The Word Every Horse Owner Dreads
Colic. It's the word that makes every horse person's stomach drop. I've dealt with colic more times than I'd like to count over the years — everything from mild gas episodes that resolved with a dose of Banamine to a surgical colic at two in the morning in a university veterinary hospital. Each time, it's terrifying. And each time, I'm reminded that knowing what to look for and acting quickly makes all the difference.
Colic is the leading cause of premature death in horses. But here's the thing that's both reassuring and frustrating: the vast majority of colic episodes — around 85 to 90 percent — are mild and resolve with medical treatment or even on their own. The challenge is that you can't always tell a mild colic from a life-threatening one in the early stages. That's why every colic should be taken seriously, and every horse owner should know what they're looking at.
What Is Colic, Exactly?
Colic is not a disease. It's a symptom — a catchall term for abdominal pain. Just like "stomachache" in humans could mean indigestion or appendicitis, "colic" in horses could mean a dozen different things happening in a 100-foot digestive tract. The pain can originate from the stomach, small intestine, cecum, large colon, small colon, or even organs outside the GI tract.
Understanding that colic is a symptom rather than a diagnosis helps frame the urgency: the underlying cause determines the severity, and some causes are far more dangerous than others.
Types of Colic
Gas Colic (Spasmodic Colic)
This is the most common type and usually the least dangerous. Excess gas builds up in the intestines, causing distension and pain. Horses show mild to moderate discomfort — looking at their flanks, pawing, lying down and getting up, and general restlessness. Gas colic often responds to analgesics (pain relief) and hand walking, and many episodes resolve within an hour or two.
Gas colic can be triggered by sudden feed changes, lush pasture, stress, or sometimes for no identifiable reason at all. I had a horse who would get mild gas colic every time the weather changed drastically — it was like clockwork.
Impaction Colic
Impaction occurs when a mass of dry, firm ingesta (feed material) blocks the intestine — most commonly at the pelvic flexure, where the large colon makes a hairpin turn. Dehydration is the biggest risk factor. Horses that don't drink enough water, especially in winter, are prime candidates.
Signs are often subtle at first: decreased appetite, reduced manure output, and mild discomfort. The horse may look at their flank, paw intermittently, and just seem "off." Impaction colic is typically treated with fluids (IV or via nasogastric tube), mineral oil or Epsom salts administered through a stomach tube, and pain management. Most impactions resolve with medical treatment, but some require surgery if they don't respond.
Displacement and Torsion
These are the scary ones. A displacement means a section of intestine has moved out of its normal position. A torsion (or volvulus) means a section has actually twisted on itself, cutting off blood supply to the affected gut wall. Torsion is a surgical emergency — without intervention, the affected intestine dies, and so does the horse.
Large colon displacements and torsions often present with severe, unrelenting pain that doesn't respond to standard pain medication. The horse may be violently rolling, sweating profusely, and showing signs of cardiovascular compromise (rapid heart rate, dark red or purple gums, prolonged capillary refill time).
The good news is that surgical colic, when caught early, has a survival rate of 80 percent or higher at good surgical facilities. Time is the critical factor.
Enteritis and Colitis
Inflammation of the small intestine (enteritis) or large intestine (colitis) causes colic signs along with fever, diarrhea (especially with colitis), and sometimes a dangerously high heart rate. These can be caused by infections (Salmonella, Clostridium), sand ingestion, or toxins. Treatment is intensive medical support — IV fluids, anti-inflammatories, and sometimes antibiotics.
Sand Colic
Horses that eat off sandy ground or in sandy paddocks can accumulate sand in their large colon over time. The sand irritates the gut lining, causing diarrhea and colic. Prevention includes feeding hay off the ground (use mats or feeders), providing psyllium supplements periodically, and minimizing exposure to sandy footing during feeding times.
Recognizing the Signs
Colic can look different depending on the severity and the individual horse. Here's what to watch for, roughly organized from mild to severe:
Mild signs:
- Decreased appetite or refusing feed entirely
- Standing quietly but seeming "off" or depressed
- Occasionally looking at the flank
- Intermittent pawing
- Lying down more than usual but getting up easily
- Reduced or absent manure
Moderate signs:
- Persistent pawing and restlessness
- Repeatedly lying down and getting up
- Stretching out as if to urinate
- Curling the upper lip (Flehmen response to internal discomfort)
- Kicking at the belly
- Elevated heart rate (over 44 beats per minute)
Severe signs:
- Violent rolling or thrashing
- Profuse sweating
- Rapid heart rate (over 60 beats per minute)
- Dark red, purple, or pale gums
- Capillary refill time over 3 seconds
- Rapid, shallow breathing
- Complete refusal to move or inability to stand
- No gut sounds on either side
What to Do When You Suspect Colic
1. Call Your Vet
Don't wait and see. Call your veterinarian and describe what you're observing. They'll advise you on next steps based on the severity. Have your horse's vital signs ready if you can safely take them:
- Heart rate: Use a stethoscope behind the left elbow or feel the pulse under the jawbone. Normal resting is 28 to 44 bpm.
- Respiratory rate: Watch flank movement. Normal is 8 to 15 breaths per minute at rest.
- Gum color: Lift the lip. Normal gums are pink and moist. Pale, dark red, blue, or tacky gums are abnormal.
- Capillary refill time: Press a finger against the gum for 2 seconds, release, and count how long it takes the color to return. Normal is under 2 seconds.
- Gut sounds: Press your ear to the horse's flank behind the ribs on both sides. You should hear gurgling. Silence is concerning.
2. Remove Feed
Take away all hay and grain. Leave water available unless your vet tells you otherwise. You don't want the horse adding more material to an already distressed gut.
3. Walk — Gently
If the horse wants to roll violently, gentle hand walking can help. Walking can also help stimulate gut motility in gas colics. But don't marathon-walk a horse in pain — 10 to 15 minutes at a time with rest breaks is reasonable. If walking clearly isn't helping and the horse is in severe distress, let them lie down quietly. The old myth that rolling causes torsion has been largely debunked — a horse rolling from colic is a symptom, not a cause, though you want to prevent injury from violent thrashing in a stall.
4. Do Not Medicate Without Veterinary Guidance
I know it's tempting to reach for the Banamine. But masking pain can prevent your vet from accurately assessing severity when they arrive. Additionally, giving Banamine intramuscularly (in the muscle) can cause fatal Clostridial infections — it should only be given IV or orally. Never give Banamine IM. If your vet has previously authorized you to administer oral Banamine paste for mild colics, follow their specific instructions.
5. Prepare for the Vet's Arrival
Have the horse in a well-lit area where the vet can work. Have a clean bucket of warm water available (the vet will need it for a rectal exam). Know your horse's recent history: when they last ate, drank, and passed manure; any recent feed changes, stress events, or medication.
Preventing Colic
You can't prevent every colic episode — some happen despite perfect management. But you can dramatically reduce the risk:
- Provide constant access to clean water. Dehydration is a leading colic risk factor. In winter, use a tank heater to encourage drinking.
- Feed forage as the foundation of the diet. A steady supply of hay keeps the gut moving and the microbial population healthy.
- Make feed changes gradually. Any change in hay, grain, or pasture should be transitioned over 7 to 14 days.
- Maintain a regular feeding schedule. Horses are creatures of habit, and their gut functions best with consistency.
- Ensure adequate turnout and exercise. Movement promotes gut motility.
- Manage parasites through fecal egg counts and targeted deworming.
- Provide routine dental care. Horses that can't chew properly swallow larger feed particles, increasing impaction risk.
- Minimize sand ingestion. Feed on mats or in feeders, not directly off sandy ground.
The Importance of Colic Insurance and Planning
Colic surgery costs $7,000 to $15,000 or more, and the decision often needs to be made within hours. Equine mortality or surgical insurance can make this decision about the horse's best interest rather than your bank account. Even if you choose not to carry insurance, have a plan. Know where the nearest equine surgical facility is. Know how long it takes to get a trailer hooked up. These are decisions best made calmly on a Tuesday afternoon, not at midnight with a thrashing horse.
Talk to your vet during a routine visit about what your colic plan should look like. They can help you think through scenarios and be prepared before the emergency happens.