Colic in horses: signs and when to call the vet

What colic is

The word colic simply means abdominal pain. World Horse Welfare stresses that it is a clinical sign of a range of conditions rather than one disease. The pain can be mild or severe, occasional or continuous, and in the vast majority of cases the problem lies in the digestive tract. The Merck Veterinary Manual adds that the usual signs reliably show pain but do not show which part of the digestive system is affected.

Only a vet can assess and confirm which type a horse has (BHS). Sometimes the underlying cause is obvious, such as a tumour, worms or equine grass sickness. Often, though, WHW says, nobody ever finds out why the gas, spasms, impaction or displacement developed.

BHS calls colic the most common emergency and cause of death in horses worldwide, and the equine department of the veterinary faculty in Zagreb notes that it occurs equally in all age groups. Not every case needs an operation: according to Merck, almost all horses need some form of treatment, but only those with certain mechanical obstructions of the intestine need surgery. Merck adds that where surgery is needed, it is critical to do it promptly.

Signs of colic

Merck says it is uncommon for a horse to show all the signs at once.

More obvious signs (WHW, BHS, Merck):

• restlessness, attempts to lie down, box-walking or circling
• pawing
• flank watching, kicking at the belly or repeatedly raising a hind leg
• rolling, sometimes repeatedly
• unexplained sweating
• curling the upper lip with an arched neck, a swollen abdomen (Merck)

Subtler, early signs (WHW, BHS):

• lying down more than usual
• eating less, or not at all
• fewer droppings, or none, or a change in consistency
• dullness, a lowered head, lethargy

If you have not seen the horse for a few hours, mud on the coat of a horse that is turned out, or cuts and grazes on the head and bony areas, can be a clue. WHW says such injuries are common in horses that have rolled violently.

Why call early

BHS warns that colic can deteriorate quickly, so early recognition and prompt veterinary attention are vital. The equine department in Zagreb writes that in the early stage it is hard to tell whether a horse will need surgery, so every colic must be taken very seriously, and that the sooner an operation is done, the better the outcome.

This article follows WHW and BHS: call at the first signs. Penn State Extension (US) does say an experienced owner can try to monitor a mild colic, while a new owner should call earlier, but even it says a phone call is always worthwhile. No article can make that judgement in place of a vet.

Until the vet arrives: what the sources say

Ring your vet first and ask on the phone what to do until they arrive: according to WHW, your vet should tell you how to manage things, and their instructions come before anything written here. What follows only summarises what the sources say (WHW and BHS in the UK, and the US university services Minnesota Extension and Penn State Extension); it is not an instruction. BHS stresses that these are recommendations: always assess the situation yourself, and if it is not safe, do not proceed.

• Safety. WHW says the most important thing is to keep yourself and others safe, because a horse in severe pain can be very dangerous to handle. If you have to hold the horse, BHS recommends a safe area and, where possible, a riding hat and gloves. If a horse is thrashing uncontrollably, Minnesota Extension says to stay out of the way. WHW: the horse is often most easily kept safe in a well-bedded box cleared of anything it could injure itself on. BHS: wait for the vet before going back into the stable of a distressed horse.
• Medication. WHW: an owner should not give the horse any medication, because it can make the referral decision to an equine hospital harder. Penn State Extension: none until you have spoken to the vet and they instruct you to.
• Feed and water. WHW says vets typically advise continued access to water but not to feed; Minnesota Extension and Penn State Extension also list removing feed.
• Walking, lying down and rolling: sources differ, so ask your vet. WHW mentions limited hand walking only if the vet recommends it and never to the point of tiredness. BHS: gentle walking may be comfortable but the horse should not be forced to move, and letting it lie down or roll if it wishes will not make colic worse. The two US services advise walking to discourage rolling (Minnesota: if it is safe, and only if the horse feels better for it). Minnesota adds that it is unclear whether walking reduces the severity of colic, that rolling can injure you or the horse, which can also become cast in a small space, and that in conditions such as laminitis, which can look like colic, walking only makes the disease worse. Both warn against tiring the horse.
• Stay reachable. Penn State Extension advises stating your name, the emergency and your contact details calmly on the emergency line and keeping your phone with you until the vet calls back.

What the vet may do

According to Merck, the vet checks heart and breathing rate and the colour of the gums, listens to the abdomen with a stethoscope, carries out a rectal examination, and may use ultrasound and take a sample of abdominal fluid. Because horses cannot vomit, a tube passed through the nose into the stomach can release gas or fluid that might otherwise rupture the stomach, so it may save the horse's life. BHS adds that the vet can treat colic at the yard, and may advise referral to an equine hospital for further evaluation, continuous observation, medical treatment or possible surgery.

Merck puts survival after colic surgery at 50% to over 80%, generally highest in horses with mild pain. If referral is not pursued, WHW says the priority is to keep the horse as comfortable as possible under continued monitoring; if its condition deteriorates further, its pain cannot be controlled, or surgery is clearly needed but is not an option, euthanasia should be performed to prevent further suffering. Your vet will help with that decision.

What is linked to a higher risk

Colic can affect any horse, from a Lipizzaner to a pony. BHS says the risk can rise with age, after recent changes in diet or management, and in horses that have had colic before, particularly those that have had colic surgery. A few details:

• A systematic review in adult horses (Curtis et al., 2019) linked most evidence of higher risk to changes in feed (5 of 14 publications) and a recent change of housing (3 of 14); most studies (8 of 14) did not meet the Joanna Briggs Institute (JBI) criterion on confounding factors, so this shows an association, not proof of cause. DEFRA says sudden diet changes can lead to digestive upsets, including colic and diarrhoea, and should be avoided.
• BHS mentions lush grass (gas colic), sandy ground and overgrazed paddocks (sand colic), drinking less when water is dirty or frozen, stress, sudden box rest, many different carers, and mares soon after foaling.
• WHW advises checking especially carefully for signs after travelling, particularly if water was withheld.

How to lower the risk

WHW and BHS give broadly the same guidance. Minnesota Extension warns that such measures should reduce colic risk but do not guarantee to eliminate it.

General care is covered in how to care for a horse.

An emergency plan

BHS says colic is often time-critical, especially if hospital referral is needed, and that any delay could affect the outcome, so make a plan in advance. It should include key contacts, the horse's normal pulse, respiration and temperature, health history and medication, insurance details including exclusions, your decisions for different scenarios and your wishes about euthanasia. Share it with a nominated person and your vet practice, and warn your transport before the vet arrives so no time is lost.

BHS says referral to an equine hospital can be very expensive (in the UK, hundreds to thousands of pounds). We found no comparable figures for Slovenia or Croatia, so think about insurance, transport and costs in advance, not for the first time during a colic; everyday costs and insurance are covered in monthly horse costs.

Save your own vet's number and their out-of-hours number, and ask who covers nights and weekends. In Slovenia, the Clinic for Breeding and Health Care of Horses at the University of Ljubljana Veterinary Faculty lists on its website (as of 29 September 2026) urgent surgical treatment of colic in horses, emergency surgery outside regular hours and a standby number for October to May; outside that period do not assume it is available, and check with the clinic before relying on it. In an emergency, call your own vet first. The equine department in Zagreb lists colic operations among its surgical work. You can browse providers in the vets directory; ask each one directly whether they take emergencies.

Colic FAQ

How do I spot colic when the signs are mild?

Mild colic is easy to miss. WHW lists lying down more, eating less and fewer droppings as early signs, with no dramatic pawing or rolling. If you do not know how many droppings your horse normally passes, the difference is hard to see. When something is off, ring your vet and describe what has changed.

Is it all right to walk a horse that has colic?

Ask your vet on the phone rather than deciding alone. WHW mentions limited hand walking only on the vet's recommendation and never to tiredness, BHS says gentle walking may be comfortable but should not be forced, and Minnesota Extension says walking may relieve pain but that it is unclear whether it lessens the severity of colic, and that in conditions such as laminitis it only makes the disease worse.

Does every case of colic count as an emergency?

There is no way to know at the start. WHW treats any colic as potentially extremely serious, Merck says only some horses need an operation, and the Zagreb equine department says it is hard early on to tell which, so the sources advise calling at the first signs, not once the horse gets worse.

Will colic pass by itself?

You cannot know in advance, so the sources advise calling at the first signs. Minnesota Extension says mild, recent-onset colic may improve with walking, but advises calling if you have not seen the horse for several hours, do not know how long the signs have lasted, the colic is severe, or the vital signs are abnormal. WHW says the severity of signs usually mirrors the severity of the disease but not always, so do not wait hours.

Why does a horse get colic?

There are several causes, because colic is a sign, not a disease. Merck names a gut stretched by gas or feed, a displaced gut, inflammation or ulceration, reduced blood flow, blockage by feed, sand or parasites, and intestinal stones. According to WHW, the true cause often stays unknown.

Can colic be prevented?

Not entirely. Sources still recommend a fibre-rich diet, gradual changes to feed and routine, constant fresh water, regular dental checks, a worm-control programme agreed with your vet and as much turnout as possible. This lowers the risk but does not remove it; the table in the risk section has the detail.

What should I say when I ring the vet?

Merck lists what the vet may ask: how long and how quickly the colic has developed, how severe the pain is, whether any droppings have been passed and how the horse responded to any measures. Worming history and the last dental check may also come up. BHS adds that you should give your exact location.