December 2015
What’s New in Laminitis Research – Part 1
Holistic Horsekeeping
How to have a healthy happy horse.
Volume 20, Number 11
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In This Issue:
1. What’s new in laminitis research – Part 1
2. Want to Have a Better Understanding of Your Horse?
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1. What’s new in laminitis research – Part 1
I attended the NO Laminitis conference earlier this month and was excited to hear what’s new in laminitis research. This conference is hosted by ECIRhorse.org. This group does an amazing job of collecting case histories on thousands of laminitis cases. The majority of the cases on the ECIR group are metabolic horses. Metabolic horses include those with cushings (PPID) or Insulin Resistance (IR). There was so much good information at this conference that I will share it in 2 newsletters.
Nutrition
The first part of the conference focused on nutrition. It is critical for all laminitis horses to have feeds that don’t cause a rise in blood sugar. This is especially important in the insulin resistant horse where higher insulin levels in the blood are the cause of so many symptoms. Simple sugars and starches are the only nutrients that cause a rise in insulin. Glucose and sucrose are simple sugars and starch is a chain of glucose molecules that the horse breaks down into usable sugar. Fructose is a sugar, but it does not cause a rise in insulin levels. Fructose is used by the liver to make fat and large amounts of fructose can cause fatty liver disease, especially in ponies.
Fructans are not sugars. Fructans are like starch but the horse is not able to digest them. High levels of fructans can cause disruptions in the gut bacteria in the hind gut but they do not directly cause laminitis. When evaluating hay and feed for a IR laminitis horse you want to look at the levels of ESC (simple sugars) and starch. The combination of these 2 levels should be kept below 10%. NSC is not as useful as it includes many substances that do not raise glucose levels.
In addition to the sugar and starch levels, you also want to consider the glycemic index of feeds. This term tells you how much and how quickly a particular feed will raise glucose levels. For example, oats contain 52% starch that is easily digested by the horse so it has a high glycemic value. Oats are not a good feed for a horse with laminitis. Safe glycemic index feeds include soybean hulls, rice bran, brewer’s grains, distilled grains, plain beet pulp, flax seeds, chia seeds, split dried green peas.
Be very careful in reading labels. Some bagged feeds that claim to be low starch are actually up to 30% starch but they are low starch compared to oats. You may need to call the company to get the sugar and starch levels on a feed. High fat feeds are not recommended for laminitis or metabolic horses. Low quality fat, such as corn oil is especially bad. Good fats include flax, chia seeds and Cocosoya.
Treatment
Metabolic testing is critical to diagnose the cause of laminitis so the correct treatment plan can be implemented. For IR horses the treatment is based more on diet and the treatment for PPID is diet plus the drug, pergolide. The gold standard for IR is the ratio of glucose divided by insulin levels. You can have normal levels of both glucose and insulin but the ratio may still indicate IR. When the ratio is greater than 10 you do not have IR. Ratios between 4 and 10 indicate compensated IR and levels below 4 indicate decompensated IR and the diet must be very tightly controlled. IR horses are also very sensitive to mineral deficiencies or imbalances so these levels have to be considered in the hay in addition to sugar and starch. www.equi-analytical.com is the best laboratory for feed and forage testing. Ask for the trainer test.
PPID is diagnosed with the ACTH test. It was once thought that PPID was only a disease of older horse but the case histories from the ECIR group are suggesting that it can start in much younger horses. PPID and IR can be present together and this makes treatment even more difficult. The level of the hormone, leptin, will help determine if laminitis symptoms are being driven more by PPID or IR.
The treatment for PPID is the drug, pergolide. The goal for the correct dosing of pergolide is to lower the ACTH levels to the normal range and control the symptoms of laminitis. This may require high levels of the drug. The brand name of pergolide is Prascend. Horses that require the higher doses of pergolide may need the drug to be compounded. ACTH levels will naturally rise in the fall so regular testing is needed to establish a normal pattern for each horse and to monitor the correct dosing of pergolide. Cornell University is the preferred lab for metabolic testing. It is the only lab that can test for leptin. Correct handling of the blood samples is critical for correct values to be represented. Your vet can get the information needed to run these tests at https://ahdc.vet.cornell.edu/docs/Test_and_Fee_List_Equine_only.pdf.
2. Want to Have a Better Understanding of Your Horse?
At Holistic Horsekeeping we’re all about happy, healthy horses and we’ve got the support resources help you learn how to keep your horse happy and healthy. By applying Dr. Ward’s temperament typing model, you’ll get a better understanding of your horse’s behavior, health concerns, and nutritional needs. Our newest resource is the Horse Harmony book available on Kindle! To help you learn more about your horse according to his or her temperament type, check out these great resources:
Five Element Balancing Formulas
Five Element Temperament Type Audios
Five Element Temperament Type ebooks
Five Element Temperament Type Consult
Mentoring Program one on one with Madalyn Ward, DVM
HHH Group Five Element Temperament Type Forum
Five Element Temperament Type Blog Articles
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