Early Signs of Colic in Horses and What to Do Until the Vet Arrives

Signs of colic in horses: the early ones people miss

The earliest signs of colic in horses are usually small changes: hay left in the feeder, fewer or drier manure piles, glancing back at the flank, pawing, stretching out as if to urinate, or lying down at an odd time. If you notice any of them, take away the feed, check the heart rate and gums, and call your vet now, even if the signs look mild.

That last step is where owners slip. In an April 2026 University of Nottingham study in Equine Veterinary Journal, 58% of 1,544 UK horse owners did not know how quickly colic can cause irreversible damage to the gut. An earlier UK survey of horse owners, carried out in 2014 and published in Equine Veterinary Journal, found that only 45% could give a normal resting heart rate for a horse.

Colic simply means belly pain. It affects an estimated four in every 100 horses each year, and fall adds its own risks: many horses drink less as nights turn cold, and a switch to a new batch of hay is a diet change the gut notices.

Subtle early signs

• Not finishing a meal, or eating slower than usual
• Fewer manure piles, or smaller, drier balls (most horses pass six to 10 piles in 24 hours)
• "Sham" drinking: dipping the muzzle without really swallowing
• Looking at, nipping at or kicking toward the belly
• Curling the upper lip, stretching out, or standing as if to urinate
• Lying down more than normal, head low, dull or "just not himself"

Obvious signs

• Pawing, circling the stall, getting up and down repeatedly
• Rolling, sweating, fast breathing
• A belly that looks bloated

Red flags that make it an emergency

• Pain that keeps returning or gets worse
• Throwing himself down or violent rolling
• A heart rate that keeps climbing
• Gums that are dark red, purple or pale
• No gut sounds at all

A serious colic does not always look dramatic. Some horses with a surgical problem never roll or thrash, so mild signs still deserve a call.

A handy memory aid from the British Horse Society is REACT: Restless or agitated, Eating less or fewer droppings, Abdominal pain, Clinical changes (heart rate, gums, gut sounds, breathing) and Tired or lethargic.

Horse vital signs: normal numbers and how to check them fast

Your vet will ask for numbers on the phone, so collect them while you wait. Practice on a calm day so you know your own horse's normal; our health basics guide walks through the routine.

Heart rate

Press a stethoscope just behind the left elbow and count each "lub-dub" as one beat. No stethoscope? Feel for the pulse where an artery runs across the underside of the jawbone.

Count for 15 seconds and multiply by four, or 30 seconds and multiply by two. Fear and heat raise it too, so take it twice, a few minutes apart.

Gums and capillary refill

Lift the upper lip. Press a thumb on the gum until it turns pale, let go and count how long the pink takes to return: two seconds or less is normal.

Horse gut sounds

Put the stethoscope, or your ear, on the flank just behind the last rib, about halfway up. Listen at four spots: upper and lower on the left, then upper and lower on the right, for at least 30 seconds each.

Normal is a steady mix of gurgles and rumbles, with an occasional big "roar." Quiet spells come and go, so listen longer before deciding a side is silent. Careful: some horses kick when a stethoscope tickles the fold of the flank.

Breathing and temperature

Count flank movements (in plus out is one breath) for 30 seconds and double it. For temperature, use a lubricated digital rectal thermometer while standing beside the hip, never directly behind, and skip it if the horse is thrashing.

What to do if your horse has colic: a checklist while you wait

1. Call your vet first. Say what you are seeing and when it started. Do not wait to see whether it passes.
2. Remove all feed. Hay, grain, grass and treats all go. Food can make colic worse. Many vets are fine with leaving water; ask on the call.
3. Move to a safe spot. A well-bedded stall with hazards removed, or a small arena. Wear a helmet and gloves, keep the lead rope long and never stand where the horse could go down on you (more in our safety guide).
4. Write down vitals with the time. Repeat them while you wait, as often as your vet asks. A rising heart rate tells your vet more than one reading.
5. Pick out the stall so any new manure is obvious. Keep a fresh pile for the vet to see.
6. Get the trailer ready. Hitched, fueled, with the route to the nearest equine hospital saved in case your vet refers you.
7. Have answers ready. When was he last normal? Last manure and what it looked like? Eating and drinking? Recent changes in hay, feed, turnout, work, travel or deworming? Any medication already given? Any past colic?

If your vet could be hours away

In rural areas a vet can take a long time to arrive. Ask your vet now to name a backup practice and agree on how you would handle an emergency by phone. Keep both numbers in your phone and posted in the barn.

Should you walk a horse with colic?

Only if it helps him. The old rule that every colicking horse must be walked is a myth, and walking a sick horse for hours can exhaust him.

• Lying quietly or standing calmly: let him rest and keep checking vitals.
• Restless, up and down, trying to roll: gentle walking can comfort him, may encourage gut movement and keeps him from thrashing in a small stall.
• Never to exhaustion: an equine vet quoted by Equus says that if a horse is no better after about half an hour of brisk walking, walking alone will not fix it. Tell your vet.
• Stop if he goes lame or refuses to move: laminitis, a hoof abscess or tying-up can look like colic, and walking makes them worse.

What about rolling?

Many of us grew up hearing that rolling twists the gut. The British Horse Society says letting a colicking horse lie down or roll won't make the colic worse; the real danger is injury to the horse or to you.

A horse in so much pain that he keeps throwing himself down, even while you walk him, is showing a red flag for a serious colic. Get out of the way, give him the safest open space you have and tell your vet the pain is escalating.

What not to do before the vet arrives

• Don't give any medication unless your vet tells you to. Pain relief can hide the signs that separate a mild gas colic from a twisted gut that needs surgery. If your vet approves something by phone, they choose the drug, the dose and how it is given.
• Don't drench oil, syringe liquids or try to pass a stomach tube. Tubing is a vet's job.
• Don't give an enema. It can injure the rectum, and rectal tears in horses are often life-threatening.
• Don't offer "just a bite" of hay or a treat to test his appetite.
• Don't lunge or trot him hard to "shake it loose."
• Don't step into a stall with a horse that is thrashing.
• Don't wait overnight to see whether it settles.
• Don't follow forum remedies over your own vet's advice.

Why some colics are treated at the barn and others need a hospital

Many colics are mild gas or impaction cases, and University of Minnesota Extension reports that more than 80% respond well to treatment on the farm. A smaller share involve a twisted, displaced or trapped piece of intestine.

Some of those can be managed in a hospital with monitoring, and some need surgery, where timing matters. Only your vet can tell which is which, using a physical exam, a rectal exam, a stomach tube and sometimes an ultrasound.

What you can do is decide before a crisis. Would you send your horse to surgery, what can you spend and what does your insurance cover? In the Nottingham study, 63% of owners did not know the costs of colic surgery or UK insurance cover limits, so have that talk with your vet now.

Lower the risk this fall: what to watch next

• Water: keep buckets and troughs clean and unfrozen. Many horses drink less when the water turns cold, and less water is linked to impaction colic.
• Hay changes: if you switch supplier or type this season, mix old and new gradually over a week or more. Our nutrition guide covers forage-first feeding.
• Movement: daily turnout or exercise helps keep the gut moving, even when weather keeps horses in.
• Teeth and parasites: book regular dental checks and a parasite plan with your vet; see the care guide.
• Know your horse's normal: record heart rate, gums and gut sounds once a week for a month.
• Count manure every time you clean the stall. A sudden drop can be an early clue.

The weeks to watch are the first cold snap, the first nights horses spend stalled and the day a new load of hay arrives. Those are the moments to look twice at the feeder, the water and the manure pile.