How Does a Horse Get Colic? A Definition and Treatment Options

Last updated: October 26, 2025

By: Miles HenryFact Checked

Medical Disclaimer: This article shares personal experience and educational information only. It does not constitute veterinary advice. Colic is a life-threatening emergency. Always contact your veterinarian immediately if you suspect your horse has colic. Never attempt to diagnose or treat colic without professional veterinary guidance. All treatments mentioned in this article must only be administered by or under the direct supervision of a licensed veterinarian.

Our horse began lying down and rolling around in the stall, which is unusual for him. I immediately suspected he was suffering from colic and called our veterinarian. While waiting for the vet to arrive, I kept him on his feet and monitored his symptoms. This experience drove home how critical it is to understand colic and respond appropriately—which always means calling your vet first.

Horses get colic for various reasons, such as dietary changes, dehydration, parasites, and eating moldy hay or feed. “Colic” is the term used to describe severe abdominal pain in horses. Most often, the cause is a gastrointestinal disturbance. Colic must be treated as an emergency, and a veterinarian must be consulted immediately. Severe colic can be fatal, and only a veterinarian can determine the appropriate treatment.

Horses lie down for various reasons, so we need to determine if our horse is just being a horse or has colic. Not all horses act the same when they have severe stomach pain, but there are common signs you need to be aware of.

A Note from the Author: What follows describes my personal experience with colic and information gathered from veterinary professionals over 25+ years of horse ownership. This is educational content to help you understand colic mechanisms and recognize when to call for help—not instructions for home treatment. Every colic case requires immediate veterinary assessment. The treatments described here were all performed by or under direct supervision of licensed veterinarians.

What is Colic in Horses?

Before we delve too deeply into colic, it’s necessary to have an understanding of the condition. Colic is severe abdominal pain in horses. Acute colic is a grave condition and can be fatal.

Horses have a complex gastrointestinal system that is adversely affected for numerous reasons, but colic is typically related to overeating or eating incorrectly.

According to Colorado State University, colic is one of the leading causes of death in horses, which is why immediate veterinary intervention is critical. The complexity of the equine digestive system means many different conditions can cause colic, and only professional assessment can determine the cause and appropriate treatment.

Emergency First Response: What to Do When You Suspect Colic

If you suspect your horse has colic, take these steps immediately:

1. Call your veterinarian immediately – Do not wait to see if symptoms improve. Time is critical.
2. Remove all feed – Keep water available unless instructed otherwise by your vet
3. Keep your horse safe – Prevent self-injury from violent rolling, but don’t force excessive walking
4. Do NOT give any medications, oils, or home remedies without veterinary approval
5. Monitor and document symptoms – Note behaviors, vital signs if you know how, time symptoms started
6. Follow your vet’s phone instructions while waiting for them to arrive

The Merck Veterinary Manual emphasizes that early veterinary intervention significantly improves outcomes. Some types of colic require surgery within hours—delays can be fatal.

Why do horses get colic?

Colic is a condition that affects horses. It can be caused by many factors, such as overeating grain or eating ruined feed or hay. The more common cause of colic is intestinal gas accumulation, which causes pain and often causes the horse to refuse food or drink because it is painful to consume anything.

The wall of the intestine is stretched.

The wall of the intestine is stretched excessively by either gas, fluid, or ingesta. This stretching causes stimulation of the sensitive nerve endings located within the intestinal wall, and pain impulses are sent to the brain.

Tension on the ligamentous attachment.

Pain develops due to excessive tension on the ligamentous attachment of the intestine to the body wall, called the “mesentery.” When this happens, intestinal displacement could occur or be in the process of occurring.

Restriction in blood supply to tissues.

Ischemia develops a restriction in blood supply to tissues, causing a shortage of oxygen needed to keep tissues alive. The lack of blood flow is usually caused by a blockage or severe twisting of the intestine.

Inflammation of the intestines.

Inflammation develops and may involve the entire intestinal wall (enteritis) or the intestine’s covering (peritonitis). Under such circumstances, proinflammatory mediators in the wall of the intestine decrease the threshold for painful stimuli.https://www.merckvetmanual.com/digestive-system/colic

What conditions lead to colic in horses?

Many conditions can cause a horse to colic. The general types of diseases that lead to colic are;

1. Flatulent colic is excessive gas in the intestine,
2. Simple obstruction of the intestine. Sometimes surgery is necessary to treat; however, it can be treated non-surgically.
3. Strangulating obstruction is obstruction of both the intestine and the blood supply to the intestine. Emergency surgical intervention is generally necessary.
4. nonstrangulating infarction, interruption of the blood supply to the intestine alone. Emergency abdominal surgery is normally required.
5. Enteritis inflammation of the intestine, especially the small intestine, usually accompanied by diarrhea
6. Peritonitis, inflammation of the lining of the abdominal cavity,
7. Ulceration erosion of the intestinal lining,
8. Unexplained colic– There are still some causes that are a mystery. In general, horses with strangulating obstructions and complete obstructions require emergency abdominal surgery, whereas horses with other types of colic can likely be treated with medicine.

Professional Veterinary Treatment for Colic

⚠️ CRITICAL: All treatments described in this section must be performed by or under direct supervision of a licensed veterinarian. This information is provided to help you understand what your vet may do—not as instructions for home treatment. Never attempt to treat colic yourself.

When a horse shows signs of colic, a veterinarian must be called immediately for evaluation. The vet will assess the severity and cause of the colic, then determine the appropriate treatment plan. Treatment approaches vary widely depending on the diagnosis.

Veterinary Assessment and Medical Treatment

The veterinarian will perform a thorough physical examination, which may include:

• Checking vital signs (heart rate, respiration, temperature)
• Listening to gut sounds with a stethoscope
• Rectal examination to check for impactions or displacements
• Passing a nasogastric tube to check for gastric reflux
• Abdominal ultrasound in some cases

Based on the examination, the veterinarian may administer various treatments:

Pain Management (Administered by Veterinarian)

Veterinarians commonly use non-steroidal anti-inflammatory drugs such as Flunixin meglumine (Banamine) and Phenylbutazone (Bute) to treat pain and reduce inflammation associated with colic. These are prescription medications that must only be administered by a veterinarian or under their direct instruction. The dosage and timing are critical—improper use can mask symptoms that indicate a surgical emergency.

Rehydration and Fluid Therapy (Administered by Veterinarian)

Dehydration is often both a cause and consequence of colic. According to Penn State Extension, proper hydration is critical for recovery. Veterinarians may administer fluids through:

• Nasogastric tube: Fluids, electrolytes, and sometimes mineral oil delivered directly to the stomach
• Intravenous fluids: For severe dehydration or when oral fluids aren’t appropriate

Horses need 10-12 gallons of fresh water daily. Dehydration increases risk of impaction colic. Signs of dehydration include elevated heart rate, prolonged capillary refill time (press your finger on the gum—should return to pink within 2 seconds), and tacky or discolored mucous membranes.

Other Veterinary Interventions

Depending on the diagnosis, veterinarians may also:

• Administer lubricants or laxatives for impaction colic
• Provide deworming medication if parasites are suspected
• Use medications to promote gut motility
• Monitor with ultrasound to track treatment progress

Important: Products marketed for colic support should only be used under veterinary guidance. While some owners keep digestive aids on hand, never administer anything without first consulting your veterinarian—what helps one type of colic can worsen another.

Treatment Risks: Understanding Potential Complications

⚠️ CRITICAL: All treatments must be administered by or under the direct supervision of a licensed veterinarian. Understanding potential risks helps you make informed decisions with your vet but does not replace professional guidance.

Veterinary treatments for colic, while often effective, carry risks that vary by treatment type and the horse’s condition. According to the Merck Veterinary Manual, discussing these risks with your veterinarian is essential for safe treatment. Common risks include:

• Pain Medications (e.g., Banamine, Bute): Non-steroidal anti-inflammatory drugs like Flunixin meglumine (Banamine) or Phenylbutazone (Bute) can cause kidney strain, especially in dehydrated horses, or gastrointestinal issues like ulcers if misused. Overdosing or improper timing may mask critical symptoms, delaying diagnosis of surgical emergencies.
• Fluid Therapy: Administering fluids via nasogastric tube or IV is generally safe but can cause complications like electrolyte imbalances or, in rare cases, tube misplacement leading to respiratory issues. Only veterinarians should perform these procedures.
• Surgical Risks: Colic surgery (exploratory celiotomy) carries risks such as post-operative infections, adhesions (scar tissue causing future blockages), or prolonged recovery requiring weeks of hospitalization. The American College of Veterinary Surgeons notes that success depends on the colic’s severity, surgical timing, and post-operative care.
• Other Interventions: Laxatives or gut motility drugs may cause diarrhea or disrupt normal digestion if not tailored to the colic type. Deworming medications, if misapplied, can trigger allergic reactions or exacerbate existing inflammation.

Important: Never administer treatments without veterinary guidance, as inappropriate use can worsen the condition or lead to fatal complications (e.g., giving mineral oil to a horse with an intestinal twist risks rupture). Work closely with your veterinarian to weigh treatment benefits against risks for your horse’s specific case.

When Surgery is Necessary: Colic Surgery Explained

Some types of colic cannot be resolved with medical management and require emergency abdominal surgery. Only a veterinarian can determine if surgery is necessary. According to the University of Florida, conditions that typically require surgery include:

• Strangulating obstructions (twisted intestine cutting off blood supply)
• Severe displacements that cannot be corrected medically
• Complete intestinal blockages
• Intestinal rupture
• Cases where medical treatment has failed and pain cannot be controlled

What Happens During Colic Surgery

Colic surgery, often called exploratory celiotomy, involves opening the abdomen to identify and correct the problem. The veterinary surgeon may:

• Reposition displaced intestines
• Remove sections of dead or damaged intestine (resection)
• Clear obstructions
• Untwist intestines and restore blood flow

The exact procedure depends on what the surgeon finds during the operation.

Recovery and Prognosis After Colic Surgery

Many horses recover well from colic surgery and return to normal activities. I had a young Thoroughbred who underwent colic surgery and made a full recovery, returning to race successfully. However, recovery requires:

• Extended hospitalization (several days to weeks)
• Careful post-operative management
• Gradual reintroduction to feed
• Close veterinary monitoring
• Significant financial investment

Prognosis depends on the severity of the condition, how quickly surgery was performed, and the quality of post-operative care. Working closely with your veterinary team throughout the process is essential for the best outcomes.

Colic accounts for approximately 10% of horse deaths, making it one of the leading causes of mortality in horses. This statistic underscores why immediate veterinary care is so critical.

While Waiting for the Veterinarian: Safe Management

Your first action must always be calling your veterinarian. While waiting for the vet to arrive (typically 20-45 minutes), here’s how to keep your horse safe:

Keep Your Horse Safe From Injury

When our horse showed colic signs, keeping him on his feet and moving calmly seemed to help keep his mind off the pain. However, walking recommendations have evolved:

• Gentle hand-walking may help with mild gas colic by encouraging gut motility
• Do NOT force excessive walking or prevent the horse from resting—this can exhaust them
• Prevent violent rolling that could cause injury, but some rolling is natural pain response
• Keep the horse in a safe area (preferably soft ground like sand or paddock)
• Always follow your vet’s phone instructions for your specific situation

The old advice of “walk them continuously no matter what” is outdated. According to modern veterinary guidance, forcing exhausted horses to walk can worsen their condition.

What NOT to Do

⚠️ DO NOT do any of the following without explicit veterinary instruction:

• Do NOT administer mineral oil or any other substance by mouth or tube
• Do NOT give bran mashes, oils, or home remedies
• Do NOT administer any medications including pain relievers
• Do NOT perform rectal examinations or attempt to remove manure manually
• Do NOT administer enemas to adult horses
• Do NOT use digestive aid products without veterinary approval

Horses cannot vomit like other animals. Administering anything by mouth without veterinary guidance can be dangerous or even fatal. What helps one type of colic can worsen another—for example, giving oil to a horse with an intestinal twist could cause rupture.

Your job is to keep the horse safe and provide information to the veterinarian—not to diagnose or treat. Let the professional determine the appropriate course of action.

What should you do when you first suspect your horse is suffering from colic?

Our instincts were correct; he needed to be up and on his feet; also, walking around is good. There isn’t any solid evidence that walking helps relieve the pain, but it seems to keep his mind off it.

Also, if he continued lying in his stall and rolling around, he could cause worse damage and cause the intestines to twist and make matters worse.

Rolling and lying down are signs of colic in horses.

Frequent lying down and rolling are the most obvious signs of colic, and he will need immediate attention to have any chance of recovery. First aid treatment requires he is brought to his feet and kept moving.

Gentle hand-walking may help mild gas colic under vet guidance, but do not force excessive walking, as it can harm severe cases. Always follow your vet’s instructions.

Contact your veterinarian.

Horses can’t vomit as we do, so don’t try any of your own remedies without checking with the veterinarian. He will probably have a good idea of his treatment plan from the information you have given him over the phone. He will likely provide a muscle relaxant to promote defecation or perhaps an enema, but that decision is best left to an expert.

Recognizing Colic Symptoms: What to Watch For

Early recognition of colic symptoms can save your horse’s life. Our horse exhibited the classic sign of colic—rolling frantically in the stall. According to the American Association of Equine Practitioners, recognizing these signs early and calling your veterinarian immediately gives your horse the best chance of recovery.

Important: Not every horse displays all these symptoms, and severity can vary widely. These symptoms indicate stomach pain but do not identify which part of the GI tract is affected or whether surgery is necessary—only a veterinarian can make that determination. If you observe any combination of these signs, call your vet immediately.

Common Behavioral Signs of Colic

Pawing the Ground Repeatedly

While occasional pawing is normal horse behavior, continuous and repetitive pawing of the ground is a clear distress signal. Horses have limited ways to communicate pain, and persistent pawing is one of their most obvious indicators of abdominal discomfort.

Looking Back at Flanks

Frequently turning the head back to look at, nudge, or even bite at the flank region is a telling sign of abdominal pain. This behavior unmistakably communicates that your horse is experiencing belly discomfort and needs veterinary attention.

Flehmen Response (Lip Curling)

When a horse curls its upper lip back while extending its neck and raising its head—a behavior called flehmen—it can sometimes indicate early onset colic pain or low-level gastrointestinal discomfort. While horses also perform this behavior for other reasons (like investigating scents), when combined with other symptoms, it may signal colic.

Neck Arching

Arching the neck, especially when done in conjunction with the flehmen response, is another indicator of abdominal pain that warrants immediate veterinary evaluation.

Kicking at the Abdomen

A horse experiencing belly pain will often try to kick at its abdomen. This is usually a reliable distress signal indicating significant abdominal discomfort requiring immediate veterinary attention.

Repeatedly Raising a Rear Leg

While this behavior typically indicates insect irritation, if you’ve ruled out insects as the cause, repeatedly raising a rear leg in an agitated manner could indicate internal pain. Many stabled horses fed concentrated feeds and kept confined can suffer from undiagnosed abdominal discomfort that manifests this way.

Critical Warning Signs: Emergency Symptoms

Frantic Rolling

It’s important to distinguish between normal rolling and colic-related rolling. Healthy horses will occasionally go to the ground, roll, pop up, and shake—this is actually beneficial for them. However, a horse suffering from colic will:

• Drop suddenly to the ground
• Roll frantically and repeatedly
• Fail to shake when getting up
• Immediately look back at their flank
• Appear messy, sweaty, and covered in manure and shavings (if rolling in stall)

⚠️ EMERGENCY: Horses with severe colic will roll and kick without any concern for their safety or others around them, sometimes causing themselves serious injuries. A horse displaying this type of violent rolling needs immediate veterinary attention—this is a life-threatening emergency.

Physical Signs of Colic

Excessive Sweating

While sweating is normal for horses and their primary cooling mechanism, excessive sweating during periods of extreme pain is a serious warning sign. Horses can lose up to 4 gallons of sweat per hour, and excessive sweating depletes water and electrolytes, potentially leading to dangerous complications including dehydration and shock.

Stretching Posture

Stretching out as if to urinate—particularly in geldings and stallions who may partially drop their penis and dribble small amounts of urine—can be mistaken for urinary tract problems but is more often related to abdominal pain.

Bloated Abdomen

Abdominal distention (bloated belly) occurs when the intestines become overfilled with gas or fluids. Common causes include:

• Overeating grain: Horses have small stomachs (only 2-4 gallons capacity). When grain stays in the stomach too long, fermentation produces gas, causing painful enlargement
• Drinking too much cold water: Especially after water deprivation, can cause stomach spasms and bloating
• Parasite infestation
• Intestinal obstruction or twist: Prevents food from moving through the digestive system

Unlike most animals, horses cannot vomit to relieve pressure from overeating. In rare cases, this can lead to stomach rupture—a fatal condition requiring emergency intervention.

Straining to Defecate

Adult horses rarely have difficulty passing manure. If you notice your horse straining to defecate, this indicates a serious problem. While this can be symptomatic of colic, it may also indicate rectal impaction, chronic diarrhea, urinary tract problems, or neurologic issues.

⚠️ WARNING: Never attempt your own internal rectal examination or try to manually remove manure from your horse’s rectum. Do not attempt to perform an enema on an adult horse that is straining. Do not insert any object into the rectum. Rectal tissue is extremely fragile and easily ruptured, which can cause life-threatening peritonitis. Only veterinarians should perform these procedures.

Appetite and Behavior Changes

Loss of Appetite

Most horses love to eat enthusiastically. If your horse shows no interest in feed, picks at food without eating, or refuses to eat entirely when food is available, something is wrong. Lack of appetite is one of the primary warning signs of colic.

Sudden Mood or Behavior Changes

A horse that develops sudden behavioral changes—refusing to eat, standing alone separated from other horses, appearing unusually lethargic or depressed—may be experiencing abdominal discomfort. These signs of depression combined with other symptoms warrant immediate veterinary evaluation.

Reduced Manure Production

Horses typically defecate 6-8 times per day, with each event lasting approximately 15 seconds. Every horse has individual patterns, which is why it’s important to know your horse’s normal bowel habits. A noticeable decrease in bowel movements, especially when combined with other colic symptoms, requires immediate veterinary attention.

Remember: Early recognition and immediate veterinary intervention are your horse’s best chance for survival. When in doubt, call your veterinarian—it’s always better to have a false alarm than to delay treatment for a life-threatening condition.

Preventing Colic: Evidence-Based Management Strategies

While colic cannot always be prevented, research has identified several management practices that significantly reduce risk. According to the University of Minnesota Extension and veterinary research on risk factors, the following practices help minimize colic risk:

Feed Management

• Provide high-quality forage: Feed good hay with no mold or dust. Moldy or poor-quality hay can cause digestive upset and colic
• Make dietary changes gradually: Sudden changes in feed type or amount disrupt the digestive system. Transition new feeds over 7-10 days
• Feed appropriate quantities: Ensure you’re feeding the correct amount and quality of grain for your horse’s workload and body condition
• Maintain consistent feeding schedule: Feed at regular times each day to support healthy digestive function
• Avoid feeding on dirt or sand: Use feed tubs or rubber mats to prevent sand ingestion, which can cause sand colic

Hydration and Water Access

• Ensure constant access to clean, fresh water: Dehydration is a leading cause of impaction colic. Horses need 10-12 gallons daily, more in hot weather or with exercise
• Check water sources in winter: Ensure water isn’t frozen and maintain appropriate temperature to encourage drinking

Exercise and Turnout

• Provide daily turnout: Turn your horse out as much as possible. Movement encourages healthy gut motility
• Maintain regular exercise: Consistent physical activity supports digestive health and reduces colic risk

Health Maintenance

• Follow veterinary-recommended deworming protocols: Keep your horse on an appropriate parasite control program based on fecal egg counts
• Schedule regular dental care: Proper dental health ensures your horse can adequately chew food, supporting healthy digestion
• Minimize stress: Stress from travel, competition, changes in routine, or environmental factors can contribute to colic

Important note: Even with excellent management, colic can still occur. These preventive measures reduce risk but cannot eliminate it entirely. Always monitor your horse for early warning signs and maintain a relationship with a veterinarian who can respond quickly in emergencies.

FAQ

Conclusion: Recognition and Rapid Response Save Lives

Our horse’s colic experience taught me that while understanding colic is important, the most critical factor in survival is immediate veterinary care. He underwent surgery for an obstruction before he ever ran his first race. With proper surgical intervention and careful post-operative management, he recovered well enough to make it to the racetrack and win a couple of races.

Key takeaways about colic:

• Call your veterinarian immediately if you suspect colic—this is the single most important action
• Colic is severe abdominal pain with many possible causes requiring different treatments
• Common signs include rolling, pawing, looking at flanks, sweating, refusing food, and straining
• Never attempt to diagnose or treat colic yourself—only veterinarians can determine appropriate treatment
• While waiting for the vet, keep your horse safe but do not administer any treatments or medications
• Some colics resolve with medical management; others require emergency surgery
• Prevention focuses on proper management, but colic can still occur

Colic accounts for approximately 10% of equine deaths, making it one of the most serious health threats horses face. However, with prompt recognition of symptoms and immediate veterinary intervention, many horses recover fully and return to normal activities.

If you suspect your horse has colic right now, stop reading and call your veterinarian immediately. This article will still be here later—your horse needs professional help now.

Further Reading and Resources:

• Colic Updates and Prevention – American Association of Equine Practitioners
• Colic in Horses – Merck Veterinary Manual
• Colic in Your Horse – University of Minnesota Extension
• Colic: What Are the Signs and How to Manage – Penn State Extension
• Colic Surgery Information – American College of Veterinary Surgeons
• Horse Colic 101: What Every Owner Should Know – Comprehensive educational guide
• What To Do When Your Horse Colics – Personal emergency story and immediate action steps