A Rupture of the stomach is relatively rare. Primary rupture is usually caused by impaction of the stomach with feed material or, more commonly, by dilation of the stomach with gas or contents from the small intestine. The latter is often secondary to various types of intestinal obstruction. Signs of really intense abdominal pain or "colic" should be an alert that the stomach might be distended. By the time it nears the point of rupture, the pain will be unrelenting, with the horse often violently throwing himself around. Sudden relief from pain might indicate that rupture has occurred. This pain is not usually relieved by medications such as xylazine, and the dilation can be confirmed and often relieved by passing a nasogastric ("stomach") tube into the stomach through the nostrils and draining fluid through it.

It’s hard to guess the time frame between onset of symptoms and rupture, because some horses are more tolerant of pain than others. The best approach is to treat all serious colic pain as an emergency, because distension of the bowel is just as dangerous! Acute cases will develop rapidly, and once the stomach ruptures, there is little that can be done other than surgical repair, which is very difficult and must be accomplished immediately after the rupture occurs for any chance of success (i.e., the horse must already be at an equine hospital and ready for surgery).

Feeding horses to minimize the incidence of colic will likewise reduce the chances of stomach rupture. Feeding good-quality roughage, feeding only the amount of concentrates dictated by the energy demand, and above all feeding on a schedule with roughage feeding spread out when possible will help