Old wives' tales spread as rapidly through the equine community as a wildfire during a dry, hot summer. One of the latest rumors to gain momentum fueled by the so-called power of social media involves drenching horses with Diet Coke to cure colic.
Dr. Oliver Liyou, a veterinarian and Director at Equine Veterinary and Dental Services Pty Ltd. in New South Wales, Australia was recently the victim of social media gone awry after posting himself administering Diet Coke to a horse with a gastric impaction.
Gastric impactions are caused by poor gastric motility leading to a mass of feed in the stomach, which leads to signs of colic and sometimes rupture of the stomach. These masses are called Phytobezoars, or masses made of organic materials (rather than body tissues such as polyps or other abnormal growths). They can form in the stomach and blocks or slow the passage of digesta from the stomach into the intestines. These masses can also irritate the lining of the stomach and cause the horse pain.
As a result, horses with gastric masses made of organic materials can suffer weight loss and exhibit signs similar to those seen with gastric ulceration: decreased appetite, abdominal pain, poor performance, dull haircoat, and behavior changes.
Liyou was recently presented with an 8-year-old stock horse gelding with signs of dull, dry coat and poor condition. Suspecting gastric ulcers, Liyou performed a gastric endoscopy, which involved passing a small, fiberoptic camera into the stomach through the horse's nasal passages and throat. As part of the scoping procedure, horses are not fed for 18 hours before the scope in order to empty the stomach so the lining can be checked for ulcers.
Instead of ulcers, Liyou was surprised to find a mass the size of a football.
“Based on recommendations made by other practicing veterinarians and a scientific paper on the use of it treating similar cases, I chose to try Diet Coke to help dissolve the mass,” said Liyou.
An initial two-liter drench of the refreshing beverage was administered via a stomach tube. The patient was re-scoped two hours later. Finding the mass still present, but softer, another three liters of Diet Coke was given. Another two hours later, the scope identified a soft, soup-like concoction in the stomach. Fueled by the progress, Liyou administered eight liters of an electrolyte drench to encourage the material to soften more and exit the stomach. The horse was given access to only water overnight, and a gastroscopy the next morning found the stomach impaction had fully resolved.
The use of Diet Coke is not a universally adopted technique by any stretch of the imagination despite its use by licensed veterinary practitioners in a few, select cases. In fact, the nasogastric administration of Diet Coke has rarely been mentioned in the peer-reviewed veterinary literature or continuing educational materials.
One case report published in the Journal Equine Veterinary Education in 2007 does, however, describe the successful resolution of a gastric mass composed of persimmons and other organic debris. In that report, the pony was severely colicky when first examined by the veterinary team, and traditional steps in colic diagnosis and treatment were attempted. Specifically, full physical examination and bloodwork, siphoning the stomach contents, and an abdominal ultrasound were performed.
“We then used gastroscopy to evaluate the stomach. This technique revealed a large mass comprising 80% of the volume of the stomach with black seeds consistent with persimmon ingestion and impaction,” said Dr. Allison Stewart, specialist in equine internal medicine and emergency and large animal critical care at the University of Queensland. Stewart was one of pony's attending veterinarians and a co-author of the case report.
Treatment with gastric lavage, intravenous fluids, anti-inflammatory medication, and the nasogastric administration of a DSS, a sort of laxative to help the mass pass out of the stomach and into the small intestine, were unsuccessful. Gastroscopy revealed that the mass remained unyielding.
The next step was taking the horse to surgery to remove the gastric foreign body, but this was not financially feasible for the owners. Instead, the veterinary team suggested using Diet Coke to try to break down the persimmon mass as previously reported in human patients with similar persimmon impactions.
“We administered two cans or 700 milliliters of Diet Coke on day three of hospitalization,” said Stewart. “Another gastroscopy on day five of hospitalization revealed that the mass was half its original size. The same 'dose' of Diet Coke was repeated, and by Day seven of hospitalization the gastric mass was no longer visible on gastroscopy.”
Although that veterinary team was able to treat the persimmon pony and with Liyou's own success, Liyou warns owners that Diet Coke does not always help resolve gastric obstructions.
“I recently tried using Diet Coke over an eight-day period along with electrolyte drenches on a third case, but repeat gastroscopies revealed that I was unable to resolve the gastric impaction,” Liyou said.
By day nine, with no further emptying of the stomach taking place, Liyou allowed the horse to eat short grass for one day then rescoped him after 12 hours of fasting. A normal stomach would have emptied in that time. Unfortunately, the stomach remained full.
“The stomach had been impacted and distended for so long that the stomach wall was likely stretched and weakened and did not function properly to contract and empty the stomach,” said Liyou. “I offered to refer the horse to a specialized veterinary internist for additional treatment, but that was not possible for the owner.”
He emphasized that the entire point of his recent Facebook post—which reached 1.5 million people and received 6.5 thousand likes—on drenching a horse with Diet Coke was actually to stress the value of gastroscopy in these cases, not help Diet Coke sales.
“The key point I wanted to highlight was that gastroscopy is absolutely necessary to diagnose a gastric impaction and 100% essential for monitoring treatment response,” said Liyou. “I am also concerned at the hundreds of thousands of dollars being wasted by owners on stomach ulcer treatments when the horse may have something very different, like an impaction, for which the ulcer treatments will do nothing. We cannot treat a colicky horse without an accurate diagnosis, with Diet Coke or any other remedy.
“I am fearful that owners will be drenching their horses with Diet Coke if ever they colic or develop signs that may suggest the presence of a gastric impaction.”
Diet Coke may help some cases of gastric impaction, but most patients won't benefit from this approach. Owners need to appreciate that not all gastric impactions can be dissolved and that other forms of colic are not amenable to this approach.
The post Can Diet Coke Really Treat Colic? Veterinarian Says His Viral Social Media Post Isn’t Meant To Answer The Question Simply appeared first on Horse Racing News | Paulick Report.
