If your horse is restless, keeps looking at its belly, or stays down, the first question is: is this colic, and how serious? This guide helps you recognize the signals, judge the urgency, and act. Diagnosis and treatment always belong with the vet. If in doubt, call right away.
What Colic Is
Colic isn't a disease in itself, but an umbrella term for abdominal pain. The causes vary widely: a blockage in the intestine, gas buildup, cramping, sand accumulation, or, in the most serious cases, a twisted gut. Many cases are cramping or gas buildup and can usually be resolved on site by the vet. Other forms are life-threatening within hours.
As an owner, you can't determine the cause in the moment, and you don't need to. Your job has three parts: recognize the signals, judge how serious it is, and call in the vet in time. The faster a serious form is recognized, the better the odds of a good outcome.
The Types of Colic
The Utrecht University Animal Hospital (UDI, Universitair Dierenziekenhuis) and the British Horse Society (BHS) describe the types below. The signs alone often don't tell you which type it is; that takes an examination by the vet.
| Type | What happens | What else you should know |
|---|---|---|
| Spasmodic colic | Sections of gut contract in an abnormal way, causing sharp pain that keeps coming back | One of the most common types; the vet can usually resolve it on site |
| Gas colic | Gas builds up in the gut, which then stretches too far | Often follows a change in management, such as moving to new grass; the vet can usually resolve it on site |
| Impaction | The gut becomes blocked, so feed no longer passes through | Less or drier manure; often after a switch to a drier diet, such as on box rest |
| Sand colic | Sand and dirt accumulate in the gut | See below |
| Displacement of a section of gut | A piece of gut lies in the wrong place and can block the passage | Pain from mild to severe; a true change in position often requires surgery |
| Twisted or strangulated gut | A section of gut twists or gets trapped, cutting off the blood supply | Critical form: likely surgery, or otherwise euthanasia |
| Apparent colic | The same signs, but the cause lies outside the digestive tract, for example an approaching birth or a muscle problem | Call the vet in this case too |
Sand Colic
Sand colic develops when sand stays behind in the gut and accumulates. According to the UDI, the sand has often been there for a long time before the horse has an acute colic attack. In that time it can abrade the gut wall, so nutrients are absorbed less well and the horse may lose weight. Sand can also prevent water from being absorbed from the gut, which can cause diarrhea.
Other signs are sand in the water bucket, changing manure, a swollen belly, and discomfort while riding or girthiness (the horse reacts irritably to the girth). If the sand is found in time, it can often be resolved without surgery. If it goes untreated, a colic operation is sometimes needed.
According to the UDI, the risk factors lie in how the horse is kept: feeding hay on or near sandy ground, turnout on very short grass (the horse then eats it roots and all), and hay that itself contains sand. The UDI names as measures forage that is available all day, for example in hay nets or slow feeders, and a preventive course of psyllium fiber once every one, two, or three months; discuss such a course with your vet. You can check manure for sand by mixing it with water and letting it settle, but sand is often passed intermittently, so a sample without sand doesn't rule it out. An X-ray of the abdomen is more reliable.
The Symptoms
A horse in abdominal pain shows it in fairly recognizable ways. Watch for behavior that deviates from what's normal for your horse:
- Repeatedly lying down and getting up again, or staying down for a long time
- Rolling, sometimes violently and with legs in the air
- Kicking or biting at its own belly, looking back at the flank
- Pawing the ground, pacing restlessly in the stall
- Refusing to eat when it normally would
- Little or no manure, or noticeably dry manure
- Sweating without having worked
- A visibly swollen belly
- Repeated yawning or curling of the upper lip
- Stretching out as if to urinate, or straining without passing manure
A horse with colic rarely shows all the signs at once, and a single isolated sign doesn't necessarily mean anything: a horse will sometimes roll out of simple comfort. It's the combination that counts: restlessness plus not eating plus clear pain behavior is reason to be alert right away.
How Serious Is It: Judging the Urgency
The rule of thumb: the more intense the pain and the more signs at once, the greater the urgency. The breakdown below helps with the assessment but doesn't replace the vet's judgment.
| Picture | What you see | Action |
|---|---|---|
| Mild | Somewhat restless, looks back at the belly, eats hesitantly, stays standing | Call the vet to discuss, keep a close eye on the horse |
| Moderate | Repeatedly lies down and gets up, rolls calmly, won't eat, little manure | Have the vet come out, don't wait it out |
| Severe | Rolls violently, throws itself down, sweats, can't be calmed | Call emergency services immediately, possible transport to a clinic |
Two things always raise the urgency: pain that persists or increases despite rest, and pain so intense that the horse throws itself down and risks injuring itself. With the latter, there's no need to hesitate. Call the emergency service. Even if the pain seems to be subsiding, call the vet to talk it through.
Does Colic Go Away on Its Own?
That can't be known in advance, so always call. According to the UDI, colic is always an emergency, and the signs often don't tell you which type it is. According to the BHS, colic can also deteriorate quickly. A horse that seems calmer therefore isn't necessarily better. Contact your own vet first: the vet judges whether the horse can be transported and can tell you what to do until they arrive.
Vital Signs: Your Baseline
To recognize "abnormal," you need to know what's normal. Measure these values on your own horse a few times at rest so you have a reference point. The ranges below come from the Merck Veterinary Manual; they can vary slightly per horse.
| Value | Normal at rest (adult horse) |
|---|---|
| Heart rate | about 28–40 beats per minute |
| Respiration | about 10–14 breaths per minute |
| Temperature | about 37.2–38.2°C |
| Mucous membranes (gums) | pink and moist |
| Capillary refill time | within about 2 seconds |
An elevated heart rate is one of the most useful warning signs. Pain, dehydration, and low blood pressure raise the heart rate, and a high heart rate often goes with a more serious problem. Still, a normal heart rate doesn't rule out a serious form. Gut sounds tell you something too: a belly that's completely silent, or one that gurgles abnormally loudly, both belong in your report to the vet. Pale, bluish, dry, or dark red mucous membranes and a slow refill time (press briefly on the gum and see how quickly the color returns) are also important to pass on. Report the values you measured when you call. They help gauge how quickly someone needs to come.
What to Do Right Away
Your role is to keep the horse safe and calm and not make the situation worse, not to treat it yourself.
- Call the vet (or the emergency service right away if you suspect a serious form). Describe the behavior, how long it's been going on, the vital signs, whether anything recently changed in feed, water, or pasture, and whether the horse has had colic before. Ask what to do until they arrive.
- Take away feed. Don't let a horse with abdominal pain keep eating. Water can usually stay available, unless the vet says otherwise.
- Let the horse walk calmly if it wants to and if that's safe, but don't force anything and don't make an exhausted horse walk. The BHS calls a lunge line safer and advises against walking for more than 30 minutes unless the vet says otherwise. Wear a riding hat, gloves, and sturdy footwear yourself. Ask the vet what makes sense in this case.
- Let the horse lie down or roll if it wants to. According to the BHS, that doesn't make colic worse. Keep a safe distance yourself: a horse in pain isn't always aware of its surroundings, including you.
- Make the surroundings safe: a thickly bedded stall or soft footing, sharp edges removed, other horses kept away so the horse doesn't hurt itself while rolling.
- Don't give painkillers or any other medication on your own initiative. These mask pain signals and make assessment harder. Only on the vet's instruction.
- Note the time the symptoms started and how they change. That's valuable information on arrival.
If your horse needs surgery, it has to happen quickly, at a clinic with an equine surgeon. So arrange in advance how you'll get a trailer, and check what your insurance covers. How to prepare further, and which other emergencies there are (such as sudden lameness, respiratory distress, or choke), is covered in When to Call the Vet: Urgency Levels, Emergencies, and Visit Costs.
What Reduces the Risk of Colic
Colic can never be fully prevented, but a number of habits lower the risk. This is especially relevant for competition riders: transport, a changed routine, and stress on a show day are known triggers.
According to the BHS, the most important measure is to avoid sudden changes in routine and feed. Change feed, forage, pasture, and time outside gradually, over at least 10 to 14 days: the gut bacteria need that long to adapt to new feed. As factors that raise the risk, the BHS also names a sudden switch to box rest, several people caring for the horse, stress and stereotypic behavior, dental problems, and a high worm burden.
- Provide generously spread-out forage and as much turnout as possible: horses that spend nearly the whole day in a stall get colic more often.
- Feed concentrates in small portions and change the ration gradually, over at least 10 to 14 days.
- Always provide clean water; drinking too little is a common factor, especially in winter and during transport.
- Keep a consistent deworming policy based on fecal egg counts and have the teeth checked yearly.
- On sandy ground, don't feed from the ground, and make sure there's enough grass or hay. Sand the horse takes in can build up in the large intestine (sand colic).
- Build back up gently after transport or a competition and keep an eye on the horse for the first few hours.
After a Colic Episode
Discuss with your vet what the cause may have been. If colic keeps coming back, the UDI says reduced gut motility or a gastrointestinal parasite may play a part. A rectal exam, ultrasound, gastroscopy, or parasite testing of the manure can reveal the underlying cause. The vet can also advise on the ration and draw up a deworming plan, for your own horse and possibly for the other horses at the stable.
Frequently Asked Questions
Does colic go away on its own?
That can't be known in advance, so always call. According to the UDI, colic is always an emergency, and a horse that seems calmer isn't necessarily better. Contact your own vet first.
What do I do if my horse has colic?
Call the vet, take away the feed, make the surroundings safe, and note the time the signs started. Let the horse walk calmly only if it wants to and if that's safe. Don't give painkillers or any other medication yourself.
Can my horse lie down or roll?
Yes. According to the BHS, letting the horse lie down or roll doesn't make colic worse. Keep a safe distance yourself, because a horse in pain isn't always aware of its surroundings.
When do I call the emergency service?
Right away if the horse rolls violently, throws itself down, sweats, or can't be calmed. Pain that persists or increases despite rest also raises the urgency.
What values are normal for an adult horse at rest?
According to the Merck Veterinary Manual, about 28 to 40 heartbeats per minute, 10 to 14 breaths per minute, and a temperature of about 37.2 to 38.2°C. The gums are pink and moist. It can vary slightly per horse.
How do I lower the risk of colic?
Avoid sudden changes in routine and feed, and change feed, forage, pasture, and time outside gradually, over at least 10 to 14 days. Provide generously spread-out forage, plenty of turnout, and clean water, keep a consistent deworming policy based on fecal egg counts, and have the teeth checked yearly.
In Short
Treat restlessness combined with not eating and pain behavior as colic until proven otherwise. Learn your own horse's normal vital signs so deviations stand out, and report them when you call. Take away feed, keep the surroundings safe, and don't give anything on your own initiative. With severe, persistent pain, call the emergency service right away; if in doubt, call anyway: better one time too early than one time too late. For diagnosis, exact values, and treatment, the vet is the only correct source.
Sources (verified October 20, 2026): Utrecht University Animal Hospital: Colic · Utrecht University Animal Hospital: Sand colic · British Horse Society: Colic in horses, causes, symptoms and treatment (REACT) · Merck Veterinary Manual: Colic in Horses (owner version) · Merck Veterinary Manual: Overview of Colic in Horses · Merck Veterinary Manual: Resting Heart Rates · Merck Veterinary Manual: Resting Respiratory Rates · Merck Veterinary Manual: Normal Rectal Temperature Ranges · AAEP Proceedings 2020: The Acute Abdomen in the Field
See also: When to Call the Vet · Vaccinations and Dental Care · Feeding Your Horse: Hay and Concentrates · Glossary terms