Signs of Colic in Horses: When to Call the Vet and What to Do

Understanding Colic: What It Is (and What It Isn’t)

Colic isn’t a single disease—it’s a symptom that means “abdominal pain.” In horses, abdominal pain can come from gas, intestinal spasms, sand irritation, impactions (blockages), ulcers, parasites, twisted gut, or even problems outside the gut (like bladder stones or reproductive issues). That’s why “colic” can range from “a little gassy and uncomfortable” to “life-threatening emergency.”

Here’s the tricky part: horses don’t vomit well, and their intestines are long, mobile, and prone to becoming blocked or displaced. So when you’re looking for signs of colic in horses, you’re really looking for pain behaviors + gut function changes—and deciding how urgent it is.

A good rule of thumb I teach barn friends: If your horse is acting “off” and you can’t explain it by obvious things (weather, hard work, trailer stress), treat it as potential colic until proven otherwise.

Signs of Colic in Horses: The Full Checklist (Mild to Severe)

Some colics are subtle—especially in stoic horses—so don’t rely on dramatic rolling as the only sign. Use this list like a quick scan from head to tail.

Early and Mild Signs (Often Missed)

These are common in mild gas colic or early impactions:

• •Reduced appetite (walks away from grain, picks at hay)
• •Slower eating or dropping feed
• •Quiet, “not quite right” demeanor (less interactive, stands away from herd)
• •Pawing lightly or shifting weight
• •Looking at the flank (turning head to check belly)
• •Stretching out like urinating (but not producing much)
• •Less manure than normal, smaller/drier balls
• •Change in drinking (drinks less, or suddenly gulps water)
• •Girthiness or sensitivity when brushing belly
• •Mild bloating (left side can look a bit fuller)

Moderate Signs (Pain Is Escalating)

These suggest the horse is struggling and may need veterinary help sooner:

• •Repeated pawing (more insistent)
• •Kicking at the belly
• •Lying down more than usual
• •Restlessness (up/down, can’t get comfortable)
• •Sweating without exercise
• •Increased respiratory rate (even standing still)
• •No gut sounds in one or more quadrants (if you know how to listen)
• •Little to no manure for 6–8 hours (depending on normal schedule)

Severe / Emergency Signs (Call Immediately)

These can indicate obstruction, displacement, twist, or severe pain that needs rapid intervention:

• •Violent rolling or thrashing
• •Repeatedly throwing themselves down
• •Inability to stay standing
• •Profuse sweating
• •High heart rate (often > 60 bpm at rest; more on this below)
• •Dark or brick-red gums, or gums that feel tacky/dry
• •Signs of shock: cold ears/legs, weakness, dullness
• •Distended abdomen (obvious bloating)
• •Persistent pain despite walking
• •Colic after recent surgery, foaling, or deworming (context matters)

Pro-tip: If your horse is showing intense pain, don’t “wait and see.” Horses can go from manageable to surgical colic fast—and time matters.

Real Barn Scenarios (So You Can Recognize Colic in the Wild)

Colic doesn’t always look like the textbook. Here are realistic situations I’ve seen (and how they typically play out):

Scenario 1: The Stoic Quarter Horse With “Just a Bad Attitude”

• •Breed example: Stock-type horses (Quarter Horses, Paints) can be stoic.
• •What you notice: He comes to the gate, but turns away from his grain. He stands with a slightly tucked-up belly and looks at his flank once.
• •What it often is: Early impaction (especially in winter) or mild gas.
• •What you do: Take vitals, pull feed, call vet if vitals are abnormal or manure is reduced.

Scenario 2: The Dramatic Arabian Who Keeps Lying Down

• •Breed example: Arabians can be expressive and sensitive.
• •What you notice: Lying down, getting up, pawing, pacing, nibbling hay then stopping.
• •What it often is: Gas/spasmodic colic, sometimes stress-related (weather change, trailer ride).
• •What you do: Walk, monitor heart rate, call vet if signs persist beyond 30–60 minutes or escalate.

Scenario 3: The Pony on Sandy Turnout With Dry Manure

• •Breed example: Ponies and easy keepers—especially those on sparse pastures.
• •What you notice: Off feed, mild belly discomfort, manure looks gritty/dry.
• •What it often is: Sand irritation/accumulation (can become serious).
• •What you do: Vet call is smart; long-term management may include psyllium and turnout changes.

Scenario 4: The Warmblood That Suddenly Looks Like a Drum

• •Breed example: Large-framed Warmbloods can hide pain until it’s significant.
• •What you notice: Distended abdomen, discomfort, decreased manure, higher respiratory rate.
• •What it often is: Can be gas, but distension + pain can also mean something more dangerous (displacement).
• •What you do: Treat as urgent; call the vet immediately.

When to Call the Vet: A Clear Decision Guide

If you’re unsure, call. Vets would much rather talk you through early colic than arrive to a horse in shock.

Call the Vet Immediately If Any of These Are True

• •Severe pain: rolling/thrashing, unable to stay up
• •Heart rate consistently elevated (especially > 60 bpm)
• •No manure and horse is painful
• •Distended abdomen
• •Signs of shock: cold extremities, dark gums, weakness
• •Colic in a foal, late-pregnant mare, or post-foaling mare
• •Pain returns repeatedly after seeming to improve
• •You gave a vet-prescribed colic med (like Banamine) and pain persists

Call the Vet Soon (Same Day) If:

• •Mild colic signs last more than 30–60 minutes
• •Reduced manure output persists
• •Horse has a history of impactions, ulcers, or previous colic episodes
• •You suspect sand, parasites, or recent feed change is involved
• •The horse is mildly painful but vitals are borderline (see next section)

“Monitor Closely” Only If:

• •Signs are mild and improving quickly
• •Vitals are normal
• •Horse passes manure and starts nibbling hay normally
• •You are able to watch continuously for several hours

Pro-tip: If you can’t monitor (overnight, you’re leaving the barn, no experienced help), treat it as more urgent. Colic can turn quickly.

What to Do Right Now: Step-by-Step First Aid (Before the Vet Arrives)

This is the practical, barn-ready plan. The goals are: keep the horse safe, gather useful info, and avoid making things worse.

Step 1: Make the Area Safe

1. Remove other horses if the colicky horse is in a herd situation.
2. Move to a safe, open area (stall, small paddock, arena).
3. Remove hazards: buckets, sharp edges, feeders they could bang into.
4. Put on gloves and have a halter and lead on.

If the horse is violently rolling and could injure themselves, a safe, well-bedded stall can be better than a hard aisle.

Step 2: Pull Feed (But Don’t Panic About Water)

• •Remove grain and hay until you speak with the vet (especially if impaction is suspected).
• •Water: In most cases, leave water available. If the horse is gulping water excessively and you suspect choke or your vet advises otherwise, follow that guidance—but don’t automatically restrict water.

Step 3: Take Vitals (This Helps the Vet Decide Urgency)

Write these down with time stamps:

• •Heart rate (pulse):
• •Normal adult resting: ~ 28–44 bpm
• •Concerning: > 50
• •Urgent/emergency: > 60
• •Respiratory rate: Normal ~ 8–16 breaths/min
• •Temperature: Normal ~ 99–101.5°F (37.2–38.6°C)
• •Gum color & capillary refill time (CRT):
• •Normal gums: pink, moist; CRT < 2 seconds
• •Concerning: dark red/pale, tacky; CRT > 2 seconds
• •Gut sounds: If you know how, listen on both sides. Silence can be concerning, but “loud” doesn’t always mean safe (gas can be loud).

Step 4: Call Your Vet With a Tight, Useful Report

Use this format (it saves time and gets you better instructions):

• •“My horse is showing signs of colic in horses: [pawing/rolling/off feed/etc.]”
• •“Pain level: mild/moderate/severe”
• •“Vitals: HR __, RR __, temp __, gums/CRT __”
• •“Manure: last manure __; amount/consistency __”
• •“Feed changes, deworming, travel, weather shift, turnout changes”
• •“Any history: previous colic, ulcers, sand, dental issues”

Step 5: Controlled Walking (Only If It Helps)

Walking can help mild gas discomfort and prevents some horses from repeatedly rolling.

• •Walk 10–15 minutes, then reassess.
• •Don’t exhaust the horse.
• •If the horse is calm and wants to rest quietly, that can be okay—constant forced walking is not automatically better.

Step 6: Do NOT Give Meds Unless Directed

Common mistake: giving pain meds too early can mask severity and delay needed treatment.

• •Do not give Banamine (flunixin) unless your vet instructs you to.
• •Never combine NSAIDs (Banamine + phenylbutazone).
• •Avoid oral paste meds if the horse might have swallowing issues.

Pro-tip: If your vet tells you to give Banamine, ask whether to give it IV only (many vets prefer this). Oral Banamine can be slower and can irritate the gut; IM injections have risks too.

Step 7: Prepare for the Vet Visit

• •Have a clean, well-lit area
• •Locate your thermometer, stethoscope, and watch
• •Keep the horse dry and safe (sweating horses can chill in winter)
• •Be ready for possible nasogastric tubing or rectal exam

Common Mistakes That Make Colic Worse (and How to Avoid Them)

These are the barn habits that accidentally turn “manageable” into “messy.”

Mistake 1: Waiting Too Long Because “He Always Does This”

A horse that “always” paws after meals may be telling you something—ulcers, feeding schedule issues, or mild recurrent gas. But any episode can still become severe. Treat each episode seriously until proven otherwise.

Mistake 2: Feeding “To Settle the Stomach”

People sometimes offer hay or grain thinking it will settle them. If there’s an impaction or displacement, adding feed can worsen it. Pull feed until you’ve spoken with the vet.

Mistake 3: Over-walking a Horse Into Exhaustion

Walking is a tool, not a cure. Exhaustion increases stress and can worsen dehydration.

Mistake 4: Giving Meds and Then Turning the Horse Out

Pain relief can make a horse look “fine” while the underlying problem continues. If you give meds, you need closer monitoring, not less.

Mistake 5: Ignoring Manure Patterns

Manure is your best low-tech data stream. Note:

• •When they last passed manure
• •Quantity (normal vs small)
• •Moisture (dry/hard suggests dehydration/impaction risk)
• •Sand or grit

Product Recommendations (Practical, Barn-Friendly)

These aren’t “magic cures,” but they can meaningfully improve prevention and preparedness.

Must-Have Colic Monitoring Kit

• •Digital thermometer (fast-read)
• •Stethoscope (basic is fine)
• •Watch/timer (for heart rate and breathing)
• •Notebook or phone notes template for vitals
• •Flashlight/headlamp (night checks)
• •Electrolytes (use only appropriately; consult vet for dehydration concerns)

Hydration and Feeding Support Tools

• •Heated water buckets (winter impactions are common when horses drink less)
• •Slow feeder hay nets to reduce binge eating and support steady gut movement
• •Soaking tubs for soaked hay cubes/pellets (excellent for horses prone to impactions)
• •Salt access (plain loose salt often encourages better intake than a hard block for some horses)

Sand Risk Management (Especially for Dry Lots)

• •Psyllium (as recommended by your vet)
• •Comparison: Pelleted psyllium is often easier to feed than loose powder.
• •Important: Psyllium is a management tool, not an emergency fix for acute sand colic.
• •Rubber mats under hay feeders or feeding hay in tubs to reduce sand ingestion

Pro-tip: If you suspect sand, a simple “manure in a plastic bag with water” swirl test can show grit settling at the bottom—but a vet exam (and sometimes imaging) is the real decider.

Vet Treatment: What They Might Do (So You’re Not Surprised)

Knowing what’s coming helps you stay calm and make faster decisions.

Common On-Farm Treatments

• •Pain control (often flunixin)
• •Sedation to safely examine and reduce stress
• •Nasogastric tube (“stomach tube”) to check for reflux and give fluids/mineral oil
• •Oral fluids and sometimes IV fluids depending on dehydration
• •Rectal exam (key for detecting impactions, distended intestines)
• •Ultrasound in some cases
• •Fecal testing or parasite-related evaluation

When Referral or Surgery Is on the Table

Your vet may recommend hauling to an equine hospital if:

• •Pain is severe or returns quickly after meds
• •Heart rate stays high
• •Significant reflux is found
• •Displacement/torsion is suspected
• •The horse worsens despite treatment

If you’re near an equine hospital, ask your vet early: “Do you think we should plan for referral now?” It’s easier to turn around than to scramble later.

Prevention: Reduce Colic Risk Without Overcomplicating It

Colic can’t always be prevented, but many cases are connected to predictable management factors.

Feed Management That Protects the Gut

• •Prioritize forage: steady hay access supports gut motility
• •Avoid sudden diet changes; transition over 7–14 days
• •Break up grain into smaller meals (or reduce it if possible)
• •For horses prone to impactions: consider adding soaked hay pellets/cubes for hydration

Water Intake: The Most Underrated Prevention Tool

• •Keep water clean and palatable
• •In winter: warm water and heated buckets increase drinking
• •Some horses drink more with loose salt added to feed (only if appropriate for that horse)

Parasite Control (Targeted, Not Random)

Work with your vet on a strategic deworming plan based on fecal egg counts. Random deworming can miss the mark, and heavy parasite burdens can contribute to colic risk.

Dental Care

Poor chewing increases impaction risk. Make sure routine dentistry is kept up—especially in older horses.

Stress and Routine

Horses are routine animals. Big triggers:

• •Trailering
• •Show weekends
• •Turnout schedule changes
• •New herd dynamics
• •Stall rest

For horses that colic after stress, plan ahead: more turnout (if safe), consistent forage, and hydration support.

Extra Watchouts by Horse Type (Breed/Build/Stage of Life)

Different horses tend to show colic differently, and some are at higher risk for certain types.

Ponies and Easy Keepers

• •Higher risk of sand intake in dry lots
• •Some are “quiet colickers” who just go off feed

Thoroughbreds and Performance Horses

• •Higher ulcer risk
• •Colic signs can be subtle: girthiness, picky appetite, intermittent discomfort

Miniatures

• •Can deteriorate quickly; treat colic signs as more urgent
• •Watch closely for fecal output changes

Seniors

• •Dental issues and reduced water intake increase impaction risk
• •Manure changes (dry/small) are often the first clue

Broodmares (Late Pregnancy and Post-Foaling)

• •Any colic signs deserve fast vet involvement; there are reproductive emergencies that can mimic colic.

Quick Reference: What to Do in the First 10 Minutes

If you want a simple script to follow:

1. Halter the horse and move to a safe space.
2. Pull feed (leave water unless vet says otherwise).
3. Take vitals: HR, RR, temp, gums/CRT; note manure.
4. Call the vet and give the data.
5. Walk calmly if the horse is restless; don’t exhaust them.
6. Monitor continuously until the vet arrives or symptoms fully resolve.

Pro-tip: Keep a “colic card” in the tack room with your vet’s number, nearest equine hospital, and a vitals checklist. In an emergency, memory gets unreliable.

Final Thoughts: Trust Patterns, But Respect the Outliers

Learning the signs of colic in horses is really learning your horse’s normal—and taking deviations seriously. Some horses scream their discomfort; others whisper it. The best colic outcomes usually come from the same formula: early detection, good vitals data, and a fast call when things don’t add up.

If you want, tell me your horse’s age, breed, typical diet/turnout, and the specific signs you’re seeing—I can help you decide what information to gather and what questions to ask your vet.