"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.

HISTORY 

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.

THE CARDIOVASCULAR SYSTEM

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.

THE GASTROINTESTINAL SYSTEM

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.

PAIN & PAIN MANAGEMENT

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.