Horse Colic: Recognising, Responding to, and Preventing a Leading Welfare Crisis

Colic — abdominal pain in horses — is one of the most common and potentially fatal medical emergencies in equine veterinary practice. Swift recognition and response is essential, and many forms are preventable through good management.

Key Facts

Colic is the leading cause of premature death in horses; studies suggest it accounts for approximately 28-35% of all equine deaths and causes significant suffering in millions of horses annually worldwide
The term "colic" encompasses all forms of abdominal pain, ranging from mild discomfort resolving without treatment to surgical emergencies requiring immediate intervention
Major types include spasmodic colic (gut spasm, often self-resolving), impaction colic (faecal blockage, typically treated medically), displacement and volvulus (twisted gut, requiring surgery), and gas colic (gas accumulation)
Signs of colic range from subtle (looking at flank, reduced appetite, pawing) to severe (violent rolling, sweating, inability to stand, rapid deteriorance)
Large colon volvulus — 360° twisting of the large colon — is one of the most acutely painful conditions in veterinary medicine; affected horses deteriorate rapidly and require emergency surgery within hours to survive
Risk factors include sudden dietary changes, reduced water intake, high cereal diets, limited turnout, sand ingestion, dental disease, and previous colic history
Horses evolved to move continuously while grazing — the gut motility and microbiome of horses are adapted to constant low-level feeding, not the meal-based feeding common in domestic management
Prevention includes: high-forage diets, consistent feeding schedules, adequate water access, gradual dietary changes, regular dental care, and maximising turnout time

Welfare Considerations

Colic is one of the most significant welfare challenges in horse keeping because pain can escalate from mild to life-threatening within hours, and horses cannot tell their owners when their pain becomes unbearable. Equine stoicism — the evolutionary tendency to mask pain to avoid predator attention — can delay recognition of severe colic by hours. A horse that was showing mild signs an hour ago may be in surgical emergency status by the time pain behaviour becomes obvious. The welfare implications of delayed veterinary attendance are therefore severe: pain that could have been managed early becomes pain that has been experienced for hours. Large colon volvulus causes pain described by veterinary surgeons as among the most severe in any domestic animal species — horses in this state require emergency surgery within 3-4 hours for survival, meaning every hour of delayed recognition is hours of extreme, unrelenting pain. Good welfare practice requires owners to know the early signs of colic, have a clear action plan including immediate veterinary contact, and not delay in hoping symptoms will self-resolve.

What You Can Do

Learn the early signs of colic — increased looking at flank, reduced appetite, lying down more than usual, pawing, and reluctance to walk — so you can identify problems before they escalate
Have a clear colic action plan: know your vet's emergency number, know when to call (any horse showing signs of abdominal pain), and know never to administer bute/painkillers before veterinary assessment as this masks pain and hampers diagnosis
Ensure horses have constant access to fresh water and high-quality forage — these are the two most important preventive factors for reducing impaction and other common colic types
Maximise turnout time and natural grazing — continuous movement aids gut motility; prolonged stabling increases colic risk
Make dietary changes gradually — any change to forage type, concentrate feeding, or grazing access should occur over at least 2 weeks to allow gut microbiome adaptation
Maintain regular dental care (at least annually) — horses with dental pain eat differently and may impaction-colic from inadequately chewed feed