Colic In Horses: Signs, Causes and Treatment

The fear of finding your horse with colic is just as bad as a nightmare.Truth be told it’s not too pleasant for us vets either!When a horse starts to show signs of colic our blood pressure rises and the deep profound worry sets in:
  • Will my horse need to be put to sleep?
  • Will my horse need surgery?
  • What will it cost for colic surgery to save my horse?
  • Can colic be managed medically?
Sadly, colic in horses is ranked as the top medical problem treated by veterinarians and in many cases can be fatal.Learning to recognise the subtle signs so that you can engage veterinary attention and start treatment promptly, is proven to save lives.In this article, we discuss the different causes of colic, the symptoms to watch out for, how it is treated and prevented.Horse stretching with pain from colic

What Is Colic?

The term colic is a generic term for severe abdominal pain, it describes a clinical symptom, not a disease as such.Hence, there can be many potential causes of colic, some of which are an emergency.It is one of the most common problems that affect horses, and a reason why many, many horses die each year.It is therefore crucial that you learn to recognise the signs of abdominal pain.

What Causes Abdominal Pain In Horses?

Equine colic is often caused by problems of the gastrointestinal tract. We can group these ‘diseases’ as follows:
  • Spasm: where the smooth muscle in the wall of the intestine contracts forcefully, or there is an excess of gas present
  • Obstruction: where ingesta cannot pass through the intestines either because of an anatomical issue (too much ingesta reaching the pelvic flexure) or there is severe dehydration, foreign material (sand), parasites, a twist or entrapment (getting stuck somewhere abnormal).
  • Blood supply strangulation: sometimes this can be blocked by a twist or parasites.
  • Inflammation either of the body wall or of the intestinal wall. When the small intestine is inflamed it is called enteritis, when it’s the large intestine it is called colitis and when it is the body wall it is called peritonitis.
There are also non-abdominal causes of colic that mimic abdominal pain such as:
  • laminitis
  • urinary tract infections, stones, rupture of the bladder
  • ovarian tumours
  • scrotal hernia
The severe nature of the problems that colic symptoms represent means that we need to be able to recognise the signs early, so that appropriate treatment can be started promptly.

What Are The Symptoms Of Colic?

An astute horse owner will notice mild signs of colic such as:
    • Off feed, or disinterest in feed
    • Lip licking, curling
    • Flank watching
    • Restlessness
    • Occasional pawing at the ground
normal adult horse vital signsAs pain gets worse or the condition deteriorates then more moderate symptoms will be noticed:
  • Constant pawing at the ground
  • Lying down, then getting up again
  • Lying down for long periods
  • Stretching
  • Posturing to urinate
Severe pain is can be noted when there is:
  • Profuse sweating
  • Violent rolling, thrashing
  • Injuries and grazes especially to the head
  • Flared nostrils and rapid breathing
  • An elevated HR (although some horses can be very stoic and continue to have a normal heart rate)
All horse owners need to learn what their own horse’s normal vital signs are. If these vital signs change, then you need to get in touch with a vet immediately. 

How Is Surgical Colic Diagnosed?

Because colic is potentially a life-threatening condition it is imperative that you get veterinary assistance.The mainstay of treatment and deciding whether a colic requires surgery or not is the response to pain relief.Vets will combine assessment of pain, with the symptoms the horse displays and other tests that they do to determine what is likely to be the cause of colic, and the best treatment.To decide what might be causing an episode of colic the vet will perform a thorough physical exam:TPR – Temperature, pulse, respiration.  If a fever is present the likelihood of surgery decreases.Colour of mucous membranes – any change from a nice pale pink indicates trouble.Rectal exam – Feeling for the thickness of bowel, dilation of the bowel, the location of bowel and any impactions.Stomach tubing – Looking for the presence of reflux, as presence indicates that there is a serious problem.
stomach tube horse

Stomach tubing allows the vet to check the horse’s stomach for reflux.

Ultrasound – To investigate areas that can’t be reached by rectal exam.Abdominocentesis – To assess what the fluid in the abdominal cavity is doing. Has there been a rupture?These tests are performed very quickly, time is of the essence.If a horse has any of these symptoms or clinical signs is likely to be a surgical candidate:
  • severe pain that is non-responsive to pain relief and/or heavy sedation
  • presence of reflux when a stomach tube is placed and the temperature is normal
  • rectal exam revealing impaction or dilated loops of intestine
  • abdominocentesis with high cell count and lactate values
  • ultrasound shows a thickened bowel wall, dilated loops of small intestine or intussusception

How To Treat Equine Colic?

The first treatment that is given will be pain relief and/or sedation depending on how violent the horse’s clinical signs are.If the pain appears to be due to spasmodic colic then pain relief and time is all that is likely to be required for the horse to gain relief and settle.For other causes of colic that are not immediately surgical, your vet will likely recommend starting fluid therapy.Depending on the type of colic fluids can be given via stomach tube or intravenously.Medications can be added to the fluids to aid the motility of the gut.In some circumstances, when there is a fever and blood test results indicate infection, antibiotics may be required.Sometimes the decision is made to take a horse with severe abdominal pain to surgery immediately, or after some time has already been spent doing medical treatments.
horse colic surgery

Colic surgery to remove an impaction in the colon. Photo credit Weston Davis Equine Surgery.


What Is The Prognosis For Colic In Horses?

The prognosis of colic depends not only on the type of colic your horse has but also on how quickly you intervene and make clinical decisions regarding therapy.Even if you are undecided on whether to go ahead with surgery, it is far better to get your horse on the transporter and to the surgical facility so that you are not wasting valuable time if you do decide to go to surgery.Early decisions mean that bowel might not be compromised and require resection or your horse might not be as systemically ill requiring intensive medical care.Many people struggle with whether to take their geriatric horse (those over 16 years old) to surgery.Although geriatric horses are more prone to strangulating lesions that often require resection, studies have shown that the success rate of geriatric horses having surgery for a strangulating lesion is no less favourable for survival than mature horses having this surgery.Age, therefore, is not a reason to euthanise your long does colic last

What Do I Need To Do If My Horse Shows Signs Of Colic?

The first step is to assess how painful your horse is.If they are rolling and showing moderate to severe signs of pain please call your vet immediately.While you wait for a vet to attend ensure that your horse cannot injure themselves or you.For mild cases and where you are not at risk of getting hurt, conduct your own clinical examination.Take the horse’s heart rate, respiratory rate and temperature.Look at the colour of the gums.
The article on equine vital signs contains details on how to perform a clinical exam and normal values.
You can get in contact with our online vets to discuss what action you need to take and what you can do at home.In essence, the quicker you get veterinary advice, the better the outcome will be.Please share this article with all your horse-owning friends so that they too can be knowledgeable in how to recognise and act if their horse gets colic.If your horse has colic and you are worried about what to do, our vets are online 24/7. You can contact us directly to ask a vet a question.