Caring for the Equine Colic Survivor

Special maintenance and nutrition can help your horse get back to (and stay in) good health after a colic episode

Ouragan was in a critical state. Four days after colic surgery, the regional show jumping champion was suffering from postoperative ileus (a lack of gut motility) and facing a mere 5% chance of survival. To make matters worse, Ouragan (French for “Hurricane”) reacted to his hospital surroundings with severe stress. The 12-year-old half-Thoroughbred was naturally high-strung, and being confined to an unfamiliar stall and surrounded by foreign sights, sounds, and smells pushed him beyond his limits.  

But one thing calmed him—his owner. Every day after work and on weekends, Claire Boillin, of Auxonne, France, would make the 200-km (124-mile) drive to see Ouragan at the clinic. It provided a moment of relief for the horse, as well as the staff.  

“He wouldn’t sleep and just kept refluxing (expelling fluid when veterinarians tubed him), and I was sure he wouldn’t make it through the night,” she says of that pivotal fourth day in his healing. “When I went in his stall, he was so exhausted, he just lay down. I sat next to him and put his head on my lap, and he fell asleep.”

Thankfully, the next morning the gelding had made a miraculous turn for the better. And today, Ouragan is back to winning show jumping medals under Boillin in the Burgundy region of France.  

Every colic case is different—and certainly not all stories can have such happy endings—but veterinarians agree that the care we give our horses after a colic episode, surgical or not, can play a major role in their recovery.  

By preventing relapses, encouraging healthy gut motility, protecting incision sites in postop horses, and seeing to horses’ welfare during their convalescence, we can help patients get back to all the things they were doing before colic—and more.  

Best-Case Scenario: No Surgery

Perhaps you’ve made it through this colic experience without sending your horse to surgery. Lucky you! Chances are he is in for a full recovery within a few days—maybe even a few hours.

A horse whose colic resolves without surgery can go back to his normal routine within 12 to 24 hours of the episode, says Louise Southwood, BVSc, MS, PhD, Dipl. ACVS, ACVECC, associate professor of emergency medicine and critical care at the University of Pennsylvania School of Veterinary Medicine’s New Bolton Center, in Kennett Square.

In fact, the sooner the better. “The more time horses spend in the stall, the more gastrointestinal problems they’ll have,” she says. “Getting them out and getting exercise is good for them. Just treat them like any other horse that’s had a short time off work, and gradually increase their workload over a couple of days.”

When There’s an Incision Site

Let’s say surgery was necessary, but your horse is on the other side of it. The good news is he’s among the approximately 80% that get to go home afterward. The bad news? He’s got a major incision in his abdominal wall. Colic surgery incisions range from 20 to 40 cm in length (8 to 16 inches), depending on the kind of surgery performed. Several layers of tissue—skin, subcutaneous fatty tissue, peritoneal lining (the membrane lining the abdominal cavity), and especially the body wall—need to heal. That body wall, composed of muscles, ligaments, and other fibrous tissues, is what essentially “holds everything in,” says Southwood. And getting that wall to heal well enough to withstand the forces of ridden exercise can take up to 12 weeks. That’s if all goes well.

Surgeons and medical staff perform the necessary wound treatment in the week or so before your horse comes home. Then, your job is to make sure he doesn’t burst that incision open with excessive movement. That means four weeks of strict stall rest (with some hand-walking and grazing), followed by another four weeks of small turnout time, alone.

“We don’t want them running and playing and bucking with other horses, but we do want them to be able to have just a little more exercise at this point,” Southwood says. After eight weeks they can be in a pasture with other horses. If the incisional scar is small and looks good, they can start some very light, unridden exercise after Week 10, she adds.

Unfortunately, that incision site can get infected, even if you’ve been careful about keeping it clean and protected. Infections can delay wound healing and postpone return to work, Southwood says.

They can also lead to hernias, in which the intestines protrude through the incision, which can reduce athletic potential, says Debra Archer, BVMS, PhD, CertES (soft tissue), Dipl. ECVS, FHEA, MRCVS, of the University of Liverpool’s School of Veterinary Science, in the U.K. “The vast majority of horses (around 86%) that are discharged home following colic surgery return to (or start) work, and one of the key factors that limits this is formation of an incisional hernia,” she says.

Veterinarians can sometimes repair a hernia via a second surgery, but it’s best to try to prevent it from happening by adhering to the rest protocol and using a hernia belt if your veterinarian suspects any weakening of the body wall at the incision site, says Archer.

Getting That Gut Moving

Surgery or not, a critical aspect of returning to health post-colic is getting the intestines to work actively again. The two keys to gut motility? Exercise and eating.

You can hand-walk and -graze your horse on the hospital lawn within hours of surgery, our sources say. “We like to get them out to grass after about 12 hours following uncomplicated surgery, just for five minutes at a time,” Archer says. “That’s what they’re designed to eat, and it’s a great way to get their guts moving again, eating little and often.”

Southwood adds that she likes to restart horses on complete senior feeds, an easily palatable source of nutrients that gets them chewing and salivating, which encourage intestinal movement.

In some cases owners of nonsurgical horses might need to withhold feed following the colic episode, says Archer. “If it’s an impaction of the large colon, you don’t want to add to that traffic jam of feed ­material … by bringing in more food to get stuck there,” she explains. “These type of cases will need repeated tubing of fluids via the stomach until the impacted feed starts to move through.”

Even so, feeding a handful of hay or a few bites of grass might stimulate the gut to move that traffic jam along, she adds. But that decision should be made with a veterinarian’s advice.

Owners can also, in certain situations, feed their horses certain small treats, with veterinarian approval.

The Isolation Blues

Horses dealing with colic are in enough pain as it is. But when they recover, they often find themselves locked up—­sometimes for weeks, sometimes in unfamiliar environments—and separated from herdmates. Such confinement and isolation can be hard on these social, mobile animals.

Again, get the horse out and walking in hand and grazing as often as your v­eterinarian recommends, our sources say. Nothing beats fresh air and open space for these animals.

“Getting them out and moving a bit helps keep edema (fluid swelling) down and really brightens the horse up,” Archer says. “That nursing care is really important for them.”

Not Again!

Now that he’s out of the woods, let’s make sure your horse doesn’t end up there again. Claire Scantlebury, BSc, BVSc, PhD, MRCVS, of the University of Liverpool, says as many as 30% of post-colic horses colic again within a year. While sometimes it’s secondary to the first colic (such as adhesions in the intestines caused by scar tissue after surgery), a repeat colic might happen because whatever caused the first colic never resolved.

To make sure you’re reducing the risk of repeat colics, first look at some common culprits, says Archer. The exact cause of colic is complex and likely involves many factors. She says dental problems that prevent chewing properly are risk factors for colic, and horses should have good, regular dental care to prevent these from developing. Parasites, especially tapeworms, are still far too often a cause of colic, Archer adds. Not all dewormers target tapeworms, and it is difficult to know if they have built up high levels. “It’s really disappointing when you take a horse into surgery when a simple dewormer (effective against tapeworms) could have prevented this,” she says.

Free access to fresh palatable water is also important, says Archer. Make sure it’s clean and not iced over, because dehydration can cause impaction colic. So can sudden stall rest, since exercise keeps the gut moving. And if you’ve got a colic-sensitive horse (and some just are), make management and feeding changes slowly and with caution. “We’re not talking about hours or days, but something like two to three weeks for feed and management changes with these horses,” Archer says.

Generally speaking, keep horses that have colicked on their normal routine as much as possible as soon as it’s permitted by their vet, says Scantlebury.

Communicate, Communicate

Good care for your horse includes good communication with your veterinarian. “It’s really important to keep an open dialogue,” says Archer. “Knowing how things are going, getting questions answered, making sure we’re following the right care plan as things progress for each horse. And also keeping up with the bill, which is really necessary.”

he encourages owners of hospitalized horses to visit frequently, which also helps with communication between the owner and veterinary staff (although she cautions that lengthy visits can interrupt regular clinic workflow).

Owners should refrain from getting too wrapped up in the dialogue on internet forums or getting information online from unreliable sources, she adds. “People can feel really overwhelmed and might be tempted to go to the internet, but there are endless websites out there with ridiculous, unscientific advice and lots of anecdotes,” she says. “The best information will come from your vet, so don’t hesitate to pick up the phone.”

When All We Do Just Isn’t Enough

Despite our best efforts and care, sometimes horses just can’t beat the challenges of colic. Some horses, like Ouragan, develop postoperative reflux, which can lead to serious complications and a vicious cycle that often (but not always) requires a second surgery. Others develop a second bout of colic requiring additional surgery. Some can have serious wound infections or painful intestinal adhesions.

When the suffering goes on too long, or when the bills get too high, euthanasia can be an ethical ending. “It’s okay to say it’s time to stop trying,” says Archer.

Southwood agrees. “Sometimes things don’t work out, and it’s entirely acceptable to make that decision, even for financial reasons,” she says. “No veterinarian would pass judgment on owners for such a decision.”

Take-Home Message

Colic can be taxing on the horse’s body, as can the recovery process. But with good after-colic care—whether the horse has had surgery or not—and preventive measures to ward off recurrence, we can help our horses safely transition back to their healthy and active lives, minimizing stressors along the way.