Horse Side Vet Guide ®

Equine Health Resource

Severe Colic Pain, Now Horse is Calm

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

Code Green - Contact Your Vet to Obtain Useful Advice & Resources

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

  • When you first notice signs of colic.
  • If the horse has no appetite and is obviously depressed.
  • If you notice high heart rate continuing in the face of sudden improvement.

Code Green - Contact Your Vet to Obtain Useful Advice & Resources

  • If the horse seems to be moving freely, and has a normal appetite and attitude.
  • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.

Your horse has been suffering from abdominal pain but is now suddenly calm. While you may be relieved that the horse seems better, in some cases this sudden improvement actually is a result of rupture of the intestine.

Colic pain can arise from several sources. Stretch on the intestinal wall from gas and fluid distention is one important source. If a blockage persists, it can lead to increased gas and fluid pressure on the intestinal wall which can cause it to rupture.

Certain conditions also cause the intestine to become damaged and weakened, ultimately leading to rupture. The rupture actually relieves the stretch. At least for a short while, the horse experiences some relief. This relief unfortunately is usually followed by rapid deterioration, shock and death.

This perceived temporary improvement in pain can lead horse owners to believe for a time that their horse is improving.

Rupture of the intestine is a common cause of death for horses with certain conditions causing colic. The most commonly ruptured segment of intestine is the stomach. The classic scenario is the display of intense pain (rolling, thrashing, getting up and down etc.) followed by sudden relaxation and calm. Usually the heart rate continues to rise after a rupture, and within minutes to hours, the horse becomes severely depressed, wobbly and then collapses from shock and dies.


If you see this scenario unfold, contact your vet immediately, even though the horse may appear to be improved. Your vet should examine the horse as soon as possible despite their seeming improvement.

Assess the horse’s general health using the Whole Horse Exam (WHE), paying particular attention to heart rate, mucous membrane color, capillary refill time and strength of pulse. One hour after an intestinal rupture, a horse usually has a high heart rate, is depressed but not painful, has cold ears and extremities, and has red or bluish gums and red whites of eyes (bloodshot eyes) from toxin uptake. Share your findings and concerns with your vet.


Your vet uses history, physical exam and other diagnostics to rule out rupture.

Diagnostics often employed include abdominocentesis (belly tap) and abdominal ultrasound to confirm or rule out rupture. If rupture has occurred, euthanasia is usually performed.

Helpful Terms & Topics in HSVGWritten, Reviewed or Shared by Experts in Equine Health

Author: Doug Thal DVM Dipl. ABVP


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