Repetitive Displacement Colic - Unknown Cause

[thatbrokerider]

My horse is a 2012 OTTB Gelding who I got during the summer of 2018. Over the years, he would occasionally act very mildly colicky (no interest in food, slightly depressed) and it had a simple fix of making sure he had a clean and full bucket of water. He’d drink and be fine, so I always figured it was mild dehydration.

In fall of 2020, I took him with me to college 6 hours from home. He always travels great, so taking him to school with me was easy and we would get to participate in the shows at the school’s barn. We did two big shows at the end of the school year in April 2021 and shortly after, he had a big colic episode. Vet noted a displacement on the left side and he went to the closest hospital. Upon arrival, the displacement had fixed itself (magical trailer ride). And he was scoped for ulcers, found grade 2/4, and treated for the next month or so with UlcerGard and Sucralfate. Rescope showed successful treatment.

I stayed at school for the summer, so my horse stayed, too. In early July 2021, he had another colic episode and was in and out of pain. Had a vet out on the 2nd day of colicking and on the 3rd day he went to the hospital again. He had a left dorsal displacement where the intestines were trapped near the spleen. He was given a drug and lounged to get everything back in place, which was successful. He then had an impaction to work through, and was scoped for ulcers again, found grade 3/4. He was treated again with UlcerGard and Sucralfate.

He finished the UlcerGard on August 13th and started on Relyne. He moved to another barn where he could have more turnout on grass and be in a lower stress environment. I have kept his work load lighter since then, but I’ve been wanting to get him back in shape again. Recently he started on some beet pulp, soaked, about 1-2lbs daily split between two meals to get his body condition up. He started getting beet pulp on the 13th, then colicked again on the 19th. This time, it was a displacement on the right side and a definite gas colic. Banamine, Buscapan, lounge him. He was fine after that.

Today on the 22nd, he was colicky again. I gave him oral Banamine and Buscapan left by the vet from the other day and lunged a few times. He passed feces, drank water, and was interested in food. I have not called the vet and plan to check on him every few hours and provide hay slowly as long as it keeps passing through normally.

I’m wondering if anyone else has had a similar experience with a horse repetitively colicking like this or if anyone has tips. I’m planning on taking the beet pulp away because what we saw online said it can cause excess gas.

Here’s more info on the horse:
Daily Ration: 40lbs Timothy/Orchard hay, 6lbs Purina Ultium grain, MSM joint supplement, salt, Probios, ~1lb Alfalfa Cubes soaked, ~1-2lbs beet pulp soaked, ~1lb Purina Outlast soaked, 12 tabs Sucralfate

Turnout: Grass w/ Roundbales provided when grass is eaten down, 12+ hrs per day (weather permitting). He moved straight to the new barn from the hospital after July colic.

16.2hh, mellow TB, doesn’t run excessively outside, cribs often, but not every waking moment. 1250lbs when healthy, approx. 1170lbs currently. Hard Keeper.

[JB]

If the issue is recurring entrapment over the spleen, this is the fix
Nephrosplenic Space Ablation » Large Animal Hospital » College of Veterinary Medicine » University of Florida (ufl.edu)

[SusanO]

Good to know! Colic is a problem I rarely have but this is very interesting and I have not heard of this before.

[foggythistle]

My guy had colic from nephrosplenic entrapment. It did not respond to drugs or a trailer ride. It was fixed surgically. He had a second colic worthy of a trip to the hospital last fall (trailer-ride resolved!). He is now on a hay-only and ration balancer diet to minimize gas production.

I noticed that almost all of his colics had been in the morning, usually within a couple of hours of the morning graining. I’ve taken to giving him extra hay at night to make sure his gut isn’t quite so empty in the morning.

He was previously getting 1lb of Trotter pellet +1lb hay stretcher 3x/day + ration balancer in addition to his hay. So far, he’s managed to hold his weight on the hay.

[thatbrokerider]

It was only splenic entrapment once. Most recently, the displacement was on the right side and the first time it may have been developing into splenic entrapment, but it never got to that point.

[4horses]

Hmm. The reoccurring ulcers are indicative that he is not getting fed often enough. These horses generally respond best if on grass pasture or allowed free choice hay. I would probably want to make sure he always has food in front of him. It is concerning that he has ulcers even on a grass pasture. What condition is the pasture in?

I can’t say if the beet pulp is a triggering factor because he has had colic before despite not being on beet pull.

How often is he fed when not on pasture? Does he bolt his grain? Finish his hay in a record time? Any effort to slow his hay consumption with hay nets?

[joiedevie99]

There is a surgery they can do for nephrosplenic entrapment that prevents it from happening again. My understanding is that it is best done when the horse is healthy. I believe they can even do the procedure standing, laparoscopically now.

[thatbrokerider]

He gets fed twice per day and was going out day and night for a while, only coming in for grain and hay and going back out when he was finished, but the bugs got bad here, so he’s staying in during the hot day and going out overnight only. The grass has been eaten down a bit, but there is enough if the horses choose to eat it. Round bales are provided if grass is low.
He shouldn’t have ulcers now. Before, he was only turned out a few hours a day and wasn’t always on grass, which is when he was scoped both times, then we moved him to the new place. I think the most recent episodes are due to beet pulp because it’s the most recent change I’ve made to his diet. He does love his food, but he doesn’t seem to eat quickly. Used to be a little aggressive at food time, but has since relaxed about it.
I’ve been considering a hay net to help prevent his cribbing by making him eat longer, but in the past he’s proven talented at ripping slow feeders apart so they don’t do their job.
My biggest concern is why it seems to be a displacement every time.

[IPEsq]

If it is happening both sides, I’d be concerned that there is a defect that will eventually result in a twist. Some horses have an abnormality where the ligament holding the colon to the abdominal wall is too lax at the mesentary, and this can create the space needed for displacement or twists to happen, with the theory being a gas bubble or something precipitating it. My last horse had never colicked until he had a 360 twist that killed him, and the surgeon said that she could pull the colon basically completely out when she opened him up, and this is not supposed to be possible. If this defect is detected in surgery where the colic can be corrected (e.g., moving the displacement, not a complete twist cutting off arterial supply), then often what they’ll do is surgically tighten up that overly lax area. Perhaps except in the case of broodmares that have this issue due to general ligament laxity following foaling out, the surgery can fix the problem and recurrence is low. But it is an open gut colic surgery.

I know one mare it was happening to a lot, and they made a correlation to her hormone shots. Which made no real sense, but the owner stopped the hormones, and she hasn’t had a displacement colic since. She avoided surgery each time it did happen, so unknown what she looked like on the inside.

My current horse has had one left dorsal displacement that resolved medically. I think it was precipitated by a gas colic. His trigger was not drinking enough on hot days and having too long of a gap in hay feedings (no real grass growing). He’d come in and gorge himself on his afternoon alfalfa flake and colic. Did that a second time without displacement. He also wasn’t sweating well. This year, he is drinking and sweating better and has different feeding schedule and is doing better overall. If it’s always the left side then there is a different surgery that can be done as mentioned above.

When your horse is in the stall during the day, what’s his feeding schedule?

https://www.vetfolio.com/learn/article/making-sense-of-large-colon-displacements-in-horses

[StormyDay]

I’d be trying to cut down on the grain. Not only can it cause ulcers there is a connection between feeding grain and colic. In 90% of horses it causes no issues, but if I had one with recurring colic that’s probably what I would be taking out first.
However, I understand this horse is a hard keeper so it might be difficult to do this. Can you switch to feeding alfalfa? Not only is it high calorie, it’s also full of calcium which is good for the ulcers.

[2tempe]

My now retired mare had this - first the left displacement over the spleen. Did not resolve, so much gas build up that she looked like the Hindenburg…so had surgery. less than a year later, displacement to the right…surgery again. No logical explanation; even the surgeon said they mostly dont know, though it is apparently seen in mares after foaling as there is all this open space… After second surgery things settled down and she was pretty much fine in the intestinal department never fully returned to her prior potential. I briefly considered the above noted procedure, but never followed through. There are indications that some horses can be prone to repeat events. If I were you (and you have managed thus far to avoid surgery) I would consider the procedure. But that said there is a fairly new horse at our barn with a history of stress-related behavioral issues and he has had several mild colics since his arrival. That might lead back to the ulcer situation. Sorry you are going through this…

[beowulf]

The answer is likely in ulcers, cribbing… Find out why these are a continued problem. It may be that a major change is needed in management.

Cribbing is typically a sign the horse needs more turnout, turnout friends, and/or hay 24/7 genuinely in front of them. Every race horse that’s come to my farm as a cribber has eventually stopped cribbing completely after an adjustment period of 2-3 weeks. It’s not because our care is top notch or we have the greenest grass and fields. It’s because they’re chucked out in a herd, with 24/7 access to a round bale and/or grass. They don’t need stereotypies anymore to cope with the stresses of industry-standard barns like stall time and solo turnout.

The ulcers could be from a number of things but generally, horses stalled for any length of time and horses not truly comfortable in their body are primary ulcer candidates. The stalled horses just tend to not get enough roughage - the barns claim “free choice hay” but what really happens is the horse gets 1-2 flakes of hay 2-3x a day… which is just not enough hay at all to keep any ulcers at bay.

I’d start first with getting more hay into this horse - a hay net is fine and a good way to keep them busy, but slow feeding haynets shouldn’t be a replacement for the real amount of roughage they need - it shouldn’t be to “spread out” 2-3 flakes at PM night check.

Have you weighed how much hay he is actually getting, or is that an estimate from the barn hands? How often is he getting this hay provided to him? 40lb means nothing if it’s all provided at once and the horse stands around for the remaining 16 hrs a day.

Generally speaking beet pulp is inoffensive enough I wouldn’t immediately jump to it as a colic-trigger in a horse that has previously had colic episodes… Beep is in most commercial grains to an extent so if the horse had a sensitivity it generally would show up before the introduction of just straight Beep…

My #1 thing, dealing with horses who have repetitive colic issues, is to get them away from a stall as fast as possible. So far it’s worked very well for me, but it’s been years since I was a barn manager for any sort of farm, and it’s very hard to get people to move away from keeping their horses stalled… but it’s so much better for the horse to be moving around as much as possible in a safe setting with herdmates.

The fact that this horse has now had three colic episodes resolved with forced movement and medication makes me think that there is an inflammatory issue at fault over a genuine abnormality. YMMV.

[TPF_Hunter]

• Reduce Grain - replace with alfalfa pellets + fat supplement
• 24/7 turnout with friends
• Small Hole Hay net if he has to be inside - they make so many durable options now. Do two nets if he eats through the hay well - more hay the better
• Allergy testing, you would be surprised what turns up and can cause gas/inflammation
• Keep him on a low dose of Omeprazole (at least in the winter or when he has to be stalled)- the omeprazole paste from abler.com works just as well as gastroguard and is $8 a tube!!!

Get insurance on this horse ASAP in the event he needs surgery!

[Fiesta01]

ETA that I’m referring to TPF-Hunter’s post - Agree with this entire management regime. Great suggestions. The only thing that might be a problem is the insurance. Once a horse has colicked, most insurance companies will not cover future episodes.

[thatbrokerider]

Yeah, it’s hard to cut down on grain, that’s why he was switched to a grain with GI support. We tried to find alfalfa bales to at least feed some, but it’s very hard to find in this area right now, so we’re just doing some cubes alongside his normal hay.

[thatbrokerider]

That’s what we were trying when he moved to the new barn. He’s able to go out with a few horses, but no pastures big enough for a huge herd. He’s generally either antisocial or a huge bully, but if he’s not cribbing it hasn’t been a huge concern.
The main thing is bugs, he despises them. Hates fly masks, would overheat in a sheet, and fly spray only works for so long. I have started using Swat, which works better, on his face and legs. He was being turned out as much as possible, only coming in for grain and hay, and hay was provided when grass was getting low outside. But he would get stressed out and start running after some time in the heat and bugs during the day. (Even in a field with plenty of trees for shelter from the sun). So he’s now on night-only turnout.
I don’t want to baby this horse. He is the typical dramatic pampered thoroughbred and I want him to be comfortable being outside a lot, but when stress causes ulcers, it’s a difficult decision to make. He has always been quite comfortable with less turnout than what is ideal, but he’s now in an environment as close to ideal as I can find.

[StormyDay]

@thatbrokerider

Yeah, it’s hard to cut down on grain, that’s why he was switched to a grain with GI support. We tried to find alfalfa bales to at least feed some, but it’s very hard to find in this area right now, so we’re just doing some cubes alongside his normal hay.

Yeah, I’d just be worried about that grain fermenting in his gut and possibly not helping issues. Can you get alfalfa cubes?

I also forgot to say, I hate beet pulp with a passion. I don’t know who decided it was a decent thing to feed horses but I want to have a stern talking with them. Most people feed/soak it wrong, and if it’s done improperly it can (in my opinion) cause worse issues. It has to be soaked for exactly 30 minutes to one hour. Any less and it can draw water from the surrounding foods and possibly cause impaction. Any more and it will start to go bad, because even though it’s low in sugar it ferments really easily. Most boarding barns aren’t setting a timer on their best pulp prep, so it’s either barely soaked at all or it’s been sitting in a bucket like slop attracting flies and fermenting since the feed time before. It’s also not got a great nutrient profile. I just don’t like it.
And yes, I know half of COTH will fight me on that.

[beowulf]

Less babying would be less stall time. Do not be afraid to let a horse be a horse. Get him some Shoofly boots and a spandex fly mask. He’ll be fine.

Like JB said, don’t let this horse train you. He doesn’t want to be back in the stall specifically. He wants to be back where his comforts are: shelter, grain, or friends.

His shelter doesn’t have any actual shelter? Can you move him to a paddock/pasture where there is a run in shed?

Being in for 12 hours is not ideal. I understand it is the industry standard, but if you do not change the management causing these ulcers, they will persist. So many people just treat the ulcers and change nothing about the horse’s management, then act all surprised when ulcers come back again. Until you drastically alter the management, they will keep returning – because they are a symptom of an issue, not the cause.

[No1]

Not only do I strongly disagree with this whole turnout vs. in the stall thing, I am aware of no studies which compare GI upset in horses pacing the fence vs. horses happily turned out.

The horse who is pacing the fence is obviously stressed. If you can make if safe and comfortable for the horse to be out all the time by changing turnout groups or adding a fly sheet, etc go for it. If not you are only stressing the horse further by insisting it stay out, not to mention that all that pacing and running around often has a detrimental effect on often not great TB feet.

OP, if you have found the right combination of turn out and stall time for your horse, I would be most concerned about what is going on while the horse is in the stall. Keep some sort of roughage in front of the horse at all times, provide a jolly ball or similar if he will play with it, if you have time or your barn can manage it, take him out for a hand graze or two during the day.

Edited to add: Is peanut hay available in your area? It is nutritional similar to alfalfa and some horses really love it. Usually cheaper than alfalfa, too.

[No1]

Glad you said it. Beet pulp There are so many things available now that are so much more nutritious than beet pulp. Also, beet pulp that has been soaking all day smells foul.