Case Report and Discussion
Jodie Stowell, DVM
Case Report
A 5 year old warmblood mare presented for colic of approximately 2 hours duration, which worsened in the last hour prior to presentation. History included recent long distance transportation, cribbing and a recent full dose of Banamine. The horse was showing signs of discomfort: elevated heart rate and laying down and rolling repeatedly. No reflux (fluid off the stomach) was obtained after a nasogastric tube was passed. Rectal examination revealed gas distended small intestine (abnormal). Sedation did not help for more than 15 minutes at a time. The combination of unrelenting pain, elevated heart rate, and rectal examination led to a decision of surgical intervention.
At surgery a large portion of the small intestine was gas distended, and an approximately two foot portion was trapped in a space called the epiploic foramen. The intestine was carefully removed and the previously entrapped portion left intact (not removed). The horse recovered from anesthesia without major complication.
Discussion
The likely cause of the gas filled small intestine was windsucking, or cribbing. This is a stable vice in which a horse may or may not place its upper incisors on a surface, arch its neck, and make a grunting sound. Air may or may not be swallowed. Any air that enters the stomach must pass through the intestines and out the anus, because unlike dogs, cats, or cattle, horses are unable to vomit or burp. One of the most common times during the day for a horse to crib is around feeding time. Periods of boredom or stress may also make cribbing more likely to occur.
So what is the association between cribbers and colic? One study examined medical records of horses that had colic surgery for epiploic foramen entrapment (the type of problem described above) and other problems with the small intestine. Horses with a history of cribbing were 35 times more likely to have epiploic foramen entrapment as were horses without a history. Does this mean that cribbing causes colic? Perhaps. No direct cause-effect relationship has been proven, but the two are associated in some way. It is possible that management situations that increase the likelihood of cribbing also happen to increase the likelihood of colic, just in different ways. The other idea is that cribbing and windsucking causes the horse to swallow air. This air passes to the stomach and then the small intestine. The intestine becomes larger than normal because it is filled with air and tends to move around and get stuck in places like the epiploic foramen. If the intestine doesn't move out on its own, the blood supply gets cut off. This is painful, and colic results. Most often this type of entrapment requires surgery to correct.
Preventing colic is a goal for horse owners around the globe. So, if you happen to own or take care of a cribber, what can be done? The best course of action is to prevent the cribbing from happening. Some horses only crib when stalled; others do it on a constant basis. Removing buckets after grain is finished and increasing time at turnout can often help. In addition, a cribbing collar is the best bet for preventing air from being swallowed (also known as aerophagia). As in all things horsey, there are many choices out there. Some collars with metal or narrow straps may cause divots in the neck from the pressure. A wider strap distributes the pressure more evenly, preventing divots while still preventing the cribbing or windsucking behavior. The wider strap collar with a felt lining is recommended (and carried in stock) by Reid and Associates.
