Recognising Horse Colic: First-Aid Steps Before the Vet Arrives

Quick answer

Equine colic is a veterinary emergency indicating abdominal pain. If you suspect your horse has colic, immediately remove all access to food, assess their vital signs, call your veterinarian, and walk them slowly only if they are attempting to roll violently.

Learn how to spot the early signs of equine colic, perform a vital health check,

:::key-facts

• Colic is a symptom, not a disease: It refers broadly to abdominal pain, which can range from mild gas to life-threatening intestinal twists.
• Time is critical: Early detection and rapid veterinary intervention significantly improve a horse's prognosis.
• Withhold food immediately: Do not let a colicking horse eat hay, grain, or grass, as this can worsen blockages.
• Avoid self-medicating: Never administer pain relief without explicit instructions from your veterinarian.
  :::

Why it matters

Unlike humans or dogs, horses cannot vomit due to a highly efficient one-way valve at the entrance of their stomach. This anatomical quirk means that any gas buildup, fluid accumulation, or physical blockage (such as an impaction) has nowhere to go but through the long, winding digestive tract.

Because their gastrointestinal system is incredibly complex and suspended loosely within the abdomen, minor issues can quickly escalate into life-threatening emergencies like a twisted gut (volvulus) or severe displacement. Recognising the early signs of equine colic and knowing exactly how to react during the critical window before your vet arrives can literally mean the difference between life and death for your horse.

:::ask-boo
"What are the most common causes of colic in horses?"
:::

What good looks like

To spot when something is wrong, you must first know what a healthy, comfortable horse looks like. A healthy horse is alert, responsive to their environment, and interested in food. They should pass normal, well-formed manure balls between 6 to 10 times a day.

Gently press the gums above the teeth; they should return from white to pink in under two seconds.

When you perform a basic health check on a healthy horse, you should find:

• Heart rate: 28 to 44 beats per minute (bpm).
• Respiratory rate: 8 to 16 breaths per minute.
• Temperature: 37.2°C to 38.5°C (99°F to 101.3°F).
• Gum colour: Moist and bubblegum pink.
• Capillary refill time: Under 2 seconds when you press and release the gum.
• Gut sounds: Active, consistent gurgling, rumbling, and fluid sounds in all four quadrants of the abdomen.

Step-by-step

If you suspect your horse is experiencing colic, follow this systematic first-aid protocol to keep them safe and gather vital information for your veterinarian.

Step 1: Ensure safety and remove food

Immediately remove all hay, grain, and treats from the stall or paddock. If the horse is in a pasture, move them to a safe, deeply bedded stall or a small, clear pen where they cannot injure themselves on fences or farm equipment. Ensure you are wearing protective footwear and a helmet if the horse is behaving violently.

Step 2: Assess vital signs

Before you pick up the phone, gather as much clinical data as possible. Take the horse's heart rate using a stethoscope placed just behind the left elbow, or by feeling the facial artery under the jaw. Check their respiratory rate by watching their flank rise and fall. Use a digital thermometer to take their rectal temperature, and check their gum colour and capillary refill time.

Step 3: Listen for gut sounds

Place your ear or a stethoscope against the horse's flank. Listen in four distinct areas: high and low on both the left and right sides. You should hear active gurgling. A completely silent abdomen is a major red flag.

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Walk your horse at a slow, steady pace only if they are actively trying to roll or thrash.
:::

Step 4: Call your veterinarian

Contact your vet immediately. Report your horse's vital signs, gut sounds, and specific behaviours. Be prepared to describe when the symptoms started and whether the horse has passed any manure recently.

Step 5: Manage movement

If the horse is resting quietly, let them lie down. You do not need to force them to stand. However, if they are actively trying to roll, thrash, or cast themselves against a wall, lead them out and walk them at a slow, steady pace. Walking helps prevent injury from thrashing and can sometimes stimulate gut motility in mild cases of gas colic.

:::pro-tip
Keep a dedicated "colic kit" in your tack room containing a working stethoscope, a digital thermometer, lubricant, a clean lead rope, and your veterinarian's emergency contact number laminated and highly visible.
:::

Signs something's wrong

Horses express abdominal pain in various ways depending on their pain tolerance and the severity of the colic. Symptoms are generally categorised into mild, moderate, and severe stages.

Mild signs of colic

• Pawing at the ground repeatedly.
• Turning the head to look at the flank (flank-watching).
• Curling the upper lip (the Flehmen response).
• Stretching out as if trying to urinate.
• Showing general restlessness or a lack of interest in feed.

Flank-watching is a classic early sign of abdominal discomfort in horses.

Moderate signs of colic

• Repeatedly lying down and getting up.
• Kicking or biting at the abdomen.
• Frequent, active pawing that creates divots in the ground.
• Uncharacteristic sweating, particularly around the neck and flanks.

Severe signs of colic

• Violent rolling, thrashing, and dropping heavily to the ground.
• High heart rate (above 60 bpm).
• Rapid, shallow breathing.
• Cold, clammy sweat covering the entire body.
• Pale, muddy, or bluish-purple gums.

:::warning
If your horse is thrashing violently, do not attempt to enter the stall or get close to them. A thrashing horse can easily crush or kick you unintentionally. Keep yourself safe and wait for the veterinarian to arrive with sedation.
:::

When to call your vet

You should call your veterinarian the moment you suspect colic. Never adopt a "wait and see" approach. Colic can progress from a mild stomach ache to a fatal intestinal rupture in a matter of hours.

When you call, have the following information ready:

• The horse's current heart rate and temperature.
• Whether you can hear any gut sounds.
• The colour of their gums.
• Their current behaviour (e.g., quiet, rolling, pawing).
• Any recent changes in their diet, turnout routine, or water intake.

:::ask-boo
"Can I give my horse Banamine or flunixin before the vet gets here?"
:::

Common mistakes

Even well-meaning owners can make critical errors during a colic episode. Avoid these common pitfalls to give your horse the best chance of recovery:

• Walking the horse to exhaustion: Walking should only be used to prevent violent rolling. Walking a tired horse for hours will exhaust them, deplete their energy reserves, and make them a poorer candidate for surgery if it becomes necessary.
• Administering pain medication without permission: Giving drugs like flunixin meglumine (Banamine) or buscopan before the vet arrives can mask clinical signs. This makes it incredibly difficult for the vet to perform an accurate assessment and can delay life-saving surgery.
• Forcing a quiet horse to stand: If your horse is lying down quietly and resting, leave them be. They are conserving energy and are not at risk of twisting their gut simply by lying down.
• Attempting to tube or drench the horse yourself: Never try to force fluids, mineral oil, or home remedies down a horse's throat. If it accidentally enters their lungs, it will cause fatal aspiration pneumonia.

Listen in all four quadrants of the abdomen; a healthy horse should have active gurgling and rumbling sounds.

Quick FAQs

Can a horse survive colic without surgery?

Yes. The vast majority of equine colic cases (around 90%) are resolved medically with veterinary treatments such as intravenous fluids, pain relief, and mineral oil administered via a nasogastric tube. Only a small percentage require surgical intervention.

Is it safe to let my horse roll?

No. While rolling itself does not always cause a twisted gut, violent thrashing and rolling can cause severe physical trauma, facial scrapes, and eye injuries, or cause the horse to become trapped ("cast") against a wall. Walk them slowly to prevent violent rolling.

How can I prevent colic in the future?

While not all colic is preventable, you can significantly lower the risk by providing constant access to clean, fresh water, feeding a consistent diet with high-quality forage, making any feed changes very gradually over 7 to 10 days, maintaining a regular deworming [program](</p/knowledge/drugs/lufenuron>), and scheduling annual dental checks.

:::ask-boo
"How much water should a horse drink daily to prevent impaction colic?"
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