Equine Colic

Preventing colic

Risk factors

Most preventable risk factors are management related:

  • Change in diet is frequently reported as a risk factor- increased risk with change in concentrate or hay, generally within 2 weeks
  • Increased risk with feeding concentrates – concentrates > 2.5kg/day or oats >2.7 kg/day, +/- feeding corn
  • Increased risk with 1)feeding coastal grass hay, 2) feeding round bale hay, 3) no pasture access or 4) decreased  pasture access
  • Increased risk if stabled more than 50% of the time
  • Increased risk if no or decreased water access
  • Increased risk if change in housing or stabling

Horses were at decreased risk of colic if the owner was the sole care giver.

Minimize the risk of colic

  • Ensure fresh water always available.
    • Add a water trough heater to prevent water from freezing in winter.
    • Increase water consumption by giving electrolytes during periods of weather change.
    • Ensure horses have water available with each meal
    • Warm the water – they tend to drink more
  • Feed easily digestible feedstuffs
  • Let horses eat pasture grasses if possible; any hay is better than no hay.
  • Don’t feed on the ground or use mats in order to minimize sand ingestion. Horses won’t eat sand purposefully but may eat it accidentally if trying to get grain off the ground.
  • Provide good dental care
  • Make changes in feed gradually
  • Monitor closely within 2 weeks of any change in management, feeding or illness
  • Owners take care of horses vs barn managers or trainers
  • Provide postoperative pain relief
  • Use atropine only as needed (eg in eye cases)

Bran mashes are often used when horses may be at risk of developing an impaction and/or recovering from one. Bran is mixed with hot water to create a fiber rich laxative. Mineral oil may be added to the mix. However, these are high in phosphorus and low in calcium so are not recommended as a continual diet!

Hospital cases

Certain hospitalized cases are particularly prone to impaction colic.

Horses hospitalized for orthopedic issues but NOT on NSAIDs are prone to pelvic flexure impactions. This is likely related to changes in exercise, management and diet.

These two groups are prone to cecal impactions which can be very challenging and often life threatening:

  • Horses with eye issues being treated with atropine and flunixin meglumine
  • Horses hospitalized for orthopedic issues on NSAIDs

These are likely related to the decreases in motility associated with stall rest, pain induced sympathetic tone and atropine treatment. The NSAIDs control the early pain associated with impactions, meaning the conditions can be very advanced before detected.

Cases at risk should be kept well hydrated and monitored closely for adequate manure production.


Client resistance

A recent study suggested veterinarian communication skills are crucial in helping clients be proactive about colic

Use of human behaviour change models to investigate horse owner intention to adopt emergency colic recommendations, Equine Vet J. 2024;56:147–158.


There were 701 horse-owners who completed the survey. Respondents fell into one of two categories: no intention to adopt or already implementing emergency planning recommendations. Most agreed that emergency colic plans would improve their horse’s welfare (68%) and aid in decision making (78%). Most disagreed that colic was inevitable (66%) and that treatment options were not within their control (69%).
Multivariable analysis showed that those who believed emergency plans were worth creating were more likely to adopt preventive (OR: 2.33, 95% CI: 1.27–4.30, p = 0.007) and personal preparation (OR: 1.61, 95% CI: 1.31–1.97, p < 0.001) recommendations.

The majority of owners were either unwilling to adopt suggested recommendations or believed that their approach was currently sufficient. Most owners perceived veterinary professionals as most influential on their decision to plan for a colic emergency, highlighting their importance in any educational campaign




Recurrent Colic Diagnosis, Management, and Expectations, Vet Clin Equine 39 (2023) 399–417

How can nutrition help with gastrointestinal-based issues? Vet Clin Equine 37 (2021) 63–87- nice review of how and why we impact equine health

Epidemiology of colic, Vet Clin Equine 39 (2023) 157–174- nice discussion of rates and risk factors

Risk factors for acute abdominal pain (colic) in the adult horse: A scoping review of risk factors, and a systematic review of the effect of management-related changes, 2019 PlosOne

Nutritional management of recurrent colic and colonic impactions, 2016 EVE

Differences in gastrointestinal lesions in different horse types, 2017 BMJ Vet Rec



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Large Animal Surgery - Supplemental Notes Copyright © by Erin Malone, DVM, PhD is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.