Spasmodic Colic in Horses | Causes, Symptoms, and Treatment

Spasmodic colic in horses is the most common form of colic a vet is called out to see, and it is the one most owners will meet at some point. It happens when the normal rhythmic movement of the gut becomes irregular and the intestinal muscle goes into painful cramps. The hallmark is a horse that looks genuinely distressed one minute and almost normal the next, which is exactly what makes it so unnerving to watch and so easy to underestimate.

The good news is that most cases respond quickly to veterinary treatment and leave no lasting damage. The catch is that you cannot tell spasmodic colic apart from a twisted gut by looking at your horse in the first hour. This guide covers what spasmodic colic actually is, the signs worth acting on, what to do while you wait for the vet, and the management changes that genuinely reduce the risk of it happening again.

What Is Spasmodic Colic in Horses?

Spasmodic colic occurs when peristalsis, the coordinated wave of muscular contraction that moves food through the digestive system, becomes disorganised. Instead of a smooth wave, sections of intestine contract hard and out of sequence. Those contractions are what hurt.

The important distinction is that spasmodic colic is a functional problem rather than a structural one. Nothing is blocked, twisted or displaced. The gut is behaving badly, not broken. That is why the pain comes in waves, why gut sounds are usually louder rather than quieter, and why the outlook is so much better than for the surgical forms of colic.

It is also why the diagnosis is a slightly soft one. As Vetlexicon puts it, spasmodic colic describes cases with no recognised pathology beyond assumed pain from gut spasm. Your vet is largely ruling other things out and watching how the horse responds.

Spasmodic Colic and Gas Colic: Why You Will Hear Both Terms

If you research this you will quickly find the terms used interchangeably, and that causes a lot of confusion. There is a reason for it.

Strictly, spasmodic colic describes the abnormal contractions and gas colic describes gas distending the intestine. In practice the two travel together: excess fermentation produces gas, gas stretches the bowel wall, and the stretched bowel responds by spasming. The Horse & Hound veterinary library now treats them as the same presentation, noting that spasmodic colic is also known as gas colic because of that gas build-up. American sources tend to lead with the term gas colic, British sources with spasmodic colic.

For an owner it makes no practical difference. The signs, the first aid and the treatment are the same, and there is no need to work out which label your vet prefers before picking up the phone.

How Spasmodic Colic Differs from Other Types of Colic

Colic is not a diagnosis in itself. It is a word for abdominal pain, and it covers everything from a cramp that resolves in twenty minutes to a surgical emergency. People often ask what the three types of colic in horses are, but there is no tidy list of three. The groupings below are the ones you will meet most often.

Type	What is happening	Typical pain pattern	Usual outcome
Spasmodic (gas)	Irregular gut contractions, often with trapped gas. No obstruction.	Sharp bouts with genuine calm in between	Very good, resolves medically
Impaction	Firm gut contents block the bowel, commonly at the pelvic flexure.	Duller and more constant, fewer droppings	Good with early treatment, some need surgery
Sand (sand colic)	Ingested sand irritates or blocks the bowel.	Variable, often with diarrhoea	Usually medical, occasionally surgical
Displacement	A section of bowel moves out of position.	Persistent, does not settle between bouts	Often needs surgery
Strangulation or torsion	Bowel twists and its blood supply is cut off.	Severe, unrelenting, rapidly worsening	Emergency surgery or the horse dies

Read down the pain pattern column, because that is the single most useful thing an owner can observe. Spasmodic colic gives you real troughs where the horse looks well. Pain that never lets up, or that escalates steadily, points somewhere far more serious and needs an urgent vet regardless of what you think the cause is.

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Signs of Spasmodic Colic in Horses

Signs appear suddenly, ease, and then return. That episodic rhythm is the clearest clinical clue you have. What you will typically see includes:

• Pawing at the ground, often repeatedly and in one spot
• Turning to look at, nudge or bite the flank
• Restlessness, getting up and down, circling the box
• Curling the top lip (the flehmen response)
• Stretching out as though trying to stale, without producing urine
• Patchy sweating, particularly behind the elbows and along the neck
• A raised heart rate during a bout that settles between them
• Loud, frequent gut sounds rather than a silent abdomen
• Lying down quietly and showing little interest in surroundings

Note the gut sounds in particular. An overactive, rumbling abdomen fits spasmodic colic. A silent abdomen is a more worrying finding and pushes the picture towards impaction or something surgical.

How Often Owners Actually See Each Sign

Research into how colic presents, summarised by the Horse & Hound veterinary library, gives a useful sense of what is common. Across horses presenting with colic of all types, roughly:

• 44% roll
• 43% paw, continuously or intermittently
• 29% lie down for long periods
• 21% repeatedly get up and down
• 14% look at their flank
• 13% curl the upper lip
• 10% back into a corner
• 7% kick at the abdomen
• 4% stand stretched as if trying to pass urine
• 1% fail to pass droppings for more than 24 hours

Those figures describe colic in general rather than spasmodic colic specifically, but they make an important point: the dramatic signs people watch for are not the most common ones. Most colicking horses are not thrashing on the floor. They are pawing, looking round at their side, and lying down more than usual.

Will a Horse with Spasmodic Colic Still Pass Droppings?

Usually yes, and this is where owners are most often caught out. Because spasmodic colic involves no physical blockage, droppings frequently keep coming, and the sight of a fresh pile in the stable is enormously reassuring.

It should not be. Faecal material sitting in the last section of the gut will still be passed even when there is an obstruction further forward that has not resolved. Droppings tell you that the very end of the tract is moving. They tell you nothing about the metre of small intestine that might be twisted. Passing manure is a mildly encouraging sign, never a reason to cancel the vet.

The Three Checks That Tell Your Vet How Serious It Is

When two large equine practices in Derbyshire and Kent reviewed 941 out-of-hours colic cases seen between 2011 and 2013, three findings came out as significantly associated with a critical outcome: a raised heart rate, an abnormal colour to the membranes of the eye and mouth, and the age of the horse. Close to a quarter of those cases turned out to be critical, so normal readings are a reason to be encouraged rather than a reason to stand the vet down.

Two of those three you can check yourself in under a minute, and it is worth knowing your horse's normal numbers before you ever need them. Learn to take a baseline temperature, pulse and respiration rate on a healthy day. A resting heart rate that has climbed well above your horse's usual figure, or gums that look brick red, purple or muddy rather than a healthy salmon pink, are the findings to report on the phone. They change how quickly a vet will come out.

Do not let this turn into a delay. Take the readings if you can do so safely, then ring. If the horse is too painful to handle, skip the examination entirely and make the call.

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What to Do While You Wait for the Vet

The window between spotting colic and the vet arriving is the part owners have most control over, and the part most often handled on folklore. Keep it simple:

1. Ring the vet first. Do not spend twenty minutes deciding whether it is bad enough. Describe the pain pattern, the heart rate and the gum colour if you have them.
2. Take the feed away. Remove hay, haylage and hard feed, and take the horse off grass.
3. Leave the water. Water should not be withheld from a colicking horse. Let the horse drink if it wants to.
4. Make the space safe. Take buckets, mangers and anything else it could injure itself on out of the box, and make sure the bed is deep.
5. Stay safe yourself. A horse in pain moves unpredictably and stops noticing where you are standing. Do not approach a violently colicking horse.
6. Note the times. When the signs started, when they eased, when they returned. Your vet will ask.

That third point is worth dwelling on, because plenty of yard advice still says to remove water along with feed. It is wrong. Withholding feed makes sense because you do not want to add to the load in an already unhappy gut. Withholding water does not: dehydration is itself a risk factor for colic and makes any impaction harder to shift. Feed comes away, water stays.

Should You Walk a Horse with Colic?

Gentle in-hand walking can help, but far less than tradition suggests, and it has a time limit. If the horse is only mildly uncomfortable, walking quietly in hand for up to about ten minutes may encourage gut movement while you wait.

What does not help is hours of forced marching. It exhausts the horse, and an exhausted horse is a poorer surgical candidate if it turns out to need an operation. Never force a reluctant horse to walk. If it wants to stand still or lie down quietly, let it.

Rolling, Lying Down and the Twisted Gut Myth

The most persistent myth in British yards is that a horse must be kept on its feet because rolling causes a twisted gut. It does not. Horses in abdominal pain often prefer to lie down, exactly as people do, and a horse lying quietly is not damaging itself. The relationship runs the other way: a twisted gut makes a horse want to roll, not the reverse.

The genuine risks from rolling are mechanical rather than intestinal. A horse thrashing in a confined box can become cast against a wall, or injure its head. If the rolling is violent and you can move the horse safely to a large sand arena, that is a better place to wait. If you cannot, a deep bed and a cleared box is enough.

What Not to Do

• Do not give any medication unless your vet has told you to over the phone. Painkillers mask the signs your vet needs to assess and can make a surgical case look deceptively settled.
• Do not drench with beer, whisky or other home remedies. These are yard folklore with no evidence behind them, and anything you pour into a horse that is not swallowing properly risks going into the lungs.
• Do not give paraffin or mineral oil yourself. It does not dissolve impacted material, and if it is aspirated into the lungs it can cause a fatal pneumonia. Anything passed by stomach tube is a vet's job.
• Do not reach for bicarbonate of soda. The effect of baking soda on an actively colicking horse has not been researched, and high oral doses can disturb sodium balance.
• Do not wait to see if it passes. Early treatment is the single biggest factor you control.

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What Causes Spasmodic Colic in Horses?

Honest answer first: in a large proportion of cases the specific trigger is never identified. The horse cramps, responds to treatment, recovers, and nobody ever knows precisely why. That is a normal outcome and not a failure of veterinary care. What follows are the triggers that show up repeatedly.

Sudden Diet and Pasture Changes

The classic scenario is a horse moved onto lush spring pasture without a gradual introduction. Rapidly fermentable grass shifts the hindgut microbial population quickly, gas production rises, and the gut becomes irritable. This is why spasmodic colic clusters in spring and after any change of grazing.

It is not only grass. A new batch of hay, a switch between hay and haylage, a change of hard feed, or a generous helping of apples or carrots in one go can all do it. The gut copes with almost any diet given time to adapt. What it does not cope with is a sudden switch.

Tapeworm and Other Parasites

Parasites have a well-documented link to this specific form of colic, which is unusual: for most colic triggers the evidence is thin, but here it is solid. A 1998 study in the Equine Veterinary Journal found that tapeworm infection is a significant risk factor for both spasmodic colic and ileal impaction colic. A later outbreak investigation in a training yard reinforced the association.

Tapeworms congregate at the ileocaecal junction, where the small intestine meets the caecum, and the local irritation there disrupts normal motility. Large redworm and roundworm burdens can also interfere with gut function. Managing worm burdens through a targeted worming programme built on regular worm egg counts and tapeworm testing is one of the few genuinely evidence-backed ways to reduce spasmodic colic risk.

Stress, Travel and Routine Changes

The gut is heavily wired into the autonomic nervous system, so stress translates directly into altered motility. travelling that the horse finds difficult, a first outing to a competition, a change of field or companions, a move to a new yard, or hard work in a horse that is not fit for it can all disrupt the normal pattern of contractions.

Unfit horses asked for a hard effort are a recurring theme, so build fitness gradually and make sure horses are cooled down properly afterwards.

Low Forage and High Concentrate Feeding

Horses evolved as trickle feeders processing high-fibre material more or less continuously. A feeding routine built on large concentrate meals and restricted forage produces a less stable hindgut and a more reactive one. Long gaps with an empty gut are a risk in themselves. Where forage intake has to be limited for weight management, hay alternatives and slow-feeding systems keep the gut occupied without the calories.

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How Vets Diagnose Spasmodic Colic

There is no blood test or scan that says spasmodic colic. The diagnosis is built by examination and by excluding the alternatives. A typical work-up includes:

• Clinical examination: heart rate, respiratory rate, temperature, mucous membrane colour and capillary refill time.
• Listening to all four abdominal quadrants: increased gut sounds support spasmodic colic, absent sounds point elsewhere.
• Rectal examination: in spasmodic colic this is typically unremarkable, with no impaction, distension or displacement palpable.
• Passing a nasogastric tube: checks whether fluid is pooling in the stomach, which suggests a small intestinal problem rather than a simple spasm.
• Abdominal ultrasound: increasingly routine, and covered in detail in a 2025 review of equine colic imaging. It is particularly good at spotting distended small intestine.
• Peritoneal fluid sampling: used in less clear-cut cases to look for signs of compromised bowel. Normal fluid is reassuring.

Why the Response to Treatment Is Part of the Diagnosis

In many cases the diagnosis is effectively confirmed backwards. A horse given antispasmodic and pain relief that settles quickly and stays settled almost certainly had a spasmodic colic. A horse that does not respond, or that improves and then deteriorates again within a few hours, has something else going on and needs further investigation.

This is why the instruction to ring your vet again if signs return matters so much. That second call is not a nuisance. It is diagnostic information, and it is often the point at which a case that looked simple gets reclassified.

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Treatment for Spasmodic Colic in Horses

Spasmodic colic is treated medically on the yard in the overwhelming majority of cases, and rarely needs referral to a hospital or anything approaching colic surgery. Treatment aims to break the spasm, control the pain, and then reintroduce food carefully.

Antispasmodics and How Buscopan Works

The mainstay is an antispasmodic, most commonly hyoscine butylbromide, which UK owners will usually hear called by the brand name Buscopan. It is given by injection by a vet and relaxes intestinal smooth muscle, breaking the cycle of cramping. It works fast, often within minutes.

Two side effects are worth knowing about because they surprise owners. Hyoscine butylbromide causes a transient rise in heart rate, so a horse that has just been treated may show a higher pulse than before the injection. It also quietens gut sounds for a short period. Neither means the horse is deteriorating, but both are why your vet takes baseline readings before treating, and why heart rate taken shortly after treatment is not a reliable guide to how things are going.

Pain Relief

Pain is usually managed with non-steroidal anti-inflammatory drugs (NSAIDs), most often flunixin or phenylbutazone. These are effective, but they are also good at masking signs, which is precisely why you should never administer them off your own bat before a vet has examined the horse. A dose of bute given at the first sign of pawing can make a strangulating lesion look like a settled horse for several hours, and those hours matter.

Feed and Water After Treatment

Food is normally withheld for a few hours after the episode resolves, then reintroduced gradually on your vet's advice. Start with small amounts of hay rather than hard feed, and build back over a day or so rather than returning straight to the normal ration. Water stays available throughout.

Monitoring Over the Next 24 Hours

Watch the horse closely for 12 to 24 hours after treatment. The things to track are droppings passed, appetite when food is reintroduced, water intake, and general demeanour. A horse that eats, drinks, passes normal droppings and looks bright is out of the woods. Call the vet again promptly if pain returns, if the horse stops passing droppings, or if it simply does not look right to you.

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Prognosis for Horses with Spasmodic Colic

The outlook is very good. Because there is no structural damage and no compromised blood supply, horses treated promptly generally recover fully. Give the horse a few days to recover and then build back up gradually, rather than going straight back to normal work the next day. Most do not go on to have repeat episodes once the trigger is identified and the management adjusted.

The prognosis is worse only where the diagnosis turns out to be wrong, which is the whole argument for getting a vet out rather than waiting.

When Spasmodic Colic Keeps Coming Back

Repeated bouts change the picture. One episode is bad luck or a management slip. Three episodes in a few months is a symptom of something that has not been found yet, and it warrants proper investigation rather than another injection.

Things worth ruling out in a recurrent case include:

• A heavy or resistant parasite burden, particularly tapeworm, confirmed by testing rather than assumed
• equine gastric ulcer syndrome, since gastric ulcers can produce grumbling, recurrent abdominal pain
• Sand ingestion in horses grazing bare, sandy paddocks
• Dental problems leading to poorly chewed forage
• An underlying feeding or turnout routine that has not actually been changed
• Rarely, early grass sickness, which can present with colic-like signs

A recurrent case is worth a proper work-up. Ask your vet about faecal egg counts and a tapeworm test, gastroscopy, and a review of the whole feeding routine rather than treating each bout in isolation.

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How to Prevent Spasmodic Colic in Horses

You cannot eliminate the risk, but the measures below address the triggers that actually recur. None of them are complicated and most cost nothing.

1. Change feed slowly. Introduce any new feed or forage over at least four to seven days, mixing increasing proportions of the new into the old.
2. Introduce spring grass in stages. Start with short periods on new grazing and top the horse up with hay so it is not going out hungry onto lush pasture.
3. Keep forage in front of the horse. Long gaps with an empty gut are a risk. Use small-holed nets or hay alternatives where intake has to be restricted.
4. Worm on evidence, not on the calendar. Use faecal egg counts and a tapeworm test to build a targeted worming programme. Blanket worming is both less effective and worse for resistance.
5. Provide constant clean water. Check troughs are not frozen in winter, which is when intake quietly drops and impactions rise.
6. Maximise turnout and keep routine steady. Movement supports gut motility, and horses cope better with a predictable day.
7. Build fitness gradually. Do not ask an unfit horse for a hard effort, and cool down properly afterwards.
8. Manage sand intake. Feed off the ground on sandy paddocks and use hay racks or mats.
9. Keep teeth in order. Annual dental checks keep forage properly chewed.
10. Have a plan. Keep your vet's emergency number to hand and know where your nearest referral hospital is before you need it.

For general horse care and welfare guidance, the British Horse Society publishes free owner resources covering feeding, turnout and emergency planning.

Spasmodic colic is manageable and usually mild, but it is never something to sit on. What looks like a simple cramp in the first half hour is indistinguishable from the start of something that needs surgery. Ring the vet, take the feed away, leave the water, and let the professionals decide which one you are dealing with.

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Frequently Asked Questions