Colic in Horses - When Abdominal Pain Becomes Life-Threatening

Colic in horses does not only occur at the beginning of the grazing season - when horses eat the first unfamiliar grass after the long winter break - the number of colics also increases in winter. In this article we will tell you which symptoms you can recognize and prevent colic.

What is colic?

Every horse owner, groom, rider and person involved in equestrian sports has at least once in his life contact with a horse that colics, but usually more often. So, of course, the fear is great when the beloved four-legged friend is suddenly lying, rolling and in severe pain. Because horse owners know that colic can also be fatal.

But what exactly is colic? Colic in horses is a collective term for various diseases or conditions that cause severe abdominal pain. It is an acute medical emergency problem and requires immediate attention and treatment by a veterinarian. Colic can affect various parts of the digestive tract, including the stomach, small intestine, large intestine and peritoneum.

There are different types of colic, including constipation colic, gas colic, intestinal torsion and intestinal twisting. The causes can be varied and range from feeding errors and stress to anatomical problems. Constipation colic, for example, can be caused by insufficient fluid intake or the ingestion of sandy feed, while gas colic is caused by the accumulation of gases in the digestive tract, often due to the fermentation of feed.

Symptoms of colic can vary from horse to horse, but can include restlessness, frequent lying down and standing up, rolling, disturbed feeding behavior, excessive sweating, flank biting, increased heart and respiratory rate, and a distended abdomen. It is important to recognize these signs early and contact a veterinarian immediately, as untreated colic can have serious consequences, including intestinal perforation and death.

The treatment of colic depends on the cause and severity. It may include the administration of antispasmodic and analgesic medication, hydration through a feeding tube, nasogastric decompression or even surgery. Prompt diagnosis and treatment are crucial for a successful recovery of the horse.

‍The following applies to all colic: the faster you can treat colic, the greater the chance of a mild outcome.

Colic can take a dramatic, life-threatening course within the first few hours, so quick action is required!

This downloadable checklist can help you stay calm in an emergency and act in a structured way:

Causes of colic

The causes of colic have been studied by scientists for several decades, as they are very diverse. In addition to age, husbandry conditions and breed, there are other factors that can trigger colic in horses:

• Stress
• Infections
• Dental problems
• Lack of exercise
• Feeding errors
• Sand deposits in the intestine
• Weather change
• Anschoppungskolik

Some horses are more prone to colic than others, but the main causes of colic usually include feeding errors such as too little hay, too much straw, too much flatulent feed (beets, corn, bread and grass), or ingested sand in paddocks or chewed-up pastures. 

Colic in horses: What types of colic are there?

Constipation colic in horses

This type of colic occurs when the horse's intestines become thickened and congested due to reduced water flow in the feces. This can be caused by insufficient fluid intake, poor feed quality or other digestive problems.

Blockages in the small intestine

Blockages in the small intestine can be caused by improper feeding, especially feeding grass clippings promotes colic. Also, fatty tumors caused by a natural constriction in the intestine or also by parasites such as roundworms.

Blockages in the large intestine

Most constipation colic is caused by reduced water intake. This is because the lack of fluids causes the horse's intestinal contents to become too solid and can no longer be properly excreted. A good example of this is when the horse has been defecating in the watering trough and this is not noticeable at first. This leads to a fluid deficit and accompanying colic, which can last for several days as it is hardly noticed due to its mild course. Nevertheless, horses that overeat or chew worse can also be susceptible to constipation colic.

Seizure colic

Cramping colic, also known as spasmodic colic, is a type of colic that can occur in horses. It is caused by recurrent, intermittent spasms in the digestive tract. These spasms can cause severe pain and cause the horse considerable suffering.

The causes of cramp colic can be many and varied. Stress is a common trigger that can disrupt the normal function of the digestive tract and lead to cramps. Poorly chewed food, for example due to dental problems, can also lead to cramp colic. Feeding errors, such as eating too much flatulent food or poor quality food, can also cause cramp colic. Another possible trigger is parasitic infections such as a severe worm infestation.

The symptoms of cramping colic can vary, but typically the affected horse will show signs of restlessness, appear stressed and may lie down and stand up frequently. It may also kick backwards more or raise its belly to relieve the pain. In some cases, the horse may also defecate more frequently or show signs of colic such as rolling.

The treatment of convulsive colic usually requires veterinary intervention. The veterinarian will administer antispasmodic and analgesic medications to relieve the spasms and stabilize the horse. In some cases, additional treatment may be required, depending on the underlying cause of the colic.

To prevent cramping colic, it is important to minimize stressful situations, ensure a balanced diet and carry out regular veterinary examinations to detect and treat dental problems and parasitic infections at an early stage. In addition, feed changes should be made slowly so as not to strain the horse's digestive tract.

Gas colic

Gas colic in horses occurs when excess gas builds up in the horse's digestive tract. These gases can be caused by various factors, such as the digestion of feed or the fermentation of bacteria in the intestine. Gas colic can be very painful and often requires rapid veterinary treatment.

The main cause of gas colic in horses often lies in the feed. Certain feedstuffs that are rich in carbohydrates or difficult to digest, such as grass cuttings, clover, turnips, soft bread or maize, form the basis for gas production in the digestive tract. Fungal spores, which thrive in hay and silage bales, especially in winter, can also be life-threatening (tip: contaminated feed can be recognized by a sour, foul and musty smell). You can recognize gas colic in your horse by increased flatulence and a noticeably larger abdominal girth. Flatulent feed such as fresh grass, clover, turnips, soft bread or corn can also lead to gas colic. Another possible cause is fungal spores, which can develop in spoiled or moist feed, especially in hay or silage bales in winter.

The symptoms of gas colic can vary, but typically affected horses show signs of restlessness, disturbed eating behavior, increased flatulence and a noticeably enlarged abdominal circumference. They may lie down and stand up frequently, raise their belly or paw with their front legs to relieve the pain. In severe cases, the horse may also show signs of colic such as rolling.

The treatment of gas colic usually requires veterinary intervention. The vet will administer antispasmodic and analgesic medication to relieve pain and support bowel function. In some cases, nasogastric decompression may also be required to release excess gas and reduce pressure in the digestive tract.

To prevent gas colic in horses, a balanced diet is of crucial importance. It is important to avoid flatulent feed or to feed it in moderation. Feed should be of good quality and spoiled or moldy feed should be avoided. In addition, the horse should have sufficient exercise and stressful situations should be avoided to support the normal function of the digestive tract.

Sand Colic

Sand colic is a serious disease in horses caused by the accumulation of sand or other foreign bodies in the digestive tract. Horses often ingest sand unintentionally while grazing on poor pastures or eating hay from sandy soils. These ingested quantities of sand can accumulate in the intestines and lead to problems.

The symptoms of sand colic are similar to those of other types of colic and can range from mild discomfort to severe pain. The most common symptoms include restlessness, disturbed feeding behavior, sudden lying down and rolling around, excessive scraping of the ground with the front hooves and an increased abdominal girth. In severe cases, sand colic can lead to intestinal engorgement or perforation, which is life-threatening and requires immediate veterinary attention.

The diagnosis of sand colic is often made by clinical examination and can be made by listening to the abdomen for digestive sounds and by rectal examination to confirm the presence of sand in the bowel. In some cases, an X-ray or ultrasound examination may also be performed to assess the extent of sand accumulation and possible intestinal torsion.

The treatment of sand colic can vary depending on the severity of the condition. In mild cases, treatment with laxative medication or a special feed composition can help to remove the sand from the intestine. In more severe cases, nasogastric lavage may be required to mechanically remove the sand. In extreme cases, surgery may be required to unblock or repair the bowel.

To prevent sand colic in horses, it is important to optimize feed and pasture conditions. Horses should eat from clean feed sources and be kept in pastures with little or no access to sand. Regular administration of high-fiber feed such as hay or grass can also help maintain gut health and reduce sand accumulation.

Intestinal rotation - devouring

Did you know that your horse is a creature of habit? This means that it prefers to eat the same food every day and sudden changes in feed do not always have positive effects on the digestive tract. 

If the feed is suddenly changed, this can lead to malfermentation in the horse's intestines. This malfermentation can cause the intestine to become so distended that it rises and is more easily engulfed when another part of the intestine sinks due to overgrowth. Intestinal torsion or intestinal engorgement is a serious and potentially life-threatening condition in horses. It involves a section of the intestine becoming twisted or entangled on its own axis or in a loop, blocking the normal flow of food and fluid. This situation can lead to an intestinal obstruction, which causes an undersupply of blood to the intestine and, in the worst case, leads to the death of intestinal tissue.

The symptoms of intestinal torsion often occur suddenly and intensely. These include severe abdominal pain, restlessness, disturbed feeding behavior, increased rolling, a distended abdomen, increased body temperature, accelerated heartbeat and breathing difficulties. In some cases, the horse may also show signs of shock, such as a pale or bluish mucous membrane.

Diagnosis of intestinal torsion usually requires a thorough examination by a veterinarian. This includes listening to the abdomen for unusual bowel sounds, a rectal examination to assess the bowel and imaging procedures such as x-rays or ultrasound to determine the exact location and severity of the twist.

Treatment of intestinal torsion usually requires immediate surgery to untangle the bowel and restore blood flow. During surgery, dead tissue may be removed and, if necessary, part of the intestine resected. After surgery, the horse often requires intensive aftercare and monitoring to prevent complications and ensure it makes a full recovery.

To prevent intestinal torsion, it is important to minimize risk factors. These include abrupt feed changes, excessive exercise after feeding, poor housing conditions and stress. A balanced diet, regular exercise, appropriate grazing and stress management can help to reduce the risk of intestinal torsion in horses.

Intestinal obstruction

How can intestinal obstruction actually occur? When the muscles of the intestine no longer work as usual, the intestine cramps up and may even be paralyzed in its activity. When this happens, it is called an intestinal obstruction. But mild colic - triggered by tumors, for example - can also cause intestinal obstruction. 

Intestinal obstruction, also known as an intestinal blockage, is a serious and potentially life-threatening problem in horses. It is when the normal flow of food and fluid in the intestine is obstructed, either by a physical blockage or by a disturbance in intestinal motility. This leads to an accumulation of food, fluid and gas in the intestine, which can cause severe pain, digestive upset and possibly death of intestinal tissue.

The symptoms of intestinal obstruction can occur suddenly and are often severe. These include severe abdominal pain, restlessness, disturbed eating behavior, increased rolling, a distended abdomen, increased body temperature, accelerated heartbeat and breathing difficulties. In some cases, the horse may also show signs of shock, such as a pale or bluish mucous membrane.

The diagnosis of an intestinal obstruction usually requires a thorough examination by a veterinarian. This includes listening to the abdomen for unusual bowel sounds, a rectal examination to assess the bowel and imaging procedures such as x-rays or ultrasound to determine the exact cause and severity of the obstruction.

Treatment of an intestinal obstruction usually requires immediate surgery to remove the blockage and restore normal flow in the intestine. During surgery, dead tissue may be removed and, if necessary, part of the intestine resected. After surgery, the horse often requires intensive aftercare and monitoring to prevent complications and ensure it makes a full recovery.

To prevent intestinal obstruction, it is important to minimize risk factors. These include avoiding abrupt feed changes, sufficient exercise after eating, a balanced diet, regular exercise and appropriate grazing. Stress in horses should also be reduced, as this can also be a risk factor for intestinal obstruction.

Bowel obstruction

If there are unnatural openings in the abdominal cavity or gaps in the abdominal muscles, the intestine can slip into these gaps and become trapped.Intestinal incarceration, also known as a hernia or intestinal hernia, occurs when parts of the intestine slip into unnatural openings in the abdominal cavity and become trapped there. This can lead to serious complications, as the trapped bowel normally does not allow the normal flow of food and fluid and may result in damage to the bowel tissue.

The causes of an intestinal impaction can be varied. In stallions, for example, parts of the intestine may slip into the scrotum and become trapped there. In mares, hernias can occur in the groin area. In addition, defects in the abdominal muscles, either congenital or acquired, can also increase the risk of intestinal incarceration.

The symptoms of intestinal incarceration can vary, depending on the location and severity of the incarceration. The most common signs include severe abdominal pain, restlessness, disturbed eating behavior, a bloated abdomen, increased body temperature, breathing difficulties and a disturbed bowel movement.

The diagnosis of an intestinal obstruction usually requires a thorough examination by a veterinarian. This includes a physical examination, palpation of the abdomen, rectal examination and possibly imaging procedures such as x-rays or ultrasound to determine the exact location and severity of the incarceration.

Treatment of a bowel obstruction usually requires immediate surgery to free the obstructed bowel and return it to its normal position. During surgery, defects in the abdominal muscles can also be repaired to minimize the risk of future incarcerations. After surgery, the horse often requires intensive aftercare and monitoring to prevent complications and ensure it makes a full recovery.

To prevent intestinal incarceration, it is important to minimize risk factors and maintain good stable and pasture hygiene. Horses should also be checked regularly for signs of hernia, especially if they have previously had problems in this area.

Stomach overload

There are many different causes for stomach overload. Either the horse has eaten too much swelling or fermenting feed, in which case the ingested feed cannot pass through the stomach at the usual speed. This causes food to accumulate and then leads to over-distension of the stomach. Or food residue, saliva and other secretions from the small intestine back up into the stomach, then there is usually an intestinal obstruction, which prevents further transport of these secretions. 

Gastric overload in horses occurs when the horse's stomach is overly full and excessive distension of the stomach occurs. This can be caused by various factors, often related to the horse's feeding and digestive system.

There are various causes of stomach overload in horses. One common cause is an excessive intake of swelling or fermenting feed that cannot pass through the stomach at the usual rate. This can lead to an accumulation of feed residues, saliva and other secretions in the stomach, resulting in overstretching of the stomach.

Another possible reason is an intestinal obstruction, where the intestine is so tight or paralyzed that the normal transport of food and fluid through the intestine is hindered. As a result, liquids, gases and food can accumulate in the stomach and lead to an overload.

Symptoms of gastric overload in horses can vary, but can include severe abdominal pain, increased salivation, disturbed eating behavior, a distended abdomen, breathing difficulties and disturbed digestion. Unlike other mammals, horses cannot vomit, so gastric overload in horses can be particularly dangerous.

Treatment of gastric overload usually requires immediate veterinary intervention. The veterinarian may administer antispasmodic and analgesic medications to relieve symptoms and decompress the stomach using a stomach tube or other methods to drain excess fluids and gas. In severe cases, surgery may be required to relieve the stomach and treat possible complications.

To prevent stomach overload in horses, it is important to offer a balanced and easily digestible diet and to ensure an appropriate feed intake. In addition, the feeding of swelling or fermenting feeds should be avoided, especially if the horse is prone to stomach problems. Regular exercise and a healthy lifestyle can also help to minimize the risk of gastric overload.

This severe pain manifests itself in extreme salivation, weakened circulation, problems with breathing, and a protruding neck in an attempt to vomit. Horses, unlike other mammals, cannot vomit due to their anatomy.

What the vet does in the event of colic

When a horse suffers from colic, prompt veterinary intervention is crucial to prevent serious complications. The vet will take various measures to examine the horse, relieve the pain and initiate the necessary treatment.

First, the vet will carry out a thorough clinical examination to assess the horse's condition. Vital parameters such as pulse, respiration, temperature and mucous membrane color are checked. Based on this examination, the vet can assess the severity of the colic and plan suitable treatment.

Antispasmodic and analgesic medication is usually administered to relieve the horse's pain and promote intestinal activity. These help to relax the muscles of the gastrointestinal tract and alleviate the symptoms of colic.

In addition, the vet will examine the horse rectally to identify possible causes of colic such as blockages, intestinal obstructions or other problems in the digestive tract. Depending on the findings, further diagnostics such as ultrasound or X-rays may be necessary to determine the exact cause of the colic.

In some cases, it may be necessary to refer the horse to a veterinary clinic to ensure more intensive care and treatment. There, additional diagnostic options and specialized veterinary equipment are available to further investigate the cause of the colic and perform surgery if necessary.

The decision on how to proceed depends on the severity of the colic, the cause and the horse's general state of health. In any case, close cooperation between the vet and horse owner is important to ensure the best possible care and treatment for the affected horse.

Feeding after colic

After recovering from colic, it is important to reintroduce the horse to food carefully and gradually so as not to overload the gastrointestinal tract and avoid further complications. Here are some steps that should be followed when feeding after colic:

1. Avoid concentrates at first: In the first few days after colic, concentrated feed such as muesli or pellets should be avoided, as these are more difficult to digest and could put a strain on the gastrointestinal tract.
2. Good quality hay: Instead, the horse should initially only be provided with a sufficient quantity of high-quality hay. The hay should be dust-free and free of mold to avoid irritation of the gastrointestinal tract.
3. Slow feed change: Once the horse is stabilized again, the feed change can be made slowly and gradually. New types of feed should be introduced cautiously so as not to overtax the gastrointestinal tract.
4. Offer drinking water: It is important that the horse drinks enough to compensate for fluid loss during colic and subsequent treatments. Fresh, clean water should be available at all times.
5. Easily digestible feeds: After colic, easily digestible feeds such as mash or linseed oil can be a good choice, as they are easy on the gastrointestinal tract and provide important nutrients at the same time.
6. Avoid treats: In the first few days after colic, treats and other goodies should be avoided so as not to put additional strain on the gastrointestinal tract.

It is important to closely coordinate feeding after colic with the attending veterinarian and to follow his recommendations. Each horse is individual and feeding should be adapted to the needs and health of the individual animal.

Learn how to feed a horse with a sensitive stomach in this video: 

When can horses be ridden after colic?

In the first week after colic you should not overwork your horse. After 1-2 days you can slowly start working with your horse again. Be careful not to overwork your horse, as you would not be able to run a marathon after a stomach bug. In consultation with your veterinarian, you can slowly start walking, lunging and riding again.

However, there are some general guidelines that should be followed:

• Recovery time: As a rule, the horse should be given rest and not ridden for the first few days after colic. However, the recovery time depends on the severity of the colic and the horse's individual state of health.
• Careful reintegration: After a few days of rest, training can be resumed slowly, but care should be taken not to overtax the horse.
• Observe signs: When returning to training, the horse's behavior should be observed closely. Signs of discomfort, tiredness or renewed colic symptoms should be taken seriously and training should be interrupted if necessary.
• Slow increase: Training should be increased carefully so as not to overload the horse's body. Slow steps, short sessions and a moderate pace can help to slowly get the horse used to the strain again.
• Consult a vet: It is advisable to consult your vet and obtain their recommendations before returning to riding. The vet can assess the horse's state of health and give appropriate advice on how to proceed.

How can I prevent colic?

Since colic is not a disease in most cases, but a symptom of a disease or a housing/feeding error, you can prevent colic by taking a few steps. 

There are various measures you can take as a horse owner to prevent colic in horses:

1. Slow feed changeover: Avoid abrupt changes in your horse's feed, especially when grazing in spring. A slow changeover helps to protect your horse's gastrointestinal tract.
2. Hay at free disposal: Always offer your horse enough high-quality hay. This promotes healthy digestion and prevents constipation.
3. Avoid stress: Minimize stress factors in your horse's environment, as stress can promote colic. Provide a calm and stress-free environment, especially during feeding and exercise.
4. Sufficient exercise: Make sure your horse gets enough exercise, either in the pasture, paddock or through regular training. Exercise promotes intestinal activity and prevents constipation.
5. Check your horse's teeth regularly: Check your horse's teeth regularly and have them corrected by a vet if necessary. Dental diseases can lead to feeding problems, which can promote colic.
6. Free access to water: Make sure your horse always has access to fresh water. Adequate hydration is important for healthy digestion and prevents constipation.

By implementing these measures, you can reduce the risk of colic in your horse and ensure its well-being and health.

Frequently asked questions about colic in horses

1. how much does colic surgery cost?

The cost of colic surgery in horses can vary greatly depending on various factors. Some of the main factors influencing the cost are:

1. Severity of colic: The more complicated the colic and the more extensive the surgical interventions required, the higher the costs will generally be.
2. Clinic facilities: Prices can vary depending on the facilities and reputation of the veterinary clinic. Well-known and highly specialized clinics may tend to have higher prices.
3. Veterinarian's fee: The fee of the veterinarian performing the operation is also an important factor. Experienced surgeons with extensive expertise can charge higher fees.
4. Aftercare and stay: The costs often include not only the actual operation, but also aftercare, medication, accommodation for the horse during its stay at the clinic and other associated services.

The total cost of colic surgery can therefore vary greatly and range from several thousand to tens of thousands of euros. It is advisable to discuss the costs with the veterinary clinic or the attending vet in advance and find out about financing options. In some cases, insurance policies for horses offer cover for medical emergencies such as colic, so it may make sense to take out appropriate insurance.

2. how long does the horse stay in the clinic after colic surgery?

The length of a horse's stay in the hospital after colic surgery depends on several factors, including the severity of the colic, the horse's condition before and after surgery, and the course of recovery. Typically, the horse will remain in the clinic for a few days to several weeks after colic surgery to receive appropriate post-operative care and to monitor its condition. During this time, the horse is cared for by veterinarians and nursing staff to ensure that it recovers well and that no complications arise. The exact length of hospitalization is determined on an individual basis and may vary depending on the case.

3. where can I find veterinary clinics in the event of colic?

In the event of colic, you should act quickly, know in advance which clinics are close to the stable and make a note of the emergency number.

You can find a list of clinics here: