A 6 year old Hanoverian mare was presented with colic, icterus, and severely increased liver enzyme activity and bile acids. Diagnostic imaging revealed sand in the colon and a dilated mesenteric vessel. The patient was refractory to analgesia and was euthanized due to poor prognosis and financial restrictions. Necropsy revealed a dilated and displaced right dorsal colon with compression of the adjacent liver, and histopathology revealed moderate hepatic portal and capsular fibrosis with other changes to the liver, and mild, multifocal astrocytosis with Alzheimer type II cells in the cerebellum. The clinical and pathological findings were consistent with a diagnosis of hepatic encephalopathy secondary to compression of the liver by a displaced right dorsal colon.