Equine Colic: Would You Know What To Do?

I still remember the first time I heard the sentence that makes every horse owner go cold: "I think your horse has colic." The air changed in the barn aisle, widening into a hush where even the dust seemed to hold its breath. In moments like that, I learned that calm is a practical skill—something you put on like a halter—so you can see clearly, act quickly, and give your horse the best chance to come through.

Colic is not one disease but a word for abdominal pain, a spectrum that runs from mild gas to surgical emergencies. Knowing the early signs, the right first steps, and what your veterinarian will do can turn fear into a simple sequence of actions. It will not make the night shorter, but it will make it safer—for both of you.

What Colic Is (and Isn't)

Colic refers to pain originating in the digestive tract. Because of the horse’s unique anatomy and physiology, small disturbances can cause outsized discomfort, while severe problems can escalate quickly. That is why we treat colic as a clinical syndrome with many possible causes—gas, spasms, impactions, displacements, strangulations—rather than a single condition.

You will hear, often, that colic is the leading cause of death in adult horses. The statement is a reminder to take every episode seriously and to manage daily routines—feed, forage, water, exercise—with prevention in mind. Prevention cannot erase every risk, but good management measurably lowers it.

Crucially, rolling does not cause a twist in the gut. A horse that rolls may already be in significant pain, and the rolling is a sign—not a cause—of the problem. If a horse is quiet and lying down, it is generally acceptable to let them rest while you keep the scene safe.

Reading the Early Signs

I look first for changes in behavior: watching the flank, pawing, stretching out as if to urinate, circling the stall, or lying down and getting up repeatedly. Dampness from sweating, a dull eye, a shift in appetite or water intake, reduced manure, and fewer or louder gut sounds also matter. Taken together, these signs say more than any single one.

Mild cases may show only subtle restlessness and intermittent discomfort. As pain intensifies, horses may roll persistently, sweat, or refuse to stand. What I monitor closely—if it is safe to do so—are simple vital signs I can repeat: heart rate, respiratory rate, gum color, and capillary refill time. Patterns over minutes matter.

If I notice a rising heart rate, worsening gum color (brick red or a purplish “toxic line”), or relentless pain, I stop guessing and start preparing to transport under veterinary guidance. These changes often separate “watch closely at home” from “refer now.”

Call the Veterinarian, Then Do This

Call your equine vet immediately. While you wait, remove feed, provide access to small amounts of fresh water, and move the horse to a safe, well-lit space. Short, calm walks can help some horses, but do not walk to the point of fatigue; the goal is gentle comfort, not miles.

Do not give medications unless your veterinarian tells you to. Pain relievers can mask important signs and complicate diagnosis. Make notes: time of onset, last feed, manure passed, water intake, and any recent changes in routine, pasture, or hay. Information is treatment.

If the horse is quiet and wants to lie down, let them. Prevent thrashing if you safely can, but do not put yourself in harm’s way. Rolling itself does not twist the gut; injury from banging into walls is the bigger risk, which is why a safe, open space matters.

Safety Matters for You and Your Horse

I halter early and clear the area of clutter. I keep a lead rope attached and a second person nearby if possible. Pain rewrites manners; a normally polite gelding can shove, swing, or crowd when his belly hurts. Your steadiness is a safety net—calm voice, simple movements, no tug-of-wars.

Lighting helps you see feet and fences. If you must move in the dark, use a headlamp and keep lanes open. If trailering becomes part of the plan, prep quietly: hitch, check tires and lights, bed the floor, and keep the route simple. You are building a path out of the problem, step by step.

Above all, stay aware of your own limits. If a horse is thrashing or crowding you, give space and wait for your veterinarian. The goal is not heroics; it is a safe handover when help arrives.

How Veterinarians Assess a Colicking Horse

Your vet will start with observation and a physical exam: heart rate, respiratory rate, temperature, mucous membranes and capillary refill, hydration, and the sounds of the gut through a stethoscope. A high heart rate—often above 60 beats per minute—raises concern for a serious lesion and may tip the plan toward referral.

Rectal examination can reveal distended or displaced bowel segments, while passing a nasogastric (stomach) tube checks for reflux and can relieve dangerous pressure; sometimes the tube is left in place for a long trip to a hospital. Sedation and analgesia may be required just to examine the horse safely and thoroughly.

Depending on findings, your veterinarian may add ultrasound, bloodwork, and, in some cases, abdominocentesis (sampling abdominal fluid). No single test tells the whole story; the diagnosis is a pattern assembled from signs, responses to pain relief, and what the vet can feel and measure.

The barn grows quiet as I steady my hands and follow the plan.

When Surgery Is the Right Call

Some horses declare themselves: unrelenting pain despite adequate analgesia, very high heart rate, abnormal rectal findings, significant gastric reflux, or worrisome blood and ultrasound results. In these cases, referral to a surgical facility is not a failure of conservative care; it is timely care.

Outcomes vary with the cause and the clock. Survival after colic surgery commonly ranges from about fifty to more than eighty percent, with earlier intervention associated with better results. Your veterinarian will weigh prognosis against what they are seeing in your particular horse.

Transport safely and as directed. If a nasogastric tube is needed for the trip, your veterinarian may secure it to the halter. Keep the trailer steady, the route direct, and your updates frequent.

What Not To Do

Do not postpone the call for help; time is tissue. Do not feed while you wait; keep hay and grain out of reach. Offer small amounts of water only, and stop if your veterinarian advises otherwise.

Do not walk the horse to exhaustion; short, calm intervals are enough. Do not dose pain medication unless your veterinarian instructs you; masking pain can cloud the picture and delay the right treatment.

Do not assume that rolling creates a twisted gut. Manage the environment to prevent injury, but let a quiet horse lie down. Save your energy for information gathering and safe handling.

Prevention Starts on Ordinary Days

I keep routines steady: ample forage, consistent turnout, regular exercise, salt and clean water always available, dental care on schedule, and parasite control guided by my vet. Management is not glamorous, but it is the strongest everyday shield we have against colic.

Horses in sandy regions may face added risk. Strategies like feeding off clean surfaces, maintaining healthy pasture cover, and using veterinarian-directed psyllium protocols when appropriate can reduce sand accumulation in the gut.

I also watch transitions: new hay, weather swings, show travel, changes in workload. Most colic stories begin on the margins of routine; noticing and smoothing those edges is prevention in practice.

Make a Stable Colic Plan

My plan is written and posted: veterinarian and clinic numbers, nearest referral hospital and trailer route, a checklist for vital signs (with my horse’s normal values), and a simple log for time, signs, water, manure, and responses. When stress is high, a plan keeps everyone on the same page.

I keep the trailer ready and the truck fueled. I walk the barn crew through roles: who calls, who clears the aisle, who holds the horse, who gathers paperwork. In emergencies, clarity is kindness.

Finally, I budget for the what-ifs. Insurance, savings, or a contingency fund cannot buy certainty, but they make urgent decisions less tangled with fear. That, too, is part of care.

Aftercare and Returning To Work

After an episode—medical or surgical—I follow my veterinarian’s refeeding and turnout instructions exactly. We reintroduce forage gradually, watch manure and appetite, and add exercise back in measured steps. A quiet week now can spare months later.

Some horses bounce back; others need time. I schedule rechecks, keep notes, and accept that healing is not a straight line. Attention in the ordinary days after colic is the companion to action on the hard ones.

And if a future night ever narrows into that familiar hush again, I know what to do: call, observe, steady the scene, and move with the plan we built when the barn was calm.

References

American Association of Equine Practitioners (AAEP). "10 Tips for Preventing Colic." 2025.

UC Davis School of Veterinary Medicine, Horse Report. "Colic Happens." 2024.

UC Davis School of Veterinary Medicine, Horse Report. "10 Things You Might Not Know About Equine Colic." 2024.

Merck Veterinary Manual. "Overview of Colic in Horses." 2021 (content page ongoing updates).

dvm360. "Decision-making for colic workup in the field." 2025.

Veterinary Practice. "Colic: When to Refer?" 2022.

The Horse. "Sand Colic in Horses: Diagnosis, Treatment, and Prevention." 2024.

Disclaimer

This article is for general information and storytelling context only and is not a substitute for professional veterinary advice, diagnosis, or treatment. If you suspect colic or any emergency condition, contact your equine veterinarian immediately and follow their instructions.