If you own a horse long enough, you will meet colic. I learned this the hard way at 2 a.m. on a Tuesday when my normally food-obsessed mare ignored her evening grain and stood with her head dropped in the corner of her stall.
That quiet refusal to eat was the first of the signs of colic in horses I learned to recognize, and it saved her life. Colic is the catch-all term veterinarians use for abdominal pain in horses, and it ranges from a mild gas bubble that resolves on its own to a twisted intestine that ends in emergency surgery.
Because colic can escalate from “watchful waiting” to a life-threatening crisis in under an hour, knowing how to spot the signs early is one of the most important skills any horse owner can build. This guide walks through subtle behavior changes, the warning signs that mean “call the vet now,” vital sign thresholds you can measure at home, and a simple action plan for before the vet arrives.
Table of Contents
What Is Colic in Horses?
Colic is not one disease. It is a description of abdominal pain, and in horses that pain almost always originates somewhere along the roughly 100 feet of intestinal tract coiled inside their barrel.
The most common types include gas colic (buildup of gas in the intestines), impaction colic (a blockage of feed, sand, or other material), spasmodic colic (cramping from increased intestinal motility), and displacement or volvulus (when a section of intestine shifts or twists on itself).
Horses are uniquely prone to colic for a few reasons. They cannot vomit, so anything that goes wrong in the gut has to travel the entire length of the digestive system. Their large colon is loosely attached inside the abdomen, which makes it prone to shifting. They also depend on a steady flow of forage to keep things moving, and they are sensitive to sudden changes in feed, water, or routine.
Statistically, colic is one of the leading causes of death in adult horses, with estimates suggesting it contributes to a significant percentage of equine fatalities each year. That is the scary part. The good news is that the vast majority of colic episodes are mild and respond to basic veterinary treatment, and catching the early signs dramatically improves outcomes.
The difference between a mild case and a surgical emergency often comes down to how quickly you recognize the warning signs and act. This is why every horse owner needs a working mental checklist of what colic looks like.
Types of Colic and How Each One Presents
Understanding the type of colic your horse may be experiencing helps you anticipate how things might progress. Your vet will make the final call, but here is what owners should know about each major type.
Gas Colic (Tympanitic Colic)
Gas colic is the most common and generally the mildest form. Excessive gas builds up in the large colon or cecum and causes visible distension and cramping. Horses typically show restlessness, mild flank watching, pawing, and may pass gas. It usually responds well to walking and analgesics.
Impaction Colic
Impaction colic happens when feed material, sand, or dehydrated ingested matter blocks a section of intestine, most commonly where the large colon narrows. Horses often show a gradual onset of mild, persistent signs. Reduced manure output is a hallmark, along with decreased appetite and dullness. Risk factors include reduced water intake, sudden feed changes, and dental issues.
Spasmodic Colic
Spasmodic colic involves increased, uncoordinated contractions of the intestinal wall. The pain tends to come in waves, with the horse showing intense discomfort that briefly resolves before returning. Excitement, stress, and rapid feed changes are common triggers.
Displacement and Volvulus
Displacement means a section of intestine has moved out of its normal position, while volvulus involves a twist that can cut off blood supply. These are surgical emergencies. Signs come on fast and severely, with violent rolling, elevated heart rate, and a horse that does not respond to pain medication. This is the type of colic where minutes truly matter.
Strangulating Lesions and Enteritis
Less common but very serious, strangulating lipomas (fatty tumors on a stalk that wrap around intestine), intussusceptions (one section telescoping into another), and enteritis (inflammation of the small intestine) can all present as colic. These cases almost always require intensive veterinary care or surgery.
Early and Subtle Signs of Colic in Horses
Early colic signs are easy to miss, especially in stoic horses that hide discomfort as a survival instinct. I now keep a mental checklist of what “normal” looks like for each horse I work with so I can catch changes within minutes.
The earliest behavioral changes usually appear before any dramatic symptoms. Look for:
Reduced interest in feed or treats, or eating more slowly than usual
Less manure than normal, or drier, smaller manure piles
Slight restlessness, shifting weight, or standing with front legs stretched out
Repeatedly turning the head to look at the flank
Pawing the ground once or twice without obvious cause
Reduced interest in the herd or in surroundings
Dull expression, ears held slightly back, lower head carriage
Licking or biting at the sides without obvious irritation
Lying down more than usual, or standing up again quickly after lying down
Subtle sweating around the flanks or behind the ears
Curling the upper lip in a Flehmen response for no apparent reason
Teeth grinding, especially in foals or when the horse is stressed
Stoic horses are the trickiest cases. Some horses, particularly older mares and certain breeds, will show almost no obvious signs until pain becomes severe. With these horses, I watch for what they are not doing rather than what they are doing. Is she greeting me at the gate? Is he finishing his hay at the same pace as yesterday? Is she still interested in her pasture buddies?
A stoic horse that simply “seems off” or “isn’t herself” should be taken seriously. Many owners on forums describe catching colic precisely because they noticed their horse seemed quieter than usual, hung back at feeding time, or just did not have the same spark in their eye that morning.
New horse owners often ask me how to tell the difference between a horse that is having a bad day and one that is starting to colic. The honest answer is that you cannot always tell from a single observation. The difference shows up over 30 to 60 minutes. A horse that is just grumpy usually returns to normal. A horse that is colicking tends to get quieter or more restless, not better.
Severe Signs of Colic: When It Becomes an Emergency
Severe signs mean the pain is escalating or the situation may involve compromised blood supply to the gut. At this stage, time is tissue, and minutes matter.
Call your veterinarian immediately if you see:
Violent or repeated rolling, especially throwing the body down hard
Sweating across the neck, shoulders, and flanks despite cool weather
Repeated attempts to lie down and get up in quick succession
Kicking or biting at the belly with intensity
Heart rate above 50 beats per minute at rest
Breathing rate above 30 breaths per minute at rest
Pale, white, purple, or brick-red gums instead of healthy pink
Capillary refill time over 2 to 3 seconds
Distended or visibly bloated abdomen
No gut sounds, or very loud, high-pitched gut sounds
Lying on the back or in a dog-sitting position to relieve pressure
Sudden collapse or incoordination
Dark or muddy-colored gums that suggest endotoxemia
One of the most useful comparisons I have found in my own work is this. A horse that paws once, glances at the flank, and then goes back to eating is most likely showing an early sign. A horse that paws repeatedly, refuses food entirely, and begins sweating under the saddle area is showing severe pain and needs a vet right now.
It is worth saying plainly that rolling itself does not cause a twisted intestine, despite a common myth. The twist comes first, the pain drives the rolling. This is why preventing a horse from rolling is less urgent than getting the vet on the way, though keeping a violent horse safe from self-injury does matter.
How to Tell if Horse Colic Is Getting Worse?
The transition from mild to severe can be quick. Watch for these specific patterns. Pain that escalates over 20 to 30 minutes instead of staying level, vital signs that drift upward on repeated checks, or a horse that switches from quiet discomfort to obvious agitation.
Heart rate is the single most reliable number you can track at home. Take it yourself if you can, or have your vet tech show you how during the next routine visit. A horse that started at 40 bpm and is now at 60 bpm is moving in the wrong direction regardless of how “good” they may look from the outside.
I also watch for the horse that suddenly gets quiet after a period of obvious pain. This can mean the pain is overwhelming, not that the colic has resolved. Any sudden improvement in a horse that was previously in distress is worth a vet check.
Repeat your vital sign checks every 15 to 20 minutes and write them down. A trend over time is much more informative than a single reading, and your veterinarian will rely on this series when deciding whether to come out immediately or continue monitoring.
What to Do When You Suspect Colic
The first ten minutes after you suspect colic matter. Walk through these steps in order.
Step 1: Remove all food and water access for now. This prevents the horse from eating into a worsening impaction, but keep the water bucket within reach until the vet arrives or you get further instructions.
Step 2: Note the time. Write down when you first noticed the signs. Your vet will want this information.
Step 3: Take vital signs if it is safe to do so. Heart rate, respiratory rate, gum color, and gut sounds. See the vital signs section below for specific numbers.
Step 4: Walk the horse if signs are mild. Slow walking can help mild gas colic resolve and keeps the horse from rolling. Do not walk a horse that is throwing itself down or in obvious severe pain, as this can worsen an intestinal twist and put you at risk of injury.
Step 5: Call your veterinarian. Even if you are unsure, call. Most vet clinics will talk you through the signs and tell you whether they need to come immediately or whether you can monitor for an hour.
Step 6: Prepare for the visit. Have your horse’s history ready, including recent feed changes, deworming, dental work, and any medications. Move the horse to a safe area with good footing and lighting. Have a halter and lead rope ready, and a stopwatch or phone for vitals.
What NOT to do: do not give Banamine (flunixin meglumine) or any other pain medication without veterinary guidance. Pain relief can mask worsening signs and make it harder for the vet to assess what is happening. Do not tube the horse, give an enema, or force the horse to walk if it is collapsing.
When to Wait and When to Panic
This is the question I hear most often from new horse owners. The honest answer is that colic is unpredictable, so waiting too long is a more common mistake than calling too early.
You can monitor at home and call for guidance if the horse is showing only one or two mild signs, is interested in surroundings, has normal or near-normal vital signs, and the signs are not escalating.
Call the vet now if the horse has any severe sign from the list above, if mild signs have not improved after 30 to 60 minutes of observation, if vital signs are climbing, if the horse has had multiple colic episodes in a short window, or if you simply have a gut feeling something is wrong.
I tell every new owner the same thing. Your vet would rather come out for a mild colic that resolves on its own than get the call too late. Erring on the side of caution is always the right call with colic, and no good veterinarian will be annoyed by a phone call from a concerned owner.
The cost of an unnecessary farm call is small. The cost of waiting too long on a surgical colic can be a horse’s life and a four-figure emergency surgery bill. When in doubt, make the call.
Vital Signs Reference Guide for Horse Owners
Knowing your horse’s baseline vital signs is the single most useful thing you can do before colic ever happens. Practice taking these on your healthy horse so you know what “normal” feels like for that individual.
Heart Rate
Normal resting heart rate for an adult horse is 28 to 44 beats per minute. Above 50 bpm at rest is concerning and warrants a vet call. Above 60 bpm usually means significant pain or compromise. You can measure this with a stethoscope behind the left elbow, or by feeling the facial artery under the jaw for 15 seconds and multiplying by four.
Respiratory Rate
Normal is 8 to 16 breaths per minute at rest. Above 24 breaths per minute in a horse that is not hot or recently exercised is a warning sign. Above 30 is a clear indication of significant pain or metabolic crisis. Watch the flank or nostrils rather than putting your hand near the face.
Temperature
Normal rectal temperature is 99 to 101.5 degrees Fahrenheit. A temperature above 102.5 or below 98 suggests infection or shock and should be reported to your vet. Foals run slightly higher than adults.
Gum Color and Capillary Refill
Healthy gums are pink and moist, similar to human gums. Press a finger firmly on the gum above an upper tooth for two seconds, then release. Color should return in under two seconds. Pale, white, purple, bluish, or brick-red gums, or refill taking more than two seconds, all indicate poor circulation and an emergency.
A toxic or muddy gum line, sometimes described as a dark band where the teeth meet the gums, can signal endotoxemia. This is a sign that bacteria or bacterial toxins are entering the bloodstream from a compromised gut and is a medical emergency.
Gut Sounds (Borborygmi)
Lack of gut sounds in all four abdominal quadrants can indicate an ileus or obstruction. Very loud, high-pitched, “pinging” sounds can indicate gas buildup. Either extreme warrants a vet call. Press your ear or a stethoscope against the belly in four spots, two on each side, top and bottom, and listen for at least 30 seconds per spot.
Dehydration Check
Pinch a fold of skin on the horse’s neck and release. It should snap back within one second. A slow return to flat suggests dehydration, which is a common contributor to impaction colic.
Distinguishing Colic from Other Conditions
Several conditions can mimic colic, which is part of why veterinary diagnosis matters. Laminitis can cause a horse to lie down and shift weight uncomfortably and may be mistaken for abdominal pain. Tying up (rhabdomyolysis) can cause reluctance to move, sweating, and muscle stiffness. A mare in heat or with ovarian pain can show flank watching and restlessness.
Foal-related issues in pregnant or recently foaled mares can also look like colic. A uterine tear, retained placenta complications, or a twisted uterus can produce signs similar to intestinal colic. Any mare that has recently foaled and shows colic-like signs should be seen by a vet quickly, as these conditions can escalate rapidly.
Gastric ulcers and right dorsal colitis sometimes present with mild, recurring colic-like episodes, especially in performance horses on heavy work and concentrated feed schedules. Pleuropneumonia (chest infection) can also cause a horse to stand with elbows out and resist moving, which looks colic-like from across the stall.
This is another reason why baseline knowledge of your own horse matters. The mare who always gets dramatic in heat will look different from the same mare showing new flank watching. The gelding with chronic mild gas will look different from the same gelding suddenly refusing breakfast. Patterns beat snapshots when it comes to colic.
Prevention: How to Reduce Colic Risk
Most colic episodes have a root cause that, with careful management, can be reduced. I have learned that consistency matters more than perfection. Small habits done every day matter more than elaborate routines done occasionally.
Make feed changes slowly. Any change in hay, grain, or pasture should be phased in over 10 to 14 days. Sudden switches are one of the leading triggers of impaction and gas colic. When bringing in a new load of hay, even from the same supplier, transition over several days if the cut looks different.
Keep clean water available at all times. Horses that drink less are at higher risk of impaction. In winter, break ice and offer lukewarm water, since horses drink more when water is not freezing cold. In summer, check automatic waterers daily and scrub buckets weekly to encourage intake.
Maximize turnout when possible. Horses that move around graze continuously, which keeps gut motility healthy. Stall confinement increases colic risk, especially for horses on concentrate-heavy diets. Even a few hours of additional turnout each day makes a measurable difference.
Stay current on deworming and dental care. Parasite damage and dental issues both contribute to colic risk. Work with your vet on a parasite control plan based on fecal egg counts rather than a calendar rotation. Have teeth floated annually, more often for seniors, so feed is properly chewed before it enters the gut.
Feed on a consistent schedule. Horses have a strong internal clock for digestion. Irregular feeding times can contribute to motility issues and ulcer development. If you board, ask about consistency on weekends and holidays, when routines tend to slip.
Watch for sand accumulation. Horses that eat off sandy ground can accumulate sand in the colon, which can eventually cause an obstruction. Psyllium supplementation on a periodic basis can help move sand through, but prevention through feeding on mats or in containers is more effective.
Reduce stress during transport and competition. Travel, new environments, and changes in herd dynamics all increase colic risk. Offer familiar water from home on the road, monitor manure output closely during shows, and reintroduce normal feed gradually after major events.
None of these habits are complicated. The trick is doing them consistently, every single day, for the life of the horse.
Frequently Asked Questions
Can horse colic go away on its own?
Yes, mild gas colic or early impaction colic can resolve on its own with movement, time, and sometimes veterinary treatment. However, you should never assume a colic will resolve without monitoring. Call your vet for guidance, watch vital signs, and be ready to escalate if the horse worsens or does not improve within 30 to 60 minutes.
Will a horse still eat if it has colic?
Usually not, or only with reduced interest. One of the earliest signs of colic is a horse that ignores food, picks at hay without finishing, or shows no interest in treats. However, some horses with mild gas colic may continue to eat normally, which is why other signs like manure output, posture, and behavior should also be monitored.
How to relieve colic pain in horses?
First, keep the horse calm and remove access to feed. Walking at a slow pace can help mild gas colic. Call your veterinarian for guidance. Pain relief medications like Banamine should only be given under veterinary direction, because they can mask signs of a worsening condition such as a twisted intestine.
What can mimic colic in horses?
Laminitis, tying up (rhabdomyolysis), ovarian pain in mares, foaling complications, gastric ulcers, and pleuropneumonia can all produce colic-like signs. This is one reason why a proper veterinary exam, including rectal palpation and sometimes ultrasound, is so important when signs persist or escalate.
Final Thoughts on Recognizing Colic in Horses
Every horse owner I know carries a quiet worry about colic. It is one of the most common emergencies we face, and one of the most preventable tragedies when signs are caught early. Knowing the subtle signs of colic in horses, taking a baseline of vital signs on a healthy day, and trusting yourself to call the vet when something feels off are the three habits that will serve you and your horse for years.
If you take one thing from this guide, let it be this. Time is tissue with colic. The decision to call the vet in the first 30 minutes of suspicious signs is the one that saves lives, not the decision made at the end of a long night when a horse finally crashes. Watch, take vitals, and make the call.