Equine Colic: Types, Signs, and When to Call the Vet | Inside the Equine

Equine Colic: Types, Signs, and When to Call the Vet

Colic is the word that makes every horse owner's stomach drop. It's the leading cause of death in domesticated horses, and it can go from mild discomfort to life-threatening emergency in a matter of hours. fortunately that the vast majority of colic episodes resolve with medical treatment alone. But knowing the difference between "wait and see" and "call the vet now" can save your horse's life.

Quick Answer: Colic refers to abdominal pain in horses and ranges from mild gas colic that resolves on its own to life-threatening torsions requiring emergency surgery. Recognizing the type and severity early is critical for the best outcome.

The term "colic" simply means abdominal pain. It's not a specific disease. It's a symptom with dozens of possible causes, ranging from a simple gas bubble to a twisted intestine. Understanding the types, recognizing the signs early, and knowing how to respond gives you the best chance of a good outcome. To fully grasp why horses are so vulnerable to colic, it helps to understand how the equine digestive system works.

Types of Colic

Gas Colic (Spasmodic Colic)

This is the most common and usually the least dangerous type. Gas builds up in the intestines, causing painful spasms of the gut wall. The horse is uncomfortable, sometimes quite dramatically so, but the pain typically comes and goes in waves. Most gas colic episodes resolve on their own or with a single dose of Banamine (flunixin meglumine) and some hand-walking. Causes include sudden feed changes, lush pasture, stress, and anything that disrupts normal gut motility.

Impaction Colic

An impaction occurs when a mass of feed material, sand, or other ingesta gets stuck and blocks the intestinal tract. The most common site is the pelvic flexure of the large colon, where the intestine makes a sharp 180-degree turn and narrows significantly. Dehydration is a major risk factor, especially during winter when horses drink less cold water. Poor dental health (leading to inadequately chewed feed), coarse hay, and insufficient water intake all contribute.

Impaction colic tends to develop gradually. The horse may be mildly uncomfortable, produce fewer and drier manure piles, and show decreased appetite. Many impactions resolve with IV or oral fluids administered by the vet, along with pain management. Severe impactions that don't respond to medical treatment may require surgery.

Displacement Colic

The horse's large colon is loosely attached in the abdomen, which means it can shift out of its normal position. A left dorsal displacement occurs when the colon moves up and over the spleen, getting trapped between the spleen and the body wall. A right dorsal displacement involves the colon shifting to the right side. These displacements cause pain because the intestine's blood supply gets compromised and gas builds up in the trapped section.

Some displacements resolve with medical management, including a procedure called "rolling under anesthesia" for nephrosplenic entrapments (the colon-over-spleen type). Others require surgical correction.

Torsion (Volvulus)

This is the emergency everyone fears. A torsion means the intestine has twisted on itself, cutting off blood supply to the affected segment. Without surgery, the trapped intestine dies, toxins flood the bloodstream, and the horse goes into shock. Torsions cause severe, unrelenting pain. The horse may be violently thrashing, rolling, sweating, and showing an elevated heart rate above 60-80 beats per minute. This is a surgical emergency with no time to waste.

Small intestinal volvulus and large colon volvulus are both possible. Large colon torsions are more common and tend to occur in broodmares shortly after foaling, though any horse can be affected.

Sand Colic

Horses that eat off sandy ground or short, sandy pastures ingest sand with every mouthful. Over time, sand accumulates in the large colon, irritating the gut lining and potentially causing impaction or diarrhea. Sand colic is particularly common in coastal areas and regions with sandy soil. You can check for sand by placing a few manure balls in a rectal glove filled with water and letting it settle. Sand sinks to the fingers of the glove.

Prevention involves feeding hay off the ground on mats, providing psyllium husk supplementation on a regular schedule, and limiting turnout on sandy pastures.

Other Types

  • Enteritis: Inflammation of the small intestine, often caused by Clostridial bacteria or Salmonella. Causes severe pain, diarrhea, and rapid dehydration.
  • Gastric distension: The stomach can rupture if it over-fills with gas or fluid, since horses cannot vomit. This is why the inability to vomit makes horses uniquely vulnerable to certain types of colic. You can learn more about this in our deep dive into the equine digestive system.
  • Lipomas: Fatty tumors on long stalks that wrap around the small intestine and strangulate it. More common in older horses and ponies. Surgical emergency.

How Do You Recognize the Early Signs of Colic?

Horses can't tell you their stomach hurts, but they communicate pain through behavior. Here's what to watch for, roughly in order from mild to severe:

  • Decreased appetite: Often the first sign. A horse that walks away from feed or picks at it halfheartedly deserves a closer look.
  • Flank watching: The horse turns its head to look at or nip at its side. This is a classic early sign of abdominal discomfort.
  • Pawing: Repetitive pawing at the ground with a front foot.
  • Stretching out: Standing in a "parked out" position as if trying to urinate, or adopting unusual postures.
  • Lying down more than usual: Occasional lying down is normal. Repeatedly lying down and getting up is not.
  • Rolling: Mild colic may involve lying down and rolling gently. Severe colic causes violent, thrashing rolls.
  • Sweating: Patchy or generalized sweating without exercise indicates pain.
  • Elevated heart rate: Normal resting heart rate for an adult horse is 28-44 beats per minute. A heart rate above 50 in a resting horse with colic signs is concerning. Above 60-80 suggests severe pain or cardiovascular compromise.
  • Absent gut sounds: Press your ear (or a stethoscope) to the horse's flank in all four quadrants. Normal gut sounds are a mix of gurgles, rumbles, and occasional loud borborygmi. Silence is worrisome, as it suggests the gut has stopped moving.
  • Lack of manure: If the horse hasn't passed manure in 8-12 hours and is showing other signs, impaction is likely.

Use the Symptom Advisor to walk through these signs systematically if you're unsure about what you're seeing. You can also visualize the digestive organs involved by exploring the interactive 3D model.

First Response Steps

When you suspect colic, here's what to do before the vet arrives:

  1. Remove feed: Take away hay and grain. Leave water available unless your vet instructs otherwise.
  2. Check vital signs: Heart rate, respiratory rate, gum color (should be pink with a capillary refill time under 2 seconds), and rectal temperature if safe to do so.
  3. Note manure production: When did the horse last pass manure? What did it look like? Was it normal, dry, loose, or absent?
  4. Hand-walk if the horse is comfortable: Gentle walking can help stimulate gut motility and prevent the horse from rolling. Do not force a horse to walk if it's in severe pain or exhausting itself.
  5. Do not administer medication without vet guidance: Giving Banamine before the vet arrives can mask pain severity and make it harder to assess the situation accurately. If your vet tells you over the phone to give a dose, follow their instructions on route and dosage exactly.
  6. Call your vet: Don't wait to see if it gets better. Even if the episode resolves before the vet arrives, the call is worth making.

When Should You Call the Vet for Colic?

Call your vet for any suspected colic. But here are the signs that indicate you need the vet urgently, not in a few hours:

  • Heart rate above 50 bpm at rest
  • Violent rolling or thrashing
  • Sweating with no obvious cause
  • Pale, dark red, or purple gums
  • Capillary refill time over 3 seconds
  • No gut sounds in any quadrant
  • Pain that returns after Banamine wears off
  • Pain that doesn't respond to Banamine at all
  • Signs lasting more than 2-3 hours without improvement
  • Any colic in a post-foaling mare (high risk for uterine torsion and large colon volvulus)

Risk Factors for Colic

Some things increase a horse's likelihood of colicking. Many of them are manageable with good husbandry.

  • Sudden feed changes: Switching hay type, introducing grain, or increasing rations abruptly disrupts the hindgut microbial population. Always transition feeds over 7-14 days.
  • Dehydration: Horses need 5-10 gallons of water per day minimum, more in hot weather or during heavy work. Dehydrated gut contents move slowly and are prone to impaction.
  • Dental problems: Poor dentition means poorly chewed feed, which is harder to digest and more likely to cause impaction.
  • Parasite burden: Heavy parasite loads can cause intestinal damage and colic. Follow a strategic deworming program based on fecal egg counts rather than rotational deworming.
  • Stall confinement: Movement stimulates gut motility. Horses on extended stall rest are at higher risk for impaction.
  • Stress: Transport, competition, herd changes, and environmental disruptions all increase colic risk.
  • History of previous colic: Horses that have colicked before are statistically more likely to colic again.
  • Coastal/sandy environments: Sand ingestion is a significant risk factor in certain regions.

Prevention

You can't eliminate colic risk entirely, but you can reduce it dramatically with consistent management.

  • Provide constant access to fresh, clean water. In winter, consider a heated water source; horses drink significantly less ice-cold water.
  • Feed a forage-first diet. Horses are designed to eat small amounts of roughage continuously. Long gaps between meals increase colic risk.
  • Make feed changes gradually over 7-14 days minimum.
  • Maintain a regular dental schedule (at least annually) to ensure proper chewing.
  • Maximize turnout time. Movement keeps the gut moving.
  • Manage parasites with a fecal egg count-based deworming program.
  • Use psyllium supplementation if your horse lives on sandy ground.
  • Minimize stress where possible. Keep routines consistent, introduce herd changes gradually, and prepare horses for transport with electrolytes and adequate hydration.

Frequently Asked Questions

Can a horse die from colic?

Yes. Colic is the number one cause of non-traumatic death in horses. Surgical lesions like torsions and strangulations are fatal without intervention, and even with surgery, survival rates vary depending on the type and duration of the lesion. That said, the majority of colic episodes (roughly 80-90%) resolve with medical treatment alone.

Should I let my horse roll during colic?

There's an old belief that rolling causes the intestine to twist, but this isn't well supported. It's more likely that the severe pain from an already twisted intestine causes the violent rolling. That said, keeping the horse walking gently is still a reasonable approach because it stimulates gut motility and prevents injury from thrashing. If the horse wants to lie quietly, that's fine. If it's throwing itself down violently, try to keep it moving and call the vet immediately.

How much does colic surgery cost?

Colic surgery typically ranges from $7,000 to $15,000 or more depending on the facility, the complexity of the surgery, and post-operative complications. This is one of the strongest arguments for equine major medical insurance. The decision to pursue surgery should factor in the horse's age, the likely diagnosis, and the surgeon's assessment of prognosis.

What's the survival rate for colic surgery?

Overall survival to discharge is roughly 75-85% for horses that make it to surgery. The specific type of lesion matters enormously. Simple large colon displacements have excellent prognoses, while small intestinal strangulations detected late carry much lower survival rates. Early intervention is the single biggest factor in surgical outcome.

Does Banamine treat colic?

Banamine manages pain and reduces inflammation, but it doesn't treat the underlying cause. It buys time and keeps the horse comfortable while the vet evaluates and the gut (hopefully) resolves on its own. Never give Banamine intramuscularly, as it can cause severe tissue damage (Clostridial myonecrosis). Oral paste or IV administration only.

Can horses get colic from eating too much grass?

Yes. Sudden access to lush, high-sugar pasture can cause gas colic and, in some cases, contribute to colonic acidosis. This is most common in spring when grass grows rapidly and sugar content is high. Gradual introduction to pasture (starting with 15-30 minutes and increasing over weeks) reduces this risk significantly.

For more answers to common horse health questions, visit our FAQ page.

Related Articles

🔍 Explore the equine digestive system and see where colic occurs in our 3D Explorer. Check it out here.

Last reviewed: March 2026

Sources

  • Texas A&M College of Veterinary Medicine & Biomedical Sciences. "Colic in Horses." vetmed.tamu.edu
  • AAEP. "Colic Guidelines for the Horse Owner." aaep.org
  • Merck Veterinary Manual. "Colic in Horses." merckvetmanual.com
  • UC Davis Center for Equine Health. "Understanding Colic." ceh.vetmed.ucdavis.edu
  • Cornell University College of Veterinary Medicine. "Large Animal Surgery - Colic." vet.cornell.edu