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Colic and Stomach Ulcers in Horses: Signs and Symptoms

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I've been working with horses for over 10 years. Horses and writing are my passions!

Is your horse's stomach gurgling? Learn how to take your horse's vital signs and understand the symptoms of colic and ulcers, which are unfortunately quite common equine issues.

Is your horse's stomach gurgling? Learn how to take your horse's vital signs and understand the symptoms of colic and ulcers, which are unfortunately quite common equine issues.

Colic and Ulcers Are Fairly Common

Colic and stomach ulcers are fairly common belly issues with horses of all breeds and disciplines. They tend to happen most in horses that are not fed a proper diet or are in stressful situations.

Every horse owner has heard the horrible "C" word before and at least knows a little bit about colic. Ulcers are not such a well-known thing among all horse owners just because it is not nearly as deadly as colic. That being said, it is something I believe more horse owners need to educate themselves on.

This article goes into detail on both ulcers and colic, similarities between the disorders, and how one condition can affect one the other.

Is your horse's stomach making gurgling or rumbling sounds?

Is your horse's stomach making gurgling or rumbling sounds?

How to Take Your Horse's Vital Signs

It is incredibly important that you know how to take vital signs of a horse. I will go over how to take vital signs here as it will be referenced in other parts of this article.

It is crucial that you take your horse's vital signs when they are healthy, resting, and calm, as that is what is normal. You should record the results of the healthy and calm vitals so when they do get sick you don't have to think about what's normal. It is also good for you to practice taking the vitals so you can do it correctly and quickly in a possible emergency situation.


Knowing your horse's at-rest pulse is a very good thing because their pulse is one of the first ways of knowing your horse is in pain. A horse's pulse can be found on the bottom side of the jaw beneath the last cheek tooth. Find the major facial artery—it sticks out a little. Using your forefinger, press against the artery while looking at a clock count the beats you feel for the next 15 seconds now multiply that number by 4 and you have beats per minute. At rest, the average pulse of an adult horse is about 30-40 beats per minute. Remember that any excitement can increase the horse's pulse.


Taking a horse's temperature is a pretty simple thing to do—it is done rectally. You don't need any special thermometer, you can just pick one up from your local drug store. You will need to attach a string to the end so that the thermometer does not get lost (not a fun thing). Put a small amount of petroleum jelly on the tip (you can also use soapy water), move the horse's tail to the side, and slip the thermometer in. Be sure that the thermometer is touching the rectal wall. Do not stand directly behind the horse, as some do not like this (but most horses don't even notice). The normal temperature for a horse is 99-101° F.


Some horse owners, enthusiasts, and specialists swear by a hydration testing method known as the "skin tent test." This involves pinching the skin on a horse's neck or shoulder and counting the time it takes to return to its normal position. It is said that if the skin returns to normal within 2-3 seconds, the horse is sufficiently hydrated. However, this has been shown scientifically to not be a reliable measure of hydration.

In 2006, veterinarians from Bristol University and The Brooke equine welfare charity studied the hydration levels of workhorses in Lahore, Pakistan over a two-month period. The researchers concluded that the skin tent test was an unreliable measure of hydration because many non-hydration-related factors could influence the effect of the reaction of the skin, including the horse's age, coat moisture levels, the side of the horse the test was taken on, and anatomical location of the test. In addition, the skin tent test did not correlate significantly with accurate blood-related measures of hydration.

The researchers concluded that "Offering palatable water to drink ad libitum [at one's pleasure] provides both the diagnosis and the remedy for dehydration in working horses." Thus, it may be good to simply have ample and palatable drinking water available at all times for your horse. The skin tent test can be performed, but it should not be treated as the final say on hydration.

Capillary Refill Time

To check CRT (capillary refill time) lift the horse's top lip and press your thumb against their gum for 3 to 5 seconds and let go, the place where your thumb was should go from white to a healthy pink in 1 to 3 seconds.

Gut Sounds

Gut sounds are a very good thing, it means the stomach is working properly. How you listen for gut sounds is by pressing a stethoscope or your ear up to the horse's flank area, just past their last rib. You should hear gurgling noises (kind of the same sounds as your stomach makes when you are hungry or have an upset belly). If you don't hear these noises on both sides there might be an issue.

How to Assess a Horse's Gut or Intestinal Sounds

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How Dose a Horse's Stomach Work?

The horse's stomach is fairly small, holding only about four gallons. Those four gallons of space are divided into two parts, the non-glandular portion, and the glandular portion.

The non-glandular portion has a lining similar to that of the esophagus. The glandular portion is lined with glandular tissue, that tissue produces hydrochloric acid and pepsin. Hydrochloric acid and pepsin are important enzymes that are needed for food digestion. Unlike us horse's body's are always producing acid, so they always need to have something for that acid to digest.

Horses digestive tract and stomach

Horses digestive tract and stomach

Signs and Symptoms of Colic in Horses

  • Lack of appetite
  • Low energy
  • Dehydration/drinking much less than normal
  • Kicking at their belly
  • Laying down a lot
  • Excessive rolling
  • White or very light pink gums
  • Slow capillary refill time
  • No gut sounds on one or both sides
  • Elevated heart rate
  • Little passing of manure/small fecal balls

What Is Colic?

The word colic simply refers to abdominal pain. When you hear about a horse colicing it means that they are showing signs of pain in their stomach. Some types of colic can be fatal without surgical intervention. Among domesticated horses colic in the number one cause of premature death. It is very important that you know the causes and types of colic as well as the symptoms of colic.

Types/Causes of Colic:

  • Impaction: This can happen if the horse consumes too much dirt or sand. The dirt/sand can build up in their system and cause a blockage. It can also result from dehydration, coarse feed (poorly chewed feed), and/or overly restricted mobility.
  • Gas: Excess fluid or gas, often cause by the over-fermentation of food in the hind-gut.
  • Enteritis: Inflammation of the intestine, caused by many things such as infection, bacteria, and viruses.
  • Torsion/Colon shift: A very lethal type of colic. This is where the colon or small intestine twists. This twist can cause blood flow to be cut off which can obviously cause many more issues.
  • Idiopathic: This is when the vet can find no exact cause of the colic issue. This can account for about 80% of all colic cases.

Diagnosing Colic and When to Call the Vet

Colic is one of those things that you don't want to underestimate. It is the number one premature cause of death in domestic horses. Most (not all) colic cases can be reversed if caught soon enough and proper action is taken. If a horse is showing any of the signs/symptoms of colic you should immediately check their vitals if any of them are abnormal it's time to call the vet and see what they want you to do.

If the horse is kicking at their stomach and/or trying to lay down and roll excessively, you need to get them to stand up and start walking them. It is a good idea to check the horse's vital signs and write them down before calling the vet, that way you have that information in front of you and you can give it to the vet. Before and while calling the vet you need to keep the horse up on its feet walking if they are trying to constantly lay down or roll.

If you suspect your horse might be colicing take away their food (always keep water in front of them) until you talk to the vet. In some situations, they will tell you to give them hay and other times they will tell you no food.

Symptoms of Ulcers

  • Mild colic periods
  • Poor appetite
  • Diarrhea
  • Weight loss
  • Poor hair coat
  • Poor performance
  • Change in attitude (from good/happy to less willing to preform)
  • Lack of energy

What Are Stomach Ulcers?

A stomach ulcer, also known as a gastric ulcer, is a wound to the lining of the stomach. It can be a very painful experience for the horse. It is estimated that 50% of foals and 1/3 of adult horses confined to a stall have mild ulcers. Show and racehorses are at high risk for moderate to severe ulcers, up to 60% of show horses and up to 90% of racehorses are estimated to have severe ulcers.

What Causes Ulcers?

Simply put acid causes gastric ulcers. The horse's stomach is always producing acid because they are a grazing animal and meant to be grazing for up to 20 hours a day. When we take away their ability to graze all day we really mess with the horse's stomach. Here are some of the major causes of ulcers.

  • Fasting: Horses stomach were designed to eat many small meals all throughout the day. When there is no food in the stomach for the acid to digest for long periods of time that's when acid can build up and become a problem.
  • Medications: Overuse of non-steroidal anti-inflammatory drugs (NSAIDs) such as bute and Banamine block the production of a chemical in the horse's body that help keep acid levels low. Without this naturally produced chemical, the acid levels in the horse's stomach can get very high.

How Ulcers Are Diagnosed

You need to ask yourself two questions when you are wondering if your horse could be suffering from ulcers.

1. Is my horse at risk for ulcers?

Risk factors for ulcers include:

  • Stalled for 6+ hours every day
  • Travel in a trailer 2+ times a month
  • Rode/worked for 5+ hours a week
  • Lack of constant access to grass or hay
  • On any kind of NSAID for longer than 3 days
  • Not turned out with other horses for 6+ hours a day
  • Not turned out at all for more than 6+ hours a day

2. If the answer to question one is yes, Then dose your horse show any of the symptoms of ulcers?

If the answer to both questions is yes then you should most definitely seek a vet for a diagnosis. If your horse falls in the at-risk category of horses but is not showing any signs of ulcers than it's something just to educate yourself on so you can be on the lookout for signs and symptoms of it and learn how you can help prevent them.

Prevention Is Key!

For both of these conditions, prevention is crucial. Prevention is very similar for both disorders. They are both stomach issues that stem from poor diet, lack of proper management, and too much stress. It is by far easier said than done when it comes to managing a horse. Below I will list some tips that will help keep your horse's stomach healthy and happy!

Tips to Keep Your Horse's Stomach Healthy

  • Proper diet with constant access to grass or hay is very important.
  • Keep stalled time to a minimum.
  • Do not use NSAIDs or medication of any kind unless it's absolutely necessary.
  • Keep on a vet recommended worming program with all of your horses year round.
  • Keep stress levels as low as possible.
  • Pasture time is golden! The more time your horse spends in a pasture and out of a stall the better!
  • Horses are herd animals, it stresses them out not to have at least one friend.

Remember, if you're ever in doubt on if your horse is colicing or is struggling with ulcers, never hesitate to call your vet. You would always rather be safe than sorry. Don't underestimate these conditions they are very painful to your horse and can lead to premature death if not handled correctly in a timely matter.

Sources and Further Reading

This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

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