Colic is a term used to describe horses showing signs of abdominal pain such as scraping, rolling, stretching, flank watching or sometimes just inappetance.

In its simplest form colic can be due to an increase in gut motility, sometimes termed “spasmodic” colic. With these cases the intestines sound very noisy or gassy and usually respond to gut relaxants or spasmolytics, Buscopan being the most commonly used drug. The opposite to the spasmodic colic is the impaction situation. This usually involves the large intestine, particularly the pelvic flexure which is essentially a u-bend located in the back, left hand region of the abdomen. With these cases the problem is that gut motility is usually reduced coupled with a high dry matter content of the food intake causing a blockage of dry fibrous material. This generally causes a low grade pain, often with the horse stretching or lying flat-out. Treatment involves stomach tubing the horse with large amounts of fluid to lubricate the impacted material, increasing activity to stimulate gut movement and often giving intravenous fluid therapy to soften-up the gut contents.

Rectal examination allows us accurately diagnose many types of colic

Rectal examination allows us accurately diagnose many types of colic

reaching a diagnosis

The aforementioned types of colic are not life-threatening and are fairly straightforward to resolve, unfortunately some colics are much more serious and require urgent surgical treatment to save the horse from endotoxic shock. This is why when your horse shows the first signs of colic you should always call us to discuss the clinical presentation and in most cases we will want to come straight away to establish the cause. We will carry out a full examination including rectal palpation; this entails us putting an arm into the rectum so that we can gently feel the intestines.

We can ascertain whether the intestines are in the correct position and also if they are distended with gas. Distension implies that there is an obstruction to the intestine possibly due to a twist. We will probably introduce a tube into the stomach to find out if it is distended with gas; if it is then there may be an obstruction to the small intestine which is usually serious.

Further investigation

Other useful tests to evaluate the abdomen include a peritoneal tap; this involves carefully introducing a needle through the ventral midline on the belly and collecting a sample of peritoneal fluid. Analysis of which can let us know if there is peritonitis or worse still, if the bowel is already leaking. Sometimes an ultrasound examination of the intestines through the body wall can provide definitive information.

Collecting a sample of peritoneal fluid

Collecting a sample of peritoneal fluid

Strangulating lipoma affecting the small intestine

Strangulating lipoma affecting the small intestine


In the majority of cases the decision to take the horse to surgery is clear cut due to the rectal findings coupled with the degree of pain shown. It is very important not to delay as the intestines deteriorate very rapidly if their blood supply is obstructed by a twist.

The common colic surgeries that we perform are as follows:

  • Large bowel torsion
  • Epiploic foramen entrapment
  • Pedunculated lipoma
  • Ileocaecal intussuception
  • Right dorsal displacement 
  • Small colon impaction

Nephro-splenic entrapment is also a common referral but is usually managed medically without the need for surgery. Intestine becomes caught between the spleen and the body wall and travels dorsally until gets stuck under the left kidney. Starving the horse, reducing the size of the spleen using drugs, and lunging usually allows the gut to return to its normal position.

At Peasebrook we take colic very seriously. We pride ourselves on reaching a rapid, accurate diagnosis so that treatment is quickly effected ensuring the best possible prognosis. We also appreciate what a distressing time this can be for owners and so we make sure that you are kept fully updated at all times.