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.

Identify or Rule-Out Possible CausesDIAGNOSES

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


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