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Unfortunately, regarding colic as a potential problem, the horse is constantly playing Russian roulette from the day the horse is born to the day it dies. 

Foals can suffer from different colic types such as meconium impaction, colonic atresia, lethal white syndrome, ruptured bladder, enterocolitis, intussusceptions, gastric ulcers and obstruction of their small intestine caused by roundworms, just to mention some of the colic causes that a foal can suffer.

Meconium impactions are very common in the few hours to a couple of days after birth. This kind of impaction is produced by the feces produced in utero and it usually passes once the baby begins to nurse since the calostrum has laxative effect on the gut. Foals frequently will strain to defecate and shake the tail but will pass nothing or very little feces, the baby usually adopt the classic stance with an arched back.  As the time pass without eliminating the meconium, the foal’s abdomen becomes distended due to the accumulation of gas.  Signs range from slight straining to very painful, going down, thrashing, and rolling.  Usually one or more soapy warm water enemas will resolve the impaction.  Very rarely the impaction is not resolved with more aggressive medical treatment and surgery should be considered if medical treatment fails as well.

More rare conditions causing colic in the first day or two following birth are congenital abnormalities such as colonic atresia and lethal white syndrome. Colonic atresia is an abnormality in which the colon is not completely formed and feces cannot pass through the GI tract. Clinical signs are very similar to meconium impaction and begin a few hours after birth. Depending on the degree of malformation, surgery could fix the problem, in some other cases the malformation is such that there is no surgical treatment.  A foal with lethal white syndrome results of the mating of two overo horses but not all overos babies suffer from this congenital defect.  The result of this syndrome is defective nerve endings in the intestine and feces cannot be propulsed through the GI tract, clinical signs are the same as meconium impaction. There are no treatments options for this condition but since not every overo baby suffers from this defect, an initial treatment for meconium impaction should be instituted.

In the first and second day of life a common cause of discomfort is a ruptured bladder.  This occurs more frequently in male foals and is thought to be due to trauma during foaling or by lifting the foal from the belly.  Foals will appear strain to urinate dribbling urine and stretched-out stance. The belly looks distended and in advanced cases the animal gets very depress. This is a medical emergency not a surgical emergency. As the urine leaks into the abdomen causes a metabolic disturbance (potassium levels rise in blood) which among other disturbances can lead to cardiac arrest.  Once the foal is stabilized, surgical correction of the bladder tear is necessary.

Necrotizing enterocolitis causing diarrhea in foals is a common cause of colic at various stages of development.  The cause is unknown but may result from disturbance of the delicate balance among gastrointestinal blood flow, gut bacteria and feeding. Clinical signs are colic due to intolerance of oral feeding, colic and passage of blood in the stools. This condition should be regarded as an emergency and immediately assessed by a veterinarian. 

Intussusceptions occur when intestine slides over itself and gets trapped, similar to how a collapsible telescope folds down.  It happens usually with motility disorder such as diarrhea. The baby shows signs of colic and the only way to fix this condition is with surgery.

As in adults, gastric ulcers can be present in foals of varying ages.  Usually gastric ulcers occur in foals in a stressful environment and when they are sick. Unlike adults, these ulcers can also occur in the outflow tract of the stomach into the small intestine.  If the ulcers scar down and heal at this location, they have the potential to cause strictures.  The clinical signs can range from diarrhea pawing and rolling upside down, foals will also express signs such as teeth grinding or assuming a position on their back with their legs in the air for extended periods of time. 

The diagnosis and treatment can be made by clinical signs and treat the baby with anti-ulcer medication. The disease can be also diagnosed with endoscopic examination of the stomach, contrast radiography, ultrasound and occult blood in feces. The treatment includes ranitidine (Xantac), omeprazol (Gastroguard) and sucralfate.

Older weanlings that are not dewormed appropriately or with worm resistance to medication can obstruct their small intestine caused by “stack” of roundworms.  This is easily prevented by routinely performing fecals and using an appropriate deworming schedule. The only way to fix this problem during an episode is with surgery. Weanlings that live in highly populated pastures with other weanlings are most likely to have problems. 

Just as in adult horses, colic in foals must be considered an emergency and treated quickly. Call your veterinarian before giving or doing anything, giving banamine to a foal can make an ulcer worst.