Colic — abdominal pain in horses — is one of the most significant welfare concerns in equine populations worldwide. It is the leading cause of death in horses (excluding old age), and causes acute, intense pain that requires immediate veterinary attention.
Colic encompasses a wide range of conditions from mild, self-resolving gas colic to life-threatening large colon displacements, volvulus (torsion), and small intestinal strangulations. Annual colic incidence rates of 4-10% per horse are commonly reported, with approximately 1 in 1000 horses requiring surgical intervention each year.
Colic pain is intense and distressing. Affected horses exhibit pawing, looking at flanks, rolling, getting up and down, and refusing to eat. The Horse Grimace Scale and composite pain scales allow objective assessment of pain severity. Prompt administration of analgesics — particularly NSAIDs and opioids for severe cases — is a welfare priority.
Under-treatment of colic pain is a significant welfare concern. Concerns about masking symptoms with analgesics have historically led to undermedication; current consensus is that appropriate pain management improves welfare without significantly masking diagnostic signs.
Colic surgery is invasive and carries significant welfare considerations perioperatively and postoperatively. However, surgery can be life-saving for horses that would otherwise die in agony. Euthanasia decisions for horses with poor surgical prognosis require careful welfare assessment — prolonged untreated pain from inoperable colic is a significant welfare concern that may require prompt euthanasia.
Management factors significantly influence colic risk. High-concentrate, low-roughage diets increase risk of hindgut acidosis and impaction. Limited water access, sudden dietary changes, and restricted movement increase risk. Prevention through management includes:
Horses recovering from colic surgery require intensive welfare monitoring. Pain management, prevention of laminitis (a common post-operative complication), management of endotoxemia, and wound care are ongoing welfare priorities. Recovery duration varies from weeks to months depending on the procedure.
A significant welfare disparity exists in access to colic treatment. Horses in developed countries with access to specialist referral hospitals have substantially better outcomes than horses in low- and middle-income countries where veterinary access is limited. Improving global access to equine veterinary care is a welfare priority.