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DIETARY Disease Prevention Muscular, joint, intestinal, and meta- grassland species and grain.

Muscular, joint, intestinal, and meta- grassland species and grain. Horses are Score on page 41). All unnecessary grain

bolic problems can be created by a horse’s confined and often precluded from exer- and supplements, including complete or
intake of inappropriate or imbalanced nu- cise by constraints imposed by the needs senior feeds containing high starch or
trition. These same problems can be solved of human management systems. In evolu- sugar, should be removed from the ration,
with proper dietary management. With tionary terms, wild horses were supposed in consultation with the veterinarian. The
careful consideration of how best to feed, to acquire some ‘obesity’ in readiness for forage intake should be decreased accord-
there might be a simple solution at hand winter that would be lost by the end of ingly at a rate of 10% per week, yet forage
that relies only on inexpensive modifica- winter. Nowadays, our horses are fed too intake should not be less than 1.25% of
tions to your horse’s nutritional routine. much energy using highly glycemic (high body weight per day.
sugar and starch content) rations, and “If the roughage proportion of the ra-

To Prevent and
Equine Metabolic Syndrome obesity not only develops, it persists.” tion is reduced too much, the horse tends
One disease that has come into the spot- Additionally, in the context of today’s to become ‘stir crazy’ and will try to eat the
light in recent years is equine metabolic culture, an obese appearance has become wood in the stall walls and develop stable
syndrome (EMS). In most cases, a horse the accepted “norm” in horses, although it vices, in addition to being more prone to

Control Disease
with EMS is obese due to breed predispo- is actually an unhealthy state. colic and gastric ulcers,” he adds.
sition, body type, and management Additionally, Johnson says,
considerations such as overfeeding “Affected horses should not be
and restricted exercise. Because
fat stores in abdominal locations
Muscular, joint, intestinal, ‘starved’ to reduce weight/obe-
sity because starvation will lead
do not just store fat, but also exert and metabolic problems to further insulin resistance. It is
hormonal effects, these horses are reasonable to eliminate grain and
By Nancy S. Loving, DVM often insulin resistant and prone to
can be created by a horse’s anything else that might contrib-

orse owners often search for a magic feedstuff that will enable horses to go farther, laminitis. intake of inappropriate or ute to sugar and starch in the ra-
The most logical and effective tion, such as molasses or sweet
run faster, be healthier, and move sounder. Often, a variety of oral supplements are
means to prevent and/or manage imbalanced nutrition. feed. Some grass hays and pastures
added to the diet, with unknown results. Some feed additives can cause more harm
obese horses is with exercise; dietary are high in sugar and starch (non-
than good, or at the very least, put a large hole in your wallet. In many cases, performance controls are second. Philip Johnson, structural carbohydrates or NSC)
improvements are best accomplished with conditioning, training, and stable management BVSc, MS, Dipl. ACVIM, MRCVS, and col- “To improve metabolic health, a philo- and should be avoided. For reasons that
rather than through some oral potion given in the feed. Yet, that being said, dietary man- leagues Nat Messer, DVM, Dipl. ABVP, and sophical shift is necessary such that a fit are incompletely understood, alfalfa
agement can work like magic for specific equine diseases. V. K. Ganjam, BVSc, PhD, at the Univer- and trim horse is a body condition that is should be avoided—it appears to be a risk
sity of Missouri, have been instrumental acceptable and desirable,” says Johnson. factor for laminitis in and of itself.”
in defining the physiology of equine meta- His treatment for obesity is based on In general, Johnson suggests feeding
bolic syndrome. common sense and dietary management. low NSC grass hay, such as timothy, but
“Overfeeding is a common malnutri- First, an owner must recognize that a horse he urges owners to run a lab analysis to
tional practice in Western society,” says is overweight. Johnson suggests, “The ideal certify the hay is safe. He says beet pulp
Johnson. “Horses evolved to eat native body weight and body condition score of is a good supplement, provided it does
grass and stay healthy. Nowadays, we feed the horse should be ascertained with ac- not contain molasses. When feeding more
horses like food animals—using improved tual measurements (see Body Condition than a pound of beet pulp (dry weight) per

Various diseases can be caused and/or cured

by using specific feeding regimens

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Almost all horse owners have fed their horses some

Erin Ryder

type of supplement to promote health or performance,

but not all supplements are beneficial. The Horse August 2006 August 2006 The Horse 
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DIETARY Disease Prevention


day, for each pound of beet pulp copper, zinc, and magnesium. Therefore, tude problems—are probably as common, improvement in gaits,” she says. “Improved
fed, 1.5 pounds of hay should be rations must be balanced relative to your if not more common, than tying-up.” muscling is often seen within two to four
removed from the diet. geographic area and feed availability. Although primarily identified in draft months of diet change.”
According to Kathryn Watts of Ralston emphasizes, “Growth formulas and draft-related breeds, Quarter Horses, Because these horses are fed high
Rocky Mountain Research and are becoming increasingly sophisticated, and Warmbloods. PSSM is also recognized amounts of fat, you might wonder how
Consulting (, with increased protein and minerals that in a variety of other breeds. this strategy can be applied to an already-
soaking hay in hot water an hour complement the average hays, and many The muscles of horses afflicted with this fat horse.
before feeding can also help re- are designed specifically for legume ver- disease is related to an abnormal accumu- Valentine clarifies, “For managing obese
duce NSC content. sus grass hays, so this must be taken into lation of glycogen and glycogen-related horses that are candidates for develop-
Your horse might have access to account. A horse under 18 months old polysaccharide (sugars) in skeletal muscle. ing laminitis, or have already done so, we
abundant pasture, yet grazing is should receive a concentrate only if it is There seems to be some abnormality with provide a diet supplement that is close to
problematic due to the high sugar formulated specifically for growth. I pre- carbohydrate metabolism that might be forage, but with fat added at an amount
content of pasture grass, especially fer the newer formulas that are pelleted or heritable; to date researchers haven’t de- the horse will accept. Feeding a forage-
in periods of high growth or when extruded, with little or no molasses added. fined the defect. based product such as timothy/alfalfa
the plants are stressed with frost, Fat is a helpful supplement to provide calo- The recommended diet for managing pellets or cubes, other hay products, or
drought, or overgrazing. While ries, but rations with more than 10% total PSSM is to reduce sugars and starches beet pulp will provide the least unwanted
turnout is one way to achieve light fat may interfere with calcium absorption (grains, molasses) from the diet, put the calories, and fat can be added to that. An
exercise, a fat horse should wear a in a growing horse.” emphasis on providing quality forage, and owner should reduce the pounds of hay fed
grazing muzzle to control forage DOD is usually an insidious disease, not supplement with fat, as much as two cups by the pounds of forage-based feed (pellets
intake. showing up clinically until after the damage per day (equivalent to a pound of oil) for a or cubes or beet pulp) fed with added oil.
The obese horse that has devel- has occurred. Ralston says while no breed 1,000-pound horse. Just don’t reduce total forage intake to less

Dr. Nancy S. Loving

oped laminitis can be a challenge. is immune, it seems to be more prevalent in “We don’t really know exactly what is than 1% of the horse’s total body weight
Johnson explains, “Laminitis is horses selected for large body size and ear- happening when we change to a high-fat per day—10 pounds of fiber fed per 1,000-
a problem from the perspective of ly performance, although that might have and low-starch and low-sugar diet,” says pound horse.
increasing exercise—there is not something to do with their management, Valentine. “This type of diet was originally Other management strategies must be
This is an example of a fat horse that has equine metabolic syndrome and has consequently developed laminitis
an easy way around this problem. since they tend to be “pushed” harder. designed to bypass what we assumed was implemented for an overweight PSSM
Theoretically (albeit not particular- “Rutgers University, is passionate about on evolutionary adaptation of the equine However, Ralston adds, not all DOD is an enzyme defect leading to defective car- horse.
ly practical), use of a swimming pool could educating horse owners to avoid DOD. It digestive tract. irreparable. bohydrate metabolism. As
get around this impediment. Certainly, is known that overfeeding of carbohydrate Ralston explains, “Even when forage “Epiphysitis and flexural and angular yet, we have found that there
increasing exercise is a logical approach, energy sources (grains, starches, sugars)— is scarce, horses do not ‘fast;’ they’ll eat limb deformities are evident immediately is no enzyme defect involving A B
as is anything to reduce ‘stress’ since stress especially in the face of mineral imbalanc- anything they can get their teeth on. One with dietary imbalances, usually appear- carbohydrate metabolism,
is associated with elevated levels of gluco- es—is a primary cause of DOD. main change in domestic conditions is the ing at three to six months when the foals and yet this high-fat and low-
corticoids (any group of corticosteroids “Excess energy, carbohydrate, and abundance of grain and carbohydrates start drinking less milk and eating more of starch and low-sugar diet
involved in metabolism) that promote in- mineral imbalances cause abnormal and year-round, although even ‘dead,’ dry grass whatever feed is available,” she says. “These works wonders on most af-
sulin resistance.” improper mineralization of bone, which in winter can have a fair amount of sugar DOD issues generally resolve quickly once fected horses. I suspect that
Johnson emphasizes that equine meta- translates into legs that are prone to devel- in it. Another change is restriction of exer- the imbalances are corrected, along with we are providing fat calories
bolic syndrome and obesity are all about op defects,” Ralston says. “Protein used to cise along with diurnal feeding and fasting corrective hoof trimming for the latter two that are needed for effective

Dr. Nancy S. Loving

feeding beyond normal requirements, par- be considered a culprit in this nutritional cycles (feed available only twice a day).” syndromes. muscle energy metabolism in
ticularly when owners provide nutrition- imbalance scheme, but it is not the protein, For a young horse, such feeding practices “New data shows that constant, unre- these horses.”
ally improved grass species, grain, and “en- which is a good thing, considering that can exacerbate DOD. Many DOD problems stricted turnout exercise results in better Fat comes in many forms,
hanced” grain feeds. many pastures provide over 20% protein for a foal begin in the uterus, with insuf- bone density and reduced DOD,” she says. such as vegetable oil, pow-
dry matter.” ficient or imbalanced nutrients provided to dered animal fat, and rice A. Developmental orthopedic disease is a complex, inclusive
Developmental Orthopedic Ralston emphasizes that a diet must the pregnant mare. Equine Polysaccharide Storage bran. Vegetable oil is 100% variety of musculoskeletal disorders including epiphysitis
Disease be balanced to achieve musculoskeletal “In the last trimester of pregnancy, Myopathy fat, whereas rice bran prod- (inflammation in the growth plates). This horse is suffering
from fetlock epiphysitis.
A common disease complex that oc- health. the mare should be on a ‘growth- type’ As research unfolds, previously elusive ucts only contain 20% fat and

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B. This is an example of flexural tendon contracture 10 days
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curs in foals and youngsters is known “Malnutrition includes both underfeed- feed formula,” advises Ralston. “The muscle syndromes are better explained. are combined with other nu-
as developmental orthopedic disease or ing and overfeeding nutrients,” she says. foal should be given access to growth- One such ailment, equine polysaccharide trients. Although somewhat post onset.
DOD. This complex is inclusive of a vari- “Underfeeding will stunt a growing horse formula feed from Day 1 on, so it is avail- storage myopathy (PSSM), causes a variety messy to handle, vegetable
ety of musculoskeletal disorders including and increase risk of disease, yet if minerals able when he begins to eat solid food. of performance issues. oil is the preferred choice to offer as a fat “For horses on pasture, a grazing muz-
epiphysitis (inflammation in the growth are lacking, will still cause DOD. Overfeed- Remember that if the mare is on straight Beth Valentine, DVM, PhD, associate supplement for a PSSM horse. zle may be necessary to reduce intake of
plates), osteochondrosis dessicans (OCD), ing, especially calories and supplements, oats (not balanced), and the foal steals from professor at Oregon State University, has In addition to the fat, Valentine suggests grass,” she says. “I’d rather see a horse out
flexural tendon contractures, angular limb potentially causes permanent damage to her, he then eats an unbalanced ration. To devoted her research efforts to this dis- feeding at least 1 international unit (IU) vi- on pasture with a grazing muzzle, moving
deformities, and cervical vertebral stenosis the limbs and has possible metabolic re- avoid this, a mare should be fed the same ease. tamin E per pound of horse per day. around, than in a stall. If the horse feels
(wobbler syndrome). While the problems percussions. There is speculation that the formula you want for the foal, even though “I consider ‘tying-up’ to be the tip of Valentine counsels that it takes approxi- better on the high-fat diet, he may exercise
often originate from multi-factorial causes increased incidence of insulin resistance it will probably exceed her actual mineral the iceberg as relates to clinical signs of mately four months for full-fat adaptation himself more and actually build muscle
such as heredity and exercise, diet and nu- may be, in part, due to overfeeding carbo- requirements.” PSSM,” she says. “Other, more subtle in PSSM horses, and in the best case a fa- rather than fat. And, of course, if the horse
trition play a key role in their inception and hydrate-rich grains.” She also points out the importance of problems—such as exercise intolerance, vorable response can occur within one to is older it is important to check for pitu-
can go a long way in prevention. One of the big upsets to equine metabo- mineral balance, and cautions that re- mysterious abnormal hind limb gait, back two months of dietary change. “Positive itary dysfunction, as these horses could
Sarah Ralston, VMD, PhD, Dipl. ACVN, lism is the tendency of humans to feed as a gional differences are significant mainly soreness, poor muscling or symmetrical signs of managing PSSM horses include benefit from medical therapy to manage
who specializes in equine nutrition at matter of convenience rather than focusing in the microminerals, such as selenium, muscle atrophy, stiff gait, shivers, and atti- increased energy, better attitude, and Cushing’s disease.” The Horse August 2006 August 2006 The Horse 
DIETARY Disease Prevention


maintained well on timothy or bermuda increased white blood cell count.
hay and oats, with free access to a salt General Feeding Recommendations Initially, gastric ulcers should be ruled
block. Research has shown that over time, As you read through the nutritional recommendations for many of the ailments that out with an endoscopic exam, and para-
there can be adaptation to slightly higher plague horses, you might notice common threads used to manage or prevent many site problems or Salmonella should also be
potassium-containing diets, so these hors- problems. One of the primary considerations mentioned by all these experts is the danger considered.
es can be fed diets higher in potassium, of overfeeding, particularly a diet rich in carbohydrates or grain. To best keep your horse “as Andrews says feeding strategies differ
provided the diet is consistent. healthy as a horse,” dietary strategies should follow some basic and simple rules: vastly from those used to prevent or treat
“Pasture and paddock turnout are best n Feed at least 1–2% of the diet as fiber (hay and/or pasture), that is 10–20 pounds gastric ulcers, so it is important to pin
since exercise stimulates uptake of potas- per day for a 1,000-pound horse. down the diagnosis.
sium by muscles. Pasture access also al- n Feed small amounts at frequent intervals or free-choice forage rather than relying He recommends, “Wean the horse off
lows a horse to graze to prevent harmful hay over a two-week period, changing over

Courtesy Dr. Beth Valentine

on twice-a-day feeding with long intervals of fasting.
periods of fasting that cause fluctuations n Feed primarily grass hay and supplement with small amounts of alfalfa only when to complete feed pellets that are 20–30%
in insulin; this helps stabilize potassium necessary. dietary fiber. The horse can be allowed to
concentrations.” n Integrate fat supplements and/or high-fat feeds to substitute for calories previously graze for 15–20 minutes a session for four
Low-potassium feeds are the goal, and provided in grain. to six times per day. Small amounts of pas-
these include pasture grasses that have n Limit grain to as little as possible, not exceeding four pounds per feeding for a ture offered at short intervals is best for
Equine polysaccharide storage myopathy causes a variety of performance issues such as tying-up, been verified to have low potassium, beet 1,000-pound horse, but better yet, use substitute feeds (fat, alfalfa) instead of providing rest to the intestinal tract affected
exercise intolerance, mysterious abnormal hind limb gait, back soreness, poor muscling or sym- pulp without molasses (0.3%); fats and grains. with colonic ulcers. The pelleted feed diet
metrical muscle atrophy, stiff gait, shivers, and attitude problems. oils (0%); and oats, corn, or barley (up to n Minimize extraneous feed additives and minerals so you feed only what is neces- decreases the bulk in the diet and decreases
0.5%). Water-soaked beet pulp can be com- sary to constitute a balanced ration. the actual work of the large intestine.”
White Muscle Disease However, too much selenium supple- bined half-and-half with grass hay to meet n Have feed analysis done at a lab to obtain specific nutrient content if in doubt. This low-fiber diet is fed for three to four
Another nutritionally related muscle dis- mentation, especially at early stages of normal roughage needs while minimizing n Consult with an equine nutritional specialist to tailor a diet specifically for each months until the horse is healed and blood
ease is due to a selenium deficiency. White pregnancy, can cause birth defects. Other potassium intake. Soaking the hay in warm individual horse. protein levels return to normal.
muscle disease occurs in foals; a related signs of toxicity include loss of mane and water for up to an hour before feeding will n Exercise the horse or provide regular turnout as often as possible. Andrews also adds psyllium products to
muscle problem can occur in adults. tail hair, and eventually the hooves can reduce its potassium content. With these dietary practices, you really will possess the magic elixir to cure many equine improve transit time of the intestinal feed
Valentine says, “The most common sign slough in conjunction with an advanced Spier adds, “Electrolyte supplements are ills and to achieve the best performance your horse has to offer. matter. He says psyllium increases the con-
in foals is difficulty eating due to degen- case of laminitis. particularly high in potassium since most —Nancy S. Loving, DVM centration of short-chain fatty acids in the
eration of masticatory (chewing) muscles, contain potassium chloride salt. Also check colon, which decrease inflammation, while
causing bilateral swelling or atrophy with Hyperkalemic Periodic Paralysis labels on commercial feed and vitamin The more acidic the stomach contents, and falfa hay fed every five hours achieves some it also helps coat the digestive tract and hy-
difficulty in chewing and swallowing. In Hyperkalemic periodic paralysis (HYPP) supplements to ensure minimum potas- the less mucous barrier available, the more benefit by buffering acid in the stomach. drates the feed contents to achieve a laxa-
areas with soils that contain virtually no is a muscle disease related to a genetic de- sium content.” the mucosal lining is at risk for injury.” There is a bit of concern about the corre- tive effect.
selenium, selenium deficiency myopathy fect that alters function of the sodium chan- As stress can precipitate an attack of Overfeeding of highly soluble lation of alfalfa in the diet and the problem In addition, he recommends feeding one
has been documented in horses of all ages. nel within the membrane of muscle cells. HYPP, stress control related to transport, carbohydrates leads to ulcers and hindgut of developing enteroliths (mineral stones cup of vegetable oil twice a day, particular-
Too often, this gets interpreted as some- This defect causes the channel to “leak,” stabling, illness, and herd relationships is problems along with overgrowth of damag- in the GI tract), particularly in the western ly corn or safflower oil. “These are useful
thing else, such as equine protozoal myeli- with accumulation of excess sodium ions important in minimizing disease. The most ing bacterial flora in the bowel. United States. to provide omega-rich fatty acids, which
tis (EPM). within the muscle cells and excess potas- sensible feeding recommendations for Andrews says studies have shown that, Andrews says, “A mixture of grass hay inhibit the production of an enzyme that
“Adults with selenium deficiency my- sium ions in the bloodstream (hyperkale- managing a horse with HYPP are consistent “When a horse must be fed grain, a protec- and alfalfa might decrease the incidence of produces prostaglandins, and thereby in-
opathy may present in recumbency due mia). The alteration of the ionic balance with good standard nutritional practices. tive diet relies on restricting the amount of enteroliths. While alfalfa provides its buff- directly decreases inflammation,” he says.
to severe, diffuse, acute muscle degenera- in the muscles decreases the threshold re- grain fed to less than one pound of sweet ering capacity, grass hay minimizes the (Read more on omegas on page 51.)
tion. Blood tests denote very high muscle quired for muscle contraction and allows Equine Gastric Ulcer Syndrome feed per 220 pounds body weight. If higher amount of calcium and magnesium that
enzyme levels associated with selenium convulsive muscular contractions. In recent years, great advances have levels of grain are needed, then do not feed contribute to enterolith formation.” Take-Home Message
deficiency myopathy.” As an attack begins, an affected horse ex- been made in the understanding of equine this amount any more frequently than ev- It is possible that the feeding of acetic There are some general trends in feed-
Selenium deficiency is fairly easy to periences sustained muscular contractions gastric ulcer syndrome (EGUS), particu- ery five hours. This keeps the horse’s stom- acid (vinegar) as a strategy to thwart en- ing your horse that can help him be health-
rectify. Valentine suggests feeding 1-2 mg visible as uncontrollable muscle twitching larly in its relationship to diet. Frank An- ach beneath a ‘threshold level’ of VFAs.” terolith formation in horses could exacer- ier, and detailed nutritional management
of selenium per 1,000-pound horse each especially noted over the thorax, shoulders, drews, DVM, MS, Dipl. ACVIM, of the Uni- He says adding calcium carbonate in the bate the risk for developing EGUS. regimens to control specific diseases. If

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day. However, before supplementing with hips, and flanks. The nostrils flare, the versity of Tennessee, is one of the pioneers form of calcium supplements or calcium- you have questions about your individual
selenium, a feed analysis and/or blood test third eyelid prolapses across the eye, and of EGUS research. containing feed (alfalfa hay) might hasten Colonic Ulcers horse’s nutritional management, discuss
should confirm its need. facial muscles wrinkle to create an anx- “Soluble carbohydrates (found in grain) the recovery of cellular sodium transport On the other end of the digestive tract them with your veterinarian or an equine
She says, “Selenium testing I’ve done on ious expression. Partial muscle paralysis are fermented by bacteria living in the systems in gastric mucosa of horses by in the hindgut, intestinal ulcers also occur nutrition consultant. H
horses receiving only selenium salt blocks or weakness results in swaying, staggering, stomach to produce volatile fatty acids increasing the pH of gastric contents and secondary to such things as the adminis-
indicates that most do not get nearly and buckling at the knees; episodes can (VFAs), which have a low pH and are lipid stimulating sodium transport in tissues. tration of non-steroidal anti-inflammato- About The Author
enough. Horses fed vitamin E/selenium progress to collapse and death. soluble,” Andrews says. “The lower the pH “This could reverse acid injury caused by ries (NSAIDs), parasites, and Salmonella Nancy S. Loving, DVM, owns Loving Equine Clinic in Boulder,
Colo., and has a special interest in managing sport horses.
products with 1 mg selenium per day for Sharon Spier, DVM, PhD, Dipl. ACVIM, in the stomach, particularly when less than VFAs and hydrochloric acid (HCl) secreted bacteria. Affected horses typically present
An endurance rider , Loving is also a veterinary judge for the
a 1,000-pound horse have good blood lev- of the University of California, Davis, has pH 4.0, the more likely VFAs can penetrate in the process of digestion,” he says. “Such with mild or recurrent colic, decreased ap- American Endurance Ride Conference and for FEI (interna-
els of selenium. For pregnant mares, it pioneered research into HYPP and the ef- cells lining the stomach and cause dam- mucosal injury is pH and VFA concentra- petite, lethargy, and/or weight loss. There tional) endurance events. She authored the books Go the
Distance: The Complete Resource for Endurance Horses,
might be necessary to double the selenium fect of dietary potassium on episodes. age. VFAs inhibit normal sodium transport tion-dependent and may be a reason why can be associated diarrhea and fever. Conformation and Performance (both available at www.
supplementation to ensure adequate pas- Spier emphasizes, “It is best to select functions in the cells, allowing an influx of diets high in fermentable carbohydrates Certain abnormal parameters seen on or by calling 800/582-5604), and her
sage of selenium across the placenta to the hays that have been tested for potassium physiologic water, with resultant cellular have been implicated in the development bloodwork give a high index of suspicion new book, All Horse Systems Go: The Horse Owner’s Full-
Color Veterinary Care and Conditioning Resource for Modern
fetus. Milk is very low in selenium, so a foal content, and try to feed diets that are less swelling and death. Affected mucosa (stom- of gastric ulcers in horses.” for this problem, including decreased Performance, Sport and Pleasure Horses.
needs internal stores to draw on.” than 1.5% potassium. Many horses are ach lining) sloughs away to form ulcers. According to Andrews, even a flake of al- protein levels, increased fibrinogen, and The Horse August 2006 August 2006 The Horse