Treating a horse with colic (and a swollen sheath!)

In her first blog for Your Horse, Beth from XLVets Equine explains all about one unlucky horse who had a vet visit twice in one weekend

As a vet on call, the sound of your phone ringing always kicks your heart rate up a notch. For me, being relatively recently graduated and given my phones rather distinctive ring tone (it’s a brick!) this experience is probably more adrenaline-fuelled that most. So when my phone rings on a bleak, cold Saturday afternoon in the middle of January, I’m conjuring up all kinds of terrible scenarios in my head. When the paging company say that the horse has a ‘swollen sheath’ and only lives five minutes up the road, I breathe a massive sigh of relief. A thorough examination, a sheath clean, some drugs prescribed and an hour later I’m back on the sofa thanking the ‘on-call gods’! 

However, when the same client’s phone number pops up on my work phone at 7am the following Monday morning, I’m definitely having palpations. What could I possibly have missed – all he had was a swollen sheath?! Desperately hoping everything’s okay, I answer the phone to an exasperated client saying ‘His sheath’s fine, but he got out overnight and ate 17 breakfasts and he’s started to colic’. Wow! That’s some serious bad luck in one weekend!

When I arrive at the yard I find out that Tyler has not only eaten the entire yard’s breakfast, but he has also has helped himself to a large bag of carrots and had a go at a couple of bags of open feed. He’s definitely a seriously greedy pony! He’s standing quietly in his box, looking a little sorry for himself and has been seen to have a little lie down and roll since he was returned to his box after his ‘night on the tiles’!



I start my assessment by doing a general physical examination, which includes taking his heart rate, looking at his gums and listening to the noises his guts are making. Having administered a sedative and gut relaxant to make it safe for both of us, I then perform a rectal examination. I’m not expecting to find anything abnormal, as it can take up to 72 hours for food to pass from the mouth to the rectum, but it’s important to rule out any other causes of colic. Up to this point everything seems normal, so I advise the owner that I suspect he's just a little uncomfortable, due to the sheer volume of food he has eaten, and possibly because it’s also causing a build up of gas in his intestine.

It’s agreed that I’ll pass a tube up his nose, down his oesophagus and into his stomach. Before administering any fluid (which is used to soften the food and help it pass), I need to check that there isn’t a large quantity of fluid building up in his stomach. This is a part of my job that doesn’t bother me, but owners find particularly disgusting, watching as I suck on the end of the stomach tube, repeatedly avoiding getting a mouthful of stomach content by a fraction of a second!

Having administered pain relief and plenty of fluids to keep him hydrated, I've done everything that can be done at this point. Now it’s time to talk about the potential risks of having eaten so much high-starch food. This is often one of the hardest parts of a consultation. In my opinion, it’s important to give owners as much information as possible. It enables informed decision making and prevents any nasty surprises further down the line. However, it can be challenging to impart this information sensitively, without scaring people and sounding very doom and gloom.

In this particular case, most of the risks were associated with the high volume of starch fermenting in the horse’s large intestine, potentially affecting the normal flora (good bacteria) of the guts. Not only can this cause a build up of gas in the large colon, it can also lead to the production and absorption of toxins and ammonia which can cause laminitis and neurological signs. This is a rare complication which we can do little to prevent, but it’s important that owners look out for any signs of lameness, wobbliness or other behavioural changes, so that we can act on them at the earliest opportunity.

Tyler was starved for the rest of the day, reintroduced food gradually, then he was fed on a bland diet for the next few days. He was kept in his stable on a nice deep bed, and given a few doses of a drug which can reduce the effects of any toxins in the blood stream. Thankfully, our very unlucky, greedy pony made a full recovery from his little adventure and is back to loving life in the field. Until next time…!