Horse colic: what to do until the vet arrives

What is colic in horses?

Colic isn’t a single disease — it’s a sign. It means abdominal pain. The Merck Veterinary Manual describes colic as an umbrella for many conditions, from excess gas that resolves in a few hours to strangulating obstructions, where a loop of intestine loses its blood supply and only surgery can fix it.

Horses are especially prone because of their anatomy. They have a very long intestine with sharp bends, narrowings and sections that can shift inside the abdomen, and they cannot vomit to relieve an overloaded stomach. That makes colic one of the most common equine emergencies — and one where speed matters.

How can you tell a horse has colic?

Merck lists the most common signs:

• Pawing repeatedly with a front foot.
• Looking back at the flank.
• Curling the upper lip and arching the neck.
• Raising a hind leg repeatedly or kicking at the belly.
• Lying down, getting up, rolling.
• Sweating without exercise.
• Stretching out as if to urinate, or straining to pass manure.
• Distended belly, loss of appetite, depression and fewer bowel movements.

A horse rarely shows all of these, and the signs tell you there is pain — not where it is or whether it needs surgery. Stoic horses and some draft breeds may only look dull and leave their feed. A horse that always cleans up its grain and suddenly doesn’t deserves a closer look.

What should you do while waiting for the vet?

1. Call your veterinarian. Don’t wait to see if it passes. Describe what you see, when it started and whether it is getting worse. Many vets will ask for a short video.
2. Remove all feed. Take away hay, grain and grazing. Water can usually stay unless your vet says otherwise.
3. Move the horse somewhere safe. A small paddock or arena with soft footing, away from fences, feeders and walls. A small stall is dangerous if a horse throws itself down.
4. Watch and write it down. What you record in the next half hour helps the diagnosis (see the table below).
5. Hand-walk only if it helps. Walking can settle a restless horse and may encourage gut movement. Don’t trot or exhaust it, and never stand between a horse that is going down and a wall.

What information will the vet need?

Merck stresses the history the veterinarian will ask about. Have it ready:

Information	How to get it
Onset and progression	When did it start? Is the pain worse, steady or coming and going?
Heart rate	Pulse under the jaw, or stethoscope behind the left elbow; count 15 seconds × 4
Gum color and refill	Moist pink is expected; dark red, purple or pale is a warning. Press the gum: color should return in about 1.5 seconds
Manure and urine	Has the horse passed manure? When? What did it look like?
Temperature	Rectal thermometer, only if you can do it safely
Recent feeding	New hay, new grain, access to the feed room, lush pasture
Water	Has it been drinking? Is the waterer working or frozen?
History	Last deworming, last dental float, previous colic, cribbing
Activity	Was the horse resting or working when signs began?
What you gave	Any medication, the dose and the time

An adult horse at rest normally has a heart rate of about 28 to 44 beats per minute. Merck notes that higher rates are associated with more severe problems such as strangulating obstructions — but not every surgical colic raises the heart rate, so a normal number is not a reason to relax.

What should you avoid doing?

• Don’t give pain medication on your own. Flunixin (Banamine) and similar drugs can hide pain and make a surgical colic look manageable. If your vet tells you to give something over the phone, follow the exact dose and note the time.
• Don’t give mineral oil, laxatives or home remedies. Some can make an impaction worse, and oil given by mouth can be inhaled into the lungs.
• Don’t walk the horse for hours. An exhausted, dehydrated horse arrives at the exam in worse shape.
• Don’t put yourself at risk. A horse in severe pain can drop and roll without warning.
• Don’t offer food “to see if it eats.” No feed until the vet clears it.

When is colic an emergency?

Tell your vet clearly if you see any of these:

• Severe pain, or pain that persists or comes back despite medication.
• A high heart rate that keeps rising.
• Dark red, purple or grayish gums, or slow capillary refill.
• A visibly swollen belly.
• Heavy sweating and trembling.
• No gut sounds when you put your ear to the flanks, and no manure.

Merck notes that referral to a surgical facility may be advised when pain persists or returns, and that the prognosis is better with mild pain and worse with severe pain, distension or signs of circulatory compromise. If surgery is a possibility, think ahead about transport and cost so you can decide quickly.

What will the veterinarian do?

Typically the vet will:

• Check heart and respiratory rates, gums, temperature and gut sounds.
• Pass a nasogastric tube to relieve gas or fluid in the stomach and check for reflux.
• Do a rectal exam when it is safe and useful.
• Give pain relief and, if needed, fluids by tube or IV.
• Recommend withholding feed, laxatives or other treatment based on the likely cause.
• Decide whether the horse can be managed at home or needs a hospital or surgery.

Because the list of possible causes is long, treatment often starts with the most likely diagnosis and is refined later.

How can you lower the risk of colic?

Not every colic can be prevented, but many risk factors come down to management:

• Forage first. Hay or pasture should be the base of the diet, offered in several meals or continuously.
• Change feeds gradually over one to two weeks — new hay, new grain, spring grass.
• Clean water at all times, and keep it from freezing in winter. Horses that drink less have a higher risk of impaction.
• Deworm strategically, with a plan built with your vet and fecal egg counts where possible.
• Regular dental care. Poorly chewed forage is harder to move through the gut.
• Daily turnout or exercise. Long periods of stall confinement are linked to more colic.
• Don’t feed on sand. In sandy areas, horses eating off the ground can accumulate sand in the gut.
• Split concentrate into small meals rather than one large grain feeding.

Hoof care and colic prevention share the same foundation of consistent routines. See also our guide to horse hoof trimming and shoeing.