Equine Performance Veterinary Practice
Colic means abdominal pain, and it can have many causes. Some episodes respond to treatment on the farm; others require intensive medical care or surgery. The safest approach is to recognize changes early, contact your veterinarian promptly, and reassess the horse as the situation develops. The apparent intensity of pain does not always reveal how serious the underlying problem is. [1]
Recognizing the early signs
A horse with colic may leave feed, paw, look at its flank, stretch as if trying to urinate, or repeatedly lie down and get up. More obvious signs include rolling, sweating, or kicking at the abdomen. Some horses simply become unusually quiet or seem uncomfortable standing. Reduced manure production is useful information, but passing manure does not exclude an intestinal obstruction: material already beyond the affected area can still pass. [1, 5]
Call when you first suspect colic rather than waiting for dramatic rolling. Describe what is different from your horse’s usual behavior and when it began. A short video may help if it can be taken safely, but should not delay the call.
What to do while waiting
Remove feed and ask your veterinarian about water access and activity. Do not give medication, oil, or other oral treatments unless directed. Report any drug already given, including its amount and time. Pain medication can alter the examination, and repeated dosing may create additional risks. [2]
Keep the horse in a safe area and protect yourself. Brief, gentle walking may be appropriate if your veterinarian advises it and the horse is manageable. Continuous walking can exhaust an already compromised horse. A horse resting quietly does not need to be forced to its feet simply because it has colic. Do not put yourself in the path of a rolling or violently painful horse. Record changes in comfort, manure, and drinking while arranging veterinary help. [2]
What the examination tells us
The veterinarian assesses pain, heart rate, hydration, intestinal sounds, and circulation, including gum color and capillary refill. Depending on the findings and safety of the examination, additional evaluation may include rectal palpation, abdominal ultrasound, bloodwork, or sampling abdominal fluid. A stomach tube can identify reflux, the accumulation of fluid in the stomach, and relieve pressure. Horses cannot effectively vomit to release this buildup. [1, 4]
These findings work together. A single normal measurement, temporary relief after medication, or a bowel movement cannot establish that the horse is safe. Changes over time may be more informative than the first examination. [4, 5]
When treatment on the farm may be appropriate
Farm treatment may be reasonable when circulation is stable, pain resolves and stays controlled, and examination findings support a condition that can be managed safely at home. The veterinarian may prescribe pain relief and fluids, with the route and amount determined by the diagnosis. Fluids given through a stomach tube are not appropriate for every colic, particularly when significant reflux is present. [4]
Home care also depends on reliable observation and access to reassessment. Before the veterinarian leaves, clarify when feed can resume, what changes require another call, and when an update is expected. Recurrent pain warrants prompt contact; do not simply repeat medication and restart the clock.
When we recommend hospital referral
Referral becomes more urgent when pain persists or returns despite appropriate treatment, circulation deteriorates, or examination findings suggest obstructed, displaced, or compromised intestine. Significant reflux, intestinal distention, concerning ultrasound or abdominal-fluid findings, and dehydration that needs intensive treatment can all shift the recommendation toward hospital care. Uncertainty and failure to progress also matter. [4, 5]
We consider the travel time as well as the horse’s present condition. Waiting for unmistakable collapse can reduce treatment options. If a section of bowel loses its blood supply, delay can mean more tissue damage and a more difficult recovery. There is no single heart-rate cutoff or fixed number of hours that safely settles every referral decision. [1, 5]
Referral does not automatically mean surgery
A hospital can provide repeated examinations, continuous monitoring, intravenous fluids, stomach decompression, and rapid access to surgery if it becomes necessary. Many referred horses receive medical treatment only. Surgical evaluation is appropriate when the suspected problem cannot resolve with medical care or when intestinal viability is threatened. The recommendation reflects the likely disease process and the horse’s response, not pain alone. [3]
An emergency plan makes these decisions easier. Identify transport, discuss hospital preferences, and understand insurance and financial arrangements before an emergency occurs. During an episode, the referring veterinarian and hospital can coordinate the safest next step. If your horse shows signs of colic, call Equine Performance Veterinary Practice or your emergency veterinarian promptly rather than waiting for a reply to a social-media message.
Sources and further reading
[1] American College of Veterinary Surgeons — Colic in Horses
[2] UC Davis — Colic Happens
[3] UC Davis — 10 Things You Might Not Know About Equine Colic
[4] Merck Veterinary Manual — Overview of Colic in Horses
[5] AAEP 2020 Proceedings — How and When to Refer the Horse with Colic Not Responding to Medical Management
This information does not replace veterinary advice for your individual horse.