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Colic in horses

Colic is used to describe clinical signs of abdominal pain or discomfort in the horse; hence colic is technically a symptom rather than being a disease

  • Last reviewed: 3rd October 2023
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Colic is the most common equine emergency and cause of death in horses worldwide. The different types of colic come under six broad categories; Spasmodic, Tympanic (flatulent or gas colic), Impaction, Sand colic, Displacements, and Strangulations.

The information below discusses the wide range of issues related to colic and has been produced from the evidence, recommendations and involvement of veterinary surgeons, horse owners and original research conducted by The University of Nottingham.


Horse owners, or the main person responsible for the care of horses, play a vital role in recognising the early signs of colic. Colic cases can quickly deteriorate so early recognition and prompt veterinary attention is vital to increase the chance of recovery for the horse.

The five REACT signs are the most common and important indicators of colic. The signs include:

Restless or agitated 
  • Attempts to lie down  
  • Repeatedly rolling 
  • Unexplained sweating  
  • Box-walking or circling  
Eating less or droppings reduced
  • Eating less or nothing at all  
  • Passing fewer or no droppings  
  • Changes in consistency of droppings  
Abdominal Pain 
  • Flank watching  
  • Pawing  
  • Kicking at belly  
Clinical Changes 
  • Increased heart rate  
  • Reduced or absent gut sounds 
  • Changes in colour of gums (healthy gums should be a salmon pink colour)  
  • Rapid breathing rate 
  • 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 
  • Lowered head position 
  • Dull and depressed 

Reducing the risk of colic

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

Knowing 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.

What will my vet do if my horse has colic?

Your vet will go through a series of steps when they examine your horse to help rule out more serious problems and attempt to establish the most likely reasons your horse is showing signs of pain.

Rectal examination

Rectal examination is the test that vets use most often to help them find the cause of colic. Rectal examination involves the vet placing their hand and arm into the horse’s rectum so that they can feel inside the abdomen. This enables them to identify anything that feels abnormal or out of place, and in many cases, it is an important part of deciding what next steps and treatments are required.

Nasogastric intubation

Nasogastric intubation, more commonly known as stomach tubing, involves passing a hollow tube up the horse’s nose, down the oesophagus (gullet) into the horse’s stomach. It is used by a vet to identify if there are any abnormal contents in the horse’s stomach, and to administer fluids and some treatments directly into the stomach. It is the second most used test to help diagnose horses with colic.

What happens at a referral?

Referral to an equine hospital for a horse or pony suffering from colic may be considered for a number of different reasons, including:

  • The need to undertake more detailed clinical evaluation that may not be possible at home
  • Provide constant observation
  • Referral for possible surgery
  • Be able to provide intensive medical treatment e.g. intravenous fluid therapy or repeated administration of fluids by nasogastric tube 

Emergency decision making

Time is of the essence when a horse has colic, especially if the case is severe and referral to a veterinary hospital is required. Any delay could potentially affect the outcome for the horse. It can be helpful to prepare an emergency care plan in advance to avoid making rushed decisions.


The British Horse Society and The University of Nottingham thank all those involved with the production of the colic information. The leaflets have been written and reviewed by: 

  • Professor Sarah Freeman, Dr John Burford, Dr Adelle Bowden and Professor Gary England School of Veterinary Medicine and Science, The University of Nottingham 
  • Professor Tim Mair – Bell Equine Clinic 
  • Professor Debbie Archer – University of Liverpool 
  • The British Horse Society Horse Care & Welfare Team

Get in touch – we’re here to help 

The Horse Care and Welfare Team are here to help and can offer you further advice with any questions you may have. Contact us on 02476 840517* or email – You can also get in touch with us via our social media channels. 

Opening times are 8:35am - 5pm from Monday – Thursday and 8:35am - 3pm on Friday. 

*Calls may be recorded for monitoring purposes.