Horse Side Vet Guide ®

Equine Health Resource

Abdominal Pain, Colic Signs

Code Red - Call Your Vet Immediately, Even Outside Business Hours

Code Yellow - Contact Your Vet at Your Convenience for an Appointment

Code Red - Call Your Vet Immediately, Even Outside Business Hours

  • When you first notice signs of colic.
  • If a horse has had flunixin (Banamine) and has not returned to normal attitude and appetite.

Code Yellow - Contact Your Vet at Your Convenience for an Appointment

  • To learn how to minimize the likelihood of the problem in your horses.
  • Once the problem is resolved it is still wise to evaluate the horse's general health and management to ensure there is no underlying problem.

“Colic” is a general term for a horse’s demonstration of abdominal pain. It is a common emergency, and can result from simple gas accumulation or gut spasm (70% of the time), or from more serious problems involving any part of the equine intestine. Occasionally a horse can show colic signs when body systems other than the intestines are involved. Examples are a bladder stone or muscle pain from “tying up”.

Signs of colic include the listed related observations. Any or all of these signs can range from mild to severe, but severity of any signs do not always correlate to the severity of the problem. Horses may show one sign, or many.

Donkeys in mild colic pain tend not to be as expressive of abdominal pain as horses and may show more subtle signs of depression such as head hanging, eyes closed, standing in corner, off feed.


Your horse is showing signs of colic pain. If it seems safe to do so, assess their general health using the Whole Horse Exam (WHE) paying particular attention to their attitude, heart rate, mucous membrane appearance, capillary refill time, and gut sounds. Share these findings with your vet when you call them.

Depending on the circumstances, your vet may advise you to treat and monitor your horse yourself or suggest that they examine the horse. If your vet advises you to treat your horse with pain medication, always remove feed and prevent access to feed.

Medications like flunixin meglumine (Banamine®) may mask the signs of colic pain regardless of whether the condition causing the pain is really resolved. This may cause the horse to become hungry again and eat (or want to eat) when they should not.

If your vet advises you to treat the horse yourself, also talk to them about the subtle signs to watch for that might indicate an ongoing problem despite medication, and when to begin feeding the horse again.


Your vet uses a history, physical examination and basic diagnostics to try to categorize the condition causing the colic pain as either simple and responsive to field treatment, or requiring hospitalization and more aggressive therapy. They treat the horse symptomatically as they are examining it.

Ultimately, your vet’s goal is to quickly differentiate between horses that require surgery from horses that will respond to medical therapy.

What Not To Do

Do not handle a colicy horse if you are not confident you can do it safely.

Do not give your horse any medication (including Banamine®) without first consulting your vet because you may mask signs of illness and delay treatment. Do not give your horse a dose of Banamine®, assume that it has "fixed" the problem, and go to bed. Do not give your horse several doses of Banamine® without veterinary guidance. Additional doses of medication do not necessarily improve pain relief and can cause fatal side effects.

Do not assume that the problem has resolved because your horse has passed manure.

Do not give "colic remedies" or any other treatments or medications without first talking to your vet. Substances containing belladonna paralyze the gut, which can be harmful. These products can help temporarily though, and since 70% of episodes are simple and will resolve on their own without such medications, most horses get better.

Do not insert anything up the rectum or give your horse an enema. The rectum is very fragile and can be torn, a potentially fatal injury.

While walking a horse can be helpful, exercising a horse to exhaustion can worsen the situation and increase stress to the horse.

Do not try to pass a naso-gastric tube yourself.

Do not assume that "colic" is always a simple problem that is simply resolved.


Lying Down More Than Normal, or Getting Up & Down
Not Eating, Loss of Appetite, Not Hungry
Looking at Side, Flank or Belly
Agitated, Anxious, Nervous or Stressed
Lip Curl, Flehmen Response
Heart Rate, Pulse Rapid, Greater than 48 BPM at Rest (in Adult)
Compulsive, Forceful Walking, Driving Forward when Led
Stretching Body Out, Front Limbs Forward, Hind Limbs Back
Depressed, Dull, Sick or Lethargic
Rolling (in Adult)
Kicks at Belly or Abdomen
Appears Dehydrated
Bloated Belly, Distended Abdomen
Membranes of Mouth, Gums appear Dark
Membranes of Mouth, Gums appear Pale
Rapid Breathing, Flaring Nostrils at Rest (Not after Exercise)
Buckling, Crouching Behind
Backs into Corner of Stall
Fever, Rectal Temperature Greater than 101.5 (in Adult)
Shivering, Muscle Trembling All Over
Sweating Excessively
Manure, Not Passing Enough
Shock, Ears & Limbs Seem Cold, Pulse is Weak & Rapid
Recurrent Colic Episodes without a Diagnosis
Pregnant Mare Showing Colic Signs
Teeth Grinding (in Adult)
Heart Murmur Heard with Stethoscope (in Adult)
Skin Pinch or Tent at Shoulder Prolonged
Manure is Hard or Dry
Membranes of Mouth, Gums are Dry or Tacky
Mare in Abdominal Pain (Colic), Soon after Foaling
Severe Colic Pain, Now Horse is Calm
Membranes of Mouth, Gums appear Blue or Purple
Biting at Side or Body
Blister Beetle in Hay, Horse May have Eaten Some
Weather Change, Snow, Rain, Lightning, Thunder
Recurrent Colic Episodes without a Diagnosis
Abrasion or Scrape, Anywhere on Body
Abrasion or Scrape on Head or Face
Dog-Sitting, Sitting on Hindquarters, Forequarters Raised
Gums have Dark Red Line above Teeth
Urine appears Dark Yellow
Foal or Newborn, Belly seems Bloated
Abdomen or Belly is Rumbling Loudly
Mare Not Eating or Depressed, Soon after Foaling
Pulse Feels Weak
Manure is Watery, Diarrhea (in Adult)
Manure is Soft But Not Liquid, "Cow Pie" or Watery (in Adult)
Pulse or Heart Beat Irregular, Arrhythmia
Foal or Newborn, Abdominal Pain (Colic)
Ate Moldy Hay or Feed, Witnessed
Eye, Sunken Area behind & above Eyes
Foal or Newborn, Belly seems Bloated
Swishing Tail Excessively
Newborn Foal, Up & Down or Rolling
Eye looks Blood Shot, White of Eye is Red
Stretching Forelimbs Far Forward & Dipping Back
Down with Limbs Tipped Up, Cast
Foal or Newborn, Grinding Teeth or Curling Lip
Abnormal Movement or Twitching of Lips
Depressed & Not Eating Right after Intense Exercise
Newborn Foal, Straining to Pass Manure
Growing Foal, Poor Growth & Condition
Ate Poisonous or Toxic Plant, Witnessed
Deworming Medication Overdose, Excessive Amount Given
Digital Pulse Can Be Felt in Foot
Eating Soil, Dirt or Sand (in Adult)
Cannot Seem to Get Up, Lying Down, Seems Aware
Bute, Banamine®, NSAID Overdose, Excessive Amount Given
Ate Wire, Twine or other Material, Witnessed
Rectal Temperature Lower than 97 Degrees F (in Adult)
Ate Poisonous Substance or Toxin, Witnessed
Foaling Difficulty, Dystocia
Ate Cattle Feed, Monensin, Known to have Occurred
Circling, Pacing or Weaving in Stall
Dull or Poor Haircoat
Eating too Fast, Bolting Down Feed
Hypersensitive to Touch on Flanks & Belly
Extending or Stretching Out Neck
Eye looks Dry or Dull
Blood on Vet's Sleeve Following Rectal Exam
Eating Slowly, Taking Long Time to Finish a Meal
Foal or Newborn, Eating Soil, Dirt or Sand
Persistent or Irregular Heat Behavior in Mare
Swollen Tongue
Slobbering, Drooling or Salivating

Identify or Rule-Out Possible CausesDIAGNOSES

Colic, Undiagnosed Conditions Causing
Colic, Simple Intestinal Gas or Spasm
Small Intestinal Strangulating Conditions
Large Colon Impaction, Pelvic Flexure Impaction
Colic, Gas, Large Colon Tympany
Plant or Weed Toxicity, Generally
Plant or Weed Toxicity, Generally
Equine Gastric Ulcer Syndrome, EGUS (in Adult)
Colic, Sand Accumulation or Impaction
Large Colon Dysfunction, Generally
Ileal Impaction
Small Intestinal Strangulation, Strangulation by a Pedunculated Lipoma
Uterine Cramping, After Foaling
Right Dorsal Colitis
Organosphosphate Toxicity
Adhesions, Intra-Abdominal
Ileus, Lack of Normal Intestinal Motility
Stomach Impaction
Large Colon Mechanical Obstruction, Generally
Ulcer, Gastro-Duodenal, Glandular Antral or Duodenal Ulcer (in Adult)
Duodenitis-Proximal Jejunitis, DPJ
Left Dorsal Displacement of Large Colon with Nephro-Splenic Entrapment
Large Colon Volvulus or Torsion
Small Colon Impaction
Ruptured Stomach or Intestine
Uterine Torsion
Enteroliths, Intestinal Stones
Right Dorsal Displacement of Large Colon
Heart Conditions, Generally
Liver Disease, Acute Hepatitis
Vaccination Reaction
Equine Inflammatory Small Bowel Disease, ISBD
Uterine Tear or Rupture
Salmonella Colitis (in Growing Foal or Adult)
Bots - Flies, Eggs, Grubs in Stomach
Enteritis, Acute
Intestinal Foreign Body
Hepatic Encephalopathy
Blister Beetle Toxicity
Coronavirus Entero-Colitis
Rectal Impaction (in Adult)
Ascarid Worm Impaction
Abdominal or Internal Abscess, Generally
Stress or Anxiety, Generally
Bladder & Urethral Stones
Carbohydrate or Grain Overload
Ruptured Aorta, Ruptured Aortic Aneurysm
Polysaccharide Storage Myopathy, PSSM
Congestive Heart Failure, CHF
Intestinal Motility Disorder, Generally
Stomach Outflow Obstruction
Infarcted Intestine or Colon
Small Strongyle Infestation
Protein-Losing Intestinal Diseases, Generally
Clostridial, Clostridium Colitis (in Adult)
Potomac Horse Fever, Neorickettsiosis
Cholangiohepatitis, Cholelithiasis
Tying-Up, Recurrent Exertional Rhabdomyolysis
Intestinal Lymphosarcoma
Granulosa, Theca Cell Tumor & Other Ovarian Tumors
Intestinal Parasitism (in Adult)
Cecal Disorders, Generally
Bastard Strangles
Poisoning by Cardiotoxic Plants, Generally
Geriatric Dental Disease
Kidney Failure, Acute Renal Failure
Avocado Toxicity
Diaphragmatic Hernia, Ruptured Diaphragm
Equine Proliferative Enteropathy, EPE
Exhausted Horse Syndrome, EHS
Neoplasia, Tumor or Cancer, Liver
Rectal Tear
Monensin Toxicity
Cardiac (Heart) Valvular Disease
Oleander Toxicity
Black Walnut Shavings Toxicity
Bile Stones
Nitrate Toxicity From Plants or Fertilizer
Testicular or Spermatic Cord Torsion (in Stallion)
Eastern, Western & Venezuelan Equine Encephalomyelitis
Amitraz Toxicity
Red Maple Leaf Toxicosis
Hypocalcemic Tetany
Re-Feeding Syndrome
Jimsonweed Toxicity
Hendra Virus, HeV
Borna Disease
Black Locust Tree Toxicity
Blue Green Algae Toxicity
Neoplasia, Tumor or Cancer, Intestine
Neoplasia, Tumor or Cancer, Kidney
Pancreatic Diseases, Generally
Equine Grass Sickness
Poison Hemlock or Water Hemlock Toxicity
Neoplasia, Tumor or Cancer, Stomach
Congenital Heart Problems
Atrial Fibrillation
Aging Changes, Generally
Frostbite on Ears, Limbs, Tail, or External Genitalia
Prolapsed Uterus, Uterine Prolapse
Plants Causing Salivation & Mouth Irritation
Lead Poisoning
Phenothiazine Toxicity
Clover Toxicity
Seasonal Pasture Myopathy
Arsenic Toxicity
Mercury Toxicity
Mare Reproductive Loss Syndrome, MRLS
Ear Tick Infestation
Sleep Deprivation
Equine Piroplasmosis, EP
Acorn & Oak Bud Toxicity
Moldy Corn Toxicity
Adrenal Insufficiency
Purpura Hemorrhagica, PH
Liver Abscess
Castorbean or Ricin Toxicity
West Nile Virus, WNV
African Horse Sickness, AHS
Author: Doug Thal DVM Dipl. ABVP


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