A horse experiencing colic is always cause for concern, but some types of colic are more dangerous than others. Most gas and impaction colics have good outcomes and can be managed on the farm with assistance from your vet. If your vet suspects intestinal torsion, surgery is your only realistic option for helping your horse. These common causes of colic are usually easy for your vet to identify and treatment is fairly straightforward. Enteritis, on the other hand, is a completely different story.
Enteritis is an inflammation of the small intestine characterized by lesions and fluid pooling in the small intestine and stomach. Affected horses present with symptoms of severe colic, including elevated heart rate and respirations, fever, distension of the small intestine palpable via rectal exam, and fluid reflux upon insertion of a nasogastric tube. Untreated enteritis can lead to dehydration, toxemia (sepsis), gastric rupture and founder. The survival rate is debatable; estimates range from 44% all the way up to 95%. Causes include a high grain diet, causing fermentation in the small intestine and production of volatile fatty acids, or bacterial infections such as clostridium difficile (c-diff), salmonella, and Potomac horse fever. In some cases the cause cannot be positively identified.
When treating enteritis, time is crucial. Since horses cannot vomit, fluid accumulating in the stomach and small intestine can quickly lead to rupture if the fluid is not refluxed via nasogastric tube. Typical treatment is supportive, and includes periodically refluxing fluids, adding intravenous fluids, and managing pain with banamine. If an infectious agent is identified as the cause, antibiotic therapy can be added. Enteritis is typically managed in a hospital setting, due to the need for IV fluids and frequent reflux. Treatment can become very costly. It is also worth noting that intestinal torsion has very similar symptoms-severe pain and gastric reflux-so some owners may opt for colic surgery. If no torsion or bowel obstruction is found during surgery, enteritis is generally the cause of colic.
Many owners choose to treat colic with banamine and handwalking for a couple hours before calling the vet. If the horse is experiencing a mild colic caused by gas or impaction, this might work, though it is risky. If the horse’s symptoms are severe, however, time is of the essence. Enteritis doesn’t wait.
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