December 5, 2025, 12:53 pm | Read time: 6 minutes
A horse appears restless, suddenly stops eating, repeatedly looks at its belly, or lies down and immediately gets back up. Such everyday observations unsettle many animal owners—often for good reason. These signs can indicate colic, a painful and potentially life-threatening emergency. Since the symptoms can initially seem harmless, valuable time is often lost. PETBOOK explains how colic develops, which signs should be taken seriously, and what treatment options are available.
What is Colic in Horses?
The horse’s digestive tract is sensitive and anatomically unique. Horses have a small stomach with another peculiarity: they cannot vomit. The horse’s small intestine is suspended from a long, movable fold of the peritoneum, also called the mesentery. This predisposes them to twists. The large intestine is massive and simultaneously freely movable—it can shift or twist.
When the mobility of the stomach or intestines is disturbed, food backs up, the intestinal contents cannot be transported further, or sections of the intestine shift, pain occurs. “Colic” describes exactly these symptoms—a variety of possible disorders ranging from mild cramps to severe emergencies.1
Causes of Colic Are Diverse
The causes of colic are diverse. Colic in horses often arises from digestive problems in the gastrointestinal tract. However, diseases of other organs can also cause abdominal pain.
Possible Causes Can Include:
- Impaction colic: Due to too little exercise, low-water-content feed, excessive straw bedding, or feeding errors, the intestinal contents can clump. An untreated impaction can lead to an intestinal blockage.
- Sand colic: Ingestion of large amounts of sand from sparse pastures or sandy paddocks, which accumulate in the large intestine.
- Stomach overload: Due to excessive intake of fermenting or swelling feed, or as a result of an intestinal blockage.
- Spasmodic colic: Intestinal cramps triggered by feeding errors, weather changes, or stress.
- Gas colic: Excessive gas formation from bloating or spoiled feed and too rapid a change in diet.
- Intestinal displacements and twists: The small or large intestine twists or becomes pinched.
- Thromboembolic colic: Parasites, especially the worm Strongylus vulgaris, can damage blood vessels and lead to poor blood supply to sections of the intestine.
- Other causes: Diseases of the liver, gallbladder, urinary and reproductive organs, or severe infections can cause colic-like symptoms.
Some horses are more prone to colic. Some naturally have anatomical narrowing in their intestines. For owners, it is all the more important to be aware of the health details of their horses. 2, 3, 4
Horses Express Pain Subtly
The range of symptoms extends from barely noticeable changes to clear, obvious signs. It is crucial that every form of colic is taken seriously, as the severity of the symptoms says little about the seriousness of the cause. Often, horses do not make it easy for their owners. When the animals are in pain, they communicate it rather subtly. It is all the more important for owners to pay special attention to the following signs.
Typical Signs in Everyday Life:
- reduced appetite or refusal to eat
- lack of feces or only small amounts
- frequent lying down and getting back up
- rolling, pawing, restlessness, or head shaking
- apathy or unusual calmness
- flehmen or increased chewing
- abdominal bloating
- circulatory problems, high pulse, rapid breathing
- sweating
- unusual body postures, such as “dog sitting” or lying on the back
Since horses cannot vomit, symptoms like drooling or gagging movements should also be taken seriously. If you notice such symptoms in your horse, your veterinarian should be informed immediately. Especially in such cases, it is better to have the horse examined one time too many than too few.
Diagnosis by the Veterinarian
Typically, the veterinarian first assesses the general condition and inquires about the onset of symptoms, feeding, water intake, previous colics, deworming, and other medical information.
Important Diagnostic Steps:
- Checking pulse, respiration, and body temperature: Deviations provide clues about circulatory stress and severity.
- Listening to the horse’s abdomen: Intestinal sounds can be reduced, increased, gurgling, or metallic.
- Rectal examination: Palpation findings on the position, filling, and condition of palpable intestinal sections.
- Nasal-gastric tube: Assessment of stomach contents, relief in case of gas formation or stomach overload.
- Ultrasound examination: Visualization of organ changes and intestinal movement.
- Blood test: Assessment of circulatory status and possible inflammatory processes.
- Abdominal puncture: Analysis of the abdominal puncture fluid in unclear findings.
The goal is to quickly decide whether conservative therapy is sufficient or a hospital stay with possible surgery is necessary.
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Stomach Ulcers in Horses – Symptoms You Should Take Seriously
How Are Colics in Horses Treated?
Once the veterinarian has determined the type of colic, the therapy is specifically tailored to the severity and cause.
Conservative Treatment:
Especially milder colics can often be treated without surgery. Primarily, the veterinarian administers antispasmodic and pain-relieving medications, which provide noticeable relief to the horse. Subsequently, infusions can stabilize circulation and support intestinal activity. In the case of an impaction, laxatives are used to loosen the intestinal contents. A nasal-gastric tube can also allow gas or fluid to escape from the stomach—an important step to relieve pressure and avoid further complications.
Surgical Treatment:
If conservative therapy is not sufficient or a serious condition, such as an intestinal twist, strangulation, or a pronounced displacement, is present, surgery often remains the only option. In a specialized equine clinic, the affected intestinal section is relieved, repositioned, or—if necessary—surgically treated. Afterward, the horse requires continuous monitoring and intensive care to safely stabilize circulation, wound healing, and intestinal function.
Prevention Is the Best Care
Those who want to reduce the risk of colic in horses can achieve a lot with good feeding and care. Key factors include a continuous supply of high-quality, clean hay and as short feeding breaks as possible. Concentrated feed should be given only after hay and in small portions. Feed changes—especially when grazing—are best done gradually to allow the digestive tract to adjust. Equally important are adequate water intake and a stress-free daily routine, as weather changes or unrest in the stable can affect intestinal activity.
Regular exercise supports digestion, while deworming, dental checks, and sand-free feeding areas reduce typical triggers such as parasite infestation or sand ingestion. Feed and bedding must be dry, mold-free, and low in dust. Additionally, psyllium husks, linseed oil, or flaxseed can support digestion after veterinary consultation—but they do not replace medical treatment.