Colic in Horses: Signs, Prevention, and When to Call the Vet

Author: Elliott Garber, DVM

Colic is a catch-all term for abdominal pain in horses, and it is one of the most common medical emergencies you will ever face as an owner. The core rule is simple: if your horse is pawing, rolling, looking at its flank, off its feed, or otherwise acting like its belly hurts, treat it as an emergency and call your veterinarian right away. Do not wait to see if it passes, and do not give any medication, oil, or drench on your own first. Early professional evaluation is what saves horses, because some forms of colic resolve with simple treatment while others are surgical and get worse by the hour.

Why colic is such a serious problem

Colic is not one disease. It is the word veterinarians use for pain coming from the abdomen, and the horse’s long, mobile, and loosely anchored digestive tract makes that pain unusually common. According to the American Association of Equine Practitioners (AAEP), colic is a leading medical cause of death in horses. A USDA National Animal Health Monitoring System study found colic to be one of the top causes of death across adult horses, which is why every serious horse owner needs to recognize it early.

The reason early recognition matters so much is that different kinds of colic have very different outcomes. Many episodes are mild and pass with basic veterinary treatment. Others involve the gut twisting or trapping on itself, which cuts off its own blood supply and becomes fatal quickly without surgery. From the outside you often cannot tell which is which, and that uncertainty is exactly why the safe move is always to call the vet rather than wait and watch.

The main types of colic

You do not need to diagnose the type yourself. That is your veterinarian’s job. But it helps to understand the broad categories so you appreciate why the same set of signs can range from minor to life threatening. The Merck Veterinary Manual groups the causes by the mechanism producing the pain.

Gas colic

Gas colic happens when gas builds up in a section of intestine and stretches the gut wall, which is painful. It is often linked to abrupt diet changes, rich pasture, or a disruption in normal digestion. Many gas colics are on the milder end, but you still cannot assume that from the signs alone.

Impaction colic

Impaction colic is a blockage, where firm, dry feed material lodges in the intestine and slows or stops the normal passage of gut contents. Dehydration, coarse or poor quality forage, and reduced water intake (common in cold weather) all raise the risk. Impactions frequently respond to medical treatment from your veterinarian, but they need to be addressed promptly.

Displacement, twist, and torsion

This is the group everyone fears. A loop of intestine can shift out of position, become trapped, or rotate on itself. When the gut twists, it can strangle its own blood supply, and that tissue starts to die and leak toxins into the body. These cases are true surgical emergencies, and survival depends heavily on getting to a veterinary hospital fast. This is the single biggest reason not to delay: the twist you cannot see is the one that kills.

Signs of colic to watch for

Colic signs range from subtle to violent, and a horse can move between them quickly. Learn your own horse’s normal behavior, appetite, and manure output so that changes stand out. Common signs include:

• Pawing at the ground repeatedly or restlessly.
• Rolling or repeatedly lying down and getting back up. Some horses roll or thrash more violently as pain worsens.
• Looking at, biting, or kicking at the flank or belly, sometimes called flank watching.
• Going off feed, refusing hay or grain when they would normally eat eagerly.
• Little or no manure, or straining without producing much.
• A quiet or silent gut. A healthy abdomen has plenty of gurgles and rumbles. Prolonged silence on one or both sides is a warning sign.
• An elevated heart rate. A relaxed adult horse usually sits around 28 to 44 beats per minute; a persistently high rate suggests pain and distress.
• Other signs such as sweating, curling the upper lip, stretching out as if to urinate, lying stretched flat, or a dull, depressed attitude.

No single sign confirms colic and none rules it out. If your horse shows a cluster of these, or even one that is clearly out of character, act on it. It is far better to call your vet for a false alarm than to miss the early window on a serious case.

What to do the moment you suspect colic

The most important step is the first one: pick up the phone. Contact your veterinarian right away and describe what you are seeing, even if the signs look mild. Your vet may ask about heart rate, gut sounds, manure, when the horse last ate, and how long the signs have been going on, so having that information ready helps.

While you wait for the vet, follow their guidance. In general, and consistent with university extension guidance:

• Remove feed. Take away hay, grain, and access to grass so the horse cannot eat while its gut may be compromised.
• Follow your vet’s direction on water. Some vets prefer water be withheld until they can examine the horse and pass a stomach tube. Ask.
• Keep the horse safe. If it is rolling or thrashing, protect yourself first, then remove hazards. Your vet may advise quiet hand walking to discourage violent rolling, but only if it is safe for you and the horse.
• Monitor and note changes. Check on the horse frequently and watch for worsening pain, since colic can escalate fast.

Just as important is what NOT to do. Do not give any medication, pain reliever, laxative, mineral oil, or drench on your own. Pain medication can mask the very signs your veterinarian needs to judge how serious the colic is, so a horse that looks comfortable after a dose may still have a surgical problem building underneath. Dosing at home can also be dangerous and can delay proper treatment. Leave all medications, tubing, and drenching to the veterinarian, and do not wait to see if the horse improves on its own before calling.

Preventing colic

You cannot eliminate colic risk, but good, boring, consistent management genuinely lowers it. The AAEP and equine nutritionists point to the same fundamentals, most of which come down to protecting a healthy, well hydrated, forage based gut.

• Constant access to clean, fresh water. Dehydration is a major driver of impaction colic. Keep troughs and buckets clean and full, check automatic waterers, and pay special attention in cold weather when horses drink less. Heated or de-iced water in winter helps keep intake up.
• A forage first diet. Horses evolved to eat small amounts of fiber more or less continuously. Base the diet on good quality hay or pasture and keep grain and concentrates modest. Our horse feeding guide and hay guide go deeper on building a sound ration.
• Make all feed changes gradually. Sudden switches in hay, grain, or pasture are a classic colic trigger. Introduce any new feed over a week or more, and turn out onto lush spring grass slowly.
• Stay on top of dental care. Horses that cannot chew properly do not break feed down well, which raises impaction risk. Regular dental checks keep the first step of digestion working. See our horse dental guide.
• Keep a sound parasite control plan. Certain internal parasites damage the gut and its blood supply and are linked to colic. Work with your vet on a strategic, fecal count guided deworming program rather than guessing.
• Provide regular turnout and movement. Time out of the stall and steady, consistent exercise support normal gut motility. Long, sudden changes in activity, such as unexpected stall rest, can raise risk, so keep routines as steady as you can.
• Keep routines and reduce stress. Consistent feeding times, sand management where soil is sandy, and minimizing abrupt changes in housing or workload all help.

None of this is glamorous, but a horse on clean water, steady forage, good teeth, sensible parasite control, and regular turnout is a horse whose gut has the best chance of staying quiet.

Keeping records that help in an emergency

When colic strikes, the details your veterinarian asks for are exactly the ones that are easy to forget under pressure: when the horse last ate, its recent deworming and dental history, whether it has colicked before, and what is normal for its vitals. Keeping those on your horse’s Creatures profile means the history is in one place and easy to pull up on your phone at the barn.

You can add your horse and log feeding changes, dental visits, and deworming as health and medical records, then set reminders for upcoming care so dental checks and parasite control do not slip. Creatures is the records and profile layer owners use to keep this history organized, not a substitute for your veterinarian. If you are ever unsure whether what you are seeing is colic, call your vet.

Frequently asked questions

Is colic always an emergency?

Treat it as one. Some colics are mild and resolve with simple veterinary treatment, but from the outside you cannot reliably tell a minor gas colic from a life threatening twist. Because early treatment dramatically improves outcomes for the serious cases, the safe and correct response to any suspected colic is to call your veterinarian promptly.

Should I walk my colicking horse?

Sometimes, but only under your veterinarian’s guidance and only if it is safe. Gentle hand walking can discourage violent rolling in a horse that is thrashing, but forced, exhausting walking is not a treatment and should never replace calling the vet. Ask your vet what they want you to do while they are on the way.

Can I give my horse pain medicine or mineral oil while I wait?

No. Do not administer any drug, pain reliever, laxative, or oil on your own. Medication can hide the signs your veterinarian needs to assess the severity, and drenching or tubing at home can be dangerous. Leave all treatment to your vet.

How do I know if it is a serious colic?

You often cannot from behavior alone, which is the whole point of calling early. A very high heart rate, a silent gut, no manure, unrelenting or violent pain, and signs that keep getting worse are all reasons to escalate urgently, but even a mild looking horse deserves a call. Your veterinarian’s hands-on exam is what sorts medical cases from surgical ones.

How can I lower my horse’s risk of colic?

Focus on the fundamentals: constant clean water, a forage based diet, gradual feed changes, regular dental care, a vet guided parasite control plan, and consistent turnout and routine. These do not remove risk entirely, but together they meaningfully reduce it.

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