The Complete Guide to Colic in Horses

Colic strikes fear into the heart of horsepeople everywhere, and with good reason – colic is the leading preventable cause of death in horses.

Of the estimated 9.2 million horses in the US, roughly 10% (or 920,000) will experience at least one episode of colic this year. Of those, about 0.7% (or 64,000) will die as a result, according to UC Davis.

With stats like these, it’s no wonder that horse lovers are ever vigilant for signs of this dangerous condition. But despite our best efforts and advancements in veterinary medicine, tens of thousands of beloved equine friends are lost every year.

Why is such a common problem so fatal? And more importantly, what can you – as a horse owner, boarder, caregiver, or equestrian- do to prevent, recognize, and respond to colic?

Let’s take a look at how colic happens, how to recognize it, what to do, and how to prevent it. But first off – what exactly is colic, anyway?

What is Colic in Horses? 

“Colic” is a general term to refer to abdominal pain in horses. But it’s a little more complicated than just a simple tummy ache. 

It’s sometimes said that horses are “built for colic.” While a horse in ideal circumstances should never colic, the horse’s digestive system does have a few notable features that make it prone to colic. 

For starters, the horse’s digestive system only moves one way. Unlike other animals, horses can’t vomit or burp. This means anything they eat MUST pass through the entire (very long and winding) digestive system.

Additionally, the horse’s intestines are very long, about 70 feet in total, if stretched end to end. This means the intestines have to fold back on themselves dozens of times to fit in the horse’s body. These folds and turns are common locations for food or foreign objects to collect, causing blockages. 

Such a unique digestive system means there are several different types of colic a horse can suffer from, each with its own cause and prognosis. 

Gas Colic

Gas colic is a common type of colic. Something even we humans are familiar with, gas colic is stomach pain caused by excess gas created in the horse’s stomach. Gas build-up is usually associated with other types of colic (for example, gas may build-up behind an impaction), but gas colic can occur on its own as well. 

Gas colic is usually caused by a sudden change in diet or ingesting food that is high in sugar, like lush spring gas. The excess sugar ferments in the horse’s stomach, producing gas. Because the horse can’t burp to release this excess gas, colic ensues. 

 This type of colic is typically easily resolved with on-farm or medical treatment (i.e., no surgery) and carries a good prognosis for a full recovery, but it’s important to call the vet right away. A gas-filled gut can cause torsion (twisting), resulting in a twisted gut that will need surgery to fix. 

Spasmodic Colic

Spasmodic colic is one of the most common types of colic. It’s a “milder” colic but also one of the most painful. It happens when the bowel muscles abruptly contract, causing pain and an overactive gastrointestinal tract. 

Horses who are high-strung, anxious, or overly excited are prone to spasmodic colic. It can also happen after a change of diet or after drinking too much cold water after a heavy workout. 

Fortunately, most spasmodic colics respond very well to on-farm treatment. Hand walking can help stimulate normal gut movement and resolve the colic, in mild cases. Or your vet may administer anti-spasmodic drugs like Banamine and Xylazine.

Impaction Colic

Impaction colic is another common type of colic, accounting for about 12-15% of colic cases. 

As the name implies, it’s caused by physical obstruction or impaction. This could be a dry mass of partially-digested food or foreign material like sand or gravel (more on that later). 

Whereas gas colic occurs in the stomach, impaction colic is more common in the large intestine, where obstructive material is likely to build up. If the obstruction does not clear, gas will build up behind it, causing more pain and increasing the likelihood of torsion. 

Lack of adequate digestible forage (like pasture or hay), dental problems that prevent the horse from fully chewing his food, foreign materials, or dehydration can cause impaction colic. 

In mild cases, impaction colic can be resolved with on-farm treatment like drenching and hand walking. In severe cases, surgery may be required to remove the impaction. 

Sand Colic

Sand colic is a type of impaction colic. As the name implies, it’s caused by sand build-up in the horse’s intestines. It typically affects horses who graze in areas with sandy soil or are fed off the ground. 

The horse accidentally ingests small amounts of sand while eating. The heavy sand sinks to the bottom of the intestines, where it builds up. Eventually, the sand blocks the movement of food through the gut, and the horse experiences a colic episode. 

Sand colic made the news recently when it was reported that a US Army horse named Tony died of sand colic. Autopsy veterinarians found a mind-blowing 44 lbs of sand and gravel in his gut. 

Displacement Colic 

Displacement colic is a very serious type of colic, closely related to a twisted gut. It happens when a part of the horse’s intestinal tract shifts – is displaced- from its proper location.

The displaced intestine can get pinched or twisted. In the most severe cases, the intestine becomes strangulated, blocking off blood flow to the area. 

The cause of displacement colic varies and, in many cases, can never be fully determined. It may be related to a build-up of gas in the intestines, which makes the intestine more buoyant and likely to shift from its original position. 

Displacement colic usually requires surgery to save the horse’s life. 

Twisted Gut Colic

Twisted gut is a rare and serious colic type that requires immediate surgical intervention. Similar to displacement colic, twisted gut colic usually requires manual manipulation of the horse’s intestines to correct the problem. 

It may occur as a “secondary” type of colic that results from a horse violently rolling in an attempt to relieve the discomfort of colic. However, twisted gut colic can also occur in its own right as a result of an accident or aggressive rolling. 

It’s important to note that in many cases, the exact cause of the colic is not determined. Fortunately, about 95% of these “unidentified cause” colics are successfully resolved without surgical intervention. 

But with so many colic hazards to contend with, it’s important to be able to recognize the signs of colic as quickly as possible. 

Signs of Colic 

Not every horse will exhibit every sign of colic every time, so it’s important to be familiar with your horse’s usual behavior and be alert for any changes. 

A horse experiencing colic may exhibit the following behaviors:

• Lack of appetite
• Not drinking 
• Lethargy or depression 
• Pawing at the ground
• Kicking, pawing, or biting at the gut
• Sweating, especially on the neck 
• Rolling, without shaking off after getting up
• Laying down repeatedly 
• Stretching as if to urinate 
• Constantly looking at the flank 
• Curling the upper lip (flehmen response)
• Sitting on their hindquarters, like a dog

Changes in manure production, such as: 

• Constipation, no manure in stall or pen
• Fecal balls are smaller than usual
• Dry or hard manure 
• Mucus-covered manure 

If you notice the above behaviors or environmental signs, assume colic and check him for the following health signs: 

• Elevated resting heart rate; over 40 – 50 beats per minute 
• Elevated rectal temperature; over 101.2° Fahrenheit 
• Increased capillary refill time 
• Abnormal or absent gut sounds
• Dry or tacky gums
• Change in gum color

You’ll need to call the vet right away, so giving her this information can help her make an accurate diagnosis.

Colic Treatment 

The treatment needed to resolve a bout of colic varies depending on your horse,