Colic is one of the most feared words in the horse industry — and for good reason. According to equine veterinarian Dr. John Sieverts, it remains the number one killer of horses. But one of the biggest misconceptions horse owners have is that colic automatically means surgery. In reality, “colic” simply refers to abdominal pain, and the causes can range from mild gas buildup to serious intestinal complications requiring emergency intervention.
In a recent interview, Dr. Sieverts shared what horse owners should truly be watching for during a colic episode, and his message was clear: timing matters. One of the biggest indicators that a horse may need surgery is unrelenting pain: continually lying down, rolling violently, some throwing themselves down or failing to improve with medication. While many owners instinctively wait and hope the horse improves, Dr. Sieverts explained that waiting too long can often make outcomes worse.
One of the biggest fears horse owners have when a horse is colicking is that trailering can be dangerous or uncomfortable for a colicking horse. While that concern is understandable, delaying care is often the greater risk. Dr. Sieverts emphasized that getting the horse into the trailer and to a veterinary clinic quickly is often the best course of action. Surprisingly, trailer movement can sometimes even help stimulate gut motility and move gas—making prompt transport not only necessary, but potentially beneficial. And if a horse is enough to roll in a trailer, that’s often a strong sign it needs immediate surgical attention anyway.
The encouraging news is that most colic cases are not surgical. Dr. Sieverts estimates that only about 10-15% of colics ultimately require surgery, meaning the majority can be managed medically when caught early. Veterinarians use a combination of pain level, heart rate, palpation, and ultrasound to determine severity and decide on the best course of action. Properly assessing the horse also plays a major role, especially when evaluating whether intestines feel tight, displaced, or impacted.
When surgery is necessary, survival rates have improved significantly over the years. Dr. Sieverts noted that with timely intervention, approximately 80% of horses undergoing colic surgery survive and recover successfully. Advances in fluid therapy, pain management, and post-operative care have dramatically improved outcomes during his 38 years in practice.
For horse owners, the takeaway is simple but important: know your horse, trust your instincts, and don’t ignore persistent pain. Early action can make all the difference. Contributing to the colic success is having a good team ready to go 24/7 which we have.