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

• Scoping review of current enteral nutritional strategies for horse after colic. • Early reintroduction of enteral feeding (12–24 h) is linked to faster recovery. • Forage-based, low-NSC diets support intestinal motility and microbiome stability. • Prolonged fasting and high-NSC feeds may increase dysmotility and colic recurrence. • A usefull, physiology-based “feed pyramid” framework is proposed for clinical use. Colic represents one of the leading causes of morbidity and mortality in equine medicine, with nutritional management recognized as a key modifiable factor influencing postoperative recovery. However, guiding principles for nutritional enteral support in horses after colic remain limited, and current practices are largely empirical. This scoping review aimed to (1) examine enteral nutritional support protocols reported in literature through a scoping review to map the available evidence on equine clinical nutrition in the context of colic, and (2) propose a physiology-based interpretative framework to consider when formulating dietary plans for post-colic horses, from a clinical nutritionist’s perspective. PRISMA 2020-ScR guidelines were applied in Scopus and Web of Science databases using “horse colic” AND “clinical nutrition.” Inclusion criteria comprised English-peer-reviewed studies reporting nutritional interventions in horses with colic. Data were extracted into predefined different categories. Twenty-three studies met the inclusion criteria, revealing marked heterogeneity. Early reintroduction of enteral nutrition (12–24 h postoperatively) was associated with faster recovery, whereas parenteral nutrition was reserved for severe intestinal dysfunction. Evidence supports the use of forage-based, low-starch diets to promote intestinal motility and microbiome stability, while prolonged fasting or high-NSC feeds increase the risk of dysmotility and recurrence. Post-colic horses benefit from the “feed pyramid” approach—maximizing forages, low-NSC, balanced supplements, avoiding fasting and offering small frequent meals in wet, digestible feed forms. Current evidence underscores the central role of early, forage-based enteral feeding in post-colic management. The integration of nutritional planning within multidisciplinary decision-making is essential to balance clinical, metabolic, and nutritional priorities.