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Why colic is not a disease

Vets should look at it as more of a clinical sign of disease

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Keep up on routine maintenance. Get teeth checked yearly and take care of problems when they show up. Check for parasites and deworm as needed.

Colic is often a subject of seemingly endless articles, myths, and firmly held opinions. Given that colic is the foremost medical problem of the horse, that’s probably inevitable. However, when it comes to discussions about colic, it may be worth considering one thing: Colic is not a disease; colic is a clinical sign of disease. Colic simply means the horse is experiencing some sort of painful stimulus; that stimulus probably is coming from inside the horse’s abdomen. In fact, there are some problems that can look as if a horse has colic that don’t have anything to do with the abdomen.

In that way, equine colic is much like human infant colic. It is well known that human babies occasionally suffer from some sort of insult that makes them cry, stop eating, and become very upset (that’s what happens to many parents and horse owners). As such, the distinction between a disease and a sign of a disease becomes very important.

To continue the analogy, colic is not a disease any more than a “tummy ache” is a disease. Everyone probably has had a stomachache or knows someone who has. What was the problem? Was the cause determined? Too much spicy food? Or, was it more serious? Was surgery required? And, most importantly, was there any way to make sure that the tummy ache could have been prevented 100 percent of the time?

What colic means

In the horse world, instead of being an occasional annoyance, albeit one with sometimes serious implications, colic has become pretty much a synonym for, “something really bad that happens to a horse.” Or, “something about which horse owners should live in perpetual fear.” And sometimes—not usually, but sometimes—it is. But it’s never a disease in and of itself.

As such, when it is asserted that there is a way to “prevent colic,” it is important to define terms. If it is suggested that by employing this feeding program, exercise program, supplement program, meditation program—whatever—a horse will never suffer pain coming from his abdomen, that’s unlikely. One would immediately cast a skeptical eye on a claim that a product would prevent an entrapment in the epiploic foramen; claims that a product can “prevent colic” should be viewed with an equal amount of skepticism.

What can be done?

That said, there are some sensible things that can be done to help keep a horse’s digestive tract in as good a working order as possible.

  1. Make sure the horse always has access to fresh, clean water. Horses drink as much as 10 gallons of water per day, depending on climatic conditions. Limiting access to water can increase the risk of some sort of abdominal problem, especially in horses greater than 6 years of age. Drinking should be easy for horses, as well. They prefer buckets to automatic waterers; when they drink, they drink a lot, and quickly. When traveling, frequent stops for water are a good idea. If water is cold, heating it will encourage a horse to drink.
  2. Allow horses to move. Unrestricted movement is important for at least part of the day. For example, it’s been shown that horses in pastures experience fewer episodes of colic pain. In pasture, they get to move around, socialize, eat, and be a horse.
  3. Restrict access to foreign materials. In areas where the soil is sandy (Southern California, parts of Florida, Nebraska, and many other areas around the world), horses will happily vacuum the ground for every last bit of feed—and consume mouthfuls of sand in the process. Sand can accumulate if the horse eats enough of it, and it can irritate, or even block, the GI tract. Products that are said to prevent sand colic, most of which contain pysllium, are not a substitute for good environmental management.
  4. Make sure the vast majority of your horse’s diet is high-quality forage. For most horses, “vast majority” can mean 100 percent.
  5. Eliminate or limit grain. Horses love grain. However, the more grain a horse eats, the more likely he is to be at risk to develop intestinal problems. While there are many ways to get additional calories to horses, grain is one of the poorer ones.
  6. Make feed changes gradually. When switching from one type of hay to another, make the switch over a period of a week or two, mixing old and new hay. Keep a regular exercise program going, as well. If feed changes are made, they should not be abrupt.
  7. Keep to a feeding routine. Horses are creatures of habit. They should be fed on a regular schedule—ideally three times a day. Slow feeders may be helpful for some horses. Free feeding is even better, but many horses get fat when free fed.
  8. Keep up on routine maintenance. Get teeth checked yearly and take care of problems when they show up. Check for parasites and deworm as needed (and, importantly, don’t do what’s
    not needed).
  9. Pay attention. Being familiar with what’s normal for a horse allows abnormal behaviors to be recognized quickly. Horses under stress are at risk for colic. They should be trained and be allowed to play, and run, and buck, as well. Overtraining is also a problem in performance horses.


Colic is not a single disease. While there is nothing that can be done to prevent episodes of colic in every horse, there are many preventive measures that make sense. Any good veterinary-client-patient relationship should include sensible counseling about colic prevention.

Dr. David W. Ramey is a Southern California equine practitioner who specializes in the care and treatment of pleasure horses. Visit his website at doctorramey.com.

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