Colic in Horses | The #1 Threat

If you own a horse, you understand the all-consuming nature of that responsibility. It’s a big emotional and financial investment, but you’re willing to put your whole heart (and bank account) into it anyway. After all, horses aren’t just pets—they’re partners. So, if you were asked what keeps you up at night worrying, it’s safe to say colic would be at the top of your list.


Colic is a fairly generic term that refers to abdominal pain. Colic in horses is most often related to the colon and can occur for many reasons. But at the core of it is equine physiology. Along with rats and rabbits (random, right?), horses can’t vomit. It’s physically impossible. This causes a lot of troubles for horses when other animals would simply throw up to dispel toxins or excess food.

A July 2019 article by Equus Magazine explains it best: “The muscles of the equine lower esophageal sphincter are much stronger than in other animals, making it nearly impossible to open that valve under backward pressure from the stomach. Also, the equine esophagus joins the stomach at a much lower angle than in many animals, so when the stomach is distended, as with gas, it presses against the valve in such a way that holds it even more tightly closed. And, located deep within the rib cage, the equine stomach cannot be readily squeezed by the abdominal muscles. Finally, horses have a weak vomiting reflex. In other words, the neural pathways that control that activity in other animals are poorly developed in horses, if they exist at all.”

So, for horses there is a point of no return when it comes to the digestive tract.

The equine digestive system


While there are many types of colic, there are essentially two categories: the kind that have a known root cause (non-idiopathic) and the kind that don’t (idiopathic). Idiopathic forms of colic—like gas and impaction—make up more than 80% of cases. However, they are usually less severe than other colic types.


Gas colic is extremely common and usually not life threatening. It’s important to note that all colics are associated with some kind of gas build-up. But generally speaking, gas colic in horses is caused by excess fluid or gas due to over-fermentation of food in the hindgut. The resulting pressure and inflammation causes discomfort. 

To treat a gas colic, the veterinarian will most often insert a stomach tube through the horse’s nasal passage to relieve the pressure. But sometimes simply hand walking or trotting on the longe line will do the trick.


This type of colic is very serious. Usually caused by tapeworms and other parasites, intussusception, according to VetFolio, is when “a portion of bowel telescopes into a more distal section.”

This means that part of the bowel essentially folds into itself, and can cut off blood supply. Although ultrasonography can sometimes help vets in diagnosing intussusception, the sensitivity of this diagnostic test is low. Ultimately, if caught and treated early, horses can survive it, but all treatments involve surgical intervention.


Perhaps the most severe form of colic is strangulation of the large colon. Colloquially referred to as a “twisted gut,” torsion is one of the most painful forms of colic in horses.

The large colon can twist up to 180 degrees without issue. But if this large, U-shaped organ twists more than 270 degrees, it cuts off its own blood supply and effectively floods the horse’s system with toxins.

It accounts for more than 15% of colic surgeries and despite swift intervention to untwist the colon, it is often still fatal.


Impaction is a cumulation of sand, dirt, or other indigestible materials in the horse’s colon. As horses naturally eat from the ground (or at least they should), they tend to ingest a bit of dirt or sand along the way.

As you can imagine, this is difficult to pass and causes pain in the process. While impaction is relatively common and usually treatable on site, severe cases can quickly become surgical.


Gastric rupture is pretty rare. It can occur when an impaction reaches the horse’s stomach or gas build-up causes the stomach to dilate.

Cases of acute idiopathic dilatation make up 16–60% of gastric rupture cases. And although there are medical and surgical interventions for gastric dilation, gastric rupture contaminates the abdominal cavity with toxins and therefore is most often fatal.


Colic is the leading medical cause of death in horses—affecting approximately 10% of the population. In the United States alone, that means colic will affect more than 920,000 horses each year. It’s so common that most horse owners have encountered it at some point, and those who haven’t live in fear of what feels like the inevitable. Another factor that makes colic so concerning is that it tends to happen overnight, when nobody is around. Many barns implement night checks, but they typically only occur once in the late evening. This leaves a lot of unsupervised time. But despite this risk, knowing the early signs can go a long way in keeping your horse out of the operating room.

It’s important to note that the role of any conscientious horse owner or caretaker is to understand a horse’s normal state. In other words, is your horse a slow or picky eater? Does he poop more while being ridden than in his stall? Is he a bit lazy by nature? Knowing your horse’s normal state for both physical and clinical patterns is key in recognizing signs of colic.

But as well-intentioned as most horse owners are, there is still a lack of education around colic. According to a study conducted by The University of Nottingham, a staggering 90% of horse owners don’t feel confident spotting early signs of colic. This data was concerning, especially paired with the findings that one in ten colic cases are critical and 80% of critical cases result in death.

So, to help remind horse owners of the signs and combat the occurrence of colic, the University of Nottingham teamed up with The British Horse Society to create the REACT Now to Beat Colic campaign. REACT stands for:

R   Restless or agitated
E   Eating less or droppings reduced
A  Abdominal pain
C  Clinical changes
T  Tired or lethargic


As “abdominal pain” is the core meaning of colic, it’s important to understand specifically what those signs are. This can give you helpful information to relay to your vet. The main physical signs of abdominal pain are pawing, holding a strained stretch with the head low and ears back, rolling, thrashing, frequently getting up and down, excessive and unexplained sweating, and kicking or looking at the belly or flank.


While there are a host of things you can do to help prevent colic from occurring in the first place, there are no sure-fire guarantees that these preventative measures will work. According to an article by the American Association of Equine Practitioners, “the objective of a conscientious horse owner is to find ways to prevent colic […] while also understanding how to appropriately manage colic if it does occur.”

So, the best way to help your horse is to be prepared for the worst. First, know the signs! Also, educate yourself on what to do and what not to do while you wait for the vet to arrive. The first and most important thing to do if you suspect colic is to call your vet immediately. But before or while calling, you can quickly gather a lot of information that will help expedite your vet’s diagnosis and treatment.


In an informative article by equine healthcare magazine The Horse, they listed 33 colic do’s and don’ts for everything from preventative measures to post-surgical care. The first thing on the list is to check your horse’s vital signs. Checking your horse’s heart rate and temperature will help your vet determine the next steps.

In addition, it warns against giving any medication without first consulting the vet, as pain meds like Banamine can mask clinical signs and delay an accurate diagnosis. Other important things to note are the presence (or lack) of manure in the stall, your horse’s behavior, and the presence of absence of gut sounds.


You can also take action while you wait for the vet to arrive. This includes removing access to food, limiting access to water, and walking the horse if he wants to lay down and roll. Your vet will give you specific instructions based on the information you provide, so be thorough! 

Ultimately, taking the steps to ensure a healthy and active lifestyle for your horse are keys to helping prevent colic, but swift action in an emergency is the best preparation for any horse owner.

If you’re a horse owner, trainer or caretaker, you live with the upsetting reality that colic could strike at any time. Piavita has harnessed the power of artificial intelligence and machine learning to bring smart monitoring to equine healthcare. This means that your vet can start leveraging data today to better care for your horse tomorrow.

At Piavita, we like happy vets and healthy horses. It’s that simple. Our mission it to transform veterinary care by providing remote health monitoring technology to the veterinary industry. With a non-invasive, sensor-enabled hardware device and sophisticated software platform, the Piavet Solution automates and digitizes repetitive, manual tasks to help vets save time and improve patient outcomes. We are a diverse group of engineers, developers, researchers, and horse people with a passion for delivering meaningful solutions to veterinarians. We operate out of offices in Zürich, Berlin, and North Carolina. 

Have a question or suggestion? We’d love to hear from you.

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