Symptoms of Equine Colic

Equine colic is a serious and potentially life-threatening condition that affects horses of all ages and breeds. As a gastrointestinal disorder causing abdominal pain, colic requires prompt recognition and veterinary attention. This article provides a detailed overview of colic symptoms, types, diagnostic approaches, and when to seek emergency care.

Symptoms of Equine Colic Common in Horses

Colic horses exhibit a range of gastrointestinal, physiological, and behavioral signs that point to abdominal pain. Early detection of the symptoms is crucial for timely intervention and treatment.

Behavioral Changes

Colic is likely to cause noticeable changes in a horse’s behavior as a result of pain. The primary behavioral signs are:

• Restlessness and frequent posture changes – The horse paces, shifts weight, or stands and lies down repeatedly.
• Pawing at the ground – A common sign of pain, where the horse scrapes the ground with a front leg.
• Looking back at the flanks – The horse turns its head to look at its sides or belly.
• Flehmen response (curling the upper lip) – This response, typically expressed as a response to sickness or pain, is curling the lip upwards.
• Kicking or biting at the abdomen – The horse tries to alleviate pain by nipping at its belly or kicking backwards.
• Repetitive rising and lying down – Unlike many resting behaviors, a horse with colic will rise and lie down, then rise again, doing so several times.
• Earse rolling or thrashing – If the colic is severe, the horse will roll violently, sometimes resulting in intestinal torsion or other issues.

Physiological Signs

Colic interferes with the horse’s essential functions, causing visible physiological effects:

• Increased heart rate (tachycardia) – A normal resting heart rate is 28–44 bpm; colic can increase it to 60 bpm or higher.
• Increased or deep breathing (tachypnea) – Breathing may become shallow and fast due to pain.
• Sweating – The horse may sweat profusely, even in cold weather, due to stress and discomfort.
• Dry or sticky mucous membranes – Poor circulation or dehydration can cause gums to feel sticky instead of moist.
• Gum color changes – Pale, white, or dark purple gums indicate poor circulation or shock.
• Fever – While not always present, fever may be present if infection or inflammation exists.

Gastrointestinal Symptoms

Since colic is primarily a gastrointestinal disease, gastrointestinal signs are valuable leads:

• Reduced or absent gut sounds – Normally, horses have ongoing gurgling and rumbling; silence can be an indication of blockage or ileus.
• Reduced fecal output or diarrhea – Straining to defecate with little or no manure is suggestive of obstruction, while diarrhea can be seen in colitis.
• Straining to urinate or defecate – The horse will have a strained posture without elimination.
• Nasogastric reflux – Fluid can retreat through a nasogastric tube when the stomach does not empty, which is a sign of a significant blockage.
• Anorexia or refusal to feed – Horses in pain completely stop eating and will even reject favorite treats.

Its signs can vary in intensity depending on the severity and nature of colic. Early detection and the veterinarian are crucial to prevent potentially life-threatening complications.

Types of Colic and Their Specific Symptoms

Equine colic can manifest in several forms, each with distinct causes and clinical signs. Understanding the differences helps in early identification and correct treatment.

Stomach Distention (Gas Colic/Impaction Colic)

Stomach distention occurs when the horse’s stomach is overfilled with gas, fluid, or feed, resulting in painful expansion. This is an extremely dangerous condition because horses do not vomit, and gastric rupture is therefore a fatal possibility if not resolved.

Principal Symptoms:

• Severe, acute pain – The horse will be noted to be extremely uncomfortable, with severe pain developing rapidly.
• Severe rolling and thrashing violently – Unlike mild colic, the horse may throw itself to the ground violently, which increases gastric rupture risk.
• Profuse salivation and drooling – Due to nausea and pressure in the stomach, the horse may produce large amounts of saliva.
• Nasogastric reflux – On passing a tube, large volumes of fluid or feed may return, indicating an obstruction.
• Acute exacerbation – The horse, if untreated, may go into shock, which is manifest by pale gums, cool extremities, and a weak pulse.

Most Likely Causes:

• Excessive intake of grain or high-energy feed
• Acute access to fermentable carbohydrate (e.g., lush pasture, molasses)
• Inadequate water intake leading to dry feed impaction

Emergency Treatment Needed:

• Immediate veterinary treatment to decompress the stomach through a nasogastric tube.
• Pain relief and fluid therapy to stabilize the horse.
• Surgery can be required if imminent rupture.

Displacement Colic (Twisted Gut/Volvulus)

Displacement colic occurs when part of the intestine becomes trapped or twisted, cutting off blood supply and causing severe pain. It is a surgical emergency since ischemia (insufficient blood supply) for a prolonged duration leads to death of tissue.

Primary Symptoms:

• Intermittent, severe pain – The horse may alternate between agony and periods of relief that are temporary.
• Visible abdominal distension (bloating) – The abdomen may be swollen, especially on one side.
• Complete absence of gut sounds in affected areas – A silent abdomen indicates a non-functional bowel segment.
• Rapid heart rate (60+ bpm) – Tachycardia worsens as shock develops.
• Dark or purple gums – Indicative of impaired circulation and endotoxemia (toxins entering the bloodstream).

Common Causes:

• Gas accumulation causing intestinal buoyancy and migration
• Sudden rolling or trauma that displaces the intestines
• Adhesions from previous abdominal surgery

Emergency Action Indicated:

• Surgery is typically the only option – The twisted segment must be corrected as quickly as possible to prevent necrosis.
• Aggressive IV fluids and pain relief for stabilization before transport.
• Time is of the essence—delayed treatment significantly reduces the likelihood of survival.

Note: Both conditions are life-threatening and require immediate veterinary attention. Monitoring for development of clinical signs (e.g., persistent pain, rapid breathing, or collapse) is important for early identification.

Less Common Signs of Equine Colic

While the classical signs of colic are familiar to most horse owners, some horses exhibit less common or subtle signs that are easily overlooked. These unusual presentations are important to recognize because they may signal very serious underlying disorders.

Atypical Behavioral Signs

• Sudden loss of interest in nursing (in foals) – Foals with abdominal pain will abruptly stop nursing, leading to dehydration and hypoglycemia with rapid onset
• Sitting in a dog-like position – Some horses will sit on their haunches with front legs extended out in front, an abnormal stance that indicates intense discomfort
• Backing into stall corners – The horse will back into corners or press its hindquarters into walls in an attempt to relieve pressure
• Abnormal irritability or aggression – Normally calm horses become abruptly aggressive when approached or touched

Distressing Physical Presentations

• Complete refusal to stand – Certain horses become recumbent and resist all efforts to stand them up, often a sign of intense pain or systemic illness
• Neurological signs – Severely affected horses may display:
• Head pressing on objects
• Aimless circling
• Sudden blindness or disorientation
• Seizure-like activity

Subtle but Significant Signs

• Excessive yawning – May indicate nausea or abdominal pain
• Repeated flehmen response – More frequent than normal lip-curling activity
• Standing with legs camped out – Unusual stance to relieve abdominal pressure
• Lack of response to pain medication – If typical analgesics do not relieve symptoms, may be a surgical lesion

These unusual symptoms typically appear in combination with more typical colic signs but may precede or dominate the presentation in certain cases. They are particularly significant because:

• They may indicate specific types of colic (e.g., neurological signs with certain intestinal displacements)
• They may precede rapidly progressing cases that require immediate intervention
• They may be the only presenting signs in stoic or compromised horses

Veterinary attention should be sought whenever these atypical signs are noticed, especially if they fail to resolve or become more noticeable over time. Early recognition of these less common symptoms can be critical for successful treatment outcomes.

Factors Influencing Colic Symptoms

The presentation and severity of colic symptoms can vary significantly between individual horses due to multiple influencing factors. Understanding these variables helps in accurate assessment and targeted prevention strategies.

Age-Related Factors

Foals (0-6 months):

• Meconium impaction (first stool retention)
• Congenital intestinal abnormalities
• Milk curd obstructions
• Higher vulnerability to dehydration

Young Horses (1-5 years):

• Increased incidence of intestinal displacements
• Greater risk of intussusception (telescoping intestines)
• More frequent spasmodic colic episodes
• Higher activity level contributing to torsions

Mature Adults (5-15 years):

• Typical presentation of most colic types
• Sand colic in certain environments
• Gastric ulcer-related colic signs

Senior Horses (15+ years):

• Strangulating lipomas (fatty tumors)
• Reduced gut motility issues
• Dental-related digestion problems
• Higher incidence of large colon impactions

Breed-Specific Tendencies

Miniature Horses & Ponies:

• Greater risk of fecalith formation
• Small colon obstructions
• Higher incidence of enteroliths (intestinal stones)

Draft Breeds:

• Predisposition to large colon volvulus
• Cecal impactions
• Greater risk of postoperative ileus

Thoroughbreds & Warmbloods:

• More frequent spasmodic colic
• Higher incidence of gas colic
• Gastric ulcer-related symptoms

Arabian Horses:

• Increased risk of enteroliths
• Small intestinal strangulations

Environmental & Management Factors

Seasonal Influences:

• Summer: Increased dehydration risk
• Winter: Water freezing leading to reduced intake
• Pasture changes (spring/fall grass transitions)

Housing Conditions:

• Stabling >12 hours/day: Reduced gut motility
• Limited turnout: Increased stress behaviors
• Poor ventilation: Ammonia exposure affecting health

Dietary Considerations:

• Sudden feed changes
• High-concentrate/low-forage diets
• Moldy or poor quality hay
• Inadequate water access
• Sand ingestion in certain regions

Exercise & Activity:

• Sudden increases in work intensity
• Prolonged transportation
• Inconsistent exercise schedules

Health Management:

• Dental neglect leading to improper chewing
• Inadequate parasite control
• Previous abdominal surgeries
• Concurrent illnesses affecting digestion

These influencing factors often interact in complex ways, making each colic case unique in its presentation and requiring individualized assessment and treatment approaches. Recognizing these variables enables more accurate symptom interpretation and targeted preventive care.

When to Seek Veterinary Care

Immediate veterinary attention is required if a horse shows:

• Continuous pain for more than 30 minutes
• Violent rolling or thrashing
• Elevated heart rate (>60 bpm that persists)
• Absent gut sounds in multiple quadrants
• Signs of shock (pale gums, cold extremities)
• Nasogastric reflux
• No fecal output for >12 hours

Emergency Signs:

• Profuse sweating
• Rapid deterioration
• Abdominal distension
• Recumbency (inability to stand)
• Signs of endotoxemia

Prevention and Management

Understanding the varied symptoms of equine colic is crucial for horse owners and caretakers. Early recognition and prompt veterinary intervention can significantly improve outcomes for affected horses. Always err on the side of caution when colic is suspected, as the condition can progress rapidly from mild to life-threatening.