Colic is the most common cause of premature death in domestic horses. It is also the most frequent cause of major veterinary bills. However, the vast majority of cases of colic could be easily prevented through proper management. A review of the existing research on this disease, including case studies covering thousands of cases of equine colic, which has identified the most common causes of colic, is the basis for the following recommendations.

deworming. Make sure the horse has a regular deworming schedule. All other horses sharing the same pasture should have a synchronized deworming program to prevent cross reinfection. If a horse has a heavy infestation of worms to begin with (for example, if it hasn’t been dewormed for a long time), then deworming itself can be dangerous, so a laxative should be used to reduce the worm population before starting a deworming schedule.

food and pasture. Horses have evolved to eat and digest throughout the day. Their digestive systems are based on “continuous processing”, rather than periodic feedings (such as those found in people or large carnivores). Consequently, restricting them to feeding only two or even a few times a day is unnatural and puts a strain on their system. The ideal situation is for the horse to spend most of its time on pasture, constantly eating and moving. If this is not possible, it should be fed as often as possible so that one gets as close as possible to the “continuous processing” for which it has evolved. Food that has spoiled (eg, moldy, fermented) should never be fed.

hay before grain. The horse’s digestive system is designed for “high volume, low calorie” foods, such as grass and hay; “low volume, high calorie” foods, such as cereals, don’t provide the volume they need and can lead to a variety of medical conditions (particularly ulcers). Therefore, use high-fiber foods instead of cereals, unless there are specific reasons to the contrary (eg, for intensive sports, cereal may be necessary).

Also, if one provides both hay and grain, the hay must be fed first. One reason for this is that by reducing appetite with hay, the horse is less likely to “runaway” the grain (see “runaway” below). Another reason is that there is evidence that hay followed by grain is digested much better than grain followed by hay.

Soak peeled food. It is advisable to soak the pelleted feed before feeding the horses. The main reason for this is that pelleted feed expands on contact with water, so if a horse ‘gulps down’ a large quantity of dry pelleted feed, it can rapidly expand to an excessive volume on contact with fluids from the stomach. By pre-soaking the granules, the food expands before you eat it. This also slows the rate at which the horse eats, reduces the risk of choking, and ensures additional water is ingested (for non-drinking horses).

excessive feeding. Horses sometimes manage to get into feed stores (for example, where you store grain or other high-calorie foods) and stuff themselves, which can lead to colic. It is advisable to keep the feeding room closed, so that if a horse leaves his stable or pasture, he will not be able to enter the feeding room.

bolted. If your horse ‘flips’ (swallows without chewing) its food, discuss options with your veterinarian. For example, hay pellets can be pre-soaked in water.

Water. Make sure the horse has access to water at all times. If for some reason the horse hasn’t drunk for some time, give him water in small amounts at first rather than letting him drink a large amount all at once (especially after exercise). Likewise, if a horse hasn’t drunk for some time (horses often refuse to drink during transport), make sure that when he does drink again it is gradually.

During the winter, try to provide warm drinking water. A study by the University of Pennsylvania School of Veterinary Medicine found that this increased water consumption by 40% (warm water compared to near-frozen water). Since inadequate water intake is a major cause of colic (impactional colic), it is recommended to provide lukewarm water. Additionally, there is strong anecdotal evidence that consuming large amounts of cold water over a short period of time (for example, after exercise or after water deprivation) can cause colic.

working out. Colic can be caused by inadequate exercise (eg, the horse spends most of the day in the stable), excessive exercise (especially if the horse is out of shape), or rapid changes in the amount of exercise. Consequently, one should avoid these extremes.

Litter. Make sure the horse doesn’t eat your bedding, certainly not in large quantities. If you persist in eating your bean, switch to another type of bean that you don’t eat.

sand and dirt. Do not feed the horse on sand or dirt surfaces. Avoid parking the horse on sand or dirt. Don’t leave a horse on overgrazed pasture.

Dental care. Correct and regular dental care (for example, an annual examination, with work if necessary) will minimize the risk of horses not chewing their food correctly due to dental pain.

Caught. A horse sometimes lies down or rolls so that its back is against a fence or wall, with the result that it cannot get up. Remaining in this position for any length of time risks serious colic (eg movement of the colon into a dangerous position), so if one sees a ‘stuck’ horse they should be moved quickly, taking care to avoid accidental injury . Similarly, a horse lying down in a paddock sometimes has its legs caught under or in the fence rails and needs to be freed.

Temperature. Extreme temperatures (very high or very low) and rapid changes in temperature can cause stress in a horse, especially those that are weak (old or sick). During extreme weather conditions, consider keeping horses in their stables. Alternatively, there is a range of horse jackets to protect you from the rain and/or the cold. These should be used if there are sudden extreme changes in the weather or if a horse is weak. Also, while stalls should be well ventilated, they should not be drafty (in general, drafts are more of a risk than just cold).

Exchange. Finally, it should be noted that horses do not react well to change or stress. One should minimize these as much as possible; if a period of change or stress is necessary (eg, long-distance transportation, feed changes), the horse needs to be watched much more closely than normal and given special care. The ways that change can negatively affect a horse are numerous. For example, horses will often stop drinking during periods of stress or if they are moved to another area where the water tastes different. As another example, adding or removing a horse from a herd can disrupt the social dynamics of the herd, leading to considerable stress.

Colic is a complex disease, with many different causes. Currently, there is no management program that is 100% successful in preventing it. However, following the above guidelines will greatly reduce your risk of colic.