Recurrent colic, Undiagnosable

First of all, a picture is worth a 1,000 words. Here’s a video of my mare’s colic “flares.” She had been munching on hay. https://drive.google.com/file/d/1JHhZwxtauHvZrUcCA8T8nYhdfDSfd9Q9/view?usp=drive_link Often, these flares are also accompanied by yoga (stretching like a cat).

Some time ago, I wrote on here about my mare (now 8yo) going into surgery for repeated minor colics with no known cause. We were hoping to find a cause. She pulled through beautifully, but unfortunately, her symptoms did not change even a smidge, and nothing suspicious was found on biopsy or in physical exploration. I am sorry if you remember me and I did not respond to you–I have been avoidant/depressed regarding this topic.

I now have more data, based on careful note-taking. This horse has baffled New Bolton and every local vet I’ve had out. So at this point, I’ll take any suggestion or idea, no matter how obscure.
These observations have held true for three years, across two different barns and different types of hay/feed.

She is “normal” from early May to mid-August.

LATE SUMMER:
Every late summer, about mid-Augaust, she begins to crib. Scopes turn up no ulcers. No mineral deficiencies. No stressful lifestyle, travel, etc. Minimal sand on x-rays.

FALL:
Almost to the day (September 21, 26, 24), she begins showing signs of discomfort during or after eating. Like digging into a new bag of green hay, eating happily for a few minutes, then sudden yoga (stretching like a cat) and repeated lip curling. Self-limiting, goes away after 15 or so minutes. But the yoga re-appears throughout the season, sometimes at seeming random. Most commonly when she is anticipating food, eating, or having recently eaten. Again, we’ve had her scoped literally the same night as these “yoga” practices. No ulcers. These persist through October and November.

Early September, and throughout all of fall, she also becomes inexplicably picky about her food. Suddenly won’t eat supplements like equishure, which she eats without complaint during any other season. Suddenly will turn her nose up at food if the consistency is wrong (meds not mixed in enough). This is NOT a picky horse, normally. She also becomes downright aggressive for cookies/treats.

WINTER:
Usually, the yoga flair ups taper off once we’ve had some consistent cold, so late November/early December.

LATE WINTER:
Last year, she had a severe sand colic in late February. Scope revealed glandular ulcers as well that were NOT there in November. Those may be a result of the sand, but she’s had glandular ulcers before (AND sand accumulation before, though not as severe).

SPRING:
Some occasional yoga returns, but not to the level of predictability of fall. Worst month is April.

SUMMER:
By late May, she’s a seemingly normal horse.

KNOWN FACTORS:
As of last spring, she has chronic inflammation in her hindgut, or scarring—we believe from the sand colic. This was not present in previous years, so we don’t believe it corresponds to the initial cause of colic fits.
She tested positive for chronic lyme last year, titers somewhere around 1400. We just re-tested her, thinking we were finally desperate enough to try minocycline, despite her not having typical lyme symptoms: no dice, she came back stone-cold negative, in the low hundreds.
Occasionally seen eating dirt in the spring and fall. Usually after other symptoms start flaring.
She’s currently on 20 tabs of Zyrtec once a day. We’ve also started giving her sucralfate twice a day.
She is on long-term compounded misoprostol and regumate, as we were looking to address the hindgut inflammation, keep the recurrent glandular ulcers at bay, and stop her cycles (which sometimes corresponded with yoga and really muddied the causative waters).

I am batsh*t insane. My vet is stumped. It’s been three hellish years. But most of her colic flares are self-limiting; I don’t feel I can put her down until we have a “bad” one. I was really holding on to trying minocycline for lyme, so that test coming back negative this time, when it was positive last time, has really thrown me.

I just don’t know anymore.

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A friend of mine has a mare who had recurring bouts of mild colic. She had surgery…her vet recommended Triple Crown Senior Active- only available at Tractor Supply. She was diagnosed w IBD…this feed is easier to digest. I have no other information about this horse, but IBD might be something to ask about.

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Oh- she is fed 5 times a day.

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Sounds like you have tried everything, how incredibly frustrating. Only suggestion I have try some gas-x/simethicone for relief of gas if that is contributing to discomfort?
Helps my sensitive hind gut horse who is thankfully fairly easy to manage and exhibits colicky symptoms very very rarely these days

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is she on pasture? Wondering if it’s the pasture based on the seasonal changes. Either that or actually a reproductive thing and not a gut thing.

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What did the surgery entail?

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Off the top of my head the things that change with seasons are PPID (meaning that cortisol levels change) and hormones. Have you checked her hormone levels or had her tested for PPID?

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The mare is on regumate, so hormonal issues can most likely be ruled out for a recurrent colic. PPID in younger horses doesn’t usually present as colic.

If NB is treating this 8 YO mare they will have no doubt have been examining every angle. Any sand in the gut is problematic though.

Has NB done reproductive imaging to look for cysts in her ovaries? Even with her cycles diminished or stopped with regumate, cystic ovaries can be very painful and flare at different times.

Good luck, it’s sometimes really tricky to diagnose a very uncomfortable mare. I have seen cystic ovaries in mares be an issue more than once, but I wold expect that NB would have already ruled this out.

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24/7. Ignores hay for grass. We were trying to cover our bases with the Zyrtec and regumate. She has had a full reproduction work up at new Bolton. Nothing unusual found.

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Resection of the colon due to multiple previous displacements, while they were in there. The main purpose was to rule out enteroliths and things of that nature, and to get a biopsy.

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We did explore that. And she did have cyst at one point, but it went away and no other abnormalities found on transvag ultrasound.

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Yep, had the full hormone panel done. Also tested ACTH at some point.

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I’m so very, very sorry your girl is still experiencing these painful episodes.

My original recommendation was to get my internist involved as I had been through a similarly awful experience, and that would be the direction I would go at this point. By way of reminder, my boy was colic-ing for 9 months and New Bolton could not identify a cause. My internist was able to identify what was happening, he was treated, and has been stable for the past 2 years. I do think a different hive mind would be useful for you and her.

Please DM if you want contact information.

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I’m sorry for what you’re going thru… I only chimed in to say there was a long thread awhile back, and I hope somebody else remembers who/what I’m talking about, where the horse had something similar? or maybe the same… and it turned out to be bacterial and was cleared up with antibiotics.

Somebody better than me, can you search these threads to find it?

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Pretty sure that was me. :slight_smile:

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I loved my team at NB, but they did not consider the very details that gave insight to my boy’s persistent colic.

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Yes! Thank you!

I would explore the grass thing a bit, small changes in the weather might be affecting her. I’ve even heard of horses who are allergic to grass and having issues.

@Pippigirl, it was exploratory. To my understanding, the only remarkable thing was a thickened wall in the colon….from which came the diagnosis of IBD. It is my understanding not much is known about it in horses.

@RaconteurRaven I would be wondering if the grass is what’s causing your mare’s colic issues. My barn owner has a broodmare that she could not keep on pasture as she would get colicky every time she was out on grass. Pulled her off and kept her in a dry lot and her colic problems disappeared. Interestingly this summer, that mare (now 20 and retired from broodmare duties) was out on a grass pasture all summer and seemed to not have an issue? I’ll have to ask my BO how she did on grass this year.

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