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  Discussion on Colic or Ulcers? Or something else?
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New Member:
kshaffer

Posted on Tuesday, Dec 22, 2009 - 11:39 pm:

My 14 yr old 800 lb thoroughbred/appaloosa mare, Aria, had a sudden loss of appetite 3 days ago.

Following is the history:

SATURDAY--After spending about 4 hours in the pasture during a snow storm, she & her 2 pasture mates were let into the barn and given hay, and later their pm grain feeding. The other two consumed their grain & hay, but Aria did not eat or drink water. She was restless, shifting her weight and wanted to lie down and roll. I did my best to keep her on her feet, called the vet, who could not come out due to being snowed in by the storm. The vet told me to give her 10 cc Banamine, which I did.

SUNDAY--AM Banamine the night before seemed to help her restlessness, but not her appetite. Vet came out about 11 am. Vet administered Banamine IV and xylazine. After rectal exam, during which vet said she was straining and so she couldn't tell if there was a twisted bowel or impaction, Aria was given water and mineral oil through nasal tube. Aria seemed to want hay, but I was told not to give her any since surgical colic hadn't been ruled out (if twisted bowel, hay would further aggravate). Soaked beet pulp was offered, but Aria not interested in that or in water. Seemed to be uncomfortable later Sunday evening, so administered another dose of xylazine in the muscle.

MONDAY: No improvement with drinking water, offered soaked beet pulp again and she ate a little. Vet came again in morning, did rectal exam and said that colon was more distended than day before. Heard slightly more gut sounds than day before. When tubed, although no reflux from stomach through the tube, it appeared that reflux, which was clear liquid, ran down the outside of the tube through her nose. Because of this and distended bowel, I was told the likelihood of a twisted bowel was greater and that if I had the means I should take her to the Penn State Veterinary Hospital where the cost would be upwards of $5,000. This was not an option for me. Since Aria appeared to be interested in hay only, the vet said I should let her have small handfuls frequently. LATER, Monday afternoon Aria began to have normal, wet, somewhat oily bowel movements at 1, 3, 5 & 7 pm. She seemed to have a good night and we were hopeful she was out of the woods...

TUESDAY(TODAY): Around 8 am, it seemed that her appetite disappeared again, she kept laying down, trying to roll, getting up again, shifting her weight, head lowered... she seemed to be in pain, so I called the vet and gave her Banamine in the muscle. With no real improvement later that morning, I called and scheduled another vet visit for the afternoon. In the afternoon, before the vet came, she became restless, but not agitated again. The vet arrived at 3:45, gave her Banamine IV, xylazine and tubed her with water and epsom salts. No rectal exam, but said there were slightly more gut sounds than the day before. Said that she ruled out twisted colon because there'd be more pain by now or she'd have died already... She said that it was time to "sink or swim" that the tubing had to stop, left me with 1 more tube of Banamine, and took a stool sample to determine if there were parasites. Said that she may have cancer, ulcers or sand colic.

OTHER FACTORS:
• I believe I can rule out sand colic since our terrain is clay and rocks.
•Don't know about cancer, but after reading articles on ulcers, the one thing that stuck in my mind was that she has not been finishing her grain and preferred to eat her hay (timothy & alfalfa mix).
•She does not have an exercise routine other than being turned out with pasture mates. HOWEVER, our area in the Mid-Atlantic US, has been unseasonably wet, which has kept the horses either in their stalls or in the paddock.
•In addition, during the warmer weather, they have had a run-in and the alpha mare has kept Aria from coming into the run-in and she'd have to stand in the rain all night. When I realized that this was happening, I started putting them in separate stalls.

QUESTIONS:
• Would any of the above factors have led to the formation of ulcers?
• Should I offer her 100% alfalfa as a remedy?
• What about administering omerprazole? Budget is an issue. If I could get Ultraguard, how much & how long should I administer before seeing results? Would it hurt to administer this drug as a diagnostic tool since the endoscopic procedure is not an option for me?
• Is the SUCEED Equine Fecal Blood Test by Freedom Health a reliable diagnostic tool and is it widely accepted & utilized by vets?
• Do you think the daily use of Banamine since Saturday night (& one day 2 doses within 7 hours) has damaged her kidneys?

THANK YOU FOR ANY ADVICE YOU CAN GIVE ME. I FEEL THAT IF I DON'T DO SOMETHING TO RESTORE MY HORSE'S APPETITE, SHE WILL DIE. (The only way we have kept her hydrated is through the tubing.)
Member:
scooter

Posted on Wednesday, Dec 23, 2009 - 7:35 am:

K I hope Dr.O. can give you some insight. I had something like this happen once and the horse actually was choking. Vet tubed gave banamine, he seemed better, then did it again. Pawing, wanting to eat, rolling, hanging head low. Went on a few day before I realized what it was. Vet didn't recognize it when there he acted like he was colicking so it didn't really occur to us that reoccurring choke was taking place.

I don't know if that is a possibility with your horse but thought I would throw it out there since it sounded similar.

Hope you are able to figure it out.
Moderator:
DrO

Posted on Wednesday, Dec 23, 2009 - 8:00 am:

Welcome Kshaffer,
I am sorry to hear you have such problems over the holidays. To answer your direct questions:
1) Gastric ulcers may be present but I see no clear indication from your post they are responsible for your acute onset of colic.
2) The horse should not be fed until the cause of the colic is known and the decision based on this diagnosis.
3) see Diseases of Horses » Colic, Diarrhea, GI Tract » Gastric Ulcers » Gastric Ulcers in Adult Horses
4) see Diseases of Horses » Colic, Diarrhea, GI Tract » Gastric Ulcers » Gastric Ulcers in Adult Horses
5) No

So now let's get to diagnosing your problem so we can guess at the future. First we cannot rule out a surgical disease (twist or otherwise) from the length of time this has been going on. Twists and other surgical problems come in a number of levels of severities with partial twists and entrapments that block food passage but do not completely obstruct the blood supply early on. These can go on for days until finally the blood supply is interrupted and the bowel degenerates and the horse goes down.

Information that would help us help you more is to know the horses vital signs and how they have changed over time. For more on this see Diseases of Horses » First Aid » Taking Temperature, Pulse, and Respiration.

Monday's transient improvement gives me hope you have an impaction that may have impacted Monday night. One diagnostic test that may help differentiate treatable and non treatable conditions is a belly tap: has one been done and what were the results? In the meantime if surgery is not an option you must keep your horse well hydrated while this problem sorts itself out. This can be done with a tube and pump or needs to be done with aggressive IV therapy. You will finds the specific of such therapy and general information on assessment and other treatment aspects in the article associated with this discussion.

To recap: if this is a surgical candidate he should be moved to a surgical facility for further evaluation. If a rectal cannot give you a diagnosis you can make a decision on whether you should continue treatment based on the belly tap results and if you continue treatment is instituted you should consider the diagnostic possibilities treat those you can but most important is to maintain the horses hydration and electrolyte balance. If this cannot be done at your home consider moving to a equine hospital.
DrO
New Member:
kshaffer

Posted on Wednesday, Dec 23, 2009 - 11:32 am:

Thank you, Dr O!

Vet checked her this morning and she said that Aria was maintaining herself well, in spite of not drinking and basically "nibbling" at hay and grain since Saturday. Initially we kept her off everything but water fearing a twisted colon, but it seemed that she passed enough manure on Monday--that the manure was wet and oily (from tubing with water & mineral oil on Sunday)--to rule out twisted bowel. At that point, vet said to start giving her handfuls of hay and 1/4 her grain, which as I said she has been nibbling at. Vet checked vital signs which she said were good, color of gums a healthy pink, heart rate strong and normal, temperature 99°. She heard more gut sounds on her right side than on her left, but more gut sounds than the day before. She is alert, will lay down quietly, but gets up when I come into the barn and whinnies to me.

The vet wanted to try some Gastrogard this morning so she was given 2.28 g. With the snow and the cost, it is not possible to endoscope her; also she has not had a belly tap which would require taking her to a facility.

Current symptoms are refusing food and water, but she is calm to uncomfortable.

I am hoping that we did not do the wrong thing by giving her the Gastrogard. She was given Gastrogard at 8 am this morning and I just checked her at 11:15. It scared me when I went into the barn because she was lying on her side, head flat with feet straight out (like a foal would lay) and when I spoke to her she didn't lift her head. I thought she was dead. I walked out of the barn and when I came back in she was still lying down, but her head was up.

I wish I could afford further diagnostic tests, but unfortunately they are not an option for me.
Moderator:
DrO

Posted on Wednesday, Dec 23, 2009 - 5:59 pm:

Belly taps are easy and inexpensive and can give information just from the visual appearance. There is no reason that I am aware of why it cannot be done safely in the field. But if the vital signs are good is not indicated.

The omeprazole is not going to hurt anything but providing 6 gallons of water with electrolytes daily is far more important to keeping your horse stable and providing the means to pass an impaction, a diagnosis consistent with your clinical signs and something the horse can recover from. Again the article provides details on how to do this.
DrO
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