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Kay posted an update
Sorry I could not participate in the forum this evening, question and feedback requested on letting a laminitic IR horse graze w/o a muzzle when grass is not growing in the upstate of SC Nov thru Jan/Feb, vet recommends muzzle at all times as a precaution, horse is increasingly anxious, ulcers a prior diagnosis, is grazing w/o a muzzle so critical during the recovery process this time of year? We are still in a farrier recovery shoeing mode, clogs to now in a traditional shoe with casting. Is soaking hay to be a year round life-long recommendation, it’s hard to manage during freezing temps…is non soaked hay safe or am I putting him at increased risk? Fasting insulin was less than 30 after initial laminitis diagnosis, worried about fluctuating sugar levels in soaked vs non soaked hay and seeking best practices to avoid another episode. Thank you.
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BTW, diet is working so well, off all supplements, soaked hay only, soybean meal added to soaked Timothy grass pellets, various soaked hays, not one type, he is looking amazing, coat, weight, etc. And too full of exuberance as an Arab would be!
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It is difficult to advise for a particular horse from my chair – and discourteous to your vet and farrier who have boots on the ground. But, this said, they must see improvement in your horse as you see it.
So the best response here is to work with your team to assess him over time. A written journal helps. It takes a year to fully replace the hoof and its attachment to the coffin bone. Being cautious is far better than not with laminitis.
An option is to turn him out without the muzzle for a shorter period. Less intake = less sugar. Be aware of any sudden greening and growing of the grass, which can occur even in winter. Most of his forage should be in soaked hay because this is the best way to control sugar intake (starch, glucose, fructose), even though it is difficult in winter. For long stretches of cold when soaking is impossible, feed less hay because less hay is less sugar. Remember, these horses are in our care, and even though things can become difficult, if you persevere, the rewards will be worth it next spring and summer.
I also agree that a muzzle is stressful for horses. I hate watching them with it on. But I hate watching a horse with sore feet even more. So work with your vet and farrier as winter progresses. If he is sound and hoof testers are negative, and the blood work is normal, slowly increase turnout time without a muzzle while constantly feeling for heat and pulse in the hooves. Every horse is different, and there is no one recipe. Listen and ask questions, then listen to your gut. And, of course, come back here with updates. Thanks, Doc T
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Thanks Doc T, I was not trying to disrespect my vet team, but more so looking for a 2nd opinion as I would for my own care, for me personally I think that is what drew me to becoming a member, having an open mind and embracing a different point of view for horse care. Tyler has been a conundrum, never tested to heat, digital pulse or hoof testers when I called my vet in July as I knew he was “off”, even 36 hours when they saw him b/4 diagnosis he had no clinical signs, then he went into a full blown laminitis attack, my vet practice has seen him since I brought him home over 6 years ago and as recently as Feb and May before his acute attack, never once was it suggested to have him tested for IR even though his bodyscore was getting increasingly high, i.e. the easy keeper though ridden 5 days a week in moderate to heavy training. My takeaway is that vets treat disease, they don’t work to prevent it, at least in my experience. The blood work is challenging, how do you do testing, send results to Cornell, wait for results and not know what may or may not have skewed those results, we need more vets that embrace the barnside testing technology vs fasting and the stress it creates which my thought is perhaps exacerbates the insulin levels and thus may skew the results. Like you, I grew up with horses in the 70’s , this never existed. What do I know, I just know this was not the hot mess I wish I had created for my horse by not being more aware. We need a method to test them as owners like they have for dogs and cats to do home testing aka Alphatrak for which there was a study done on Equines with what seem to be favorable clinical results, I contacted them, they will not provide a response for using their device on Equines as I presume it is not “approved” for other than cats and dogs. That’s a shame.
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I apologize for my delay in responding. I had replied before in my “admin” role, so I missed the notification of your reply to me. I have corrected this.
I don’t think you were requesting an answer but were more venting your frustration that vets (and MDs) are more interested in fixing rather than preventing. Your other frustration is in the lack of stall-side diagnostics. So now you feel my pain.
The bottom line is that horses are being phased out, and in the next generation, they will be almost extinct as far as people owning them. In another hundred years, they will be seen only in zoos. The number of horses in developed countries is shrinking, and so is the number of horse vets. There is no substantial money for developing or researching anything for horses. Only the “big guys” can afford lost leaders in equine care. This is exactly why I am making this website. Horse owners everywhere will need a resource to care for their horses. Veterinarians will only be in horse-dense areas. We will soon be back to the age before vets in rural areas. (sorry to sound so down in this festive holiday season…)
Do you know about the protein leverage hypothesis? It states that we will continue to eat until our protein levels have been met. This is important for horses like yours who need to limit their intake of glucose-laden pasture. The good news is that if you decrease glucose intake by limiting pasture, soaking hay in water, and adding high-quality protein (SBM), your horse may not eat as much this spring on pasture. However, it is also important to remember that hay is last summer’s grass and should be soaked, limited or eliminated in laminitic horses. I hypothesize that increased circulating glucose damages the capillaries of the hoove just like it does damage to human vessels, causing atherosclerosis (the leading cause of death?).
This will take time. Look for fat loss in your horse, and don’t be afraid of the sight of lost muscle (top line). If body fat is being mobilized, that is proof that insulin is gone (reduced); therefore, blood glucose is reduced with reduced blood vessel damage.
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Yes, so sorry to vent. I have located a vet that has the Wellness Ready stall side diagnostic equipment, not licensed in my state but only 45 minutes away, so trying to discern if working in concert with my vet is viable. I struggle with knowing if we are managing his insulin. I understand the protein leverage hypothesis and have noticed both horses are acting less like a hoover vacuum on their hay which I am “assuming” may be due to more satiety in their “feed” with the SBM. And we have fortunately found a hay supplier that tests, Alfalfa Orchard 60/40 NSC tested at 7.85%, it is a bit stemmy so I think is increasing chew time, vs the softer soaked local fescue hay. The farrier did comment on the last visit that Tyler had a lot of hoof growth, and we have rapidly moved from clogs, to a cast shoe to now a bar shoe in 3 shoeing’s. Looking forward to the next chat, have friend with a horse atypical to getting laminitis, on a forage diet, no grain, but he has other gastro issues and has had 3 fecal transfers at NC state, just diagnosed with laminitis last week, so I would like to ask some questions relative to the diet for such a horse and how one would ever define them as at risk, he is probably a bodyscore of 5, now being tested for allergies by yet another vet. Thank you for what you do even when we vent some frustration and just need a sounding board. If you celebrate, Merry Christmas and Warm Regards, Kay
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Merry Christmas @Kay I have listened to a book and podcast on fecal transfers in humans and I am not sure we have enough info on this yet to make good decisions. I’m glad to hear that NC State is doing this in horses. There are other universities looking into this. My take-away from listening to these researchers is 1) you need to feed the hind gut bacteria food they can thrive on (fiber) and 2) you need to stop the death of good bacteria through removing medicines (antibiotics, anti inflammatories, others) and food (high sugar foods, lectins) that alter the gut microbiota. For most microbiota, the good guys will return (not true for antibiotic use).
Another horse owner in South Africa has found that feeding 20 ml of baker’s yeast has reduced bloating and calmed horses that are perpetually nervous. This is in addition to feeding SBM, forage only, and cabbage leaves. I’ll have more on this during the rounds next week. But maybe adding this will help calm your horse. Remember, the microbiota is not just bacteria but yeasts, parasites, viruses and fungi all living together harmoniously. It is our job to find what each individual needs to support their gut health.
As far as insulin goes, you must reduce this by reducing glucose intake. The largest source of glucose is hay and grain. In Australia, research is being done with SGLT-2 inhibitor drugs and one is now available in the US for cats. This drug prevents the reabsorption of glucose in the kidneys causing any blood glucose to be dumped out in the urine. These show promise in humans but there are unwanted side effects if not used properly. In horses, they are very expensive. While hard to do in the winter, soaking or reducing the amount of hay fed is the only way. They WILL lose body fat and blanketing and excellent care must be given during the winter months. Restoring protein is also essential. Testing may help guide you, but action in reducing glucose intake is the only effective course of action both in function and economics.
Thank you for being a part of this and contributing your story. The more who do this, the clearer the story becomes.
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