Horse Side Vet Guide ®

Equine Health Resource

Abdominal Pain, Colic Exam



“Colic” (abdominal pain) is not a diagnosis, it is a sign of an underlying problem. The colic exam is a specialized physical exam that focuses on specific body systems, and takes into account the horse’s age, breed, sex (signalment) and history. Common CONDITIONS CAUSING COLIC (CCC’s) affect horses of different signalments. 

The goal of the colic exam is to reach a diagnosis, i.e. determine what is causing a horse to colic, so that the proper course of treatment can be chosen. Depending on the diagnosis, treatment may be simple (pain-relief and monitoring) or more aggressive (hospitalization and/or surgery).  A diagnosis is critical to determining the best treatment(s).  

The amount of information gathered during a colic exam depends on the vet’s knowledge and experience and the horse’s pain level. The exam takes into account the complex anatomy and function of the 30 meter (100 feet) long equine gastrointestinal tract. The goal is to determine which anatomic region(s) are affected, and how.

Horses that are violently painful are difficult to assess properly without sedation. However, sedation completely changes the horse’s physical exam findings, making it harder to identify the cause of the colic. Due to this, when possible, vets often perform a physical exam prior to medicating the horse.


Your vet will ask you about how you feed and manage your horse, and ask about factors that might have recently changed. This information often provides valuable clues that suggest the existence of particular CCC’s.  Horses suffering from particular CCC’s experience particular changes in their physical exam parameters.


More severely affected horses have elevated heart rates and poor blood pressure reflected as weak pulse, abnormal appearing gums and prolonged capillary refill times. The severity of these changes often, but not always, parallel the severity of the CCC.


Horses usually have decreased intestinal sounds (sometimes increased), may be bloated, and may or may not be producing manure. 

Horse owners are often optimistic when they see their colicy horse produce a pile or two of manure, hoping it is a sign that the CCC is resolving.  While it is important to share this information with your vet, it is only one of many things your vet considers while performing a colic exam.


The horse’s degree and duration of pain as well as their response to initial treatment are important factors. Hospitalization is more likely for horses that do not respond to pain management, or go back to showing signs of abdominal pain too quickly after being medicated.

Vets often use their findings from a basic colic exam in conjunction with other diagnostics (passage of a nasogastric tube, rectal exam, etc…) to reach a diagnosis and recommend treatment.  

Reasons to UseRelated Observations

Lying Down More Than Normal, or Getting Up & Down
Abdominal Pain, Colic Signs
Stretching Body Out, Front Limbs Forward, Hind Limbs Back
Recurrent Colic Episodes without a Diagnosis
Looking at Side, Flank or Belly
Severe Colic Pain, Now Horse is Calm
Fever, Rectal Temperature Greater than 101.5 (in Adult)
Kicks at Belly or Abdomen
Rolling (in Adult)
Not Eating, Loss of Appetite, Not Hungry
Stretching, Dropping Penis, Trying to Urinate
Teeth Grinding (in Adult)
Lip Curl, Flehmen Response
Mare in Abdominal Pain (Colic), Soon after Foaling
Backs into Corner of Stall
Down with Limbs Tipped Up, Cast
Pregnant Mare Showing Colic Signs
Membranes of Mouth, Gums appear Dark
Gums have Dark Red Line above Teeth
Membranes of Mouth, Gums appear Red
Membranes of Mouth, Gums appear Pale
Pulse Feels Weak
Biting at Side or Body
Bloated Belly, Distended Abdomen
Abdomen or Belly is Rumbling Loudly
Manure has Visible Sand in It
Foal or Newborn, Grinding Teeth or Curling Lip
Compulsive, Forceful Walking, Driving Forward when Led
Intestinal, Gut Sounds with Stethoscope Less Than Normal
Membranes of Mouth, Gums appear Brown
Dog-Sitting, Sitting on Hindquarters, Forequarters Raised
Mare Squatting, Urinating Small Amounts
Abdomen or Belly seems Rigid, Painful to Pressure
Circling, Pacing or Weaving in Stall
Burping or Belching
Grunting or Groaning when Breathing
Membranes of Mouth, Gums appear Blue or Purple
Urination, Straining or Difficulty
Sudden Collapse or Apparent Loss of Consciousness
Stretching Forelimbs Far Forward & Dipping Back


A rapid and thorough colic exam provides important information that guides the plan going forward - including further diagnostics needed and the choice of symptomatic treatments.


Limitations include our inability to see inside (image or palpate) the very large horse abdomen.

The findings that result from a colic exam often suggest the existence of certain conditions that cause colic, but do not prove their existence. Additional diagnostics may be helpful to confirm a diagnosis.

Helpful Outside ResourcesCredible Equine Health Information on the Internet


  • Are you going to perform a rectal exam on my horse?
  • Since the exam has not yielded a diagnosis and my horse is still in pain, what other diagnostics can you perform in the field?
  • Since my horse is experiencing ongoing pain with no diagnosis, should my horse be hospitalized?
  • Author: Doug Thal DVM Dipl. ABVP


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