Colic in Horses

Colic is an emergency – if you are concerned about your horse please call our 24/7 helpline immediately. The information below is intended as a guide only – talk to Stride about any specific concerns.

Colic is the most common equine emergency and cause of death in horses worldwide. It can range from mild discomfort to life-threatening conditions, and its causes vary widely. Due to the complexity of the equine digestive system, colic requires prompt recognition, veterinary diagnosis, and treatment to prevent serious complications.

Colic is not a specific disease but a general term for gastrointestinal pain, which can arise from a variety of conditions. The different types of colic come under these broad categories; Spasmodic, Tympanic (flatulent or gas colic), Impaction, Sand colic, Displacements, Strangulations, Colitis and Enteritis.

1. Spasmodic Colic:
   • Caused by increased intestinal motility or spasms of the intestines, leading to cramping pain. It can be triggered by stress, dehydration, or sudden dietary changes.
   • Signs: Intermittent sudden (often extreme) discomfort, stretching out, or kicking at the belly.
2. Gas Colic:
   • Occurs when there is excessive gas buildup in the intestines, causing distention and pain. This can result from rapid fermentation of food or dietary changes.
   • Signs: Mild discomfort, bloating, pawing at the ground, and restlessness.
3. Impaction Colic:
   • Results from a blockage in the intestines, usually due to feed, sand, or other material obstructing the flow. It often occurs in areas where the intestines narrow, such as the pelvic flexure.
   • Signs: Gradual onset of discomfort, reduced faecal output, lying down, and straining to defecate.
4. Sand Colic:
   • Occurs when horses ingest sand while grazing in sandy environments. The sand settles in the intestines, leading to blockages and irritation of the bowel.
   • Signs: Gradual discomfort, diarrhoea, and sand in faeces.
5. Displacement/Volvulus/Torsion:
   • These types of colic involve a section of the intestines becoming displaced or twisted. This can severely cut off blood supply and result in tissue death, making it one of the most serious forms of colic and highly life-threatening. Referral to the hospital as soon as possible is indicated.
   • Signs: Severe, unrelenting pain, sweating, rolling, and refusal to stand.
6. Strangulation Colic:
   • Occurs when a portion of the intestines become trapped or strangulated, often by a lipoma (a benign fatty tumour), hernia, cutting off blood supply to the tissue, or movement of the intestine through a structure called the epiploic foramen. Another potential cause is Nephrosplenic entrapment (NSE), when the left colon becomes trapped between the spleen and the left kidney.
   • Signs: Acute, intense pain, rapid deterioration, and often requires immediate surgery.
7. Colitis:
   • Inflammation of the large intestine, often caused by infection or stress, leads to diarrhoea and abdominal pain.
   • Signs: diarrhoea, fever, lethargy, and mild to moderate pain.
8. Enteritis:
   • Inflammation of the small intestine, which can be caused by bacterial or viral infections, leading to pain and sometimes fluid buildup (reflux) in the stomach.
   • Signs: Fever, reduced gut sounds, and moderate to severe pain.

Signs of Colic in Horses

Horses exhibit a range of signs when experiencing colic, which may vary depending on the severity and type of colic. Stride Equine Vets is a BHS REACT to Colic champion practice, and we work by the REACT signs, which are the most common and important indicators (based on research from The University of Nottingham). The signs include:

Restless or Agitated

• Attempts to lie down – Horses may lie down more than usual and refuse to get up.
• Repeatedly rolling – Lying down and rolling repeatedly, sometimes violently.
• Unexplained sweating – can be a sign of severe pain, especially if the horse is not exerting itself.
• Box-walking or circling – A sign that the horse is in distress.

Eating Less or Droppings Reduced

• Eating less or nothing at all – A sudden disinterest in food and water is a warning sign.
• Passing fewer or no droppings – A reduction in faecal output may indicate an intestinal blockage or impaction
• Changes in consistency of droppings – Dry hard droppings or watery diarrhoea are signs for concern

Abdominal Pain

• Flank watching – Frequently turning their head toward their sides or belly
• Pawing at the ground – shifting weight and inability to settle
• Kicking at belly – Indicative of abdominal pain or discomfort

Clinical Changes

• Increased heart rate – Pain and distress can cause elevated heart rates
• Reduced or absent gut sounds – In a healthy horse, gut sounds are typically audible; their absence suggests gastrointestinal stasis
• Changes in colour of gums – healthy gums should be a salmon pink colour
• Rapid breathing rate – Another indication of pain and distress
• Skin abrasions over the eyes  – Indicates that the horse has been thrashing around and has caught this prominent area on their face, for example, on the walls of the stable

Tired or Lethargic

• Lying down more than usual – Indicates the horse is feeling unwell
• Lowered head position – Happy, healthy horses generally keep their heads up
• Dull and depressed – Some horses with colic may appear very quiet and listless

Horses may show any of these signs, and it is important that owners/keepers contact their vet if any of these signs are observed or there are any concerns.

Nottingham’s research showed that classically described signs of colic, such as flank watching and kicking at the belly are not seen in every case, and therefore waiting for these signs to be displayed may delay diagnosing a problem or cause one to be missed completely. Other signs, such as eating less or passing fewer droppings, are more commonly seen and are important in recognising a problem early.

The REACT signs are not an exhaustive list of every possible sign of colic, but instead highlight five key aspects of your horse’s health and behaviour that should be considered.

Know your horse’s vital signs

Knowing the ‘normal’ temperature, pulse and respiration (TPR) rates for your horse means you’ll be able to recognise when these values are abnormal. If there is no reason for a change in TPR due to factors such as recent stress or exercise, seek veterinary advice. Ask your Stride vet to check these for you on a regular basis, so you know what is normal for your horse.

Causes of Colic

Colic in horses can be caused by a variety of factors related to diet, management, anatomy, or underlying health conditions. Some of the most common causes include:

1. Dietary Factors:
   • Sudden changes in diet: Rapid changes in hay or grain can disrupt the delicate balance of the horse’s digestive system.
   • Poor-quality feed: Mouldy or spoiled hay or grain can irritate the digestive tract.
   • High-grain diets: Diets that are too high in concentrate can lead to fermentation, gas buildup, and, ultimately, colic.
2. Inadequate Water Intake:
   • Dehydration can lead to impaction colic, especially in colder months when horses may drink less water.
3. Parasites:
   • Heavy parasite infestations, particularly from large strongyles, can damage the intestines and cause colic.
4. Sand Ingestion:
   • Horses grazing on sandy pastures may ingest sand, leading to sand colic over time.
5. Stress:
   • Transport, changes in the environment, and competition can all contribute to colic by affecting gut motility.
6. Anatomical Issues:
   • Horses have a long, complex gastrointestinal tract that is prone to displacement, twisting, or entrapment of sections of the intestines.
7. Lack of Exercise:
   • Horses that are confined to stalls or do not get enough regular movement may have reduced gut motility, increasing the risk of colic.
8. Dental Care:
   1. Inadequate dental care can lead to an inability to chew and cut food correctly, increasing the risk of impaction.

Diagnosis of Colic

Diagnosing colic involves a combination of clinical examination and diagnostic tools. We will assess the horse’s vital signs, perform a physical exam, and possibly use additional tests to determine the severity and type of colic. Common diagnostic procedures include:

1. Physical Examination:
   • We will check heart rate, respiratory rate, mucous membrane colour, and capillary refill time to assess the horse’s overall condition.
   • Gut sounds will be auscultated using a stethoscope to determine intestinal activity.
2. Rectal Examination:
   • The vet will perform a rectal exam to feel for any abnormalities in the intestines, such as displacement, impactions, or gas distention.
3. Nasogastric Intubation:
   • A tube may be passed through the horse’s nostril into the stomach to check for reflux (excess fluid that accumulates when there is an obstruction in the intestines). At this time we may pass fluids and electrolytes into the stomach to aide gut survival and break down blockages.
4. Ultrasound:
   • Abdominal ultrasound can help detect abnormalities in the intestines, such as fluid buildup, thickened intestinal walls, or displacement of organs.
5. Blood Tests:
   • Blood work can help assess dehydration, electrolyte imbalances, and inflammation.
6. Abdominocentesis (Belly Tap):
   • In some cases, fluid is collected from the abdominal cavity to evaluate the health of the intestines and detect conditions like peritonitis or bowel strangulation.

Treatment of Colic

The treatment of colic depends on the type and severity of the condition. Treatment options include:

1. Medical Management:
   • Pain relief: NSAIDs (Non-Steroid Anti-Inflammatory Drugs) are commonly used to reduce pain and inflammation.
   • Fluid therapy: Administering fluids, either orally or intravenously, can help rehydrate the horse and resolve mild impactions.
   • Laxatives: Epsom salts or other laxatives may be administered via a nasogastric tube to help soften an impaction or encourage the passage of gas.
   • Anti-spasmodic medications: These may be used to reduce spasms in the intestines.
2. Surgical Treatment:
   • In severe cases, such as those involving a twisted or displaced intestine, surgery is necessary. Surgery may involve repositioning the intestines, removing dead or damaged tissue, or correcting an obstruction.
   • Horses requiring colic surgery have better outcomes the sooner the surgery is performed, emphasising the importance of rapid intervention.
3. Post-Colic Care:
   • After a colic episode, the horse may need supportive care, including close monitoring, limited feed intake, and a gradual return to normal activity.
   • Adjustments to the horse’s diet, hydration, and management practices are often recommended to prevent future colic episodes.

Prevention of Colic

Colic can occur at any time of the year in both grass-kept and stabled horses and there are many potential risk factors. However, there are many simple steps that can be taken to help reduce the risk of it occurring.

• Consistent Diet: Avoid sudden changes in feed or forage. Gradually introduce any dietary changes over 7–10 days.
• Adequate Hydration: Ensure horses have access to fresh, clean water at all times. In cold weather, warm water may encourage drinking.
• Regular Deworming: Maintain a parasite control programme tailored to your horse’s specific needs, including regular faecal egg counts and strategic deworming.
• Regular Dental Care: Ensure the horse’s teeth are checked and floated as necessary to prevent dental problems that could affect chewing and digestion.
• Frequent Turnout and Exercise: Provide regular turnout and opportunities for movement to promote gut motility and reduce the risk of impaction.
• Feed Quality: Use high-quality hay and avoid feeding mouldy or dusty feed.
• Slow Feeding: Use slow feeders or spread hay out in multiple piles to mimic grazing behaviour and avoid large, infrequent meals that can upset digestion. Use a ‘+1’ approach to hay piles in fields to prevent competitive grazing and fast eating. For example, if 4 horses are in the field, put 5 piles.

Make a Plan

Colic needs speedy diagnosis and treatment. In our experience, it doesn’t stick to a convenient timetable and can happen at any time of day or night, so you need to know what to do. Do you have your vets phone number conveniently to hand? If hospitalisation is needed, how will you arrange it? If emergency surgery is needed, have you thought about the expense and trauma – do you want your horse to go through that?

Every horse owner and handler should make a plan in advance so that, if colic does present, you know who to call and what your instructions might be. If you don’t look after your horse at home, it is vital that stable friends or livery staff know your instructions in case they can’t get hold of you.

As a REACT to Colic champion, your Stride vet can advise you on these issues and help you write up a plan. We’ve developed a simple form for you to use, which can make the process easier.

Conclusion

Colic is a common but potentially life-threatening condition in horses. Early recognition and prompt veterinary intervention are essential for a favourable outcome. Prevention through good management practices can significantly reduce the risk of colic, ensuring that horses remain healthy and comfortable.

If you are concerned about the welfare of a particular horse, please contact us immediately for support. Our emergency line is open 24/7. This website contains general information on horse related welfare matters, but is not advice which should be relied upon to treat any individual horse. Unfortunately, it is not possible in the context of this website to take into account individual situations or consider unusual problems or circumstances.

Whilst we try to ensure that the information within this website is accurate, we can accept no responsibility for the accuracy of the site content. Users who rely on the information in this site do so at their own risk. This website is made available for public viewing solely on the basis that Stride Vets excludes to the extent lawfully permitted all liability whatsoever for any loss or damage arising out of use of this site, or reliance upon its contents.