Colic in horses: causes, symptoms and treatment

They’ll ask you questions about your horse and what signs they’ve been showing.

It’s likely your vet will assess your horse’s breathing and pulse rates, check their mucous membranes, see if they’re dehydrated and listen to their gut sounds.

Performing a rectal exam allows your vet to feel parts of the abdomen internally for abnormalities, such as a blockage.

Horses are unable to vomit, so fluid may build up in the stomach. Your vet can pass a tube through your horse’s nose, down into their stomach to remove this fluid and provide some relief. It’s not uncommon for this tube to cause your horse to have a nosebleed which can alarming but will be carefully managed by your vet.

Your vet can draw a sample of fluid from your horse’s abdomen. This can be tested for signs of infection and damage.

Your vet can prescribe various medications including pain relief and muscle relaxants. They can also give fluids if needed. Many cases of colic can be managed medically at your yard. In more serious cases, horses may need to be referred to hospital for closer monitoring and medical support.

If your horse has colic surgery, they’ll need support during their recovery. Your vet will discuss this with you but it’s likely to include several weeks of box rest, close monitoring, slowly increasing time grazing in hand and gradual rehabilitation to recover from major surgery. Many horses make a full recovery and return to same level of work as before their surgery³.

In critical cases where surgery isn’t an option, or if your horse’s pain can’t be managed, your horse may need to be euthanised to prevent further suffering.

• One of the most common types of colic
  
  

• Intermittent sharp bouts of pain, presumed to be when sections of the gut contracts in an abnormal manner
  
  

• Loud gut sounds may be heard.

• Excess gas builds up in the intestines, causing them to over stretch and become painful
  
  

• Loud gut sounds and horses can look bloated
  
  

• Often associated with a change in management, such as moving to new grass.

• The digestive system becomes blocked and prevents normal passage of food through the gut
  
  

• Reduced number, or drier droppings are often seen
  
  

• Low grade prolonged pain often with more subtle signs
  
  

• Often associated with a management change on to a drier diet such as box rest with more dried forage.

• Accumulation of sand and dirt in the digestive tract which can irritate the bowel lining

• Sand may be present in the horse’s droppings.

• A section of the gut moves abnormally within the abdomen which can cause an obstruction

• Signs can vary from mild to severe

• Droppings often reduced.

• A portion of gut becomes twisted or trapped, which cuts off the blood supply to the affected area

• Critical form of colic that will likely require surgery or euthanasia

  
  

• Usually severe and continuous signs of pain, but some horses may be very dull and depressed.

• Gastric ulcers in the stomach can cause discomfort

• Enteritis or colitis - inflammation of the digestive tract which causes pain and often diarrhoea.

Feed a high fibre, forage-based diet. This could be fresh forage such as grass, or preserved forage including hay, haylage or short chopped fibre, such as chaff.

How this helps -This will make sure your horse’s gut has a regular supply of food to digest and encourage a consistent, healthy motion throughout their digestive system.

Lush and excess amounts of grass can cause weight gain, obesity, laminitis, spasmodic or gas colic. Horses can consume a lot of grass in a short space of time so carefully managing your horse’s grass-intake by strip grazing with electric fencing or using a grazing muzzle can help to slow down the rate of grass being eaten.

How this helps - Controlling the rate at which your horse eats allows the digestive system enough time to break down the food and reduces the risk of gas building up in their intestine.

Avoid horses eating directly from a sandy surface such as an arena for example, if pasture turnout is being restricted. Lift your forage (such as hay or haylage) up from sandy ground. This could be in haynets or feeders or adding mats or hardcore down.

If your horse is prone to sand colic, try to avoid them eating very short grass on sandy soil.

How this helps – This reduces the risk of taking in sand and dirt while they eat.

Make sure plenty of clean, fresh water is easily accessible at all times and monitor how much your horse drinks. Horses may drink less if their water is unclean, unable to access due to resource guarding from another horse or not enough water is provided.

Consider the weather as horses will drink more in hot weather and when exercised. They may also drink less during colder weather and if sources are frozen.

How this helps – Drinking enough water helps make sure the digestive system remains healthy and hydrated, allowing the food content to move freely through the gut, which reduces the risk of impactions and blockages.

Make any changes to your horse’s diet and routine gradually over at least 10-14 days. This includes using a new supply of forage, moving to rested pasture or altering their time spent in the field or stable/housing.

How this helps -The horse’s gut contains billions of bacteria that take at least 10-14 days to adapt to new feed and effectively digest it.

Horses that are suddenly moved onto box rest are at an increased risk of colic⁴. There are steps that can be taken to help support a horse with this sudden change management.

Horses with multiple people caring for them have an increased risk of colic¹. If other people help care for your horse, make sure they have the information available to maintain your horse’s routine. We recommend completing a daily care plan which can be shared with the relevant people.

If concentrates, such as cereals, need to be fed to your horse, provide feeds that are low in starch and sugar, little and often.

How this helps - Concentrates are mainly broken down in the stomach. If fed in large quantities, they can pass through the stomach undigested and begin to ferment in the intestine producing excess gas or causing blockages.

Don’t feed horses grass cuttings, garden waste or human food. Horses are grazing animals and struggle to effectively digest large quantities of food that are eaten quickly. Use our Be Horse Aware signs on your field borders to advise passersby of the dangers related to feeding horses.

Soak any feeds that need it (e.g. sugar beet) following the feed company’s instructions.

How this helps - Insufficiently soaked feeds will absorb water from within the digestive system. This can cause choke and impaction colic.

Horses use their teeth to grind long stem fibre and begin digestion. Dental disease or pain can affect your horse's ability to chew and grind their food and can lead to impaction colic.

Have your horse’s teeth checked every 6-12 months by an equine vet or a qualified Equine Dental Technician, registered with the British Association of Equine Dental Technicians or category 2 members of The World Wide Association of Equine Dentistry. 

High worm burdens can cause significant damage to the horse’s digestive tract.

Protect your horse by following a risk-based worm control programme, developed alongside your vet and make sure good pasture management is in place.

Stress and stereotypic behaviours can increase your horse’s chance of developing colic³. Look out for the signs of stress and identify changes that can be made to support your horse. Your vet or an equine behaviourist can help you if you’re concerned. Enrichment can offer the horse a greater variety and choice and positively contribute towards their physical and mental needs.  

1. Bowden, A., et al. (2017). Prevalence and outcome of conditions seen at out‐of‐hours primary assessment at two practices over a 3‐year period (2011–2013). Equine Veterinary Journal, 49 (S51), p.11.

2. Burrell, K., et al. (2024) Horse owners' and veterinary practitioners' experiences of decision-making for critical cases of colic. Equine Veterinary Journal, 56(6), pp.1216-1228.

3. Christophersen, M., et al. (2011) Sporting activity following colic surgery in horses: a retrospective study. Equine Veterinary Journal, 43 (40), pp.3-6.​

4. Curtis L., et al. (2019) Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes. PLoS One, 14(7):e0219307.