Colic First Aid: Step-by-Step Actions to Take Immediately

Your horse is pawing. Looking at its flank. Maybe it just went down and rolled. Your stomach drops because you know what this might be. Colic. The word every horse person dreads, and for good reason; it is the number one killer of horses after old age. But panicking helps nobody. What helps is having a clear, step-by-step plan and executing it calmly. So let us walk through exactly what to do.

Step 1: Remove Food Immediately

First thing: pull the hay, pull the grain, pull any feed the horse has access to. If the colic is related to an impaction or any kind of GI obstruction, adding more material to the system makes things worse. Water can stay available unless your vet tells you otherwise; dehydration is a major concern with colic and you do not want to make that worse either.

This includes bedding. A horse standing in straw who starts eating it out of boredom or discomfort is still ingesting fiber. If you can switch to shavings or rubber mats temporarily, do it. Every mouthful matters when the gut might be backed up.

Step 2: Assess the Situation and Take Vitals

Before you call your vet (and you likely will be calling), gather information. Your vet is going to ask you specific questions and having answers ready saves precious time. Grab your stethoscope and thermometer from your first aid kit and check:

• Heart rate: Normal resting is 28 to 44 bpm. A horse at 50 is mildly painful. At 60 to 80, things are getting serious. Over 80 suggests severe pain or cardiovascular compromise. Place the stethoscope behind the left elbow to hear the heart clearly.
• Respiratory rate: Normal is 8 to 16 breaths per minute at rest. Elevated respiratory rate with colic usually means pain.
• Temperature: Normal is 99.0 to 101.5 F. Fever with colic symptoms might indicate enteritis or colitis. A subnormal temperature can signal shock.
• Gut sounds: Listen on both sides, high and low on the flank. Each quadrant. Normal sounds like a washing machine: gurgling, rumbling, occasional louder sounds. Complete silence is bad. Hypermotile (loud, frequent, rushing) sounds can indicate spasmodic colic or diarrhea. Reduced sounds suggest ileus or impaction.
• Gum color and capillary refill time (CRT): Lift the lip. Healthy gums are pink and moist. Press a finger against the gum, release, and count how long it takes for color to return. Normal CRT is under 2 seconds. Dark red, purple, or pale gums with a CRT over 3 seconds indicates compromised circulation and is a red flag for surgical colic.
• Skin turgor (dehydration check): Pinch the skin on the horse's neck. It should snap back immediately. If it stays tented for 2 or more seconds, the horse is dehydrated.

Also note what the horse is doing behaviorally. Pawing? Stretching out like it wants to urinate? Lying down repeatedly? Rolling violently? Looking at or biting at its flanks? Sweating without exercise? Every detail matters for your vet's assessment. Check our vital signs reference if you need a refresher on normal ranges.

Step 3: Call Your Vet

When do you call? If the horse shows signs of pain and the vitals are abnormal, call now. If the signs are mild, a little pawing, a bit of restlessness, you can monitor for 15 to 30 minutes. But here is the thing: if you are unsure whether to call, call. No good equine vet is going to be annoyed at a colic call that turns out to be minor. They would much rather hear from you early than get the call two hours later when things have deteriorated.

When you call, report: what symptoms you see, how long they have been going on, all the vitals you just took, when the horse last ate and drank, when it last passed manure (and what it looked like), any recent changes in feed or routine, and whether you have given any medication.

Have your vet's emergency number programmed in your phone. Not in a drawer, not on a business card stuck to the fridge with a magnet that fell behind the counter three months ago. In your phone. Your barn manager's phone. Your spouse's phone. Everyone who might be the one standing in the barn at midnight should have that number instantly accessible.

Step 4: The Walking Debate

Ah, the great walking debate. "Walk your colicky horse" is probably the most common piece of advice handed down through generations of horse people. And it is not wrong exactly, but it is more nuanced than most people realize.

Walking is useful for several reasons: it provides mild stimulation to the GI tract, it distracts the horse from pain, and it prevents violent rolling that could (in rare cases) cause the intestine to twist. Gentle hand-walking for 10 to 15 minutes at a time is reasonable for a horse showing mild to moderate colic signs.

But, and this is important, do not walk a horse into exhaustion. If you have been walking for 30 minutes and the horse is still in obvious pain, walking is not fixing the problem. Let the horse rest. If it wants to lie down quietly, that is okay. Lying down is not dangerous. Quiet rest on its side is actually fine and can even help the horse relax its abdominal muscles.

What you do want to prevent is violent, thrashing rolling. A horse that goes down and thrashes can injure itself on stall walls, bang its head, or (though this is debated) potentially displace already compromised intestine. If the horse wants to roll violently, get it up if you can do so safely. But do not put yourself at risk; a horse in severe pain is not paying attention to where you are.

A middle ground that works well: walk for 10 minutes, rest for 5. Walk for 10, rest for 5. Watch the horse during rest periods. Does it settle and stand quietly, maybe cocking a hip? Good sign. Does it immediately try to go down and thrash? Back to walking, and probably time to call the vet if you haven't already.

Step 5: Banamine: When and How

If your vet has previously prescribed Banamine (flunixin meglumine) for you to keep on hand for colic situations, this may be the time to use it. But there are important caveats:

• Call your vet first before giving it, if at all possible. Banamine can mask the signs of a surgical colic, making it harder for your vet to assess severity when they arrive. Some vets want to see the horse before you medicate.
• Use the oral paste form. Do NOT give injectable Banamine in the muscle. Intramuscular flunixin causes severe, potentially fatal, clostridial myositis (massive muscle infection and tissue death). This is not an exaggeration. Horses have died from IM Banamine injections. If you have the injectable form, it can be given orally on the gums; squirt it into the side of the mouth or onto the tongue. Confirm dosing with your vet.
• Standard dose is 1.1 mg/kg. For an average 1,100-pound horse, that is one full tube of the paste. Do not double the dose thinking more is better. It is not, and it can cause kidney damage or gastric ulcers.
• Note the time you gave it and tell your vet. This information affects their treatment plan.

Step 6: Monitor and Document

While waiting for your vet (or while monitoring a mild episode), keep track of changes. Write down the time and what you observe every 15 to 20 minutes. Is the horse getting better, staying the same, or getting worse? Has it passed any gas or manure? (Both are good signs.) Did it drink any water?

Use your phone. Take videos of the horse's behavior. Record the vital signs with timestamps. A 30-second video of a horse's pain behavior tells your vet more than five minutes of verbal description. If you end up at a referral hospital, that documentation becomes invaluable for the surgical team.

Signs that things are getting worse and you need your vet immediately if you have not already called:

• Heart rate climbing above 60 bpm
• Gum color changing from pink to dark red, purple, or grayish
• Increasing violence of rolling episodes
• Profuse sweating
• Signs of shock: cold ears and extremities, rapid breathing, depression
• No response to Banamine within 30 to 45 minutes

That last one is significant. Most mild colics (gas, spasmodic) will respond to Banamine within half an hour. If the horse is still in obvious pain after Banamine, the problem is more serious and may require veterinary intervention or surgical evaluation.

What NOT to Do

Do not administer any home remedies you found on the internet. Do not give beer, coke, baking soda, or mineral oil by mouth without veterinary instruction. Mineral oil in particular can end up in the lungs if given improperly, and that is fatal. Aspiration pneumonia from well-intentioned oral drenching kills horses every year. Only a veterinarian should pass a nasogastric tube.

Do not withhold water. Do not trailer the horse to the vet clinic without calling first; they need to be ready for you, and they may have different instructions depending on the severity. Do not give multiple doses of Banamine hoping that more medication will break through the pain. Double-dosing NSAIDs can cause right dorsal colitis, which creates an entirely new and serious problem on top of whatever caused the original colic.

Do not blame yourself. Colic happens. You can do everything right: proper feeding, gradual changes, regular dental care, good digestive system management, and colic can still happen. The best thing you can do is respond quickly, provide good information to your vet, and stay calm enough to be useful.

After the Episode

Once a colic episode resolves (assuming it does without surgery), reintroduce feed slowly. Start with small amounts of hay and gradually increase over 12 to 24 hours. Monitor manure production closely for the next several days. Keep an eye on water intake. And have a conversation with your vet about whether any management changes could reduce the risk of recurrence.

Horses that colic once are statistically more likely to colic again. That's not a death sentence; it just means you need to be more vigilant about the predisposing factors. Was the horse dehydrated? Was there a recent feed change? Insufficient forage? Dental issues causing poor chewing? Sand ingestion? Identify what you can control and control it.

Understanding colic does not stop the fear entirely, but it does replace panic with purpose. Know the steps, have the tools, and trust your gut; when something feels wrong with your horse, it probably is. For more on recognizing emergency situations, read our when to call the vet guide.

Frequently Asked Questions

Sources

• Texas A&M College of Veterinary Medicine - Equine Colic vetmed.tamu.edu
• American Association of Equine Practitioners - Colic in Horses aaep.org
• Cornell University College of Veterinary Medicine - Colic Management vet.cornell.edu
• Merck Veterinary Manual - Colic in Horses merckvetmanual.com
• UC Davis Center for Equine Health - Colic ceh.vetmed.ucdavis.edu