At six years old, reading the Pony Pals book series (iykyk!) I first encountered a word that would follow me throughout my life with horses: colic. And as Lulu, Pam, Anna discover – something as innocent as too many treats could make a pony (or horse) dangerously ill.
Every horse person is familiar with the mix of respect and fear this word elicits. Colic hovers in the back of our minds every time our horse glances at their belly or rolls one time too many out in the pasture. It can be as simple as needing to walk it off… or as traumatizing as an emergent euthanasia within hours of noticing symptoms
As I grew older, working in different corners of the equine industry, and starting my own journey of horse ownership and stewardship, the concept became more muddled. Some horses experienced mild, chronic colic episodes their owners didn’t worry much about. Others had experienced the single sudden episode that was fatal within 24 hours.
Now, almost a decade into my career as a veterinary technologist, I’ve noticed a very common—and totally understandable—misconception: when clients bring in a horse for suspected colic, they expect us to confirm the diagnosis the way you might confirm a fracture or an infection. But colic isn’t a diagnosis. It’s a symptom.
I hope that, through my background as an equestrian and my experience in the field, this explanation will help remove some of the ambiguity surrounding colic and provide you with realistic expectations should your horse require veterinary care.
What colic actually means.
By definition colic simply means abdominal pain. Horses show this discomfort in a variety of ways, including: pawing, flank watching, restlessness, repeatedly lying down and getting up, rolling, sweating. If your horse is showing any of these behaviours and they are persisting or worsening – they are likely dealing with abdominal pain.
It is from here that it is our job (veterinary team) to work with you to determine how severe their pain is and what is causing it to help us determine prognosis.
Why YOUR participation matters so much
You know your horse best. If something feels off – trust your instincts! A phone call is always worthwhile. What is their normal behavior and reaction to change or pain? Horses vary widely in how they show discomfort. A thorough history may help us determine a cause or decide on different diagnostic tools.
- See if your veterinary team has a quick reference guide on valuable history for colic!
How the veterinary team assesses colic when imaging is limited
Because horses are large animals with complex digestive tracts, diagnostic imaging is far more limited than in small-animal medicine. Instead, we rely on assessments, patterns, and physical findings:
1. How severe is their pain – and can we control it?
Pain severity often correlates with resting heart rate, which helps classify colic pain as moderate, severe, or excruciating.
- Severe pain often indicates that surgery may be needed.
- Excruciating pain (heart rate > 80 bpm) is almost always surgical, if the horse isn’t already in shock.
- We also assess mucous membrane color (gums). Abnormal color can indicate shock or sepsis—conditions associated with a poor prognosis.
We address significant pain immediately with injectable medications, which typically provide 30–90 minutes of relief.
2. Is there an Indication for Surgery? We use two key tools:
- Rectal Palpation: A veterinarian manually examines the hindgut and nearby organs to feel for:
- impactions, displacements, sign of a twist or abnormal ‘bands’ suggesting restricted or malpositioned structures.
- Nasogastric intubation: A tube is passed into the stomach to check for excess fluid (reflux) or feed material that isn’t moving properly.
- Reflux is a possible indication that there is a blockage preventing normal gastric flow.
3. If surgery isn’t an option, can medical management help?
If surgery isn’t clearly indicated – or not feasible – then we consider:
IV fluids, pain management, anti-inflammatories, electrolytes, close and repeated monitoring.
4. Bloodwork.
Bloodwork always provides valuable information—even when it’s normal!
It helps us determine whether the horse is mounting an immune response, showing early inflammation, experiencing tissue damage, or developing sepsis. These details guide treatment and prognosis, especially when the physical exam is inconclusive or symptoms are severe. In some cases, bloodwork helps guide the decision to refer to a surgical facility or consider humane euthanasia.
Conclusion
Colic is one of the most frightening and ambiguous terms in the horse world. But understanding what the term actually means—and how veterinarians evaluate the condition—can help set clearer expectations during stressful moments.
Remember: you know your horse better than anyone.
If something feels wrong, call your veterinary team. Early attention can be the difference between a straightforward medical case and a life-threatening emergency.