Recurrent colic—the type of abdominal pain that goes away but just keeps coming back—isn’t technically considered a disease itself.

Rather, recurrent colic is the result of other underlying causes, such as inflammatory bowel disease (IBD), intestinal adhesions, gastric ulcers, and/or dental problems. In some cases the primary cause isn’t even a gastrointestinal issue at all—such as when ovarian cysts, displaced ligaments, or chronic stress trigger abdominal pain.

Determining the Cause of Recurrent Colic in Horses

That’s why the first step in managing recurrent colic should always be to take a step back and look at what pathologies might be behind it, says Alicia Long, DVM, Dipl. ACVIM (LA), ACVECC (LA), assistant professor in Large Animal Emergency and Critical Care at the University of Pennsylvania’s New Bolton Center, in Kennett Square. Some causal diseases, such as gastric ulcers, reproductive system disorders, enteroliths (intestinal stones or calculi), and enteropathies (disease or damage of the intestinal tract), can be successfully treated with medications, changes in management, and/or surgery.

The underlying issue might not even be a physical disease at all but, rather, inappropriate management, adds Kris Hiney, PhD, associate professor and extension specialist in Animal and Food Sciences at Oklahoma State University, in Stillwater. “Don’t forget that physiological health depends on mental health,” she says. “That’s super important.”

Finding the cause of your horse’s recurrent colic could take weeks, months, or even longer, says Long. When you get a diagnosis, there aren’t always rapid treatment options—which is the case with spasmodic gas colic and colon displacement—arguably two of the most common sources of recurrent colic, she says. Worse, in some cases, there might not be any diagnosis at all.

In the absence of a diagnosis or targeted treatment plan, it’s critical to feed the horse in a way that provides relief, our sources say. In addition, following a carefully devised plan could lead to valuable clues that help pinpoint the cause.

And although robust research is still needed, practical experience suggests a well-designed feeding regimen might even—in some cases—give the digestive system just the break it needs to heal and get back on track, Long says.

“It’s sort of like resetting the system,” she explains. “The hope is that it would be just an intermediate phase to then go back to more normal.”

Importantly, feeding the recurrent colic horse is never as simple as throwing in a dietary supplement, Hiney emphasizes. “I would really take a holistic look at the entire program for the horse before saying, ‘Oh, I’ll just give him a probiotic,’ ” she says. “Because that’s not going to help if the problem is somewhere else.”

To help you understand the best ways to feed your recurrent colic patient while awaiting a diagnosis or targeted treatment, we’ve provided these five helpful tips.

1. Go for Low-Bulk Fiber

Horses evolved to thrive on bulk fiber such as long-stem hay and grass, and even leaves and small branches. But the digestive system—particularly the small intestine—works hard to break down all that bulk, Long says. To give the intestines some rest, she recommends feeding low-bulk fiber such as chopped hay, hay cubes, and pellets.

Based on various clinical cases she’s seen, Long notes that low bulk seems particularly beneficial for horses with inflammatory intestinal conditions such as IBD. “Basically, you’re making it really easy for those intestinal cells to digest food,” she explains.

Made of finely ground fiber, pellets offer “the most extreme of low bulk,” says Long. She’s found pellets work best in confirmed IBD cases. Because hay pellets are hard, they need to be soaked for easier chewing. When the diagnosis is uncertain, horse owners can try chopped hay or cubes first, if they prefer.

Hiney says she looks out for any forage that might be “too coarse,” especially when the recurrent colic patient is an older horse with dental issues. “Does he need to be on a finer stem, or perhaps less-mature forage?” she asks.

Fresh grass usually makes a great low-bulk forage, provided horses can chew it, Long says. Horses with recurrent colic can benefit from full- or part-time pasture, as long as their dental and metabolic health—particularly concerning laminitis—allow it. This approach offers the added benefit of mimicking the natural behavior of horses, which evolved to have constant access to forage and move regularly to obtain it.

While researchers haven’t linked high-starch diets and recurrent colic, Long says she nonetheless recommends keeping concentrate feeds to a minimum for these horses. Any concentrates should be fed on a full stomach of forage to avoid digestive upset, she adds.

Horses with recurrent colic needing extra energy for performance or weight gain could consume fats and oils instead of concentrates, Long says. And all horses on forage-focused diets need a balancer to shore up their vitamin and mineral intake.

2. Limit Variety

Free-roaming feral horses consume dozens of plant species. But to allow an upset digestive system some rest, it’s important to keep your horse’s “salads” simple, our sources say.

“In general, limit the number of different ingredients you’re giving your horses—
especially those whose intestines aren’t totally normal from a functional standpoint,” Long says.

That includes the supplements we’re hoping could be helpful, as well as the treats we use for training or just to show our love. “Apples, carrots, and peppermints have simple ingredients versus processed treats,” she explains.

Providing pasture in addition to stored forage (hay and hay products) also constitutes variety, says Hiney. That creates somewhat of a conundrum because, again, horses—and notably those with recurrent colic—usually benefit from fresh grass. The trick is introducing the variety slowly, increasing the amount of turnout time over a matter of weeks.

3. Scrutinize Your Forage, Pasture, and Bedding

Do you really know what’s in your forage, out in your field, and under your horse’s feet? Examining the composition of these food sources could provide crucial insights into what triggers your horse’s colic episodes, Long and Hiney say.

Hiney recommends regularly checking your turnout areas for toxic plants such as branching ivy, sycamore maple (Acer pseudoplatanus), or buttercups.

Fence lines are likely spots for unintended plants, including weeds and poisonous species such as pokeweed, distributed by birds in their droppings. “Really look at everything that could be going on,” she says. “They could all be part of the problem.”

Grass length could also cause trouble if a horse has dental issues that prevent proper chewing. Long fibers are harder to digest.

You can work with an extension agent to evaluate your pastures and hay and help you identify any toxic plants.

Sand buildup in the digestive system can also create digestive issues, particularly sand colic. So, it’s important to know if you have sandy soils and if your horse’s recurrent colic might be associated with that.

Owners should thoroughly inspect their stored forage for dust, mold, coarse texture, or poor quality in general. Any of these issues could further upset a sensitive digestive system, our sources say. In addition, they need to watch for dead animals and other foreign objects that could cause disease or injury.

Finally, inspect your bedding for similar problems, and observe your horse’s behavior. Is he eating his bedding? Straw contains coarse, long fibers that are difficult to digest, but bored, hungry horses, or those needing to chew or lacking long fibers in their diet, are prone to eat it, Long says.

While shavings might be a better option, some horses—especially hungry ones—eat them as well. Long says researchers have not documented any cases of horses developing recurrent colic because they consumed shavings. Even so, it’s worth keeping an eye on what horses are doing with their bedding. “It sometimes requires some experimenting to keep them from eating it,” she says.

4. Prioritize Consistency

Generally speaking, horses are creatures of habit. Those with recurrent colic thus face fewer challenges when they have consistent management—meaning consistent meals at consistent times of day in consistent settings.

“Often what you see with these recurrent colic horses is that they colic with changes in routine—even changes in weather,” Long says. “Obviously, the weather’s going to do what the weather’s going to do. But if you can try to make sure that their feeding is as consistent as possible, that’s going to be a big thing, too.”

That routine means what time, how much, and what you’re feeding—right down to the same batches of hay from the same source, she says.

However, consistency goes far beyond just feeding (and weather), Hiney adds. Susceptible horses need welfare-friendly environments that meet all their unique natural needs, such as forage, companionship, and free movement.

“My answer is always to go through all of the management first, doing all the things that are logical for the horse,” she says. “People like to go first to supplements right away, but you really need to make sure your management program is where it needs to be before you start adding things on top.”

5. Try Supplements and Other Changes One at a Time

Once you’ve examined and addressed your horse’s diet and management, try adding or removing an element to see what helps—or what, unintentionally, might make things worse.

“It’s a little bit of trying and seeing,” Long explains.

Specifically, that means experimenting with different types of hay or pasture, feeding times, and even surroundings or nearby companions, notes Hiney.

“So, ask yourself, ‘Okay, I’m changing this, did this help?’ ” she says. “You need to really start figuring out what works and what doesn’t for each horse. Dialing into the needs of that individual horse is how we want to do it.”

Supplements such as antacids, pectins, lecithins, aloe vera, and papaya might be helpful and, in fact, some probably are, says Hiney. However, the current research is too limited to provide clear recommendations.

“If you’re going to do supplements, you’ve got to be very clinical in your approach,” she says. “So don’t just throw everything at them. Try one thing, then give it a good chance (at least a month) to see if it does anything before you switch.”

This deliberate approach can help you determine what’s responsible for improvements—management or dietary changes or the product.

Importantly, owners need to keep in mind that frequent changes could themselves trigger colic episodes in a colic-prone horse, she adds. Consult an equine nutritionist about dietary management and work with your veterinarian to create a comprehensive health plan for such a horse.

Take-Home Message

Recurrent colic threatens horses’ health and welfare and causes significant stress and frustration for owners. A few helpful feeding tips can give them a chance to take a break and possibly even recover. Scientists still need to gather significantly more data before making evidence-based recommendations. In the meantime our experts advise easing the recurrent colic horse’s digestive burden with consistent, simple, low-bulk forage diets and a welfare-friendly management approach, while making changes gradually.