Clinical nutrition in equine colic: a scoping review from an equine nutritionist’s perspective.

Overview

• This study reviews how nutrition is managed in horses recovering from colic, a serious digestive condition, to identify best feeding practices and develop guidelines for post-colic nutritional care.

Background

• Colic is a major cause of illness and death in horses, often requiring surgery.
• Nutritional management after colic surgery significantly impacts how well horses recover.
• Currently, feeding practices after colic are largely based on anecdotal experience rather than evidence-based protocols.
• There is a lack of comprehensive guidelines on how to optimally provide enteral (via the digestive tract) nutrition after colic surgery.

Objectives

• To systematically map the existing scientific literature on nutritional support in horses diagnosed and treated for colic.
• To create a physiology-based framework for clinical nutritionists to design effective diets that support recovery after colic.

Methods

• Conducted a scoping review adhering to PRISMA 2020-ScR standards for transparent reporting.
• Searches performed in two major academic databases: Scopus and Web of Science.
• Used specific search terms: “horse colic” AND “clinical nutrition”.
• Included only peer-reviewed English studies that examined nutritional interventions in colic-affected horses.
• Extracted data according to predefined categories to ensure systematic synthesis and comparison.

Results

• Identified 23 relevant studies showing wide variation in nutritional protocols post-colic surgery.
• Early enteral nutrition, typically reintroducing feeding within 12-24 hours post-surgery, correlated with faster recovery times.
• Parenteral nutrition (intravenous feeding) was primarily reserved for horses with severe intestinal dysfunction where enteral feeding was unsafe or impossible.
• Evidence indicates feeding diets high in forage and low in starch (low non-structural carbohydrates, NSC) supports healthy intestinal motility and maintains microbiome balance.
• Prolonged fasting or feeding high-NSC diets increased risks of gut motility problems and colic recurrence.

Interpretative Framework for Nutritional Planning

• Advocates a “feed pyramid” approach prioritizing:
• Maximizing forage intake as the foundation of the diet.
• Using low-NSC feeds to reduce digestive upset and support gut microbial health.
• Incorporating balanced nutritional supplements to meet macro- and micronutrient requirements.
• Avoiding extended periods of fasting post-surgery to prevent negative gastrointestinal effects.
• Offering small, frequent meals in wet and easily digestible forms to enhance tolerance and absorption.
• This framework integrates physiological understanding of equine digestive processes with clinical nutrition principles.

Conclusions

• The review highlights the critical importance of early refeeding with forage-based diets for optimal post-colic recovery.
• Feeding strategies must be balanced to address clinical condition, metabolic needs, and nutritional status.
• Coordinated, multidisciplinary clinical decision-making that includes nutrition experts is essential for successful outcomes.
• Further research is needed to refine evidence-based feeding protocols that can be standardized in equine clinical practice.