📋 At a Glance

What it isAbdominal pain — a symptom, not a single disease. Many underlying causes.

UrgencyAlways call your veterinarian — severity ranges from mild to life-threatening

PrevalenceThe leading cause of equine emergency veterinary calls

Most at riskAll horses; risk increases with diet changes, reduced water intake, stress, heavy parasite burden, and reduced exercise

DiagnosisRequires examination by a licensed equine veterinarian — physical exam, rectal palpation, nasogastric intubation, and diagnostics

TreatmentDetermined by veterinarian based on type and severity — ranges from medical management to surgical intervention

🚨 Signs That Require an Immediate Veterinary Call

Violent rolling or throwing the body to the ground
Continuously pawing, looking at the flank, or attempting to roll and unable to get comfortable
Complete absence of gut sounds in all four quadrants
Elevated heart rate above 60 beats per minute at rest
Gum color that is pale, white, gray, or brick red (dark pink to salmon pink is normal)
Distended or bloated abdomen
Profuse sweating without exercise
Any signs that persist beyond 30 minutes, even if mild

What Is Colic?

The word "colic" describes abdominal pain in horses — not a single disease, but a symptom that can arise from dozens of different underlying causes involving the digestive tract, and occasionally structures adjacent to it. Because the equine digestive system is anatomically complex, physically constrained, and physiologically sensitive, horses are uniquely susceptible to disruptions that produce pain.

The horse's gastrointestinal tract is approximately 100 feet in length from esophagus to rectum. Unlike humans, horses cannot vomit — meaning anything that reaches the stomach must move forward through the system. The stomach is relatively small for the animal's size, the colon makes multiple tight flexures and passes through anatomical landmarks that create natural chokepoints, and large sections of the large colon are mobile enough to shift position in ways that produce obstruction or torsion. These characteristics explain why abdominal pain is so common and why veterinary assessment of every colic episode — regardless of initial severity — is strongly recommended by equine health professionals.

Educational Overview: Types of Colic

Veterinarians categorize colic cases based on the underlying mechanism identified through examination and diagnostics. The following table provides educational context — your veterinarian determines the actual type and appropriate treatment for your horse.

Type	Mechanism	Examples	General Severity
Spasmodic	Increased intestinal motility / gas accumulation causing cramping	Gas colic, spasmodic colic	Often mild — may resolve with veterinary treatment
Impaction	Ingesta accumulation forming an obstruction, typically at anatomical narrowings	Large colon impaction, cecal impaction, small colon impaction	Mild to severe depending on location and duration
Displacement	A section of large colon shifts into an abnormal anatomical position	Right dorsal displacement, left dorsal displacement (nephrosplenic entrapment)	Moderate to severe — often requires surgical evaluation
Volvulus / Torsion	Intestinal segment twists on its mesenteric axis, cutting off blood supply	Large colon volvulus, small intestinal volvulus	Severe — surgical emergency; survival depends on speed of intervention
Strangulation	Blood supply to a segment of intestine is compromised by entrapment or adhesion	Epiploic foramen entrapment, lipoma strangulation	Severe — surgical emergency
Enteritis / Colitis	Inflammation of the small intestine or large colon from infectious or toxic causes	Salmonella, Clostridium, NSAID toxicity	Variable — can be severe with systemic compromise
Sand Colic	Accumulation of sand and dirt in the large colon, common in arid regions	Sand impaction	Mild to severe depending on accumulation

Educational reference only. Actual diagnosis of colic type requires examination by a licensed equine veterinarian.

Recognizing Signs of Abdominal Pain

Horses express abdominal pain in characteristic ways. Recognizing these signs quickly — and communicating them clearly to your veterinarian — is one of the most valuable skills a horse owner can develop. Signs range from subtle behavioral changes in mild cases to dramatic and violent behavior in severe cases.

Mild Signs

Decreased appetite or refusing feed
Mild pawing or restlessness
Occasionally glancing at flank
Reduced or absent manure output
Slight increase in resting heart rate
Standing stretched out (like urinating)
Lying down more than usual

Moderate Signs

Repeated pawing and restlessness
Frequent looking at or biting at flank
Attempting to lie down and roll
Elevated heart rate 48–60 bpm
Reduced gut sounds
Sweating without exertion
Kicking at the belly

Severe Signs — Call Now

Violent, uncontrollable rolling
Throwing body to the ground
Heart rate above 60 bpm at rest
Abnormal gum color
Visible abdominal distension
Absence of gut sounds all quadrants
Profuse, constant sweating
Signs of cardiovascular shock

What To Do While Waiting for Your Veterinarian

Your veterinarian is the authority on treatment. When you call, they will provide specific instructions for your situation. The following represents general educational information — always follow your veterinarian's guidance over any general resource.

✅ While Waiting for Your Vet — General Educational Guidance

Call your veterinarian first. Before anything else. Describe what you are observing: heart rate if you can check it, gum color, gut sounds, when you last saw normal manure, and any diet or management changes in the past 48 hours.
Remove access to feed until your veterinarian advises otherwise.
Allow access to fresh water unless your vet instructs otherwise.
Keep the horse as calm as possible. Hand-walking is sometimes appropriate for mild cases — ask your vet before doing so, as walking is contraindicated in some colic types.
Do not administer medications (including Banamine/flunixin meglumine) without specific guidance from your veterinarian. Medications can mask signs that your vet needs to assess and may complicate diagnosis.
Monitor and record heart rate, gum color, gut sounds, and behavior changes so you can give your veterinarian an accurate update when they arrive or call back.
Be prepared to transport to an equine hospital if your vet advises it — have a trailer available or know how to arrange one quickly.

Risk Factors Associated with Colic

Research in equine gastroenterology has identified management factors associated with increased colic risk. Understanding these does not eliminate colic risk entirely, but supports evidence-based management decisions you can discuss with your veterinarian.

Dietary and Feeding Factors

Abrupt changes in feed type or quantity
High grain, low forage diets — the horse's digestive system evolved for continuous forage consumption
Extended periods without access to forage (more than 4–6 hours)
Feeding on sandy or dirt ground (particularly relevant in the Southwest)
Access to lush pasture after restricted grazing — a significant laminitis and colic risk factor
Moldy or poor-quality hay

Water and Hydration Factors

Reduced voluntary water intake, especially in cold weather
Changes in water source or water temperature
Limited or inconsistent water access
High water intake post-exercise without adequate cooling (particularly gastric issues)

Management and Environmental Factors

Sudden changes in exercise level or work intensity
Prolonged stall confinement
Travel and transport stress
Recent changes in environment or herd composition
Inadequate parasite management — especially in areas with significant parasite burdens
Poor dental health affecting chewing efficiency

Horse-Specific Factors

History of previous colic episodes — horses who have colicked before may have elevated risk
Older horses — increased risk of lipoma formation and small colon problems
Body condition and metabolic status
Breed (Arabians may have elevated risk of some types)

Preventive Care Strategies

While no management program eliminates colic risk entirely, the practices below are consistently supported by equine health research and recommended by veterinary professionals as part of a comprehensive health program. Discuss specifics with your equine veterinarian.

✅ Evidence-Based Prevention Discussion Points for Your Vet Visit

Forage access: Provide continuous or near-continuous access to appropriate hay or pasture. Long periods without forage disrupt hindgut motility and fluid balance.
Consistent fresh water: Monitor intake, especially in cold weather. Heated water tanks in winter support adequate hydration. Impaction colic risk rises when horses voluntarily reduce water consumption.
Dietary changes gradually: Any change in feed type, quantity, or hay source should be transitioned over 7–14 days minimum.
Regular exercise and turnout: Supports normal gut motility. Sudden transitions from exercise to stall rest increase displacement and gas colic risk.
Strategic deworming: Work with your vet to develop a targeted deworming program based on fecal egg counts rather than calendar-based deworming.
Regular dental care: Inadequate chewing contributes to impaction risk. Schedule dental exams as your veterinarian recommends.
Sand management: In sandy regions, feeding hay off the ground on mats or feeders, and discussing psyllium supplementation protocols with your vet, may reduce sand accumulation risk.

🪲 Parasite Control

Healthy Parasite Control — A Colic Prevention Factor

Monty Roberts University / HandsOnGloves

Questions to Ask Your Veterinarian

When your veterinarian sees your horse — whether for a colic episode or a wellness exam — these are productive discussion points related to colic risk and prevention:

Based on my management setup, what are my horse's primary colic risk factors?
Should I have a fecal egg count done, and what does my current deworming program look like in terms of coverage?
Is my horse's dental health adequate for effective forage processing?
Is my current feeding program — including forage type, grain quantity, and feeding schedule — appropriate?
What are the signs you want me to monitor, and at what point should I call you versus wait?
If I suspect colic, what is your preferred after-hours contact protocol?
Does my horse have any history or anatomical factors that increase surgical risk if colic becomes severe?

Colic in Horses