Colic is the most common cause of death in domestic horses and a significant welfare concern; most cases are preventable through evidence-based management practices.
The high prevalence of colic in domestic horses reflects a fundamental mismatch between management practices and equine digestive physiology. Modern stable management often involves prolonged stabling, restricted forage access to control bodyweight, high-starch concentrate feeds, and limited movement, all of which increase risk. Horses spending more than 50% of their time on forage have significantly lower colic risk than those on restricted diets. Water access is critical, as dehydration is a primary cause of large colon impaction. The welfare dimension extends beyond the acute episode; horses suffering repeated colic are in chronic poor welfare, and surgical colic causes significant perioperative suffering. Most prevention is achievable through management reform rather than medical intervention, making colic primarily a welfare education challenge.