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of the diet as alfalfa hay increased the risk of enterolithiasis. Statistical analysis of that study revealed that feeding grass and oat hay had a protective effect above and beyond that of the reduction in alfalfa feeding. The authors hypothesised that the combination of lower protein and magnesium content and higher fibre content, resulted in liberation of short chain fatty acids, the primary end product of fibre fermentation, helping to create a colonic environment less conducive to enterolith formation. Ingestion of lower quantities of protein and magnesium may also result in less ammonium and magnesium availability for the precipitation of struvite (Hassel et al. 2008). Additionally, the study found the odds of enterolithiasis 2.8 times higher in horses that did not have access to daily pasture grazing. If daily pasture access is associated with an increase in activity level, this may play a role in reducing the risk of the disease (Hassel et al. 2008). Although feeding wheat bran, rice bran, and oat bran have been implicated as risk factors for stone formation, multiple studies have found no association with feeding bran products (Cohen et al. 2000; Hassel et al. 2004, 2008). Based on the 2008 study by Hassel et al. and others, recommended preventative measures for high risk horses or those with a known history of enteroliths include elimination of alfalfa products, feeding an oat or grass hay, daily access to pasture grazing, and potentially the addition of a daily grain feeding. The addition of apple cider vinegar (112–205 ml q.i.d.) was shown to be effective at reducing the pH of the colon in ponies fed a grass hay and grain diet (Hintz et al. 1989); however, the use of vinegar has not been evaluated with regard to enterolith prevention.
In summary
Nutritional management of recurrent colic can be challenging and may lack evidence-based recommendations in cases where a definitive aetiology has not been established. A complete diagnostic evaluation to elucidate the cause of recurrent colic is ideal whenever possible. As mentioned above, all changes to the diet should be made gradually, especially in circumstances when a feed trial is instituted and a definitive diagnosis has not been established.
Authors’ declaration of interests No conflicts of interest have been declared.
Source of funding No funding was obtained for this work.
Authorship
Both authors contributed to this review and have approved the final version of the manuscript.
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