Colic is one of the most common equine emergencies, characterized by pain in the abdomen. [1] Some types of colic are life-threatening, requiring immediate veterinary intervention. [1]

Currently, colic is a leading cause of death in horses, with some studies indicating that it may be responsible for up to 28% of equine fatalities. [1][2]

It’s important for horse owners to familiarize themselves with common signs of colic so they know when their horse needs prompt medical intervention.

Studies show that rapid identification of colic symptoms improves the chance of a successful outcome, reducing the risk of mortality, and decreasing complications associated with colic surgery. [1]

If your horse is showing signs of colic, your veterinarian’s evaluation is critical to determining whether your horse needs life-saving surgery, or can be managed with medical treatments alone. [1]

Understanding how to accurately describe your horse’s symptoms can help your veterinarian make a treatment decision quickly, ensuring your horse receives critical care as fast as possible. [1]

Signs of Colic in Horses

Knowing the common signs of colic, your horse’s normal behavior, and the basics of horse health examination are important for early detection of colic. Prompt diagnosis and treatment are key to improving treatment outcomes. [1]

Since there are many different causes of colic with ranging severity, the symptoms can vary widely. How colic manifests depends on the condition, severity of disease, and how much pain the horse is in. [1]

In some cases, the timing of when an owner identifies symptoms may also impact interpretation, as horses with severe pain may show milder symptoms if they are exhausted after a period of colicking. [1]

Additionally, individual horses may show varying symptoms for the same condition because some horses are naturally more stoic. [1] These horses may exhibit mild symptoms despite being in severe pain. [1]

It is important to have a veterinarian evaluate all horses showing signs of colic, even if signs are mild.

Behavioral Symptoms

The behavioral manifestations of colic result from the horse’s abdominal discomfort. [1] Horses may display unusual behavior as they attempt to relieve pain, or when they become frustrated that their attempts to resolve the pain are unsuccessful. [3]

1. Depression (Lethargy)

Depression is a common symptom noticed by owners during a colic episode. [1] In horses, depression refers to the general feeling of discomfort and unease associated with an illness.[4]

Signs of depression in horses include: [1][4]

  • Quiet, subdued demeanor
  • Disinterest in their environment
  • Ears pulled back or down
  • Low head carriage
  • Reluctance to move
  • Reduced appetite
  • Disinterest in drinking water

Depression may occur at the beginning of a colic episode, or it can indicate exhaustion after the horse experiences a prolonged period of pain. [1]

Some horses show depression as their primary symptom after a catastrophic, life-threatening event such as internal organ rupture. Rupture of the organ relieves the pressure buildup that causes pain. [5]

2. Flank Watching

Horses with a painful abdomen may “flank watch”, or turn their head back to glance at their flanks. [1]

This symptom does not necessarily indicate the precise location of the horse’s pain, but shows that the horse is uncomfortable. [1]

3. Restlessness

Abdominal discomfort can cause horses to become restless, as they cannot find a comfortable position to rest in. [1]

Signs of restlessness in horses include: [3]

  • Shifting weight between limbs
  • Frequently changing activity between resting, standing, laying down, etc.
  • Circling or pacing
  • Nibbling at bedding or other non-food items
  • Biting, mouthing, or rubbing against objects
  • Staring off into the distance for long periods
  • Frequently repositioning the body while laying down

Restlessness is most common in horses with mild pain. Horses who develop moderate to severe pain usually display more violent behaviors such as rolling. [1][6]

4. Grinding Teeth (Bruxism)

Teeth grinding refers to moving the jaws back and forth while tightly clenched, grinding the molars together. [3] This behavior produces a crunching, squeaking, or scraping sound as the teeth move against each other. [3]

Horses typically grind their teeth as an attempt to relieve the high amounts of stress and discomfort associated with moderate to severe colic. [1]

5. Unusual Postures

Horses with colic often adopt unusual postures as they try to relieve pressure or pain associated with their abdominal discomfort. [1]

Example postures include: [1][3]

  • Standing stretched out: this position is similar to a urination posture
  • “Dog-sitting”: the horse sits on its hindquarters with its chest elevated
  • Crouching: the horse circles and buckles its knees as if to lie down, but does not
  • Dorsal recumbency: lying on their back to try and reduce pressure in the abdomen

While in these postures, horses may groan, swish their tails, have their ears pointed backwards, and flank watch. [3]

6. Flehmen Response

The Flehmen response is curling of the upper lip. [1] Typically, horses perform this behavior to maximize their sense of smell, as it allows scents more direct access to the vomeronasal organ, the smelling organ. [3]

Horses with abdominal discomfort frequently show the Flehmen response. [1] Although the exact reason for this behavior is unknown, it is associated with mild to moderate discomfort. [1]

Flehmen response on horse face

7. Pawing

Pawing is a common symptom o