senior grain soup. Fluids, fluids, fluids for little Otto, and luckily he is a very good boy who is not picky about the consistency of what he eats. He was very excited to have something to snack on, yet another sign he was perking up.

 

We ran a sand test on Otto, and found a staggering 1 ¼’ of sand in his sample. Along with his re-feeding schedule, Dr Lewis gave us a hefty psyllium fiber (sand rid) regime for Otto to follow for the next few weeks. Take 16oz and call us in the morning.

 

Going forward, Otto will get a monthly course of psyllium to keep him hopefully sand-free. This colic situation also made us consider what was going on in the guts of our entire herd. Dr Lewis told us that sand can sit in the gut for a long time, so even if we are seeing clear sand tests, it doesn’t necessarily mean sand is not present or will not appear down the road. Otto’s colic made us decide to treat our entire herd with psyllium quarterly to hopefully mitigate the risk of situations like this arising in the future.

 

And as far as sweet Otto is concerned, he is doing fantastic. As the days following his colic went on, he continued to perk up, eagerly awaiting his soupy mash mealtimes and calling out for his friends. We had separated him to keep an eye on his manure (the consistency of which also continued to improve), and it was clear he was eager to return. After a slow and careful reintroduction of hay, Otto was cleared to go back out with his buddies, and the four of them enjoyed a sweet reunion. Otto’s sand tests have since run clear, and he has returned to his regularly scheduled programming.

 

While it is tremendously stressful in the moment, these types of situations are great teaching opportunities that lead to the development of best practices that are potentially life-saving for our herd. Especially in a case like this, where everything worked out in the end.