What you see. The starting point for addressing any equine health related issue is your observation.


Looking at Side, Flank or Belly


Sometimes known as flank watching, this is a common sign of abdominal pain (colic) in horses. It is usually seen in combination with other signs of abdominal pain like loss of appetite, kicking at belly or lying down, among many others. Sometimes however, this is the only sign you will see.

In some cases, skin irritation, a wound or other injury to the flank causes a horse to look at this painful or irritated area. Some horses also will bite at the side as part of this behavior.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • If you are convinced this is a sign of colic (abdominal pain).
    • If the behavior continues with no explanation.
    • If the results of the Whole Horse Exam (WHE) in the resting horse indicate fever (Temp >101F/38.3C) or heart rate greater than 48 BPM.
  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If this seems mild or occasional and the horse seems normal otherwise.
    • If the horse's appetite and attitude are normal and you see nothing else wrong.
    • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.
You also might be observing
Very Common
Less Common
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your role


What To Do

Watch the horse carefully for a few minutes, and look for other signs of abdominal pain. Examine the area carefully for flies or other sources of skin irritation or a wound.

Assess the horse's general health using the Whole Horse Exam (WHE), paying particular attention to heart rate, attitude and appetite, appearance of gums and intestinal sounds. If there is no evidence of other causes for the behavior, consider this as evidence of abdominal pain (colic) and contact your vet with your findings and concerns.

What Not To Do

Do not assume that this is anything other than abdominal pain.

your vet's role

Your vet approaches this as a sign of abdominal pain (colic) unless other signs are evident.
Questions Your Vet Might Ask:
  • Do you notice anything that might be irritating this area?
  • Are you seeing other signs of abdominal pain (colic)?
  • When did you first notice this?
  • How is your horse's attitude and appetite?
  • Does your horse have a history of colic?
  • What are the results of the Whole Horse Exam (WHE)?
  • When did you first notice this behavior?
  • Have you changed your horse's feed or management lately?

Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

Very Common
Less Common
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Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

Very Common
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further reading & resources

Author: Doug Thal DVM Dipl. ABVP