Fall Laminitis

There are many possible causes of laminitis but the vast majority of cases have a hormonal/endocrine root.  There is a peak in the spring, related to grazing young high sugar growths of grass.  A second peak occurs in the fall, but the cause is more complicated.

grazing

             Spring laminitis cases are often grass related but fall is more complicated.

Grass does undergo a period of regrowth in the fall in some areas, but many cases of fall laminitis aren’t even on pasture.  There is a natural rise in the hormone ACTH from late summer through end November in all horses.  ACTH stimulates release of cortisol.

In older horses and horses that are early cases of Cushing’s Disease this rise can be very exaggerated and causes or worsens insulin resistance, often pushing the horses into laminitis.  Reversing this means attacking both on the dietary end and also using medication, pergolide, to control exaggerated ACTH release.

Insulin resistance is managed with the same dietary adjustments whether it is a primary insulin resistance built into the horse’s genetic makeup or caused by hormonal changes with Cushing’s disease.  The horse should be fed primarily grass hay with a combined sugar (ESC) and starch level below 10%.  A good starting point is to feed 2% (20 pounds per 1000 lbs) of ideal body weight or 1.5% of current body weight, whichever is larger.  This can be adjusted up or down to maintain a lean body weight but do NOT starve the horse.

There are several vitamins and minerals that play key roles in insulin function.  Keeping mineral intakes at correct levels and balanced is one thing completely within our power to control.  Ideally, supplementation is based on the results of hay analysis.  If that is not possible, regional average analysis figures are often available.

For example, it has been well documented that normal magnesium status is important to maintaining cellular sensitivity to insulin.

Avoid supplements with any added iron in the ingredients list (look for both iron and ferric).  Also check for mono and dicalcium phosphate in the ingredients list.  Those minerals are typically very heavily contaminated with iron.  Iron is already adequate if not excessive in virtually all hays.  IR horses not on mineral balanced diets can be iron overloaded.  Iron has been shown to worsen IR.

Hays from many areas are also deficient in copper and/or zinc but with adequate to high manganese so most people need a supplement to correct that – i.e. low to no manganese.  These trace minerals can compete with each other for absorption.

Vitamin E is needed because this vitamin is always deficient in hay.  Feed 2 IU (international units) per pound of body weight daily.  Vitamin E requires fat for absorption so either use a liquid E in oil or mix a powdered E into some oil before feeding it.

Hooves recovering from laminitis need balanced minerals too, as well as adequate protein. Biotin supplementation supports hoof growth and pyridoxine is needed for amino acid/protein metabolism.  The hoof wall is composed almost entirely of protein.  Nitric oxide production inside blood vessels counteracts hoof blood vessel constriction that can occur with IR and Cushing’s.  Jiaogulan provides potent support for nitric oxide production in the vessels.

There is no quick fix or magic bullet to prevent or reverse laminitis linked to hormonal disruption.  Even pergolide can’t do the job on its own.  Fortunately, the nutritional tools needed to win this battle are available to anyone who takes the time to learn what is needed and implement it.

Eleanor Kellon, VMD

 

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The Heart of the Immune System is the Gut

The function of the immune system is to protect the body from outside organisms and substances that may harm it.  It should be no surprise then that mucus membranes lining all the portals of the body open to the world have high immune capacity.  The most important of these is the digestive system.

The immune system of the intestinal tract is called GALT – gut associated lymphoid tissue.  Throughout the intestinal tract there are immune system cells, macrophages and lymphocytes, under the intestinal lining cells. Structures called Peyer’s patches are very similar to lymph nodes and are located in the small intestine. They have been called the tonsils of the intestinal tract.  Specialized immune cells also line the liver.

peyers-patches

Microscopic view of Peyer’s Patches lying under the lining cells of the small intestine

Microfold cells, or M cells, are located over collections of lymphoid tissue along the intestinal tract. The M cells reach out to engulf bacteria and other material from the intestinal tract then pull it inside and present it to immune system cells. This material is processed through T and B lymphocytes, eventually resulting in the production of IgA antibodies, which remain in the local tissues to protect them. However, it doesn’t stop there.

The lymphocytes that will eventually produce local IgA antibody are released into the bloodstream before they come back to home in the intestinal lining again. In the process, they can share this information with the entire body’s immune system so that the rest of the body can produce circulating antibodies (IgG, IgM) to the same organisms the local IgA targets.  A good example of how GALT interacts with the rest of the body is oral vaccines. Several human oral vaccines have been developed, including against polio and malaria. Oral rabies vaccines in bait have been used to successfully battle rabies in wild animals.

Research has found that interactions between the immune system and the bacteria colonizing it can have profound effects. Probiotics are defined as bacterial strains capable of colonizing and surviving in the gut which have a beneficial effect on their host by suppressing the growth of harmful bacteria and interacting with the immune system.

Documented effects of probiotics to date include directing activity of immune cells, encouraging production of protective mucus, reducing inflammation and increasing the production of IgA antibody, which in turn decreases the risk of allergy related IgE antibody forming.

Prebiotics support the growth of probiotic strains of bacteria by feeding them or maintaining an environment in the gut that is favorable for proliferation of probiotic strains. Some also have direct immune system effects.

The diet itself plays a major role in the health of the intestinal tract and the beneficial probiotic strains inhabiting it.  Quality hay free of mold and other easily fermentable dietary ingredients like beet pulp feed these beneficial strains.  Avoid overfeeding of grains as this can bypass small intestinal digestion to upset the balance of organisms in the hind gut.

In summary, the intestinal tract is a major player in the immune system. It has been estimated that 70% of the body’s immune system cells originate there. Immune activity in the gut has a body-wide effect. One of the best ways to boost and balance the immune system is through the oral administration of probiotics, prebiotics and other substances documented to support and balance immune function.

Eleanor Kellon, VMD

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Hay Analysis

If you could pick between a feed with a balanced complement of vitamins and minerals, known adequate protein or one deficient in several minerals, excessively high in others with unknown protein which would you choose?

HAY SAMPLES

When you feed hay without the benefit of a hay analysis you are feeding an unknown.  It is well established that hays across the country, around the world in fact, vary widely in protein, digestibility, mineral levels and mineral balance.

The advent of vitamin and mineral supplemented feeds, and later “balancers”, was a very positive development in equine feeding but you can’t rely on them to solve all the issues in a horse’s diet.

One problem is calories, particularly a problem for horses that are not performing significant work on a regular basis. These products contain 2 to 3 times more calories than hay, so for every 5 pounds of grain fed you deprive the horse of 10 to 15 pounds of hay.  This is less of an issue for balancers fed in 1 to 2 pound amounts but because of the starch content even balancers may be inappropriate for insulin resistant horses.

Protein can be an issue with feeds.  Even fed in full recommended amounts, feeds and balancers do not fulfill protein needs and hay must supply 50% or more.  For 1 pound of the more calorie dense feeds to supply as much protein as 2 to 3 pounds of hay they would have to have 2 to 3 times more protein than the hay.  They don’t.  If the hay already had extra protein enabling you to feed less it’s not a problem but you can’t know that without a hay analysis.

On the mineral front, when fed as directed most products will result in an adult, not pregnant or lactating, horse getting at least close to the minimum required level of each individual mineral.  However, the feeds and balancers cannot reliably correct for imbalances that influence how well these minerals are absorbed.  Even if they are used as directed there’s a good chance a hay analysis will identify areas where you still need to adjust to achieve balanced ratios.

A common example is a horse getting fortified grain or a balancer that still has issues leading to buying a coat or hoof supplement.  A major thing many of those coat or hoof supplements do is to target imbalances commonly present in hays.   You can avoid all that double supplementing by getting a hay analysis and using a mineral supplement that correctly addresses both imbalances and total amounts in the first place.

If the mineral profile of your fortified feed or balancer does not correctly address the issues with your hay it could even actually do more harm than good.  Do the job right for best results and save money in the process with a hay analysis.  It can be the best investment in solid nutrition you have ever made.

Eleanor Kellon, VMD

 

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Opinions

There’s a saying that opinions are like noses – everybody has one.  Not very respectful but not a bad place to start in evaluating opinions, including our own.

OPINION

Another good one is that the right to have an opinion does not make your opinion right.

By definition, an opinion is not fact.  For something to be fact, it has to be verifiable as true.  Paper will burn in fire is a fact, not an opinion.  Opinions can rarely measure up to that level of certainty, and if they did they would technically cease to be just opinions.

Opinions are a blend of what we believe to be true based on our experiences and what we think/feel/suspect is true from our reading, education, cultural influences or just personal preference.

If you are about to have a “Duh!” or “So what?” reaction about now, remember that opinions no matter how strong are not facts.  Then think about how many of your horse care decisions are based only on opinions.  If we’re honest, it’s a very high percentage.  It doesn’t matter a whole lot for something like halter styles or colors, but when you get into the realm of  diet and health care it certainly does.

Should you just trust your gut or your instincts?  I hope not.  That’s not a very strong foundation on which to build an opinion.  We’re not born knowing instinctively how to correctly care for a horse.  When asking others for advice and guidance you’re likely to get a hefty dose of opinion too, but not all opinions are equal.

Equine nutrition is an area where everyone seems to have an opinion.

Working the cash register in a feed store, or answering the phone, doesn’t make that person any more capable of correctly advising you on nutrition than a school crossing guard, or your plumber, but that won’t necessarily stop them from telling you their opinion.  Equine professionals with unrelated specialties like trainers or farriers might be free with their nutrition advice too, but without any real background or training to back it up.  In fact, many people like to fancy themselves as knowledgeable about nutrition when actually they’re not – or at least not as widely as they think.

Someone who has spent decades raising or successfully training thoroughbreds can tell you a lot, but if your goal is to work with minis their advice is potentially disastrous.  Rule #1 is to seek out people familiar with your specific circumstances.  If your horse has, or is prone to, any health issues it becomes even more important to narrow your focus.  If your Arabian is only used very lightly for occasional trail rides you won’t be able to feed her the same as an Arabian actively competing in endurance.

Veterinarians don’t receive much in the way of formal nutrition training in school but they are uniquely qualified to study and apply nutrition in a clinical situation if they develop an interest in doing so.  Even if your vet does not focus on nutrition he/she should be able to refer you to an independent consultant whose opinion really is based on solid facts and experience.

Eleanor Kellon, VMD

 

 

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Switching from Pasture to Hay

Hay is just dried grass but there are several things to consider when making the transition from pasture to hay.

FALL PASTURE

                                     Fading pastures necessitate a change to hay

As grasses mature and develop their seed heads, fiber fractions progressively increase while more easily digested carbohydrates, protein and even minerals drop.  The horse can compensate for a while by concentrating on grass that is still green and otherwise eating more but eventually the quality of the pasture becomes more like straw and the horse’s condition obviously suffers.  You want to step in before that point.

Begin offering hay when grass growth has stopped and areas are turning brown.  Unless the hay was baled off fields being grazed, it is a diet change and should be made gradually.

Hay is basically “grass jerky” and much lower in water.  Properly cured hay runs about 10% moisture while pasture is around 80%.  To keep intestinal contents flowing easily and facilitate digestion and fermentation, water consumption will have to increase substantially.  Try to keep hay feeding areas close to water supplies and make sure salt is freely available.  You can also sprinkle salt onto moistened hay to help guarantee intake.  Use 1 oz (2 tablespoons) per horse.

Hay has other key nutritional differences besides lower water content.  Omega-3 fatty acids comprise 50% of the fat content in fresh grass and are lost very rapidly when hay is cured and stored.  This omega-3 shortage is exacerbated by the fact all other feed ingredients in the equine diet are also low in omega-3 and high omega-6.  To boost omega-3 intake, feed flax or Chia seed, 2 to 8 oz/day.

Other major losses when grass is cured include vitamins C and E.  The horse can manufacture vitamin C and never develops full blown vitamin C deficiency but levels may not be optimal for health off pasture.  This is especially so for exercising horses and horses with allergic or lung disease.  Supplementation with 3 to 5 grams/day of vitamin C is reasonable.

Vitamin E is a key antioxidant for protecting cell and organelle membranes throughout the body.  It is particularly important in the nervous system, muscles and immune system.  Minimum recommended intake is 1 IU/lb of body weight which can be increased to 2 IU/lb for exercising horses and immune system support.

Recently baled, obviously green hays have plenty of carotene, which the horse’s body converts to vitamin A.  As color fades and/or hay approaches the 1 year old mark, these levels can drop to deficient.  Coats become coarse and dry.  Fertility drops in mares.  Supplement with 20,000 to 40,000 IU of vitamin A.

Careful attention to nutrients missing from hay can help keep the bloom on your horse when they come off pasture.

Eleanor Kellon, VMD

 

 

 

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Dealing with Old Lower Leg Problems

It’s difficult enough to support the mass of a horse on a tiny column like the leg if it is a   rigid structure.  When it also has a moving part (the fetlock), the problem becomes much more complicated.

Exaggerated flexion of the fetlock is an easily seen outward indicator of the force being applied to the leg.  This occurs when speed is added to the mass of the horse, as in racing,

Injured, but a winner to the end: Xcellent is victorious in the Trentham Stakes on Saturday, in what was to be his last race.

also in dressage movements requiring suspension, cutting/roping, takeoff and landing from jumps, negotiating hills or uneven ground and sometimes plain old horseplay.

It is the soft tissue structures of tendon, ligament and dense investing fascia that allow the horse’s lower leg to function as it does.  Damage to the extensor tendons, suspensory ligament or any of the myriad other supporting and reinforcing structures is very common.

Once damaged, they never completely regain their normal strength and flexibility but with a little extra care many horses can continue to be athletically active, even at their preinjury level.

STRETCH

Once the healing period from an acute injury has been successfully completed, you need a strategy for reducing the risk of reinjury.  Passive stretching as part of warm up is a good idea.  The flexor tendons are attached to muscle bellies.  Increased tension is common when injury has occurred and can be gently relaxed by stretching.  Even pure connective tissue/ligament injuries can show contraction that may respond to gentle stretching and massage.

Absolutely meticulous attention to hoof balance, regardless of barefoot, shod or type of shoes, is an absolute must.  Every effort must be made to ensure that the leg is loaded evenly.

Physical fitness and good balance (neuromuscular conditioning) are two of the best guardians against reinjury.  Introduce work slowly but with steadily increasing increments.  Avoid unfavorable ground conditions whenever possible.  Do not ask for sudden, sharp movements or speed changes but introduce elements that challenge control and balance, like ground poles.

Finally, use the best and cheapest therapy there is – heat and cold.

ICE

Like massage and stretching, warmth encourages tissue relaxation.  Standard wraps, sweat wraps and neoprene can all be used to advantage when the horse is stalled.

It’s impossible to overemphasize how important ice can be to the horse coming back from an injury.  Apply ice to the previously injured area as soon as possible after exercise stops and maintain it for a 30 minute cooling period.  Ice slows excessive blood flow and/or inflammatory enzyme activity that often result in annoying periods of  intermittent heat and edema as you bring the horse back into work.  I use it faithfully after every work regardless of intensity.

Investing these few extra minutes can mean a smooth uneventful rehab and maximize your chances of avoiding reinjury.

Eleanor Kellon, VMD

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Herbs for Topical Use

If you haven’t tried herbal products for skin and coat use, you really should.  Not because they’re herbal or natural – because they are effective!

Chemicals are chemicals whether they are inside a plant or in purified form.  Many effective pharmaceuticals were isolated from or based on chemicals in plants.  One thing that makes herbals distinctive in their effectiveness is a low side effect profile.  This is related at least in part to the fact that for every active constituent in a plant there will often be another that has an opposite or moderating effect.

Black mortar and pestle with fresh picked herbs, over white background.

The topical use of herbs has a very long history and is easier to validate than systemic use simply because the results can be readily seen.  The following are some common topical herbal ingredients and their actions.

Tea Tree (Melaleuca) Oil:  Most people have heard of tea tree oil because its use is so widespread.  Tea tree oil is extracted from Melaleuca alternifolia, a small tree/bush native to Australia. It has a pungent, camphor-like aroma.  At least 98 components have been identified in the oil.  Tea Tree oil is only needed in low concentrations and excels in antiseptic properties with activities even against antibiotic resistant strains and fungi.

Calendula officinalis:  Calendula is the common marigold.  Its use on skin dates back at least 600 years.  They were heavily used in wound dressings in the American Civil War and World War I.  Formal research has documented that Calendula stimulates fibroblast activity in wound healing, assists with closure of pressure sores and has anti-inflammatory effects.

Comfrey (Symphytum):  Comfrey is a small flowering herb native to Europe.  Written history of its topical use dates back to ancient Greece although use was estimated to date back considerably before that.  A major component is allantoin, which is documented to speed wound healing and has both anti-inflammatory and antimicrobial effects.  Inulin adds to its soothing effects.

Lavender:  Everyone recognizes the scent of lavender.  The flowers and oil are used.  You may be more familiar with lavender being used as a fragrance to induce calming, an effect that has been proven by formal research. There is also a long history of topical use.  In addition to gentle support of circulation, lavender has healing and anti-inflammatory properties.

Rosemary and Thyme:  Not the Simon & Garfunkel album, and not your Thanksgiving turkey either!  These common edible herbs are also used topically both for their wonderful aroma and the mild antimicrobial effects they have.

Plantain:  Plantain is a member of the banana family.  It’s long, fat leaves can be used to make a poultice for wounds or skin irritations.  Like Comfrey, it is rich in allantoin.

Whether herbal or not, any topical can cause a skin reaction.  If you know your horse is prone to sensitivities, do a test of any product before using by applying a small amount to either the back of the pastern or the inner hind leg just above the hock.

A variety of skin issues from wounds to itching can be helped with topical herbals.  They are pleasant to use and typically inexpensive.  Definitely worth a try.

Eleanor Kellon, VMD

 

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