Nutrition is one of the most important aspects of managing a horse following colic surgery. Horse owners should follow basic feeding principles and tailor some elements toward the horse's specific condition to create an optimal recovery environment.

Protective practices to avoid another case of colic include allowing a horse access to small amounts of feed frequently and introducing feeding changes gradually.

Horses that have undergone colic surgery, especially for small intestinal disorders, might suffer from postoperative ileus, which is decreased motility of the intestine. These horses benefit from immediate feed withdrawal and gradual reintroduction to small frequent feedings of highly digestible grass, complete pellets, or alfalfa leaves once they no longer have reflux or when they show improved motility on ultrasound exam.

Horses with gastric ulcers should be fed forage continuously if possible, as constant access to pasture or other feed buffers the stomach acid with saliva.

Grass Free access to pasture can decrease the risk of colic and the risk of diet variation with seasonality, and it can protect against conditions such as colon impaction, epiploic foramen (the passage between the liver and the pancreas) entrapment of the small intestine, and enterolithiasis (intestinal stones). However, make changes in pasture access gradually, and take into consideration factors such as obesity and metabolic disorders.

Hay A horse should generally consume 1-1.5% of his body weight in hay per day. Although hay is less variable in quality than grass, poor-quality hay can increase the risk of small intestinal and colon impactions. High-quality, low-bulk grass hay is ideal for postoperative patients that have undergone large colon repair.

Alfalfa hay provides more calories and is more digestible than grass hay. It has been found to be protective against ulcers and is recommended for horses that have undergone colon resections. Restrict alfalfa hay to less than 50% of a horse's forage diet, however, since high amounts can predispose horses to enterolithiasis in certain geographical areas.

Concentrates The risk of colic increases when feeding greater than 2.5 kg of concentrates per day,1 whole grain corn, or feeding greater than 2.7 kg oats per day.2 This might be due to acidification of intestinal contents, which causes a bacterial flora shift and consequently decreased function, gas distention, and possible displacement/twisting.

Oat and sorghum concentrates might be more digestible than barley, wheat, and maize-based feeds. Other sources of fiber or fat, such as alfalfa cubes or vegetable oil, can supplement some of the caloric needs of horses that they don't get in the concentrates. Ideally, owners should feed the average-sized horse a maximum of 2 kg of starch per meal.

Complete pelleted feeds are highly digestible and can be beneficial for horses that suffered colon impactions or underwent colon and small intestinal resections. In horses suffering from right dorsal colitis, a life-threatening ulcerative inflammatory condition of the colon, withdrawing roughage and feeding frequent small amounts of low-roughage pellets for at least three months decreases the digestive load on the colon and allows ulcers to heal.

Supplements Horses should always have access to a mineral-salt lick. Psyllium is often recommended to help prevent sand impactions, and it might aid mucosal repair in horses with right dorsal colitis. Vegetable oil (1 cup per day) can help supplement calories after intestinal resection, and enterolithiasis cases might benefit from mild acidification from apple cider vinegar supplementation (1 cup twice daily). However, it's best to consult your veterinarian and/or equine nutritionist before adding supplements to your horse's diet.

As long as owners work with their veterinarians, make feeding changes gradually, and provide small, frequent feedings of grass, quality hay, and/or pelleted feed, they should be able to furnish their horse with an optimal environment for recovery.


1. Tinker MK, White NA, Lessard P, et al. A prospective study of equine colic risk factors. Equine Vet J 1997;29:454-8

2. Hudson JM, Cohen ND, Gibbs PG, et al. Feeding practices associated with colic in horses. J Am Vet Med Assoc 2001;219:1419-25

About the Author

Jean-Yin Tan, DVM, Dipl. ACVIM

Jean-Yin Tan, DVM, Dipl. ACVIM, works at Syracuse Equine Veterinary Specialists, an equine consulting practice in New York. Her professional interests include neonatology, respiratory disease, and gastroenterology.

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