Colic is the leading cause of death in horses and causes acute, severe pain requiring prompt veterinary assessment and welfare-centred decision making about treatment and humane endpoints.
Colic represents one of the most acute and severe welfare emergencies in equine medicine. Severe colic pain causes extreme distress — horses roll violently, sweat profusely, paw, and look at their flanks in behaviours that clearly indicate intense suffering. Appropriate welfare response to colic requires immediate veterinary contact, adequate analgesia to control pain while assessment proceeds, and honest discussion of prognosis versus welfare implications of each treatment option. The decision between medical management, referral for surgical intervention, and humane euthanasia involves weighing the pain and stress of treatment against realistic prognosis for recovery and return to acceptable quality of life. Financial considerations should not force horses to endure prolonged suffering when prognosis is poor; euthanasia as a welfare decision should always be available. For horses that do require surgery, post-operative welfare requires vigilant pain management, careful monitoring for complications, and realistic assessment of when quality of life has returned to acceptable levels versus when euthanasia is the kindest option.