Horse Colic: Types, Emergency Signs & What to Do

Colic is not a single disease — it is a broad term for abdominal pain in horses, and it is the single most dangerous medical emergency you will ever face as a horse owner. Every year, colic kills tens of thousands of horses worldwide. Some episodes resolve on their own within minutes; others spiral into life-threatening crises within hours. The terrifying reality is that you often cannot tell which type you are dealing with until a qualified equine veterinarian examines your horse. This guide explains the different types of colic, the emergency warning signs that demand immediate action, and exactly what you should — and should not — do while you wait for professional help to arrive.

Understanding the Types of Colic

Not all colic is created equal. Veterinarians classify equine colic into several distinct categories, and the prognosis for each varies dramatically. Understanding the differences helps you communicate clearly with your equine vet and understand why certain cases require emergency surgery.

Spasmodic colic is among the most common and often most manageable forms. It occurs when spasms or excessive gas accumulation cause waves of cramping pain in the large intestine. Horses with spasmodic colic may improve with antispasmodic or analgesic medication administered by a vet, but you should never assume this is what you are dealing with without professional evaluation.

Impaction colic develops when feed material — typically dry hay, sand, or coarse fibrous matter — accumulates and forms a firm blockage somewhere in the digestive tract, most commonly at the pelvic flexure or the right dorsal colon. Horses that do not drink enough water or that have recently changed feed are at elevated risk. Impactions can resolve with aggressive fluid therapy, but severe cases require hospitalization or even surgery.

Displacement colic happens when a portion of the large colon shifts out of its normal anatomical position, becoming trapped in an abnormal location — for example, becoming lodged over the nephrosplenic ligament (left dorsal displacement). The colon then fills with gas and cannot drain normally. This type frequently requires surgical correction.

Strangulation colic is the most dangerous category and constitutes a true surgical emergency. In strangulation, the blood supply to a segment of intestine is cut off — often by a lipoma (a fatty tumor on a stalk that wraps around the intestine), by a twisted small intestine (volvulus), or by an intussusception where one section of gut telescopes into another. Without surgery within hours, affected tissue dies, toxins flood the bloodstream, and the horse goes into fatal shock. This is the colic that kills horses overnight.

Emergency Warning Signs: When Every Minute Counts

Horses experiencing colic will exhibit a characteristic set of behaviors that signal abdominal pain. You must be able to recognize these immediately.

Pawing at the ground is one of the earliest signs — your horse repeatedly scrapes or stamps at the floor of the stall or paddock. This is a pain behavior, not a normal activity. Looking at or biting at the flanks is another classic indicator; a horse in abdominal distress will repeatedly turn its head toward its belly, sometimes nipping at its own sides. Stretching out in a posture resembling urination, but without producing urine, is common as the horse tries to relieve internal pressure.

As pain escalates, watch for flank-watching while standing still, refusal to eat or drink, sweating disproportionate to the ambient temperature, and an elevated heart rate above 48 beats per minute at rest. A horse that repeatedly lies down and gets back up is experiencing severe, worsening pain. Violent rolling — throwing the body to the ground repeatedly with force — signals an extreme pain state and is a veterinary emergency without exception. In cases of strangulation or volvulus, the deterioration from mild discomfort to violent rolling can occur within 30–60 minutes.

One of the most useful diagnostic tools an owner can perform before the vet arrives is listening for gut sounds (borborygmi). Place your ear or a stethoscope against both sides of the abdomen, high and low. Normal horses produce a constant symphony of rumbles, gurgles, and tinkles. Absent or dramatically reduced gut sounds on one or both sides indicate that intestinal motility has stopped — a grave sign that demands an urgent veterinary response.

What to Do While Waiting for Your Equine Vet

The single most important action you can take is to call your equine veterinarian immediately — not a general or small animal practice. Equine colic requires specialists with the diagnostic equipment (nasogastric tubes, rectal palpation experience, ultrasound) and pharmaceutical options specific to horses. Describe every symptom you have observed, when it started, your horse's feeding routine, water intake, and recent manure output.

While waiting for the vet, keep your horse in a safe, open area — a large stall or small paddock where it cannot injure itself. Remove all feed immediately. Do not offer hay, grain, or water until the vet advises you to. Hand-walking a horse with mild pain can help encourage intestinal motility and prevent injury from rolling, but only if your horse is calm enough to be led safely. Never force a horse in severe pain to walk — you risk injury to yourself and the animal.

Monitor and record vital signs every 15 minutes: heart rate, respiratory rate, gum color (pale, tacky, or bluish gums indicate cardiovascular compromise), and capillary refill time. This information is invaluable to the arriving vet.

To support your horse's hydration and electrolyte balance in the days following a colic episode — and as an ongoing preventive measure — consider providing a high-quality equine electrolyte supplement that encourages water intake. Adequate hydration is one of the most powerful tools for preventing impaction colic.

What You Must NOT Do

Misinformation about colic management has cost horses their lives. There are several common but dangerous actions that horse owners must avoid.

Do not allow violent rolling. While gentle rolling or lying quietly may not worsen some types of colic, a horse that is throwing itself violently to the ground risks traumatic injury — fractured bones, ruptured organs — and can potentially cause a torsion (twist) of the colon or small intestine if one was not already present. Prevent this if you can do so safely. If you cannot restrain the horse safely, prioritize your own safety and clear the area.

Do not administer pain medication (NSAIDs or sedatives) without veterinary guidance. Giving banamine or phenylbutazone before the vet arrives may mask worsening signs that the veterinarian needs to evaluate. This is especially dangerous if the horse is in early strangulation — the apparent improvement in pain is deceptive, and critical treatment time is lost.

Do not give food or additional water until the type of colic has been diagnosed. Feed can worsen an impaction or increase gas accumulation. Do not wait more than 15–20 minutes to call the vet, hoping things will improve.

Prevention: Your Best Weapon Against Colic

No prevention strategy eliminates colic risk entirely, but certain management practices significantly reduce it. Maintain a consistent feeding schedule and make any dietary changes very gradually — over 10–14 days minimum. Ensure unlimited access to fresh, clean water at all times, especially in cold weather when horses tend to drink less. Regular dental care prevents poor chewing that leads to impactions. Adhere to a deworming protocol tailored by your equine vet, as parasites — particularly encysted small strongyles — are a documented colic risk factor. Keep your horse moving: regular exercise promotes healthy gut motility.

References

1. Tinker MK, White NA, Lessard P, et al. Prospective study of equine colic incidence and mortality. Equine Veterinary Journal. 1997;29(6):448–453. PubMed PMID: 9413723
2. Traub-Dargatz JL, Kopral CA, Seitzinger AH, Garber LP, Forde K, White NA. Estimate of the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1998 to spring 1999. Journal of the American Veterinary Medical Association. 2001;219(1):67–71. PubMed PMID: 11439769

Written by Sarah Bennett, Certified Animal Nutritionist. Always consult a qualified equine veterinarian for diagnosis and treatment of your horse. This article is for educational purposes only and does not constitute veterinary medical advice.