What You Need to Know About Colic in Horses

Colic, or abdominal pain, comes in many forms, with a wide range of signs and ways to treat it. To provide some clarity for horse owners, Martha Mallicote, DVM, Dipl. ACVIM, clinical associate professor in the University of Florida’s Department of Large Animal Clinical Sciences, reviewed this common condition during the university’s 2020 Healthy Horses Conference.

“The equine gastrointestinal tract is complicated, and those complications lead to some of the types of colic we see in horses,” Mallicote said.

She divided those types into three main categories:

  1. Intestinal dysfunction, which occurs when the GI tract isn’t moving properly. These are the most common colics and include gas, spasmodic, and impaction colic. For the most part, said Mallicote, these respond well to medical therapy.
  2. Intestinal accidents, which include displacements, twists, and strangulations. Unfortunately, she said, there’s almost nothing you can do to prevent these colics from developing. Blood supply is often cut off, things are in the wrong place or twisted around each other, and they typically require surgery.
  3. Inflammatory disease, which includes stomach ulcers and small or large intestinal enterocolitis. The latter horses are often very sick and might have diarrhea, extreme dehydration, and shifts in white cells but don’t necessarily need surgery, just intensive medical care, said Mallicote. Ulcers are much less dangerous and respond well to treatment.

Colic’s Clinical Signs

Colic signs vary widely in type and severity. “The least severe might just be a horse that doesn’t finish its breakfast or has decreased manure output,” said Mallicote. “It might do lip curling, may be depressed, lay down more than normal. These are all pretty mild signs, but if it’s a change in behavior for your horse, it may be a sign of colic.”

More serious signs include pawing, stretching out, flank watching, teeth grinding, a bloated abdomen, kicking at the abdomen, rolling, or getting up and down repeatedly.

“When horses are so painful that they’re up and down and bumping around their environment, it’s often because they’re colicky,” she noted.

What Do You Do?

If you notice any of these signs or odd behaviors in your horse, get in touch with your veterinarian right away. You can discuss what’s going on and receive instructions on what to do—the vet might not even need to come out and evaluate your horse in person.

Collect and relay vital signs such as heart rate, mucous membrane color, and capillary refill time (the time it takes for the gums to return to pink after being pressed with a finger), which will provide your veterinarian with valuable information about the horse’s pain level, said Mallicote.

If your veterinarian deems the colic serious enough to warrant a farm call, he or she will perform an exam that might include:

  • Listening to gut sounds;
  • Investigating manure production;
  • Passing a nasogastric tube through the nose down into the stomach, which Mallicote said can help identify reflux and can even be life-saving if it allows the vet to drain a stomach full of fluid before it ruptures;
  • Rectal palpation to get an idea of what’s going on in the colon and elsewhere;
  • Ultrasound; and
  • Bloodwork.

“Once we evaluate the horse and have a shortlist of what we think might be going on, the treatment plans follow a few basic tenants,” including:

  • Pain management such as flunixin meglumine (Banamine);
  • Anti-spasmodic medications such as buscopan for gas/spasmodic colics;
  • Oral or intravenous fluid therapy;
  • Laxatives, electrolytes, or mineral oil; and
  • A feeding strategy.

Mallicote explained that pain and the veterinarian’s ability to control it are often the best means of gauging the severity of a horse’s colic.

“If they’re able to stay comfortable with just a little bit of pain medication, that’s great,” she said. “If I have to continue to administer it and they continue to show signs through that or remain painful after passing a nasogastric tube, that tells me this is more serious and may need surgery—I need to get this horse on the road if that’s an option for the owner.”

Heading to the Hospital

A subset of colic cases do require referral to an equine clinic, either for surgery or intensive medical treatment. As a horse owner, it’s important to think about this scenario before it happens, said Mallicote.

Ask yourself: What am I going to do if this horse gets sick? How am I going to get it to the hospital? What are the logistics going to look like? What are my limitations? Do I need insurance?

“Not everyone can go through colic surgery with their horse, so it’s good to make that decision ahead of time before you’re in an emotional and stressful situation and forced to make a decision you might be uncomfortable with later,” she said.

Mallicote reminded owners that not all referral cases need surgery. Some, such as those colics that fall under the inflammatory category, benefit from additional diagnostic testing, constant fluids and monitoring, and pain management that might be difficult or impossible to perform at home.

If your horse does go to surgery, she emphasized that outcomes are much better than they were decades ago. “Most performance horses can return to their prior job after about a three-month recovery,” she said. “The other good news is we used to think old horses don’t do well after colic surgery, but research shows age alone is not a risk factor when it comes to outcome.”

Avoiding the Issue

While some colics are going to happen no matter what you do, there are steps you can take to avoid the preventable types. Mallicote urged owners to:

  • Follow a feeding routine that includes offering meals at certain times of day and always providing free-choice forage access.
  • Offer high-quality feeds and forages.
  • Provide free access to water, and make sure your horse is drinking it, particularly at season changes. If you notice he’s not drinking enough, add salt or electrolytes to his feed to encourage hydration.
  • Work with your veterinarian to make sure your horse is healthy. This includes physical exams, vaccination, dental exams, and deworming based on fecal egg counts.
  • Beware of sand ingestion. Use a feeder and/or place rubber mats under feeders if your horse lives on sandy ground.

Following these steps will not only reduce your horse’s colic risks but also help keep him healthier as a whole.