Colic in horses: the signs, what to do, and why winter raises the risk

Colic is pain in a horse’s abdomen, and it is always a reason to ring your vet straight away, even if the signs look mild. Colic can get worse fast, and quiet signs do not mean a small problem. Phone first, then read on.

The British Horse Society calls colic the most common emergency and cause of death in horses worldwide, and Redwings puts it at around 10% of horses every year. Most owners will deal with it at some point.

What is colic in horses?

Colic is not one illness. It is a general word for pain in the belly, which can range from uncomfortable to life threatening. Most of it comes from the gut, but the BHS notes it can be caused by other organs too.

The BHS lists the main types:

• Spasmodic colic: one of the most common. Sharp bouts of pain that come and go, often with loud gut sounds.
• Gas colic: gas builds up and stretches the gut. Often linked to a change in management, such as new grass.
• Impaction colic: the gut becomes blocked. Droppings are often fewer or drier, and the pain is low grade and prolonged, with subtler signs.
• Sand colic: sand and dirt build up in the gut, sometimes visible in droppings.
• Displacement colic: a section of gut moves out of place, with signs anywhere from mild to severe.
• Strangulation colic, the “twisted gut”: blood supply to part of the gut is cut off. It is critical and will likely need surgery or euthanasia.

Gastric ulcers and inflammation of the gut can also cause colic signs. You cannot tell these apart from outside the horse. As Redwings puts it, only a vet can determine whether it is spasmodic colic, a twisted gut, an impaction or something else.

What are the signs of colic in a horse?

The BHS and the University of Nottingham run a campaign called REACT, and their REACT colic pocket guide groups the signs into five letters. Their advice for every group is the same: contact your vet.

Redwings adds tail swishing, loose droppings or diarrhoea, and tension in the face and body to that list.

The signs that catch people out are the quiet ones. The BHS says a horse’s behaviour may not reflect how much pain it is in, and some horses simply look quieter than normal. Redwings goes further: milder signs do not necessarily mean the underlying problem is less serious, and donkeys in particular can hide a very serious problem behind looking a little off colour.

That is why there is no “wait and see” row in the table.

How do you tell if a horse has colic?

By knowing what normal looks like for your horse, then noticing when it changes. The BHS suggests knowing your horse’s usual number and consistency of droppings per day, its normal behaviour, and its eating and drinking habits. Redwings recommends checking every horse carefully at least twice a day.

Temperature, pulse and respiration help too. The BHS says a pulse and breathing rate above your horse’s normal may suggest pain, which could be colic, while a raised temperature points more towards illness or infection and is less likely to be linked to early colic. Our guide to normal horse temperature, pulse and respiration covers how to take each reading and why a baseline taken on a good day matters.

Only take readings if it is safe. If it is not, wait for the vet.

What should you do if your horse has colic?

Ring your vet first. The BHS says to contact your vet straight away, and they will advise on what to do next. If they don’t know your yard, share a what3words or your live location, and make sure they have a number they can actually reach you on. Yard signal is not always reliable.

Then, while you wait, the current BHS guidance is:

• Keep yourself safe. Horses in pain behave unpredictably and may not notice you. Wear a hat, gloves and proper boots. If anything would put you at risk, don’t do it.
• Make the area safe. A stable, arena, field or shelter can all work. Take out water buckets, haynets and any equipment the horse could hurt itself on.
• Let it lie down or roll if it wants to. The BHS is clear this won’t make colic worse. Redwings says the same and now keeps horses with colic signs somewhere safe to lie down or roll while the vet is on the way.
• Walk gently only if it helps. Some horses are more comfortable walking, and a lunge line gives you more room. Don’t force a horse that is reluctant, and don’t walk for more than 30 minutes unless your vet has told you to.
• Get your emergency plan out. Think about money, insurance if you have it, and how you would get the horse to a hospital if needed.
• Keep watching, so you can tell the vet what changed and when.

What not to do

• Don’t walk a horse for hours to stop it rolling. That was the old advice. The BHS and Redwings both say rolling does not make colic worse.
• Don’t wait to see if it passes, even if the signs look mild.
• Don’t give anything from the medicine cupboard unless your vet tells you to. If someone already has, tell the vet exactly what and when.
• Don’t leave hay or feed in front of it. The BHS lists haynets among the things to remove.

What does the vet do when a horse has colic?

The BHS describes the usual steps:

• Questions about the horse and the signs you have seen.
• A clinical exam: heart and breathing rate, gum colour, hydration and gut sounds.
• A rectal exam to feel for problems such as a blockage.
• A tube through the nose into the stomach to release built up fluid, since horses can’t vomit. A nosebleed afterwards is not unusual and the vet will manage it.
• A belly tap, taking a fluid sample from the abdomen to test.
• Pain relief, muscle relaxants and fluids as needed.

The BHS says many colic cases can be managed medically at the yard, with more serious ones referred to hospital.

Can horses die from colic?

Yes, and it is the reason this post starts with “ring the vet”. The BHS describes colic as the most common emergency and cause of death in horses worldwide.

Many cases respond to treatment at the yard. Redwings cites the National Equine Health Survey as showing around one in seven colic cases need surgery. Of those that do, the BHS says colic surgery can be successful and many horses make a full recovery and return to the same level of work as before.

Surgery is not right for every horse or every owner. The BHS gives the average cost of colic surgery in 2023 as £8,690, with a range of £4,764 to £20,343, before the costs either side of the hospital stay. Recovery usually means several weeks of box rest and a gradual return to grazing and work. In critical cases where surgery isn’t an option, or the pain can’t be managed, euthanasia prevents further suffering.

This is why the BHS asks owners to fill in a free emergency care plan before anything happens: whether you would choose surgery, what you can afford, what your insurance covers, and how you would travel. With colic, the decision often has to be made fast, and it is far easier to make in October with a cup of tea than at midnight in a stable.

How long does colic last in a horse?

There is no standard answer, because colic is a sign with many causes. A spasmodic colic may settle soon after the vet has treated it. The BHS describes impaction as low grade pain that goes on for longer, and a twisted gut does not resolve without surgery.

I looked for a sourced figure for how long a typical colic lasts and did not find one I would stand behind. The practical answer is that your vet decides when it is over and tells you what to watch for afterwards, usually appetite, droppings and behaviour. If the signs come back after the vet has left, ring again.

Why do horses get colic in winter?

Winter does not cause colic on its own, but it brings several changes linked to it, often in the same few weeks.

• Less water. The BHS notes horses may drink less in colder weather and when water sources are frozen, and drinking enough keeps food moving through the gut. Our post on how much water a horse drinks covers how to check intake when the troughs start icing.
• More dry forage. As grass dies back, hay and haylage take over. The BHS associates impaction colic with a change to a drier diet, such as box rest with more dried forage. Our guide to how much hay a horse needs covers the amounts.
• More time in. The BHS says horses moved suddenly onto box rest are at increased risk. A 2019 systematic review of colic risk factors found the largest bodies of evidence for management change were changes in feed and a recent change in housing.
• A new batch of hay. The BHS counts a new supply of forage as a diet change, and recommends making any change to diet or routine gradually over at least 10 to 14 days.

How can you reduce the risk of colic?

Not every colic can be prevented. Redwings says it often happens without warning. But the BHS and Redwings agree on the basics:

• Forage first. A high fibre diet based on grass, hay or haylage, fed little and often.
• Change things slowly. New hay, new grazing, more or less turnout: spread it over at least 10 to 14 days. Mix the old batch of hay into the new one where you can.
• Clean water, always available, and keep an eye on how much goes down, especially in a freeze.
• Teeth checked every 6 to 12 months by a vet or a BAEDT registered equine dental technician, since poor chewing can lead to impaction.
• A worming plan based on testing, made with your vet.
• Share the routine. The BHS says horses with several people caring for them have a higher risk, so write it down if others help.

Where the technology fits

No app can tell you whether your horse has colic. Ring the vet. Stride has nothing that assesses colic, no emergency button, and no place to store your vet’s number, insurance details or an emergency care plan as a form. Keep the BHS plan on paper at the yard.

Where it helps is the record, before and after.

• Observations let you log signs of colic, off food, not drinking, loose droppings and sweating against the horse, each with an optional mild, moderate or marked severity and a short note. Several a day is fine. They are dated by day, not by time, so put the time in the note if it matters.
• Vet visits can be logged with a date, a type, a status and a note. There is no “colic” type, so a colic call goes in as other, or surgery if it came to that.
• Attachments: a vet visit or a note can carry photos or PDFs, so the discharge letter, the treatment plan or a photo of the vet’s notes stays with the visit.
• The health timeline shows observations, vet visits and notes together, newest first, which helps when the vet asks “has he coliced before?”.
• Reminders come in set kinds: vet, vaccination, worming, farrier, dental, bodywork and other. A dental or worming reminder covers two of the BHS prevention points. There is no reminder that is specifically about colic.

There is no field for droppings counts, no TPR field and no alert when something changes. It is a notebook that keeps the history in one place. The judgement is yours and your vet’s.

If you take one thing from this: this week, while your horse is well, download the BHS emergency care plan, fill it in, and pin it up in the tack room with your vet’s number on the front. Colic does not give you time to think, so do the thinking now.