Equine asthma is a condition that can affect horses of all abilities, but is most frequently diagnosed in performance horses and racehorses, and is a common cause of poor performance. The term ‘equine asthma’ covers a broad range of inflammatory conditions of the lower airways, which can vary in their presentation and severity. Conditions that were previously referred to as ‘recurrent airway obstruction’, ‘heaves’, ‘inflammatory airway disease’, ‘chronic obstructive pulmonary disease’, and ‘summer pasture associated asthma’ are now all known as ‘equine asthma’.

When a horse has been diagnosed with, or is suspected of suffering from asthma, it is natural for us to want to provide them with relief. From a pharmaceutical standpoint, that can often mean the use of corticosteroids and, in many cases, clenbuterol (often sold under names such as Claire Gel, Broncopulmin, Airway Gel, Ventipulmin, Equipulmin, etc). While use of these medications may help relieve some clinical signs of asthma, they do not address the underlying causes of the condition and may also come with unintended health consequences. Unfortunately, these side effects are often overlooked, or simply not discussed.

Whilst clenbuterol may provide some initial relief in equine asthma, the use of this drug can contribute to a vicious cycle, potentially perpetuating the condition.

Clenbuterol has been demonstrated to deplete the amino acid taurine. Taurine plays a significant protective role in lung health by exerting powerful anti-inflammatory, antioxidant, and membrane-stabilising effects. It also helps to inhibit allergic responses, which can play a role in many cases of equine asthma. Reduced taurine levels may increase the severity of equine asthma and the likelihood of lung tissue damage as a result of ongoing airway changes. Taurine is also needed to promote healthy gut integrity and microflora: gut health is increasingly recognised as an important factor in respiratory conditions such as asthma.

Clenbuterol decreases levels of potassium and magnesium in the body—two key nutrients known to support respiratory health and reduce the severity of asthma. Potassium is essential for controlling airway smooth muscle tone and supporting respiratory muscle function.  Low potassium can increase airway reactivity and hamper breathing, further exacerbating clinical signs of asthma. Depleted potassium levels can also lead to cramping in susceptible horses. Magnesium acts as a bronchodilator (helping the airways relax) and helps reduce airway hyperactivity, spasms, and inflammation.

Long-term use of clenbuterol may also have negative impacts on immune function, further contributing to a self-perpetuating cycle of equine asthma.

An often overlooked side effect of clenbuterol is the influence it may have on temperament and behaviour in our horses. Clenbuterol belongs to a class of drugs known as beta-2 adrenoceptor agonists, which work by mimicking the effects of epinephrine (adrenaline) in the body. This results in a stimulating effect, which may lead to changes in behaviour, including increased excitability, reactivity or nervousness in some horses.

Helping a horse at risk of, or diagnosed with asthma, starts with good management practices. Identifying and appropriately addressing the factors that contribute to the underlying pathophysiology of equine asthma, meeting the individual horse’s nutritional requirements (which often differ from basic nutrient requirements due to medication use), and the judicious use of suitable herbal medicines can significantly support respiratory health, allowing a horse to remain healthy and perform at its best. There is much that can be done for the horse diagnosed with asthma, using approaches that not only support airway health and performance, but also promote overall wellbeing. If your horse has been diagnosed with asthma, or you suspect respiratory issues may be affecting performance or comfort, a tailored approach can make a significant difference. Get in touch with Optim Equine to discuss a personalised plan to your support your horse’s health and performance.

At Optim Equine, we regularly work with horses affected by respiratory conditions…

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Depending on the herb (or combination of herbs used) and their application, they can help to:

• reduce inflammation
• modulate immune function
• aid healing and tissue repair
• assist recovery from infections
• prevent and/or manage equine asthma
• soothe the gut lining and promote healing of both gastric and colonic ulcers
• reduce colic 
• support digestion
• assist fertility
• help regulate hormone levels
• calm nervous horses
• provide gentle pain relief
• promote healthy hoof growth and integrity
• help to reduce the severity of osteoarthritis and maintain joint health
• Aid in blood glucose control and assist in the treatment of insulin resistance, equine metabolic syndrome and laminitis

Whilst herbal medicines are incredibly versatile, they’re not magic. And they can’t replace a poorly balanced diet….

One of the biggest misconceptions I see is that herbs can fully meet a horse’s nutritional needs or correct nutritional deficiencies on their own. 

This is simply not true. 

The vast majority of herbs (with few exceptions) do not provide sufficient quantities of key minerals and vitamins our horses need for optimal health and functioning.

Take the calcium rich herb nettle (Urtica diocia) for example….

100 g dried nettle leaf (~4–5 cups) provides approximately 300–500 mg calcium.

For a 500 kg (1100 pound) horse, calcium requirements typically fall in the range of 20–40 g/day (depending on life stage, workload, and physiological status).

This means:

• 100 g nettle provides roughly 0.3–0.5 g calcium
• This equates to approximately 1/40 to 1/133 of daily calcium requirements

To meet calcium needs via nettle alone would require:

• 4–5 cups × 40–133 = ~160–665 cups per day

This is neither practical nor appropriate.

Whilst strategically employed herbal medicines can help to restore optimal gastrointestinal health and function in our horses (including digestion, absorption and metabolism)- which in turn, can aid in better nutritional status, herbs in and of themselves don’t provide enough levels of nutrients our horses needs to meet daily nutrient requirements.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The composition of our hose’s gut microbiota has a profound impact on their behaviour and health. This is mediated through the gut-brain-immune axis. Changes in the composition of their gut microbiota can influence neurotransmitter production and function. Neurotransmitters are the natural chemical messengers which have important roles influencing many processes in our horses. Temperament, behaviour, motor control, learning patterns and digestive function are all influenced by neurotransmitters. Gut microbial population also affects neuroinflammation (inflammation of the brain and spinal cord), which can further influence mood and behaviour. Excessive levels of neuroinflammation may worsen stress, anxiety, tension and irritation in our horses.

Many things can adversely affect our horse’s gut microbiota, which may contribute to dysfunction of the gut-brain-immune axis. Clinical signs, changes and conditions we may see in our horses when their gut-brain-immune axis has been disrupted include:

• Faecal water syndrome
• Gastric ulcers
• Colonic ulcers
• Failure to thrive
• Failure to put on/maintain weight
• Susceptibility to infections and/or recurrent, chronic infections
• Nervousness, erratic behaviour, shying, anxiety, irritability
• Equine metabolic syndrome
• Insulin resistance
• Inflammatory bowel disease
• Colic
• Scours/diarrhoea
• Laminitis
• Osteoarthritis
• Equine Asthma Syndrome
• Recurrent skin conditions
• Poor recovery post exercise, training and/or competition
• Excessive muscle tension

In some horses, however, dysbiosis (unhealthy balance of the microbial community in the gut microbiota) may result in no obvious outward signs, yet their health is likely impacted under the surface, and this may become evident further down the track. Many of the signs associated with a dysfunctional gut-brain-immune axis health are non-specific, meaning they can often be dismissed or attributed to something else. Unfortunatel,y this means that often the underlying cause(s) of the condition or clinical signs can be overlooked in our horses.

Some of the factors which compromise GI health, and in turn influence immune health and behaviour include (but are certainly not limited to): insufficient dry matter (long-stem) fibre in the diet; large sized ‘hard feeds’ (ie concentrates and grains); large percentages of starch and/or sugar in the diet; abrupt changes in diet and/or pasture; the use of certain medications (including antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids and ulcer medications); viral and/or bacterial infections; high parasite burdens; nutritional insufficiencies, deficiencies and/or excesses (usually certain minerals, but sometimes particular vitamins); heavy metal toxicities; stress; pain; dehydration; high levels of inflammation in the body; extended travel; intense exercise.

Given the modern demands, management, feeding and medication use in horses, most horses will have compromises to their gut microbiota. The effects of these can be long-lasting, unless specific, targeted, supportive and corrective action is taken. This is crucial not only for their GI health, but in turn their immune health and behaviour, in addition to their overall health, performance and recovery.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The way a foal enters the world can have a lasting impact on its gut health, immune function, and even its risk for developing inflammatory conditions later in life.

In the absence of infection, foals in utero have sterile intestines. 

The ‘healthy’ bacteria needed to colonise the foal’s gut microbiota primarily come from the maternal birth canal and rectum. Through the process of normal delivery, these bacteria are swallowed by the foal, travelling through the stomach and colonising the upper and lower intestine, a complicated process that evolves rapidly.

Foals born via cesarean section fail to encounter the bacteria of the birth canal and maternal rectum. Instead, bacteria from the skin and environment they are delivered in, quickly populate the bowel. As a result, the bacteria inhabiting the lower intestine following a cesarean birth can differ significantly from those found in the vaginally-born foal. Foals born via cesarean are likely to have different, less beneficial and health promoting bacteria to those foals born normally.

Through either mode of delivery, a core gut microbiota is well established within a few weeks of life. This bacterial balance persists largely intact throughout life. A less stable peripheral microbiota—one that is more sensitive to changes in diet and environmental factors, like antibiotics—is also formed.
In cases where cesarean deliveries are necessitated, there are strategies which can be employed to help establish and promote a healthier balance of microflora, thereby positively influencing the foal’s health for life.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

In the lead up to and during breeding season, many pregnant mares are relocated to different properties from where they are normally kept, in order to be foaled down.

Mares which are to foal at properties different to where they are currently residing should be moved a minimum of 30 days prior to foaling. It is generally well accepted not to travel a mare close to foaling (due to increased cortisol levels in response to travel, which influence hormonal changes and can induce labour). What few people actually stop to consider is the importance of the environment the mare is kept in prior to foaling and the impact it has on her foal’s immune system.

The newborn foal is entirely dependent on the antibodies provided in the colostrum by its dam (unlike humans, foals are not born with any circulating antibodies) in order to prevent/fight infection.

The antibodies contained in a mare’s colostrum are active against microorganisms specific to that mare’s environment: whatever might be circulating on the farm she is kept on, as well as against pathogens the mare has confronted or been vaccinated against in the past.

By ensuring mares are moved in a timely manner to the property where they will foal, they are able to stimulate colostral antibody production to local pathogens, thereby helping to pass these onto the offspring, giving their foal’s immune system the best chance to ward off pathogens specific to the environment it is in.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

These bacteria play essential functions in our horses and ponies: they help to digest fibre through fermentation, providing our horses and ponies with a valuable energy source.

Through this fermentation of fibre, these bacteria also produce substances which have immune-supporting and anti-inflammatory properties. Importantly, some of these substances help to strengthen gut wall integrity and help prevent against the development of gastric and colonic ulcers. Additionally, these bacteria produce B group vitamins (including biotin) and vitamin K.

Fibre is a key component of our horses’ and ponies’ diets for their overall health, wellbeing and performance. Ensuring they are fed sufficient fibre is a dietary factor which is often overlooked, yet is arguably one of the most important feed related factors which influences every facet of their health.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Understanding pain in our horses

The experience of pain is unique to each individual horse and pony: in the way it presents, the intensity, frequency of the pain and how the horse or pony responds to treatment. In recent years, we have come a long way in better understanding the many different physical signs a horse or pony may display to indicate that they are in pain.

Pain seldom appears alone: it can impact a multitude of different aspects in a horse or pony. A horse or pony in pain can concurrently experience changes in behaviour or temperament: this may be one of the first indications which alerts us to the fact our horse or pony is experiencing pain. If the pain is new/acute in nature, these behavioural changes can appear totally out of character. If the pain is chronic/ongoing, the horse or pony may become withdrawn or ‘shut down’ in order to manage their pain. Poor performance, immune health challenges, digestive health issues and compromised fertility may all be associated with pain in our horses and ponies.

To effectively address and relieve pain in our horses and ponies, it is important to consider that pain can be multifaceted and complex. When we think of pain in our horses and ponies, we commonly think of pain which is a result of a direct physical cause. That is, pain that is associated with injury, lameness, poorly fitting tack or saddles, etc. This is what is referred to as ‘somatic pain’.

Yet pain can (and often is) so much more complex than this. Which in part, helps to explain why the use of anti-inflammatory drugs and corticosteroids doesn’t effectively resolve pain in many cases.

Different types of pain respond better to different treatments due to their varying mechanisms, mediators, impact on the brain and inflammatory pathways.

To provide the best pain relief for our horse or pony, an individual, targeted approach is essential. Read on to learn more about the different types of pain our horses and ponies can experience.  

Nociceptive Pain

Nociceptive pain is experienced due to ongoing activation of nociceptors (pain sensing neurones located within body organs and internal cavities). Nociceptive pain is caused by damage to body tissues as a result of trauma and/or inflammation. When we think of pain in our horses and ponies, nociceptive pain is generally the first type of pain that comes to mind.

Nociceptive pain serves as a protective response to injury or potential harm. In cases of chronic pain however, nociceptor activation can remain ongoing, even after healing of damaged tissues is complete and there is no further sign of damage/injury. Accurately identifying and understanding the causes and mechanisms behind this chronic pain in our horses and ponies can be incredibly difficult: an injury may be visibly healed (even on thorough imaging and diagnostic methods), yet the horse is still demonstrating signs of pain.

Nociceptive pain can be further divided into two main categories: somatic pain and visceral pain.

Somatic Pain

Somatic pain has a direct physical cause and arises from the musculoskeletal system (muscles, bones, joints, tendons, ligaments, connective tissues) and skin. Osteoarthritis, tendon injuries, ligament injuries, hoof abscesses, cuts and wounds are all examples where a horse or pony may experience somatic pain. It is what many vets, body workers, farriers and other equine health care professionals are often looking for when trying to identify the source of pain. In order to help identify the pain, lameness exams, nerve blocks, imaging (radiographs, MRIs, PET scans, CTs, nuclear scintigraphy etc) may be used.

Yet sometimes our horses and ponies still clearly demonstrate they are in pain, even when these avenues have been exhausted and there seems to be no explainable cause for their pain. So why is this? Despite the best technology, we can’t always see structural issues, so the pain can indeed be somatic in nature, but despite our best efforts, we can’t physically see what is causing the pain. Another reason, which may be overlooked, is the pain they are experiencing may not be somatic pain (or not just somatic pain alone). 

The pain our horses or ponies may be experiencing in this case is likely one (or a combination of) any of the other following types of pain.

Visceral Pain

Visceral pain is pain which originates from internal organs of the body, including the stomach, intestines, liver and kidneys. It may arise due to distension, inflammation or lack of blood supply to internal organs. Colic is a common clinical sign of visceral pain in our horses and ponies. The chronic, inflammatory nature of inflammatory bowel disease may cause visceral pain in some horses and ponies. In many cases we may not be able to visually ‘see’ the source of pain using diagnostic methods, instead relying on history and assessment of clinical signs in the horse or pony. Identifying visceral pain can be even more challenging as it may be masked by other conditions. The discomfort a horse or pony experiences from visceral pain can vary from mild to intense.

Neuropathic Pain

Neuropathic pain is what we commonly think of as ‘nerve pain’. It is caused by nerve damage or dysfunction, resulting in dysregulation of the transmission of nerve signals into the spinal cord. Many causes of neuropathic pain are often linked to excessive inflammation in both the peripheral and central nervous system. Inflammation however, is typically only one element of neuropathic pain. The pathophysiology of neuropathic pain is generally complex and multifactorial, which partly explains why the use of anti-inflammatories and/or rest may only provide minimal relief in many cases.

Central sensitisation

Central sensitisation is pain without identifiable nerve or tissue damage, which makes it challenging to diagnose. This type of pain is thought to result from persistent neuronal dysregulation. It may play an element in cases of neuropathic pain. Some types of neck and back pain without structural pathology may be examples of central sensitisation.

Inflammatory pain

Although somatic pain can definitely be a type of inflammatory pain, immune responses in our horses and ponies can also result in inflammatory pain. This may arise in cases of infection.

Referred pain

Referred pain is pain felt in a different location from the actual source. This form of pain can be challenging to diagnose. An example of referred pain may be highlighted by a horse or pony experiencing problems with its temporomandibular joint (TMJ) or teeth: in such cases, a horse or pony may have referred pain in the neck- with the neck appearing as if it is the source of pain itself.

Psychogenic Pain

Psychogenic pain is physical pain that is caused, increased or prolonged by emotional, mental or behavioural factors, without evidence of physical injury or illness. Psychogenic pain may not yet be commonly recognised as a clinical diagnosis in horses and ponies, but as we understand more about the role of stress, social isolation, anxiety, lack of freedom of movement, insufficient forage in the diet, boredom and frustration in the equine- the role of psychogenic pain should not be overlooked. From a clinical perspective, monitoring and/or observing signs such as heightened reactivity, increased heart rate and/or respiratory rate, stereotypies (wind sucking, cribbing, weaving, box/stall walking, paddock walking) may all be indicative of psychogenic pain.

So how can we help a horse or pony in pain?

In any case of a horse or pony experiencing pain, taking a thorough case history and conducting a comprehensive, holistic assessment gives us the best chance to understand the potential causes and contributing factors to their pain. It is important to note that in many cases, whilst clinical signs can be useful to help understand pain better in our horses and ponies, they are often non-specific.

Viewing, managing and treating pain from a holistic perspective gives us the best possible chance of helping our horses and ponies. We are fortunate that a wide range of judiciously employed nutraceuticals, herbal medicines, dietary and management strategies can significantly help horses and ponies who are experiencing pain. Within the scope of herbal medicine and nutraceuticals alone, we have multiple options in the choice of the herbs and nutrients which can be used to best help treat and manage different types of pain.

The treatment approach we take for specific types of pain should be different if we want the pain relief to be truly effective for our horses and ponies and to resolve the source(s) of the pain.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Corticosteroids (such as prednisolone and dexamethasone), non-steroidal anti-inflammatory drugs (such as phenylbutazone, firocoxib, flunixin), gastric ulcer medications and antibiotics all impact gastrointestinal (GI) ‘gut’ health through several different mechanisms. These may include: irritating the sensitive tissue which lines the digestive tracts of our horses and ponies, potentially causing gastric ulceration and/or bleeding; causing GI dysbiosis (adversely impacting the delicate microflora populations within our horses’ and ponies’ GI tracts); and altering nutrient absorption and metabolism (the way our horses and ponies digest, utilise and excrete nutrients). 

Good gut health is central to the overall health and wellbeing in our horses. We know that beyond digestive health, gut health in our horses and ponies significantly influences: immune health; bone, cartilage and joint health; respiratory/airway health; metabolic health; reproductive health/fertility; hoof health; laminitis risk; and even behaviour and motor patterns in our horses.

These are just some of the reasons why it is important to use any medications judiciously- even ones that are routinely employed in many situations. In the case that these medications are required, strategic nutritional supplementation and in many cases, appropriately prescribed herbal medicines can help to address some of the nutrient depletions and side effects caused by these medications. Additionally they can help to return the digestive system to the best possible state of health.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

One welfare issue which may be associated with the use of gastric ulcer medications and which is commonly overlooked is rebound gastric hyperacidity.

Omeprazole and esomeprazole belong to a class of drugs called Proton Pump Inhibitors (PPIs). These drugs work by stopping the production of hydrochloric acid. Hydrochloric acid is a healthy, key component of normal digestive and immune function in our horses.

When we shut down the production of hydrochloric acid through the use of PPIs, we also interfere with our horses’ own negative feedback mechanisms which regulate hydrochloric acid production. When we stop the use of omeprazole or esomeprazole, particularly abruptly, as commonly occurs at the conclusion of a course of ulcer medication, or in racehorses, prior to racing- then rebound gastric hyperacidity may occur. That is, for a period of time, their bodies lose the ability to regulate the amount of hydrochloric acid produced, resulting in a production of excessive amounts.

This in turn, can increase the risk of EGUS and feed into a self-perpetuating cycle: where a horse is put on ulcer medications, and may (or may not) experience some relief in clinical signs, believed to be associated with EGUS, before coming off the medication and reverting to displaying clinical signs and/or developing EGUS

The use of ulcer medications in any instance should be critically evaluated and when prolonged use is felt necessary, the contributing factors to the development of EGUS should be addressed.

EGUS is often considered a ‘man made’ disease in our horses and ponies: that is, it occurs largely due to our feeding, management and medication practices. The good news is that there is much which can be done to help treat and prevent further episodes of EGUS: Through changing what and how we feed our horses; managing our horses in a way that is conducive to good gastrointestinal ‘gut’ health; providing therapeutic support where appropriate; and reviewing medication practices.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

At birth, foals have only achieved approximately 17% of their mature bone mineral content. What we feed our broodmares (and therefore, the nutrients passed from a mare’s milk to her foal) has significant influence on healthy bone and joint growth and development, immune function, and overall health. A newborn foal consumes 15-25% of its body weight in milk daily. It may also nurse from its mother an incredible 70-80 times per day! In the first few days of life it may nurse even more frequently…as often as every 10 minutes.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Objectives: To describe the successful treatment of two cases of LPE with differing presentations that underwent thorough diagnostic evaluation and failed to respond to conventional therapy. The importance of addressing the gut microbiome- immune system axis is emphasized.

Study design and data collection: Retrospective analysis of medical records. Case details and setting: Case one: a 10-year-old Quarter Horse gelding with diffuse LPE confirmed by laparoscopic biopsy. Case two: a 12-year-old miniature gelding with diffuse LPE diagnosed by intestinal biopsies and transabdominal ultrasonography. Both horses had undergone repeated extensive physical examinations, gastroscopy (with no lesions evident) as well as complete blood counts and basic metabolic panels. Case two had undergone faecal egg counts and microbial culture. Both horses were resident in Australia. Case one presented with a 15-week history of lethargy and depression, ventral oedema extending from the jaw to the prepuce and daily episodes of mild to severe colic. Colic events were managed with per os administration of flunixin meglumine, but not always successfully. Daily medication consisted of oral dexamethasone, omeprazole and vegetable oil. The horse was also receiving a proprietary GI- specific dietary supplement and had previously been treated with sucralfate. Complications with wound healing following the laparoscopy had necessitated an extended period of hospitalization. Case two presented with sudden onset, profuse watery diarrhoea of 2 years ‘duration; bruxism; intermittent passing of mucus; lethargy and sporadic inappetence for hard feed. At the time of assessment, 8 weeks after LPE diagnosis, the gelding was receiving daily oral doses of dexamethasone, omeprazole and codeine. Previous treatments included a five-day course of benzimidazole followed by single doses of moxidectin and praziquantel; bentonite; yoghurt; oral faecal transplantation; misoprostol; corn oil; psyllium husk; phenylbutazone; sucralfate and antimicrobials (metronidazole and sulfadiazine/trimethoprim).

Intervention: Case one received treatment with an ethanol-based preparation of astragalus, echinacea, chamomile, cramp bark, ginger and liquorice in combination with glutamine, zinc citrate, vitamin D3, slippery elm bark and a multi-strain probiotic. The vegetable oil was stopped immediately. A compound of corydalis, California poppy, valerian and cramp bark was used to manage colic episodes, as required. After 1week, the gelding was weaned off the dexamethasone and omeprazole. The diet was modified to increase dry matter and hard feed meal sizes were reduced while the horse was transitioned to a grain-free diet. Walking exercise was introduced and the owner was encouraged to leave the horse without rugs/ blankets. Case two was administered an ethanol-based blend of goldenseal, meadowsweet, echinacea, corydalis, aniseed and ginger alongside glutamine, zinc citrate, vitamin D3, slippery elm bark and a multi-strain probiotic. Concentrate feed and oaten chaff were withheld temporarily, with lucerne and teff hay quantities increased. Dexamethasone, omeprazole and codeine were gradually curtailed while hand walking was introduced and the pony was left without rugs/blankets.

Results: Case one: 24- h video surveillance confirmed significant reduction in severity and frequency of colic episodes within 2 weeks. The ventral oedema resolved after 4 weeks, with noticeable improvements in perceived energy levels. The gelding has had no recurrence of oedema for 20 months and has been colic-free for 14 months. Competition use has resumed. Case two: within 3 weeks bruxism had ceased, there was a notable improvement in manure density and markedly improved energy levels. After 3 months, faecal output was normal on most days and a grain-free balancer feed and lucerne chaff were introduced, which the pony readily consumed. By 5 months manure density was normal, and has remained so after 2 years.

Main limitations: Biopsies were not repeated after treatment and recovery; efficacy of treatment based on observation of clinical signs; small case numbers.

Conclusion: Chronic LPE, including cases unresponsive to pharmaceutical intervention, can be stabilized and treated successfully by integrating nutraceutical, herbal medicine, dietary and management strategies.

­Ethical animal research: No ethical approval required.

Funding information: None.

Conflict of interest statement: None.

Reference:

Vitale, V. (2022) Inflammatory bowel diseases in horses: What do we know? Equine Vet. Educ. 34, 493–500.  

Published in Equine Veterinary Education Volume 36 | Supplement 13 – Link

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Commonly, the first thing a trainer or owner does is request ‘bloods’ (a full blood count) be taken from the horse. In many cases, a full blood count may yield no significant abnormalities. That however, doesn’t guarantee that a horse is healthy. Nor that the horse isn’t suffering from the lingering consequences of viral infection.

Acute viral pathogens can survive in their latent (inactive) forms driving chronic, and persistent poor performance, impaired recovery and symptoms. This is often not reflected in pathology (blood test) results. Viral infections progress in the body in a multistep process. There is very little that can be done from a pharmaceutical (standard medication) perspective to help a horse recover from post-viral illness.

Fortunately, there are many nutritional supplements and herbal medicines which when employed appropriately, can aid in our horses’ recovery from viral illness. Tailored treatment can aid in promoting optimal health in our horses and help them return to their full athletic potential. Treatment is often targeted at aiding different components of the immune system, whilst concurrently reducing inflammation and supporting antioxidant status.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

In addition to compromising the health, vitality, growth and immune function of the foal, Rotavirus has been associated with gastrointestinal ulceration in foals.

This is likely due to nutritional and systemic stress, interruption of suckling in foals and the direct damage the virus causes to the epithelial cells which line the gastrointestinal (GI) tract.

In addition to appropriate veterinary treatment (where required), strategic use of appropriate nutritional supplements and herbal medicines can help restore integrity to the digestive system, support immune function, and optimise the health and growth rate of the foal.

It is worth keeping in mind that commonly prescribed ulcer medications (those containing omeprazole or ranitidine) can adversely impact nutrient availability- including key nutrients needed for both immune function and proper restoration of the GI epithelial lining. To learn more about the effects of ulcer medications visit Ulcers in Horses: The importance of understanding how medications work.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

But there’s so much more to hoof health than biotin, and if we just focus on one nutrient we miss an important opportunity to help improve not only our horse’s hoof health but their overall health.

It’s also worth remembering that horses with a healthy hindgut microbial population are able to synthesise their own biotin.

Gastrointestinal (GI) health

Poor hoof health can often be indicative of poor gastrointestinal health and/or nutrient deficiencies and/or inadequacies in their diet.

Good gastrointestinal (GI) health in our horses is central to their overall health. The integrity of the cells lining the GI tract, the types and numbers of specific microbes which inhabit the digestive tract and the production of special enzymes within the GI tract all play key roles in many facets of their health.

Long-stem fibre should form the foundation of our horses’ and ponies’ diet: yet fibre intake in many equines falls well below the minimum recommended requirements.  Fibre passes through a horse’s stomach and small intestine undigested, where it reaches the large intestine. Here it undergoes bacterial fermentation by special types of microbes (note: it is normal and healthy for horses to digest fibre in their hindgut, it is not healthy for them to ferment undigested grains and starches). The fermentation of fibre by these microbes results in the production of various substrates important for immune, gastric and nervous system health in our horses. Some of these healthy microbes also produce biotin. A horse with a healthy hindgut microbial population who is fed adequate fibre, can synthesise good levels of biotin needed for hoof health. To read more about the importance of fibre in our horses’ diets, see: Grass, Hay, Fibre and Short Chain Fatty Acids.

Many other nutrients are required for healthy hooves: sufficient quality protein (including adequate amounts of the amino acids lysine, methionine and choline read more about the importance of protein here);  copper; zinc; iodine; calcium; selenium; B group vitamins; vitamin E; vitamin C and vitamin D. Some of these need to be provided in a horse’s diet. Others such as B group vitamins, vitamin C and vitamin D a horse can synthesise if given the right conditions. Simply supplementing biotin alone without ensuring other nutrient needs are met is of limited value. All the aforementioned nutrients also play various key roles in other facets of our horses’ and ponies’ health: fertility; metabolism; immune health; joint and musculoskeletal health; neurological function and behaviour.

Anything that interferes with a healthy GI microflora population in our equines, and/or interferes with the integrity of the cells lining the GI tract, in turn influences nutrient absorption and/or metabolism. Ironically, some of the things which interfere with digestive function are often used to help counteract digestive or other health complaints: gastric ulcer medications; antibiotics, non-steroidal anti-inflammatory drugs and corticosteroids to name a few. To learn more about the influence of ulcer medications in relation to the overall health of our horses, visit: Ulcers in Horses: The importance of understanding how medications work.

It’s worth considering the aforementioned aspects before trying to solve an issue such as poor hoof health by adding more supplements to a horse’s diet. If a horse or pony isn’t consuming sufficient fibre or nutrients, and/or is unable to properly digest, absorb or utilise specific nutrients, then adding more supplements to their diet is unlikely to provide an effective solution to the issue at hand.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The availability and use of antimicrobial herbal and pharmaceutical medicines gives us the ability to help our equines live longer, healthier lives. If we want this to continue, however, we need to be incredibly judicious in how we use these treatments.

Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial agents. Using antimicrobial drugs inappropriately or unnecessarily increases AMR. This means that antibiotics and other antimicrobial agents become ineffective in helping our horses in conditions they were once effective in helping to resolve.  This can mean that when our horses actually genuinely need such medications to help, our options are more limited.

The largest contributor to AMR is overuse and misuse of antimicrobial agents. It can be quite easy to accidentally fall into the trap of using such medications without stopping to give thought to what we are actually doing. For example, we give our horses antibiotics unnecessarily, such as in the case of a horse with a snotty nose (viral infection), which we want to ‘treat’ with antibiotics. Antibiotics are ineffective in the case of viral infections. Or when we routinely deworm our horses on a seasonal basis as opposed to employing strategic deworming, faecal egg sampling and pasture management methods (for example regularly picking up manure, harrowing and/or rotating paddocks). To learn more about deworming, see the article: Drenching/Deworming with Panacur.

In some parts of the world (such as Australia and New Zealand), the use of feed supplements that contain antibiotics is a real concern. An example of this is a product which claims to assist in helping prevent laminitis (claims which are not supported in many other parts of the world) Laminitis ‘Prevention’- But at what cost? Even something as innocent as using anti-fungal washes on any skin condition that we may see on our horses and ponies increases the risk of AMR.

Starting with sound animal husbandry practices such as feeding our horses well-balanced diets which meet key nutrient requirements Nutrient Requirements for Horses: Fortified Feeds and the need for Supplementation; employing good pasture management and stable hygiene practices; avoiding self-prescribing for our horses ‘just-in-case’; and disposing of unused antibiotics and anti-fungals appropriately are all really good places to start to help reduce AMR.

In many instances, appropriately applied and selected nutritional supplements and herbal medicines can be used to effectively prevent, treat or manage health challenges in our equines: sometimes used as stand-alone therapies, other times used in conjunction with standard medications. In both cases, they can help to significantly reduce AMR.

We can also be mindful not to pressure our vets to prescribe medications when they don’t feel it is necessary for our horses and ponies. This is in the best interests of not only our equines, but all animals and humans for the long term.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

In recent years, much attention has been given to grain-free feeds. Low-GI, low starch, ‘calming’ and low sugar feeds also get plenty of airtime. All the terms can relate to different aspects of the feed, but in the majority of cases, it is clever marketing and doesn’t ensure that the feed we are purchasing is necessarily suitable or safe for our horses and ponies.

Clever marketing and loopholes in claims that can be made on feed packages can become very confusing. Feeds can claim to be ‘grain free’, a ‘calm performing feed’ or low GI, yet in some cases the predominant ingredients in the feed may be made from grain! If we take a look at an ingredients list (remembering that ingredients are ordered in descending order of the percentage they make up of the feed) grain may be present in the form of millmix, millrun, pollard, cereal by-products, wheat middlings to name a few! Other products may be truly grain-free but contain large amounts of molasses and other high-calorie oils and ingredients to bind the feed together and/or make it more palatable. In either case, for many horses with metabolic issues, these feeds are likely to not be suitable. Generally ‘grain-free’ refers to the fact that no whole grains are present, yet many of these feeds contain processed grain ingredients- which certainly doesn’t make them grain-free! Along the same lines, there are feeds widely available in Australia that are advertised as suitable for horses with ‘grain intolerance’ which have barley or millrun as the predominant ingredient in the feed!

There are many reasons why it may be preferable to feed a horse or pony a truly grain-free diet, particularly a diet low in starch and sugars. For many equines, they don’t need the calories/energy provided by such grains and concentrated feeds, and in the case of horses with equine metabolic syndrome, insulin resistance and many cases of laminitis and Pituitary Pars Intermedia Dysfunction (PPID) (formerly known as ‘Cushings’), steering clear of grain is generally a good idea.  For other horses with higher calorie needs, the incomplete digestion of grain products and the resulting fermentation of starch and sugars in the hindgut can increase the risk and/or severity of gastric and colonic ulcers, inflammatory bowel disease, ’tying up’, developmental orthopaedic diseases (such as OCDs and bone cysts), immune dysfunction, inflammatory conditions and behavioural issues.

If a horse needs to be on a grain-free diet, and more specifically a low starch and sugar diet, we need to pay particular attention to all the ingredients contained in a feed, as well as the feed’s nutritional analysis- not just the marketing claims! We also need to remember that a horse’s or pony’s ‘hard feed’ should only make up a small percentage of its diet. We need to consider the role which pasture and hay play in each equine’s intake: from the perspective of calories, starch and sugar. Additionally remember that for multiple health reasons, long-stem fibre (such as that found in hay) should form the basis of their diets. To read more on the importance of fibre and hay, see the articles Fibre, Chewing and Gastrointestinal Health; Why Basics Matter: The Importance of Chewing; Hay, Stomach (Gastric) & Hindgut (Colonic) Ulcers; and Grass, Hay, Fibre and Short Chain Fatty Acids. 

What and how we feed our horses and ponies plays a crucial role in their overall health. In many cases, we can mitigate the risk of severe health conditions, whilst also ensuring that we are giving our equines everything they need to perform at their best and be in the best of health. Clever marketing and loopholes in regulations governing feed claims can make it both challenging and confusing to feed your horse or pony in a way that is best for each individual equine. Seeking independent advice from suitably qualified and experienced nutritionists and equine health practitioners is one of the best investments you can make in your horses’ health and performance. Prefer listening to podcasts or watching webinars to learn more about equine nutrition, gut health, ulcers, immune health and other horse health conditions? Be sure to visit our Media page for plenty of informative recordings.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

In short, it relates to the microbiota of our equines’ digestive systems.

The bacteria, fungi, protozoa, and viruses that colonise the equine gastrointestinal tract (GIT) (collectively known as the microbiota), play many crucial roles in horse health.

These microbes influence digestion, energy and nutrient production, immune health, levels of inflammation in the body, overall GI health, body condition, respiratory health, skin health, metabolic health, reproductive hormones and the production of neurotransmitters (chemicals which influence their mood, temperament, learning, motor control and behaviour).

When the microbiota deviates away from what is optimal, a horse is more susceptible to conditions of inflammation, illness, pathology, GI disturbances including colic, gastric and colonic ulcers, stressed behaviour and diminished nutrient and energy production and uptake.

The large population of microbes that inhabit the equine GI tract are influenced by what our horses and ponies eat. The specific types of microbes become accustomed to what our equines are fed and must adapt to different types of feed. This means that when they eat different types of feed, there are different populations and types of microbes.

Sudden dietary changes induce rapid shifts in this delicate balance of microbes and the byproducts they produce, rendering a horse more susceptible to illness. Whilst this is a broad simplification, the sudden changes in the microbes and their activity are largely indicated in many cases of colic, laminitis and other serious health conditions.

When we add new feeds to a diet or change a horse’s diet- we want to facilitate a gradual change in the microbial population and the products these microbes produce. The best way to do this is to introduce new feeds into their diet gradually over a 7-14 day period, slowly increasing the amounts of the new feed as the microbial population adjusts.

It’s a simple process, which is largely overlooked: something which can save a lot of pain, heartache and expense.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

With plenty of fresh pasture available, it can be tempting to stop feeding or reduce the amount of hay we give our horses. Yet if we want them to have good gastrointestinal (GI) ‘gut’ health, then keeping feeding sufficient hay to them is a must! To learn more about the important role of hay in the diet, visit the article: Hay, Stomach (Gastric) & Hindgut (Colonic) Ulcers.

Green grass is predominantly water and as a result, is low in dry matter fibre. Dry matter fibre is incredibly important for our horses and ponies for a multitude of reasons. Dry matter fibre supports the proliferation of and helps to maintain a healthy GI microflora population. To read more about fibre, see Fibre, Chewing and Gastrointestinal Health.

Dry matter fibre is also needed for the production of short chain fatty acids (SCFAs) also known as volatile fatty acids (VFAs). Short-chain fatty acids are predominantly produced by the fermentation of fibre by the GI microbiome.

These SCFAs have many health benefits, including significant anti-inflammatory and immune-regulating properties. Furthermore, they help to promote the production of specific neurotransmitters (chemical messengers) which help our horses to be calm and relaxed. They have also been shown to help decrease fat accumulation and improve insulin sensitivity (an important consideration with insulin resistance, laminitis and equine metabolic syndrome (EMS)). 

From a direct gut health standpoint, SCFAs play a crucial role to help promote proper GI barrier function- thereby helping to protect against the development of gastric and colonic ulcers. To read more about ulcers, see articles: Hindgut (Colonic) Ulcers in Horses and Ponies; and Ulcers in Horses: The importance of understanding how medications work.

Sometimes the simplest things can make the most profound difference in helping the overall health of our horses and ponies. Adequate fibre is one important dietary measure we can put in place to help promote calm behaviour in our horses, support sound bone and joint health, reduce inflammation, and reduce the risk of laminitis, insulin resistance and EMS.

Prefer listening to podcasts or watching webinars to learn more about gut health, ulcers, immune health and other equine health conditions? Be sure to visit our Media page for plenty of informative recordings.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

And whilst all these can be examples of a horse or pony which is stressed, sources of stress and the effects it has on their body can encompass so much more.

We can actually have horses and ponies who in their nature are very relaxed and settled, yet their body is under significant stress. Stress is a type of change that causes physical, psychological or emotional strain in our horses.

Multiple forms of stress can have a cumulative effect, creating significant demands on the bodies of our horses. As a result of ongoing stress, our equines have increased requirements of particular nutrients.

Stress is also an important consideration in relation to stallion fertility, pregnancy in mares, gastric and colonic ulcers, inflammatory bowel disease (IBD), laminitis, insulin resistance (IR) and equine metabolic syndrome (EMS), chronic infections, bone health and failure to thrive.

Some of the many different sources of stress to our equines include:

• Separation/Isolation
• Injury
• Illness
• Use of certain medications
• Nutritional deficiencies/insufficiencies
• Nutritional excesses
• Travel
• Dehydration and/or withholding water
• Withholding feed
• Weaning
• Pain
• Inflammation
• Intense exercise
• Parasites
• Heavy metal burdens
• Exposure to chemicals, pesticides

What other sources of stress can you think of?

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

For the owner or rider considering taking on an OTTB, careful thought and planning should go into ensuring that the transition from the life of a racehorse to the next phase of the horse’s career is as smooth as possible. Some of the biggest considerations need to be given to changes in the horse’s diet, routine and optimising health parameters. Equipping yourself with knowledge and enlisting the help of suitably qualified professionals can help to realise your horse’s full potential.

Goals and Capabilities as a Rider/Handler

Before even inspecting an OTTB for potential purchase, clearly know what you are wanting in your new horse and your capabilities as a rider. Are you looking for a future show hack with impeccable conformation and looks? Are you looking for a pony club mount that needs to be calm and versatile? Are you looking for a horse with the potential to be a top-class eventer, thereby needing to be very sound, athletic and able to withstand high levels of training? Are you looking to get a cheap yet athletic horse to re-educate and sell on? Knowing the answers to these questions will quickly help to narrow down the horses you inspect for potential purchase and look to undertake a pre-purchase veterinary examination. By clearly knowing your goals, you can save yourself a lot of time and money and are far more likely to choose the most suitable horse.

When taking on an OTTB (particularly one that has come straight from a racing stable environment), honestly assessing your capabilities as a rider is critical. Are you confident and competent enough to safely and effectively manage and deal with an anxious, highly geared horse (whose temperament may or may not change significantly whilst in your care)? Or are you better suited to taking on a more relaxed OTTB or even one that has been off the track for some time and has spent time being re-educated with a different owner? One of the many beauties of OTTBs is that there are so many to choose from and at many different life and career stages- you are bound to find one that suits you perfectly! Be patient and choose wisely.

Vet Check

One of the first things to consider (and often most overlooked) when purchasing an OTTB is getting a thorough vet examination prior to purchase. Musculoskeletal soundness and airway health are two of the most significant considerations. Just like human athletes, racehorses’ bodies are put under strenuous physical demands, with the potential to develop injuries. Due to the hard galloping done by many young horses in training, considerable stress is put on bones, tendons and ligaments. This can lead to soundness issues. A thorough vet examination can help to identify previous injuries or any potential issues which may influence the ability of the horse to be suitable for its intended next career. On radiographic screening (x-ray), many racehorses will have some degree of osteoarthritic changes in their joints. With planning, sound dietary practices and the strategic use of appropriate supplements and management interventions, many of these conditions can be well managed. Furthermore, the fact that many OTTBs transition into their next careers at a relatively young age is advantageous. From a physiological perspective, when given suitable nutrition and support, their body is better able to repair and regenerate than an older horse. Referring back to your goals and what you intend to do with your OTTB is an important consideration here. A past injury in a racehorse which may prevent it from high-level eventing may pose no issues for a horse intended for general pleasure riding.

Suboptimal hoof health is a common finding in the newly transitioning OTTB. This is often due to a combination of poor gastrointestinal (GIT) health (which influences nutrient absorption and the production of essential vitamins such as biotin needed for sound, healthy hooves). For more information on the role of GIT in overall health and the role of nutrition in hoof health see articles: Fibre, Chewing and Gastrointestinal Health; Ulcers in Horses: The importance of understanding how medications work; Hay, Stomach (Gastric) & Hindgut (Colonic) Ulcers; and Beyond Biotin: Optimising Horse Hoof Health.

Routinely being shod in race plates can also compound the problem of poor hoof structure and health. Many racehorses have contracted hooves with under-run heels, long toes and thin soles. Encouragingly, hoof health is an aspect that can readily be turned around in a period of around 8-12 months with appropriate dietary changes and good farriery. Including radiographs of the hooves as part of the pre-purchase examination may be a valuable investment in some horses: x-rays can help to demonstrate what is going on in the hoof and can aid the proactive farrier to trim, shoe and manage the hoof appropriately.

It is important to remember that often racehorses in training will initially go footsore when their shoes are removed and they are left barefoot during a spell. This is especially true of the front feet. Some farriers and owners will choose to keep their horses in shoes. In many cases however, it is advisable for the spelling horse to have an extended period of time being unshod: this helps to positively influence hoof shape and integrity and aids in proper circulation and blood flow to the hooves. Feeding the horse a diet which reduces inflammation, using nutritional supplements (nutraceuticals) and herbal medicine under qualified supervision, and potentially easing the transition to barefoot through the use of padded, removable boots are all beneficial strategies.

Another aspect of the pre-purchase examination should also include an upper airway scope. Respiratory conditions which may be evident when assessing an OTTB include a history of exercise-induced pulmonary haemorrhage (EIPH, more commonly known as bleeding), airway inflammatory disease, and laryngeal hemiplegia (roaring). The first two can generally be well managed with appropriate feeding and supplementation practices and adopting strategies to minimise the inhalation of air particulate matter and dust.

History

Where possible, finding out as much history about the horse as possible can help to make a smooth transition to the next phase of its career. For a horse coming straight off the track, contact with the trainer and/or stable manager can help provide you with valuable information as to any health or injury concerns with the horse, the dates it was last vaccinated and drenched (de-wormed), any medications and/or supplements it may have been receiving, its current diet and any quirks, habits or temperament considerations to take into account. Having said this, it is also important to remember that when a horse is put in a new environment, some of the aforementioned things may change! For example, a horse that was previously often irritable can become much calmer with a more natural diet and living environment. Similarly, horses which may have been very picky eaters whilst in training often become very good eaters once their GIT health has improved and the stress of the training environment has been removed.

Diet

The majority of diets fed to thoroughbreds in training are not conducive to optimal GIT health and function. Practices vary between trainers and stables, but most often, horses in training are fed two or three large grain and/or concentrate-based meals per day. Grass and/or lucerne hay are often provided in limited amounts. Many trainers do not have the luxury of turning horses out to graze. This puts the horse’s digestive system under strain and increases the likelihood of many health issues including ulceration throughout the GIT (gastric and colonic ulcers), colic, disturbances in the GIT microflora (bacterial balance of the digestive system), hindgut acidosis, suboptimal ability to utilise feed properly and nutritional deficiencies/insufficiencies. The addition of high cortisol levels produced by the horse in response to stress and high-intensity exercise further compromises GIT health and digestive function. To read more about the contributors and effects of stress in our horses see: Stress in Horses: Why it isn’t always obvious.

Horses, by nature, are designed to be constantly moving about and grazing high-fibre roughage. This is important as the stomach of the horse is relatively small in volume and has little capacity to expand. As a result, small amounts of feed which are consumed often are digested much better than the large volume feeds given a couple of times per day. The constant grazing a horse does in its natural environment also ensures that there is a physical buffer in the stomach to protect against the breakdown action of hydrochloric acid and digestive enzymes. These substances are constantly produced in the horse and are essential for proper digestion, as well as immune function. To read more, visit: Ulcers in Horses: The importance of understanding how medications work. Grazing and chewing also stimulate the production of saliva. Saliva serves many important functions in the horse, including releasing bicarbonate ions into the stomach (which also protects the stomach lining, another smart natural mechanism of the horse to protect against ulcers). To learn more about the benefits of grazing, visit: Why Basics Matter: The Importance of Chewing.

Sudden changes in feeding practices (even those that are beneficial to the horse) can increase the risk of colic and other complications. This is thought to be largely attributed to rapid changes in GIT microflora in response to the feed offered. Finding out the horse’s current diet prior to purchasing can help to make smooth transitions to a more fibre-rich feed, whilst ensuring the gut microflora change at an appropriate rate. It is advisable to make the transition of feeds gradual (over a period of 12-14 days) to help best facilitate this.

Whilst horses who come directly out of training will have been maintained on high-energy rations, their relative energy needs during their initial transition into an OTTB will be much lower. Furthermore, if GIT health is optimised as part of their transition (through feeding, management practices and appropriate supplementation), they will be better able to use fibre rich feeds (ie pasture and hay) as energy sources. This is made possible through bacterial fermentation in the hind gut (helpful microbes in the large intestine break fibre down into short-chain/volatile fatty acids, a high source of energy for the horse). It is important to remember that whilst a horse’s actual energy needs may be much lower than when they were in training, their need for specific minerals, vitamins and protein may remain relatively high. Without the excess demands of training and racing the body is in a prime position to help address and heal any niggling injuries, musculoskeletal damage or immune health challenges. To find out more about nutrient requirements and the role of protein for horses visit Nutrient Requirements for Horses: Fortified Feeds and the need for Supplementation; The Importance of Protein. These are commonplace in any athlete involved in demanding sports. To facilitate optimal healing and health, is essential to ensure that the OTTB receives at a minimum the recommended dietary intake of minerals and vitamins, in addition to good quality protein sources. A good quality balancer feed or supplement, in the addition to sufficient pasture, hay and lucerne hay (where appropriate) will help to meet these needs.

Some people find challenges in putting condition on their OTTB and/or the horse being picky with their feed. This is most often due to irritation of GIT, use of ulcer medications and non-steroidal anti-inflammatories (NSAIDs) such as ‘bute’ (PBZ), and the diet racehorses are commonly maintained on,. These factors can all significantly compromise gut integrity and health. Add to this the stress of a new environment and the change in the horse’s routine and it can take a little time for the horse to adjust. Whilst the prescription of appropriate nutritional and herbal supplementation can help immensely in these cases, basic management practices including turning the horse out to graze, the provision of sufficient roughage (hay, pasture), and keeping the OTTB  with a sensible paddock mate are all effective starting points owners are encouraged to implement. One of the most common mistakes that can be made when wanting to put weight on a newly acquired OTTB is to continually increase the ration of grain or high-energy concentrate feed, without the provision of sufficient roughage and fibre. This contributes to additional compromises in the integrity of the GIT lining and further shifting the hindgut microflora away from that which promotes the best utilisation of feed and energy. As a result, the cycle of struggling to gain weight is perpetuated, and often leads to frustration as the horse seems to take an extended period of time to ‘let down’ and gain condition. To read more about horse’s who struggle to put on condition, visit the article: HELP! My horse won’t put on body condition.

Down Time

One of the best things you can do as an owner of a newly transitioning OTTB is give it some much needed ‘down time’. The majority of racing stable environments are far removed from what is a natural for the horse. Like humans constantly under work deadlines, family demands and everyday pressures, horses too routinely experience stress. This stress is manifested in many forms, primarily driven by changes in levels of the stress hormone cortisol (which can lead to reduced immune function, high levels of inflammation, changes in temperament and behaviour, and reduced capacity to recover). Additionally, the constant physical demands of training and racing can lead to ongoing musculoskeletal ‘niggles’- aches, pains and minor injuries. A period of 4-8 weeks, turned out in the paddock, fed a fibre-rich diet, and not in the demands of work or being fussed with is one of the most beneficial things you can do to help the newly transitioned OTTB. It helps the horse to mentally wind-down, aids in the restoration of GIT health, gives any small niggles the chance to heal, and lets the horse settle into a new environment and freshen up. Just like humans, horses too need holidays. Simply giving them time out before asking new demands from them in their new career, can help them get off to the best start. 

Temperament

A significant (and often highly variable and unpredictable) consideration in the OTTB is temperament. This can be a challenge when acquiring a new horse, as it is difficult to know exactly how much is ingrained behaviour and the horse’s natural tendency, compared to how much it is a result of the environment the horse has been in, the feeding practices and GIT health. An important consideration to note is that 70-80% of the neurotransmitters (the chemicals which influence mood, temperament, behaviour and learning) are produced in the GIT. There are clear links between GIT health and levels of anxiety, mood changes and behaviour. This is useful to take into account: an OTTB which has struggled with compromised gut health in training and may be nervous, edgy or readily spook can change significantly when GIT health is addressed. A combination of appropriate supplementation and feeding, combined with appropriate ‘down time’ can really significantly impact the behaviour of an OTTB for the better. It routinely plays a role in why many horses that are temperamental/nervy/anxious in training become more relaxed away from the stable environment. Keep in mind too, that the actual environment the horse is kept in also plays an important role.

Monitoring and Progress

From a basic health standpoint, once the new OTTB has arrived and settled, it is wise to measure temperature, respiratory and heart rates at roughly the same time each day for a week to establish what is ‘normal’ for your horse. Record these and keep on hand (using the notes section on your mobile phone can be great, otherwise written on a whiteboard or somewhere easily accessible). This information is incredibly helpful in the instance that your horse may become unwell: you know what is ‘normal’ and healthy for your horse, helping to implement appropriate strategies in a timely fashion.

Taking photos of your horse from the side and back (safely), on a fortnightly or monthly basis is a simple tool to monitor body composition changes and progress. The same thing can be done with their hooves front and side-on, in addition to picking the hoof up and taking pictures of the sole and frog. It can be incredibly rewarding to look back over a 4-6 week period and notice the subtle improvement in body condition. Horses can make significant progress in gradual increments, which may be missed when you are seeing the horse on a daily basis. By having photo evidence on hand, you are able to make a more objective assessment. Keep in mind that changes in hoof shape and quality will be much slower to notice: front hooves take a full 8-12 months to grow from the coronary band to the toe.

The majority of horses in training are maintained on a routine drenching (deworming) schedule. Given our current state of understanding in relation to resistance to worming products, it makes sense to adopt a strategic drenching approach. In order to implement this safely and effectively, taking routine faecal samples to be sent off for testing are encouraged. Doing this at the commencement of ownership can help to provide guidance to the most effective drenching requirements of your horse. For more information on drenching/deworming visit the article Drenching/Deworming with Panacur.

Conclusion

Like most worthwhile things in life, effectively transitioning a racehorse to an accomplished OTTB takes time and patience! Knowing your capabilities as a rider and having clear goals as to what you want to achieve with your new mount are important starting points. Enlisting the expertise of suitably qualified professionals and equipping yourself with the knowledge of best practices can help make for a smooth and rewarding journey. Choosing an OTTB can make for one of the most gratifying experiences as a horse owner and rider. Careful consideration, planning and attention to detail can ensure you give your horse every chance to excel in its new phase of life.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The cause(s) of IBD are not fully understood, however, it is thought that abnormal immune responses to bacterial, viral, parasitic, and/or dietary antigens play a key role. 

One such dietary allergen which has been highlighted is gluten, a protein which causes intestinal damage to people who suffer from coeliac disease. In recent years, gliadin (a component of gluten) has been reported to increase the permeability of the small intestinal mucosa and cause concurrent intestinal inflammation associated with IBD in the horse.

The key takeaway points from this are that diet can and does play an essential role in the health of the horse- beyond merely providing energy to fuel their work, growth and metabolic processes. 
As with any health condition in the horse (especially IBD), diet needs to be addressed for effective treatment/management of the condition in the horse. If the allergen remains in the diet, then inflammation and intestinal damage persists, despite treatment.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Horses and ponies are able to synthesise (make) their own vitamin B12 when they have a healthy balance of hindgut microflora, sufficient fibre in their diet and a suitable mineral intake- particularly adequate dietary cobalt.

What is commonly overlooked is the fact that injectable vitamin B12 is rapidly and nearly completely excreted via bile into a horse’s manure. In essence- they can’t use or absorb this form of B12…it just makes for expensive poo!

Having a healthy digestive system is incredibly important in our horses and ponies to promote many facets of their health: good hoof quality and growth, optimal metabolic and immune function, the production of neurotransmitters (natural chemicals) which help to promote calm behaviour and reducing inflammation.

The production of optimal levels of vitamin B12 to aid in athletic performance are just another reason why we need to focus on sound feeding and management practices and the judicious use of medications in order to promote good gastrointestinal and overall health. It is also an important reminder that we often just can’t out supplement poor dietary practices.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The horse or pony prone to laminitis can be a challenge to keep healthy. Poorly managed or severe episodes of laminitis can lead to devastating consequences. Diligence and modification to the diet and management regime of a horse or pony at risk of or with laminitis are required to prevent further deterioration or episodes of the condition and keep the equine in the best health possible. If a supplement on the market claimed to prevent acute episodes of feed related laminitis AND didn’t require changes in the way we feed and manage our horses and ponies, then surely that would be great? On the surface, maybe, but when we understand about HOW such a product possibly prevents laminitis and the potential long-term health repercussions, then stopping to reconsider its use is certainly warranted. Especially when one of the leading equine veterinary authorities in the world completely ban its use.

One widely promoted and used product on the market contains the active ingredient Virginiamycin. Virginiamycin is an ANTIBIOTIC.

It is well known, researched and demonstrated that antibiotics have an adverse impact on gut health through several mechanisms. They kill off not only ‘bad’ but ‘good’ bacteria which play many essential roles in our horses’ and ponies’ digestive systems. Amongst other functions, these healthful bacteria help to break down the fibre in hay and roughage to produce ‘cool’ energy for our horses; they produce substances which play a role in preserving the lining of the gastrointestinal tract (GIT) helping to reduce inflammation and protect against ulceration; they produce B group vitamins, biotin and vitamin K- essential for energy production, hoof health, reproductive health, bone health and strength, and recovery from exercise to name a few; they are intimately involved in the production of neurotransmitters (chemical messengers which influence our horses’ moods, temperament, behaviour, gut motility, etc); and these helpful bacteria also play a crucial role in proper and healthy immune function. Furthermore, compositions of specific ‘good’ GIT microflora have been shown to play an important role in metabolism, blood glucose control and insulin sensitivity: all which may have a protective effect in the horse or pony at risk of insulin resistance (IR) and equine metabolic syndrome (EMS). It is well known that horses with IR and/or EMS are at an increased risk of laminitis.

Antibiotics are also known to increase intestinal paracellular permeability and promote intestinal barrier dysfunction- sometimes referred to as ‘leaky gut’. Episodes of laminitis are commonly a sequelae of the above.

Through the use of antibiotics, bacteria (both ‘good’ and ‘bad’) are kept in check (although with increasing antibiotic use and levels of antimicrobial resistance eliminating the ‘bad’ bacteria is becoming increasingly more difficult) thereby keeping some of the triggering factors to laminitis episodes at bay.

We KNOW that diet has a significant influence in the majority of cases of laminitis. We also know that the integrity of the GIT lining also plays a paramount role. In horses with poor digestive health (which is common and can be caused by many factors- visit the Articles section on Optim Equine’s website to read more) high grain/carbohydrate diets have been shown to change bacterial populations (to non-favourable bacteria) in the hindgut. These bacteria produce lactic acid through fermentation, damaging the GIT lining and contributing to a cascade of events that can result in laminitis. In theory, as long as the horse is kept on this antibiotic, rapid shifts in gut microflora which may precede laminitis are less likely to occur. Therefore helping to ‘prevent’ it.

There are a few issues with this. The constant use of antibiotics actually impairs the integrity of the gut lining through several mechanisms. One of the many supportive roles of ‘healthy’ bacteria are to protect and promote a healthy GIT lining. Part of this mechanism involves reducing intestinal inflammation.

Secondly, when a horse comes off the ‘supplement’ (medication) unless strategic dietary practices are implemented, the microflora balance will more likely default to an unhealthy one as a consequence of the use of antibiotics…thereby actually further increasing their risk of future episodes of laminitis than before they were on the supplement in the first place. Keep in mind too that antibiotics also degrade the protective barrier function of the intestinal lining. 

Then we’ve got the nutritional consequences as a result in shifts in GIT microflora. Horses on antibiotics are now lacking the beneficial bacteria to help them properly digest and utilise fibre as an energy source, in addition to the myriad of roles those healthy bacteria play in overall health and performance as outlined previously.

Virginiamycin has been completely banned for animal use in the UK since 2014. This alone should ring alarm bells! The antibiotic was banned as it posed a risk to increased development of antimicrobial resistance. The Veterinary Medicines Directorate (VMD) also found no robust evidence that Founderguard prevents laminitis. They supported that this condition can be managed though animal husbandry and pasture management. They declared the use of Founderguard in horses no longer justified. Globally, we need to recognise the very real problem of antimicrobial resistance and responsible prescribing of antimicrobials in the veterinary profession. As the pathology which drives laminitis is not caused by bacterial infection, we must ask ourselves is the use of antibiotics in this instance responsible? 

We have the opportunity to support healthy GIT microflora, promote healthy GIT integrity and feed our horses so they are able to perform at their best and be in the best of overall health and help prevent laminitis. This is largely dependent not only what we feed our horses, but how we feed them too. It also involves looking at the way we use routine medications in our horses and incorporating alternative strategies to minimise unnecessary use and addressing the side effects they cause when they are required…

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Spooking, shying and anxiety in horses and ponies are some of the most common challenges we face from a behavioural aspect. When we have a horse or pony which is on edge, spooks at imaginary monsters and feels like they are a bomb under us just waiting to explode, we know something must be done. One of the easiest things for us to manipulate is their feed. We try eliminating things from their diet- often with mixed success. Maybe it helped? Maybe it didn’t. But because our horse possibly seemed quieter or less spooky, we’re not going to add back what we’ve already taken out. Surely they’re better off with less feed anyway and there can’t be any harm in reducing what we are giving them? We also tend to add a myriad of supplements- typically ‘calming’ ones. It’s easy to get to the point where we’re too scared to stop giving any of the supplements we’ve added in case it makes the problem worse. We can get to the stage where we are feeding very little actual feed and so many additives. Sadly, often our horse is no better off in terms of behaviour, and nutritionally is often left with deficits of important nutrients. Furthermore, we can be lacking a solid plan of action going forward in terms of properly feeding and nourishing our horse and addressing the cause of their behaviour.

We need to remember that anxious, spooking or edgy behaviour can be caused by many different things, not just feed. It’s important to consider the potential role of pain, social dynamics, poor fitting tack, the amount of work/exercise we are doing with our horses, their education, learned behaviour, environment and routine. As horsepeople, we also need to take the (challenging) step back and honestly ask ourselves what expectations we have of our horse, and what emotional state and frame of mind are we in? With the fast pace of life many of us lead, it is easy for us to be tense, uptight or in a rush, even when doing the things we love. Our horses instinctively sense this and it can influence the way they behave. The question needs to be posed if what we are asking our horse or pony to do is both clear and appropriate for their stage of development.

But if we focus back to the role of diet in anxious, spooking and edgy horses, one of the most common dietary problems which influence this behaviour is restricting/minimising protein intake, and in particular the amino acid lysine. It’s easy to think that eliminating protein rich feeds can only help a problem and not make it worse. Protein and protein rich foods are commonly blamed for fizzy and bad behaviour in our horses. Yet there is very little worthy evidence to substantiate this and good research to support the contrary.

Protein is made up of small molecules called amino acids. Amino acids and proteins are the building blocks of life. There are 21 amino acids required for a horse to make all the proteins it needs to function, grow and be in good health. Nine of these amino acids are deemed ‘essential’, that is they must be obtained through the diet. In a healthy horse, the remaining 21 amino acids can be produced by the body, even if they are not obtained directly through the food a horse eats. To read more about the role of protein in our horses’ diets, see the article The Importance of Protein.

One crucial essential amino acid in our horses’ and ponies’ diets is lysine. Different foods are comprised of different amino acids. It is important to remember that not all protein sources contain adequate balances of essential amino acids which our horses need for good health. The richest dietary source of lysine for horses and ponies is cooked soybean products. (To read more about soy in the equine diet, visit Soy: The Good, Bad and Confusing! Hay, grass and forages, grains, and beet pulp are all low in lysine. It’s easy for our horses’ diets to become low in lysine. Especially as soon as we start putting them on restrictive diets.

So how can a restrictive diet, low in lysine affect our horses’ behaviour? Through multiple mechanisms! Studies have shown lysine to reduce stress-induced anxiety and to reduce levels of the stress hormone cortisol. Lysine is also needed to facilitate proper calcium absorption. Calcium plays a key role in the function and release of neurotransmitters (natural chemical messengers which influence mood, temperament, learning and behaviour). Insufficient lysine in the diet can interfere with proper neurotransmitter signalling, which can be exhibited as anxiety. Lysine also plays a key role in normal serotonin production and function. Serotonin is a mood-stabilising neurotransmitter and helps our horses to feel calm, happy and relaxed.

It’s important to remember that we don’t always see an immediate or direct correlation between removal or addition of a nutrient in the diet and behavioural changes. It can take some time for effects to be noticed. In the case of lysine, it’s a nutrient which plays many key roles in the body and insufficient amounts affect many body systems. It plays a crucial role in immune function and collagen structure (needed for healthy muscles, bones, tendons, ligaments, skin and hooves). The longer a horse has a low lysine diet, the more the effects compound systemically. 

Our horses’ and ponies’ diets can have profound influences on their overall health, performance, ability to recover, mood and behaviour. It can be tempting to look for a quick fix to our horses’ behavioural issues, yet it is easy to unknowingly compromise their long-term health when doing this. Correctly identifying the contributing cause(s) of fizzy behaviour and addressing them in the most appropriate way(s) is essential to ensure we are doing the best for our equines. Getting professional help to identify potential dietary causes of poor behaviour in horses can pay dividends not only in terms of behaviour, but also in terms of their long-term health and performance.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Research has clearly demonstrated that weaning is a stressful period in a foal’s life. From a biochemical perspective, this results in the stress hormone cortisol being produced at very high levels.

Stress (and in turn high cortisol levels) affect the horse’s immune system in many different ways. It commonly reduces the body’s ability to mount or maintain an effective immune response and immunity. The high levels of cortisol may decrease the production of specialised cells of the immune system and reduce the appropriate response of the immune system to the vaccine. This results in a less effective response to vaccination and less protection from what we’re trying to vaccinate the foal against. In some horses, this can result in ‘vaccination breakthroughs’ where the horse still gets the disease despite being vaccinated for it.

As a general rule, timing vaccinations at least 2-4 weeks away from the time of being weaned may help the horse to have the most effective response to vaccination and reduce the likelihood of vaccination breakthroughs. 

The use of appropriately prescribed specific nutritional supplements and herbal medicines around the time of weaning and vaccination can be invaluable. Key pathways can be targeted to help modulate the stress response and support optimal immune response to vaccination.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The smell of our horse’s breath isn’t something we generally give much thought to. Yet if you’ve ever smelt the breath of a horse or pony with halitosis (bad breath)- then it becomes something hard to ignore. So why do some horses and ponies have bad breath and is it something to be concerned about?

Many factors can contribute to bad breath in the horse or pony: the most common being bacterial overgrowth in the mouth, decreased saliva, dental plaque, periodontal disease, cracked teeth and tooth abscesses. Yet the causes of bad breath aren’t just limited to the mouth alone. Infection in the respiratory tract and poor digestion can all contribute to bad breath. The side effects of some medications may also contribute to halitosis.

Oral Contributors

Halitosis can arise due to a lack of saliva production. The major salivary gland in our horses, the parotid gland, only secretes saliva when a horse chews. When our horses or ponies go long periods of time without grazing or consuming fibrous feeds such as hay, there are significant periods of time when there is little saliva in the mouth. The horse fed one or two concentrated/hard feeds daily, with little hay or grazing in between producing much less saliva than nature intended them to. Saliva has a multitude of functions in relation to our horse’s health, one of these being important antimicrobial activity through naturally occurring antibodies it contains. Lack of saliva production due to lack of chewing creates the perfect breeding ground for high levels of specific bacteria to build up in our horses’ mouths. This results in malodour. The effect is compounded by feeds that are high in sugar and/or starch, which can further ‘feed’ these ‘bad’ bacteria.  Furthermore, a dry mouth and lack of chewing fibrous feeds can also contribute to increased volumes of plaque on the teeth, giving rise to bad breath. Saliva helps rinse away tiny particles of food debris that may otherwise settle on the teeth and cause dental plaque. For more information on saliva and the importance of chewing in our horses visit the article: Why Basics Matter: The Importance of Chewing.

Gingivitis (gum inflammation) and periodontitis (where the inner layer of the gum and bone pull away from the teeth and cause pockets of air between the gums and teeth) affect horses in a similar way to humans. Gingivitis usually precedes periodontitis and begins when bacteria in the mouth proliferate around the teeth and gums. The build-up of large numbers of bacteria that attack the gingiva or gums leads to inflammation and malodour. It’s important to note that as the disease progresses and the gums become swollen and bleed, bacteria are able to enter a horse’s bloodstream and travel around the body. The effects of periodontal disease extend far beyond the mouth: it may be associated with reproductive problems in our horses and other undesirable conditions. Gum disease can contribute to loosened teeth, tooth loss and infections in the bone surrounding the teeth.

Poor Digestive Function

Hydrochloric acid (HCl) is an essential component of healthy digestion in our horses and ponies. It is produced by specialised cells in the stomach called parietal cells. One of the many functions of HCl is to help keep bad bacteria and opportunistic micro-organisms in check. When HCl production is reduced or shut down (as is the case with the use of ulcer medications) a perfect environment is created for opportunistic bacteria to flourish (for more information on the way ulcer medications work and their effects, visit the article: Ulcers in Horses: The importance of understanding how medications work). These bacteria produce compounds that result in a foul odour. Another crucial role of HCl is facilitating proper digestion and breakdown of food. Without sufficient HCl to help initiate normal digestion and maintain an acidic pH in the stomach, feed can ferment in the gut- resulting in the production of malodorous gasses. For these reasons, bad breath can be an indication to look at digestive health beyond the mouth. 

Medication Side Effects

A wide variety of medications commonly used in horses and ponies may contribute to halitosis through differing mechanisms. Some antibiotics, anti-fungals, anti-histamines, diuretics, sedatives, bisphosphonates and dimethylsulfoxide (DMSO) may all cause or contribute to bad breath in equines.

Respiratory Tract Infections

Sinusitis (inflammation of the lining of one or more of the sinuses) and upper respiratory tract infections can also contribute to bad breath in our horses. These are generally accompanied by mucoid (whitish, yellowish) nasal discharge out of one or both nostrils. Clinical signs may also include swelling or bulging of the facial bones, decreased appetite, lethargy and weight loss.

Nutritional Deficiencies/Insufficiencies

Beyond the type of feed our horses consume and how frequently they are fed, many key nutrients play important roles in oral health. Insufficiencies and/or deficiencies in protein, vitamin A, vitamin D, zinc and impaired production of B group vitamins and vitamin C may all be implicated in compromised oral health, leading to bad breath.

Conclusion

There are many causes and contributing factors to bad breath in horses and ponies. Whilst poor dental and oral health are obvious cases of bad breath, diet, medications, gastrointestinal and respiratory system function may all play important roles. Foul smelling odours from the nostrils and/or mouth warrant further investigation by suitably qualified professionals. Properly identifying and addressing the cause(s) of halitosis help to promote overall health in your horse or pony, as well as helping them to have a non-offensive smelling breath!

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Selenium is a nutrient which has a relatively low safe upper limit range. High intakes (through diet and/or supplementation) can result in toxicity and even death in severe cases.

Many parts of the world have soils that are notoriously deficient in selenium- and thus the pastures and feeds grown for horses in them are also low in selenium. This has led to selenium being a commonly added mineral to horse feeds and many supplements.

Selenium comes in two main forms: organic and inorganic. Organic selenium has been demonstrated to have superior absorption, tissue uptake and ability to enhance antioxidant status compared to inorganic selenium. This is attributed to selenomethionine, the effective organic part of organic selenium.

One of the most popular sources of selenium used in horse feeds and supplements is selenium yeast (produced by them is the micro-organism Saccharomyces cerevisiae). Although selenium yeast contains high levels of organic selenium, not all of it is in the form of selenomethionine. Research has demonstrated that there are significant limitations in using selenium yeast to help achieve good selenium uptake and stores in the body. Although the product should in theory contain a certain amount of organic selenium on paper, the actual amount of organic selenium in the form of selenomethionine provided by selenium-containing yeast is often far less. A large percentage of the selenium provided by selenium-containing yeast is in a poorly absorbed inorganic form. This means that your horse is potentially utilising much less selenium than what is written on the label and may well be falling short of their requirements. Not all feeds and supplements use this form of selenium- so it is incredibly valuable to ascertain not only the amount of selenium in a product but also the form it is in. Seemingly minor details in feed and supplement formulations can have profound influences on our horse’s health and wellbeing.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

What is Protein?

Protein is a crucial macronutrient in a horse’s diet and is comprised of long chains of building blocks called amino acids. There are 21 amino acids. The specific order and combination of amino acids determines the structure and function of each protein. Insufficient dietary intake of specific amino acids limits the production of key proteins essential in our horse’s bodies. For more in-depth information on protein quality see the article: Soy: The Good, Bad and Confusing.

Protein is Needed for Growth, Maintenance and Repair of Tissue

We commonly only think of this as important when we are trying to increase muscle mass in a horse. For instance, building top-line on our ridden horse, or conditioning a thoroughbred yearling for sale. Yet protein is absolutely essential for normal growth and development of the young horse, and recovery from riding and training in active horses. Insufficient protein in the diet can therefore increase risk of illness and injury in our horses. Times of illness and injury also increase protein requirements in order to help recover from the illness or heal from the injury. Providing insufficient protein to a sick or injured horse during their recovery can significantly delay and/or impair their healing and adversely impact their future athletic potential.

Protein Facilitates Biochemical Reactions

Enzymes are a specific type of protein that aid in the normal biochemical reactions that take place in a horse. Specific enzymes are needed to facilitate proper digestion (therefore helping to promote optimal gut health and utilisation of feed); energy production (helping a horse to perform); normal metabolism (helping to regulate weight and temperature in a horse); blood clotting; and muscle contraction. Insufficient protein in the diet can lead to digestive problems- a critical consideration given the heightened focus on gastrointestinal (GI) health. A common mistake is to restrict protein intake in the overweight horse: this can further slow metabolism (compounding the problem) and compromise overall health.

Protein is Required for Proper Communication in the Body

Hormones are chemical messengers that aid in communication between a horse’s cells, tissues and organs. They are needed for everything from normal growth, metabolism, reproductive function and digestion. Amino acids are also an important component of neurotransmitters: the chemical messengers which play a crucial role in a horse’s mood, temperament, learning and behaviour.

Protein Provides Structure

Different types of protein are essential for the formation of healthy bones, tendons, ligaments, muscles, skin and hooves. Depending on the type of protein, they aid in providing structure, strength, elasticity and rigidity to specific tissues. Insufficient protein in the diet can make a horse more susceptible to injury to muscles, tendons, bones and ligaments. They may also have poor skin and/or hoof quality.

Protein Helps to Maintain pH Balance in the Body

Proteins act as a buffer system, helping a horse’s body to maintain proper pH values of the blood and other bodily fluids.

Protein Helps to Balance Body Fluid Levels

Albumin and globulin are two important proteins found in a horse’s blood. They help to maintain the body’s fluid balance by attracting and retaining water. If a horse’s diet has consistently has low quantities of quality protein, the levels of albumin and globulin eventually decrease. This can result in swelling or oedema as these proteins can no longer keep blood in the blood vessels, forcing the fluid into the spaces between cells. The irony is that protein is often blamed for causing swelling in horses- with the reverse often being the cause!

Protein is Needed for a Healthy Immune System

Protein is absolutely essential for white blood cell production and the formation of immunoglobulins (antibodies) needed to fight infection in our horses. Insufficient protein in the diet can leave a horse more susceptible to bacterial, viral and fungal infections.

Protein Aids in the Transportation and Storage of Nutrients

Transport proteins carry substances in our horse’s blood streams- into, out of and within cells. The substances transported by these proteins include nutrients such as vitamins and minerals, blood sugar, cholesterol and oxygen. Whilst we often think of iron as being a key driver in helping oxygen delivery to the body’s tissues, protein plays a paramount role- yet is often overlooked. Specific proteins also have a storage role: ferritin is a storage protein that stores iron.

Problems with Excessive Protein: Myths or Facts?

So now we can see that protein is absolutely vital in keeping our horses healthy, yet is there a downside to this nutrient? And can we feed too much? Like most things, the answer is relative to the situation and the individual horse.

Excess Protein

To overly simplify, horses are unable to store excess protein that they consume in their diet for later use. The metabolism of excess protein increases levels of nitrogen end-products, such as ammonia and urea. A diet containing excess protein will increase the horse’s water requirements and urine output as the ammonia and urea are flushed out of the body. If a horse is kept out at pasture, is only in light work and has free access to plenty of fresh water, this generally isn’t a problem. It is an issue however where horses are stabled. Exposure to this strong urine can cause lung irritation and other respiratory problems. Extra urination means extra wet bedding, which equates to more mucking out.

Metabolism of Protein Produces Heat

Protein digestion and metabolism is a heat generating process. A horse that is on a high protein diet that is burning a lot of protein as an energy source will sweat more to help get rid of the heat. It is important to remember that the body has a preference for using carbohydrates and fats over protein as an energy source, and will only use protein as a significant energy source when these other two nutrients don’t meet their requirements. Protein fed in appropriate amounts to meet a horse’s needs will not contribute greatly to heat production or sweating. Feeding excessive amounts of protein however, particularly to horses in hot and humid climates, or those undertaking moderate to heavy work, can contribute to dehydration and heat stress.

Protein Causes Poor Behaviour/ Hot Horses: MYTH

Protein is often blamed for making horses ‘hot’, nervy or spooky. This is turn can cause some owners to avoid including quality sources of protein in their horse’s diet. Protein has not been shown to cause behavioural issues in horses. Diets which are high in energy and excessive to a horse’s energy needs which are also high in protein can contribute to a horse being hyperactive or silly. The problem here is the overall energy intake, not the protein!

Kidney and/or Liver Damage: MYTH

In healthy horses, high protein diets have not been demonstrated to cause kidney and/or liver damage. In horses that have pre-existing liver or kidney problems, then protein intake may need to be restricted- ensuring that intake is still sufficient to meet a horse’s daily requirements but does not exceed them.

Take Home Message

As a general rule, I see far more horses in clinical practice with insufficient protein intakes compared to those with excessive protein intakes. Insufficient protein in the diet may leave a horse more susceptible to illness and/or injury and delay or impair their recovery. Including adequate, quality protein in the diets of our horses is absolutely essential in order for them to be healthy, perform and recover at their best.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Problems start to occur when levels of inflammation are excessive, and/or occur for extended periods of time- beyond that which the body needs for normal healthy repair and functioning. Inhibiting the body’s own repair and defence mechanisms however, can also be problematic.

Non-steroidal anti-inflammatories (NSAIDs) are one of the most widely used classes of drugs in horses. The most commonly used NSAIDs in equines include phenylbutazone (bute), flunixin meglumine (commonly sold under brand names including Banamine, Finadyne, Flu-Nix, Flunixamine), firocoxib (Equioxx, Previcox) and meloxicam (Metacam).

How do Non- Steroidal Anti-Inflammatories Work?

When it comes to using NSAIDs in horses and ponies, understanding how these drugs work can help to make an informed approach about their appropriate use.

Non-steroidal anti-inflammatory drugs work on a chemical level. They inhibit the effects of special enzymes: specifically cyclooxygenase (COX)-1 and COX-2 enzymes. These enzymes play a key role in making prostaglandins which promote inflammation. By blocking the COX enzymes, NSAIDs reduce the production of prostaglandins and in turn inflammation. It is important to remember that other inflammatory pathways exist in the horse: COX-1 and COX- 2 are most commonly targeted.

COX-1 is expressed in nearly all tissues in the horse’s body and is necessary for proper gastrointestinal (GI) function, renal (kidney) function, and blood coagulation. COX-2 is also expressed at low levels in many tissues, contributing to normal kidney function and interestingly, playing a critical role in the healing of the gastrointestinal (GI) mucosa (cells lining the GI).

The potential risks

Most people are well aware of the deleterious effects the use of NSAIDs can have on the GI lining in our horses. Although ulcers commonly come to mind, the effects of these drugs on the digestive tract of our horses extend far beyond this. In the case of phenylbutazone and flunixin, the production of mucin (which is one of our horse’s internal mechanisms for protecting and maintaining a healthy gut lining) is stopped. This is the primary way in which damage to the GI (including the development of ulcers) can occur with NSAID use. It is critical to note that this occurs regardless of whether the NSAID is given orally or by intravenous (IV) injection. It is not the physical presence of the drug in the GI system that causes the damage, it is the changes in inflammatory pathways.

It is common practice to give ulcer medications (specifically those containing omeprazole) in conjunction with NSAIDs, with the belief that this may help to offset the detrimental effects to the GI. Research has demonstrated however, that this practice can further compound damage caused to the GI mucosa. This is likely due to changes in blood flow to the gut lining and shifts in protective microflora of the GI.

Changes to GI microflora associated with NSAID use is a lesser discussed but equally important aspect in terms of our horse’s health. Although beyond the scope of this article, specific microflora serve crucial protective and anti-inflammatory actions in the GI of our horses. Significant changes in these fine balances of microflora can occur in association with NSAID use. This in turn has significant implications on the nutritional status of our horses. To read further on this topic visit the Gastrointestinal (Gut) Health heading in ‘Article’ section of the Optim Equine website.

Research has also indicated that the use of NSAIDs following hard work, competition or training is likely to inhibit desired adaptations and proper recovery to the exercise undertaken. Changes in blood flow and cellular repair mechanisms vital for proper recovery are altered by the use of NSAIDs. The practice of giving NSAIDs as a precautionary or ‘preventative’ method after hard work, racing, competition or training may in fact work against what is trying to be achieved.

What about selective and preferential COX-2 inhibitors?

In more recent years, the use of NSAIDs that selectively or preferentially inhibit COX-2 and don’t (in theory) inhibit COX-1 may cause fewer adverse effects than nonselective NSAIDs. Examples of these drugs include firocoxib and meloxicam.

Selective COX-2 inhibitors don’t entirely spare COX-1. They also inhibit COX-1 to a small degree, but generally carry a lower risk for direct damage to the gut lining. An interesting point to note is although COX-2 selective drugs may decrease the risk of developing GI ulcers compared to non-selective NSAIDs, they can impair the healing of pre-existing ulcers.  Additionally, similar to non-selective NSAIDs, COX-2 inhibitors are associated with changes in gut microflora, which in turn can lead to adverse effects on the GI system.

It is important to note that COX-2 is involved in normal, healthy kidney and cardiovascular function (thus administration of selective COX-2 inhibitors can still cause adverse renal and hameodynamic effects in susceptible horses).

The dosage amounts of COX-2 inhibitors needs to be taken into account when evaluating their potential risks and side effects. When COX-2 inhibitors are used in higher doses, their ability to be selective in their action on COX-2 enzymes decreases. That is, higher doses may cause effects similar to those of nonselective NSAIDs. Combining NSAIDs (for example, administering firocoxib and phenylbutazone together) has also been shown to increase the risk for adverse effects, including that to the kidneys.

Takeaways

Non-steroidal anti-inflammatories have their place in illness and injury in horses and like all drugs, their use should be judicious. Selective and preferential COX-2 inhibitors may have less adverse effects on the GI system than non-selective NSAIDs, but still come with risks. Appropriate dietary, nutraceutical and supplementation practices may help to decrease detrimental effects to the GI, cardiovascular system and kidneys associated with NSAID use. Employing specific therapeutics and dietary strategies to restore gut mucosal integrity and reinstate a healthy GI microflora following NSAID use is highly advisable. In low and appropriate doses, selective COX 2 inhibitors may be a better choice in reducing adverse side effects when NSAID use is necessitated

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

It is well understood that performance and racehorses are subject to significant amounts of stress. This stress in and of itself can result in sub-optimal or poor performance in our horses. Performance aside, prolonged stress has a myriad of flow on effects to the overall health of our horses: it can compromise the wellbeing and function of the gastrointestinal system, the immune system, and the production and function of neurotransmitters (the brain chemicals influencing temperament and behaviour).

What is easily forgotten is that stress affecting our horse’s performance and well being does not necessarily have to originate from sources associated with training or the competitive event. Read that sentence again.

Performance and racehorses are exposed to a range of stressors most of which relate to the way they are kept, fed and managed (this is largely dictated by training regimes, available facilities or convenience). These are stressful because they affect the behavioural needs of the horse as a species.

Behavioural needs are species-specific highly motivated behaviours that are performed by an animal and more often than not have a functional role. The horse has some physiological ‘need’ to perform the behaviour. Foraging (grazing) is a primary example of this. In a natural environment, forage is generally available ad lib with a horse spending up to 70% of its day eating! For horses, the reduction of eating time to two meals per day can meet the nutritional requirements of the animal, but is unlikely to meet the horse’s behavioural need to forage. In the competition horse, restriction of behavioural needs induces a chronic stress response which will subsequently prevent optimal individual performance. It also has a significant flow on effect to gastrointestinal (gut) and immune health.

Some of the most basic feeding and management practices have the most profound influence on our horse’s health and performance. It can be easy to rush in and add the latest fad supplement to our horse’s feed to try and remedy a stressed horse or poorly performing horse, but it is more valuable to ask ourselves:

• What are some of the less obvious sources of stress in our horses?
• What are some of the dietary and management changes we can make for true lasting benefit?

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

For the purpose of this article, we will focus on soy bean meal and feeds containing processed soy- not soy oil or soy bean hulls- as these components alone have significantly different nutritional value and properties.

Pros

Soy is one of the more widely fed significant sources of protein in a horse’s diet. It is a common misconception that protein is only needed to promote weight gain, muscle condition or the development of topline. Whilst it is important in these instances (in combination with appropriate exercise and training), protein is absolutely essential for a multitude of functions in all horses at any life stage and exercise level: it is a critical component of normal immune function; facilitates proper growth and repair of the musculoskeletal system; and is needed for the majority of metabolic processes in the horse. Even horse’s who aren’t in heavy work and/or actually need to lose weight need sufficient protein in their diet.

Protein is comprised of smaller units called amino acids. Horses require 21 amino acids, 12 of which a horse can synthesise (produce) themselves. The remaining nine (and in the case of illness or injury- potentially ten) amino acids must be present in a horse’s diet. These are known as ‘essential amino acids’. In addition to all essential amino acids being present in the diet, they must be present in appropriate quantities- so a horse has enough of each of them to facilitate various bodily functions. If they fall short of any essential amino acids then health, normal development, performance and recovery may be compromised.

With the exception of oils, practically all horse feeds, grains and forages contain SOME protein- Depending on the exact feed source, the actual amounts of protein contained in these feeds will vary. Different sources of protein are comprised of different sequences of amino acids. This influences how useful they are to a horse. Some high protein feed sources are actually of little value to a horse, as they lack decent amounts of essential amino acids that a horse needs, or they are unable to be properly digested and absorbed by a horse.

So how does all this relate to soy? Soy is one of the best dietary sources of lysine for our horses and ponies. Lysine is a very important essential amino acid in the equine and it is generally one which is lowest in our horse’s diets. Lysine is absolutely essential for normal muscle growth and turnover, helps to promote collagen integrity (important for healthy bones, skin, muscles, tendons and ligaments), is critical for proper immune function, and may further help bone health through improving calcium absorption and utilisation. Animal studies have also shown that diets low in lysine may be associated with anxiety. Thus, a diet low in lysine may be one of many potential contributing factors in some cases of horses with an anxious tendency.

For horses competing in endurance events, optimising hydration pre-event is an important consideration. Commercial soy feed products which require soaking before being fed, can help to increase fluid intake in horses. It’s important to keep in mind that there are other feeds which can be used for this same purpose. Soy is not the only option.

Being a low starch and protein rich feed, processed soy meal can aid in stabilising blood glucose levels- thus helping to prevent rapid spikes in insulin levels. High insulin levels are a driving factor of equine metabolic syndrome and are commonly implicated in many cases of laminitis. Horses with Pituitary Pars Intermedia Dysfunction (PPID) (also commonly referred to as ‘Cushings’) and Polysaccharide Storage Myopathy (PSSM)- a component in many cases of ‘tying up’, may also particularly benefit from a diet low in starch and containing adequate quantities of quality protein.

The phytoestrogen content of soy is an important, yet often misunderstood concept. Soy is unique in that it contains a high concentration of isoflavones, a type of plant oestrogen (phytoestrogen) that is similar in function to the hormone oestrogen but with much weaker effects. Soy isoflavones can bind to oestrogen receptors in the body and can either increase or decrease oestrogen levels in the body. Research has demonstrated that when oestrogen levels in the body are naturally low, then ingestion of phytoestrogens may help to increase the body’s levels.  When oestrogen levels in the body are naturally high, then consuming phytoestrogens may help to reduce oestrogen levels, as they bind to some of the receptor sites that naturally produced oestrogen may bind to.

Potential Cons

The phytoestrogen activity of soy may also potentially be a drawback of this feed. Excessively high intakes of phytoestrogens have the potential to decrease testosterone levels, an important consideration in stallions and colts. Soy certainly isn’t the only source of phytoestrogens commonly found in horse diets: clover grass is rich in phytoestrogens. Before attributing potential positive or negative effects of phytoestrogens in a horse’s diet, the total quantity of all phytoestrogen rich food sources needs to be taken into account.

Soy is commonly attributed to causing allergic symptoms in horses- everything from itchiness and skin irritation, colic and digestive disturbances, to overly-reactive behaviour and respiratory issues. Whilst soy is a common allergen in humans, the same has not yet been demonstrated in horses. Diagnostic tests for equine food allergies are difficult to carry out, time-consuming and often unreliable. In clinical practice, I find that the majority of horses with allergy related symptoms (whether these be environmental or food related) improve significantly when overall nutritional status and specific components of both immune and gut health have been therapeutically addressed. Generally something which may appear to cause allergic symptoms in a horse is not the real culprit.

A significant valid concern with soy is the fact that it is one of the most commonly genetically modified (GM) crops. Whilst this is only an issue in some parts of the world, it is certainly worth taking into consideration. Animal studies with GM foods indicate that they may cause some common toxic effects such as hepatic, pancreatic, renal, or reproductive effects and may alter blood parameters and immune function.

Soy is high in omega six fatty acids. Whilst these types of fatty acids are an essential component in our horse’s diets, they are generally present in higher than desirable amounts. Of further importance is the percentage of omega six fatty acids in proportion to omega three fatty acids. High levels of omega six fatty acids with accompanying low levels of omega three fatty acids are known to promote inflammation. Adding large amounts of soy products to a diet already high in omega six fatty acids further accentuates the shift towards a pro-inflammatory tendency. This can  have wide-ranging effects from impairing recovery from training, competition and exercise; compromising immune function; and exacerbating already existing inflammatory conditions such as osteoarthritis, desmitis, placentitis and laminitis to name a few.

Uncooked or even inadequately cooked soybean meal has some anti-nutritional factors. Trypsin inhibitor is the most significant one. Trypsin is an essential enzyme which helps horses to properly digest protein, allowing for absorption and metabolism of the amino acids which make up the protein. Trypsin inhibitor found in uncooked soybean prevents trypsin from being able to properly break down proteins. This means that in the presence of trypsin inhibitors a large percentage of all protein from all sources a horse is consuming is unable to be properly digested, absorbed and metabolised.

Some concerns exist that soy can have a negative effect on thyroid function and can alter the levels of thyroid hormones. Whilst the majority of data is from human studies, it is unlikely that regular consumption of small amounts of soy containing foods have significant impact on thyroid function in healthy subjects. In cases where hypothyroidism already exists (keeping in mind that diagnosis and true cases of hypothyroidism in horses is rare), then reviewing the appropriate feeding of soybean containing products is warranted.

Conclusion

Processed soybean meal and feeds containing this product can be a valuable inclusion in the diets of many horses. Factors which may caution against the feeding of soy to some horses include specific health concerns and where in the world the soy is grown and produced. Soybean meal MUST be properly heat treated to prevent trypsin inhibitor from interfering with protein digestion. The quantity of soy products fed and the overall diet of the horse are crucial factors to take into consideration.

Rarely is anything inherently good or bad: the same may be said of soybean products. The most important consideration is that one size doesn’t fit all: feed the individual horse in front of you!

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Successful rehabilitation should certainly address physical aspects (farriery, bodywork, laser and other therapies where appropriate), management factors (restricted turnout, etc if relevant) and graduated exercise and training. Yet one of the most influential factors in a horse’s successful recovery is its nutrition- something which is often given very little consideration.

One of the primary concerns for many owners, trainers and riders are to stop their injured horse from getting overly fat- particularly in an extended layoff. As a result, many people understandably cut their horse’s feed right back. However, during the initial phases of healing post-injury- a horse’s energy and nutrient requirements are actually elevated. Healing of the body is an energy-requiring process. Structurally, bones, muscles, tendons and ligaments need specific nutrients to ensure their optimal repair and integrity.  Thus, drastically cutting both their energy and nutrient intake can significantly impair, delay or compromise healing. It is important to note, however, that a horse’s energy and nutrient requirements will change throughout its recovery. After the initial phases of healing have occurred, there is generally a decrease in energy needs. Depending on the type of injury, nutrient needs (for example certain minerals, vitamins and specific nutraceuticals) often remain elevated beyond normal.  This is where it is important to adjust a horse’s diet so that it still receives proper nutrition for continued good health, whilst also ensuring that it doesn’t get too heavy. In terms of musculoskeletal injuries, particularly of the lower limbs, weight is an important factor. More weight equates to more force going through the limbs, which can compromise healing. A healthy balance needs to be achieved between appropriate weight given the phase of recovery, whilst ensuring optimal nutritional intake.

Nutritional requirements are further compounded by the medications used in many cases of illness or injuries in our horses. Anti-Inflammatory drugs including NSAIDs such as phenylbutazone (‘bute’) and flunixin interfere with our horse’s ability to synthesise B group vitamins (including biotin) and vitamin K (essential for proper bone and connective tissue healing). They also adversely impact a horse’s gut microflora, which in turn is likely to result in increased production of inflammatory mediators (thus more inflammation, despite the use of anti-inflammatories). The effects of corticosteroids on nutritional status are more complex than NSAIDs: they are known to reduce the absorption and/or increase the excretion and/or impact on the metabolism of important nutrients essential for optimal healing. Some of these nutrients include magnesium, zinc, vitamin A, vitamin C, vitamin D, calcium and selenium.

Antibiotics also significantly influence the nutritional status of the horse. Through changes in gut microflora in the horse- the production of B group vitamins and vitamin K are compromised. Some classes of antibiotics also interfere with the normal metabolism of vitamin A, calcium, magnesium, zinc and iron. Similar to NSAIDs, they may also influence the production of inflammatory mediators through changes in gut microflora.

Ulcer treatments are another commonly used medication in the horse recovering from illness or injury.  Those containing key active constituents of omeprazole (the ‘gold standard’ ulcer medications on the market) or ranitidine, drastically reduce the uptake of minerals essential for healing- including calcium and magnesium. These medications also may influence the production of inflammatory mediators: their mechanism of halting or drastically reducing hydrochloric acid production significantly changes the environment needed to promote healthy gut microflora in the horse.

So the effect of such medications during injury or illness is a double whammy: a horse already has increased nutrient requirements to properly heal AND many of these critical nutrients are at decreased levels because of the use of such medications.

Whilst pharmaceutical drugs are certainly indicated in the recovery from many illnesses and injuries, their use needs to be judicious. When they are used, the appropriate supplementation of specific nutrients is critical to firstly compensate for what is altered through medication use, and secondly to meet the body’s elevated needs of certain nutrients essential for optimal healing.

Illness or injury in the horse can be used as a most valuable opportunity to review your horse’s feeding, supplementation, management and riding practices. Whilst many injuries and accidents are unavoidable- there are plenty where appropriate dietary and supplementation practices tailored to the individual horse may have helped to prevent or reduce the severity of the setback. The same may be said of the review of medications used in the horse where relevant. These factors, combined with appropriately structured training and competition (which includes ‘down periods’ and rest days), farriery, and bodywork are keys to keeping our horses healthy, sound and well.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Inflammatory Bowel Disease (IBD) in horses refers to a group of intestinal diseases that are caused by the infiltration of different types of inflammatory cells into the mucosal and submucosal walls of the intestine, resulting in intestinal dysfunction. Each disease in the IBD group involves a different combination of white cells or involves a different part of the intestinal tract.

Corticosteroids are the veterinary treatment of choice in horses diagnosed with IBD. Generally, a prolonged, tapering course is used, however, there are no particular indications on doses and duration of these drugs. It is well known that systemic administration of corticosteroids to horses has been associated with several adverse effects, including adrenocortical suppression and dysfunction, laminitis, hepatopathy (liver damage), muscle wasting, altered bone metabolism (reduced bone density and strength), and increased susceptibility to infections. 

One of the other major, yet less well-acknowledged considerations is that disruption of the protective mucus barrier of the gastrointestinal tract (GIT) is a key contributor to the initiation and perpetuation of IBD. The use of corticosteroids can further compound this problem, as these drugs adversely impact several of the body’s natural mechanisms for maintaining a healthy mucus barrier in the GIT.

To successfully resolve/manage the horse with IBD, an approach that addresses the inflammation and associated abnormal immune response, in addition to promoting healthy mucus production and function in the GIT is absolutely paramount.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Many regions in the world have low iodine levels in the soil. Iodine deficient soils are most common in inland regions, mountainous areas, land that frequently floods, and on occasion, some coastal regions. Unless horse diets are adequately supplemented, horses that graze on pastures in these regions and/or consume hay and feed crops grown in these areas, are likely to fall well short of their minimal iodine requirements. Research has also demonstrated reduced uptake of iodine by pastures which have been grown with high levels of nitrogen fertilisers, even in soils with otherwise reasonable iodine levels.

Like many minerals however, too much iodine can be just as problematic as too little iodine. This can easily occur when our horses are given multiple supplements, and/or feeding inappropriate quantities of fortified feeds. An innocent mistake commonly made in relation to iodine supplementation is the use of seaweed supplements. In many cases, this can result in excessive iodine intake.

Many clinical signs and health consequences of iodine excess often mimic those of iodine deficiency. An important reminder that more is not better, and supplementing without taking specific details into account can be detrimental to horse health, fertility, metabolic function, growth and development.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Equine gastric ulcer syndrome (EGUS) affects 60-90% of adult horses and 25-50% of foals and weanlings. The condition collectively refers to sores or erosions that develop in portions of the horse’s sensitive stomach lining. EGUS is largely a man-made disease: common feeding practices; lack of forage in the diet; stress we place on our horses; intense exercise; travelling; and the use of non-steroidal anti-inflammatory drugs (for example ‘bute’ and flunix), corticosteroids and/or antibiotics are some of the many factors which increase a horse’s risk of developing EGUS.

Ulcers can also occur in the hindgut (colon), however, treatment approaches tend to differ to that from EGUS and for the purpose of this article, we will focus on EGUS.

The function and health of a horse’s stomach significantly influences that of the rest of its digestive system- often referred to as the gastrointestinal tract (GIT).

Ulcer medications are sold under many different trade names, but generally contain one of two main drugs. The gold standard pharmaceutical for treating gastric ulcers is the drug called Omeprazole. This medication belongs to a class of drugs called proton pump inhibitors (PPIs). Omeprazole is available in both oral and injectable forms. The other less commonly used medication is Ranitidine. Ranitidine belongs to a class of drugs known as Histamine (H2) Receptor Antagonists.

Although slightly different in their mechanisms of action, both omeprazole and ranitidine result in the prevention/significant reduction of hydrochloric acid production (HCl). This however, is where the problem begins. Hydrochloric acid is an essential and normal component of a horse’s digestive system. It also plays a key role in immune function. 

Hydrochloric acid acts as a barrier against foreign microorganisms and helps prevent infection.

Hydrochloric acid is a key component to help horses breakdown, digest, absorb and utilise their feed, and hence many of the nutrients contained within it.

When HCl production is suppressed, the proper absorption of many key minerals such as calcium, magnesium and iron is inhibited. This in turn can have significant consequences in terms of bone/skeletal health, immune health, energy production, fertility, etc.

The pH of a horse’s digestive tract naturally varies depending on the region of the GIT. The production of HCl is key in controlling the pH in the horse’s stomach. Altering the pH in the stomach subsequently alters pH throughout the rest of the digestive tract. Changes in these normal/natural pH levels for horses influences the community of microbes (bacteria, protozoa, archaea and fungi) that inhabit a horse’s digestive system. Like humans, there are microbes which are beneficial and healthy for horses, and there are also those that are not. When we start interfering with the natural pH of a horse’s digestive tract by shutting down HCl production, we start to create an uninhabitable environment for these beneficial microbes. The result? Commonly an overgrowth of undesirable bacteria, fungi and protozoa. 

The consequences of these changes extend beyond the digestive system. Fine balances in these microbes have significant impacts upon a horse’s overall health, metabolism, ability to digest, absorb and utilise their food and immune function.

In terms of immune function, shutting down HCl production is a double whammy: the horse loses its first line of immune defence from the direct action of HCl in the stomach (helping to counter ingested pathogens), in addition to the changes in microflora further down the digestive tract. Research suggests that approximately 70% of immune function is attributed to the role of specific cells of the GIT and the microbes which inhabit it. Thus adverse changes in the microbial population and balance can result in significantly impaired immune function.

Healthy bacteria further down the GIT are also vital to synthesise B group vitamins (including biotin). Hence it is no coincidence that horses with compromised gut health often have poor hoof quality. B group vitamins play vital roles systemically in our equines: they are required for energy production and proper metabolic function; reproductive function and neurotransmitter production and function (natural chemical substances produced in our horse’s bodies).

In terms of neurotransmitter production and function, again ulcer medications can have a wide ranging effect. Undesirable changes in microbes throughout the digestive tract directly influence the production and function of neurotransmitters (chemicals which influence temperament, behaviour, motor control, pain perception and learning in horses). It is thought that 60-95% of neurotransmitters are produced by microbes of the GIT. This may in part explain why you can still have a cranky, irritable, spooky horse despite extensive treatment for ulcers. Neurotransmitters also play a key role in influencing sensitivity and motility of the GIT. Ever had a horse prone to colic that is routinely on ulcer medication?

Unfavourable changes in GIT microflora are also known to heighten systemic inflammation in the body. Thus any inflammatory condition (including: sesamoiditis; arthritis; inflammatory bowel disease, placentitis, desmitis, laminitis) are potentially exacerbated by adverse changes in GIT microflora.

When it comes to fertility and reproductive function, the use of omeprazole needs to be considered. In stallions, omeprazole use may result in impaired sperm quality, abnormal sperm morphology, reduced sperm motility and reduced sperm count. Omeprazole may also cause a reduction in serum testosterone levels. In mares, particularly those with chronic recurrent infections and biofilms-their ability to colonise their reproductive tract with beneficial microflora may be hampered by the use of ulcer medications.

The effective prevention of gastric ulcers requires an holistic approach that focuses on dietary and management strategies. Through diligent management and qualified prescription, ulcers can be treated effectively with a combination of nutraceuticals and specific herbal medicines. These should always be prescribed in conjunction with appropriate dietary modification. Use of any medication needs to be judicious- as medications rarely come without side effects. Not only is repeated and/or extensive use of PPIs or H2 receptor antagonists financially expensive, their long-term effects on a horse’s health can be extremely costly.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

If a foal doesn’t receive or absorb adequate levels of colostrum within 16 hours of birth, it is predisposed to a higher risk of bacterial infection. The capacity of the small intestine to absorb and transfer antibodies is greatest during the first 6-8 hours after birth. Thus the sooner a foal gets colostrum into it, the better. A foal’s ability to absorb colostrum declines substantially after 12 hours and within 24 hours after birth the specialised intestinal cells which absorb colostrum are replaced by cells incapable of transferring antibodies.

Colostrum contains three types of protein immunoglobulins:

*IgG- which helps to provide immunity against bacterial and infective diseases;
*IgM- for general immunity
*IgA- which increases in milk after a mare has foaled. IgA is unique in that it is not absorbed into the body. It provides local gut protection against bacteria, viruses and other germs that can cause diarrhoea in a foal.

Colostrum also has a natural laxative effect- which helps stimulate a foal’s bowels to promote the passing of meconium (accumulated wastes).

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The most commonly used equine ulcer medications on the market generally come under names containing Gastro/Ulcer/Guard and contain the active ingredient omeprazole, which belongs to the class of drugs known as Proton Pump Inhibitors (PPIs)^{[i] [ii]}. These drugs work by reducing (normal, healthy) gastric acid production by blocking the enzymes located in the parietal cells of the stomach wall, which are responsible for producing these essential digestive acids^[iii].

Pepsin, hydrochloric acid and other digestive enzymes are normal, healthy products of the equine digestive system and are essential for the proper digestion of food, as a line of defence against some pathogens, and maintaining healthy bacterial flora of the gastrointestinal tract (GIT).

By using omeprazole, normal digestion is inhibited. The digestion of protein and fats occurs primarily through the action of pepsin and hydrochloric acid, both of which are unable to be produced through the use of PPIs. Hydrochloric acid and pepsin are also essential to prevent excessive bacterial fermentation of soluble sugars in the stomach^[iv]. By blocking the production of these digestive acids, gastric nitrate rendering bacteria levels increase, as do carcinogenic nitrosamines in gastric juice. Without adequate digestive enzyme production, there is an increased risk of intestinal bacterial overgrowth and excessive gas production, which further inhibits digestion and can increase the risk of colic^[v].

Intestinal bacterial overgrowth is also associated with poor immune function, increased inflammation and increased risk of viral infections^{[vi] [vii]}. Stop for a minute and consider what this means for you as a trainer, owner or rider. For a racehorse this can mean increased risk of respiratory infection and increased susceptibility and slower healing from injury. This translates to more down time for the horse and likely lost revenue. For a stud manager, think of a foal who is stabled due to compromised health, is on multiple treatments and is given omeprazole as a precautionary measure. The foal’s ability to be nourished by it’s mother’s milk and therefore grow and thrive has been impeded; it’s ability to further fight infection has been reduced; and its risk of developing diarrhoea has increased. For a horse with an inflammatory condition such as osteoarthritis owners are constantly doing all they can to reduce inflammation. Therefore, consider the increased likelihood of lameness and joint destruction associated with elevated inflammatory mediators, as a by product of using PPIs.

Omeprazole is commonly co-prescribed with the use of non-steroidal anti-inflammatories (NSAIDs) such as phenylbutazone (bute) and flunixin meglumine (Banamine). Most people are well aware that the use of NSAIDs commonly induces gastro-duodenal injury and can be a causative factor of GIT bleeding and ulcers. Many horse people take a proactive approach and thus use omeprazole as a believed preventative measure to avoid these side effects. Animal research has clearly demonstrated that PPIs do not prevent the development of these undesirable side effects, instead actually exacerbating NSAID-induced intestinal damage^[viii].

Human studies have also shown that the use of omeprazole may increase the risk of bone fractures^{[ix] [x]}. Again, think of this in practical terms: Many trainers treat their racehorses daily with some form of ulcer medication, believing that they are taking a proactive approach. Now consider the increased risk of fracture.

PPIs also decrease intra-gastric vitamin C levels and may increase serum cortisol levels^[xi]. Consistently elevated cortisol levels can lead to reduced performance, poor immune function and delayed recovery. Vitamin C is absolutely essential for a multitude of functions including: immune health; healing; collagen production; bone health and growth; nutrient absorption; healthy hoof growth; iron absorption; sperm motility; and regulating cortisol levels. Therefore, regardless of the discipline your horse is involved in, and its life stage, this is an important factor.

Evidence suggests that long-term use of omeprazole is associated with vitamin B12, iron, magnesium and calcium deficiencies, through altered metabolism and absorption^[xii]. Amongst other things, these are nutrients essential for energy production; musculoskeletal health; red blood cell production; immune function; growth and performance^[xiii].

The effects of fatigue are an important concern for horses competing across all disciplines. Omeprazole may be a significant cause of fatigue, not only through altered nutrient status as outlined above, but also through direct effect on proton pumps throughout the body. Proton pumps are present in just about every cell in the body, and whilst omeprazole is designed to interact with proton pumps in the stomach, research suggests that its actions are non-specific: it can effect all proton pumps in the body^[xiv]. Given this, PPIs have the ability to hamper mitochondrial function, leading to a reliance on anaerobic systems for energy production, leading to rapid fatigue^[xv].

So what can you do to optimise your horse’s GIT health?

Naturopathically, there are many beneficial herbal, nutritional and management strategies that can be employed to help both prevent and treat ulcers, in addition to achieving optimal GIT health. Therapeutics prescribed and treatment aims differ between cases and depend upon the individual horse and the circumstances. When the most appropriate treatments are professionally selected and prescribed, they will benefit the horse’s overall health, yielding favourable results without the negative side effects of omeprazole.

Conclusion

It is extremely important to consider the following questions in relation to the use of any treatment for your horse:

• What is this treatment specifically for?
• What treatment aims will this drug/supplement/additive support?
• What is necessitating this treatment? Are there practical management or dietary steps that can be employed to reduce the perceived need for this treatment?
• What are the potential risks associated with this treatment?
• What are the potential benefits associated with this treatment?
• What alternatives are available to this treatment? Are they safer? More effective? More relevant?
• Am I prescribing this treatment ‘just because’ or ‘just in case’?

If you cannot confidently answer all of the above questions, then seek the professional advice of those that can. We all want what is best for our horses, and it is sad (and expensive) when we are employing methods that may not only be ineffective for our horse’s ‘problem’ at hand, but cause further negative health implications.

References

^[i] Merial 2014, GastroGard (omeprazole) inhibits acid production at the source, viewed 14th March 2017, www.ulcergard.com

^[ii] Thomson, A et al. 2010, Safety of the long-term use of proton pump inhibitors, World Journal of Gastroenterology, vol.16, no.19, pp.2323-30.

^[iii] Marks, J 2017, Proton Pump Inhibitors (PPIs), viewed 14th March 2017,  www.medicinenet.com

^[iv] Cubbit, T 2010, The horse’s digestive system, Hygain, viewed 31st March 2017, hygain.com.au

^[v] Fujimori, S 2015, What are the effects of proton pump inhibitors on the small intestine?, World J Gastroenterol. v.21, no.22, pp.6817-9.

^[vi]Wilhelm, S et al 2013, Perils and Pitfalls of Long-term Effects of Proton Pump Inhibitors, Expert Rev Clin Pharmacol,vol.6, no.4 pp.443-451. 

^[vii] Dukowicz, A et al 2007, Small Intestinal Bacterial Overgrowth: A Comprehensive Review, Gastroenterology and Hepatology, vol.3, no.2, pp.112-22.

^[viii] Wallace, J et al. 2011,Proton pump inhibitors exacerbate NSAID-induced small intestinal injury by inducing dysbiosis, Gastroenterology, vol. 141, no.14, pp.1314-22.

^[ix] FDA 2016, Possible Increased Risk of Bone Fractures With Certain Antacid Drugs, U.S. Food & Drug Administration, viewed 14th March 2017, www.fda.gov

^[x]Wilhelm, S et al 2013, Perils and Pitfalls of Long-term Effects of Proton Pump Inhibitors, Expert Rev Clin Pharmacol,vol.6, no.4 pp.443-451. 

^[xi] Heidelbaugh, J 2013,Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications, Ther Adv Drug Saf, vol.4, no.3, pp.125–33.

^[xii] Heidelbaugh, J 2013,Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications, Ther Adv Drug Saf, vol.4, no.3, pp.125–33.

^[xiii] UHN Daily 2016, Don’t Ignore The Health Hazards of Proton Pump Inhibitors, viewed 3rd April 2017, universityhealthnews.com

^[xiv] Mattsson, J et al 1991,Omeprazole and bafilomycin, two proton pump inhibitors: differentiation of their effects on gastric, kidney and bone H(+)-translocating ATPases, Biochem Biophys Acta, vol. 1065, no.2, pp.261-8.

^[xv] Kresser, C 2016, The Dangers of Proton Pump Inhibitors, viewed 4th April 2017, www.chriskresser.com

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

The condition is caused by biting midges or gnats (Culicoids). It’s not the actual bite that causes the reaction, but rather the insect’s saliva. Whilst this may not affect some horses, other horses are abnormally sensitive to the midge saliva. 

There are many different species of Culicoides, and although their activity is commonly seasonal, in some regions, they are active year round.

In those horses with sensitivities to Culicoides, there are two types of commonly recognised allergic responses: Type 1 which is an immediate reaction, often resulting in hives; and Type 4, which is a delayed reaction. The reactions are mediated by different chemicals in the body. Horses can experience both Type 1 and Type 4 reactions.

Those horses who experience hypersensitivity reactions to Culicoides are commonly atopic, referring to their genetic tendency to develop various allergic conditions, with heightened immune responses. This in part explains why simply applying various lotions and medications to help ‘treat’ the symptoms are merely a ‘band-aid’ effect as they do not address the underlying atopic cause. 

Atopic conditions are associated with imbalances in T helper 2 and T helper 1 cells (important cells of the immune system).

Whilst minimising exposure (as is feasibly practical) is important, correctly employed ingestive herbal and nutraceutical supplements, used under qualified and experienced guidance can play an incredibly valuable role by regulating T helper 1 and T helper 2 cell balances, thereby helping horses with such sensitivities.

Skin conditions are so often more than skin deep, and without addressing the underlying cause, results will only ever be superficial….

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Yet current routine approaches aren’t necessarily addressing all contributing factors to this problematic condition, and doing so in a way that optimises both mare and foal health.

What is commonly know/accepted is that:

• A major cause of placentitis is due to bacterial or fungal infection that enters via the vagina and breaches the cervical barrier, a process known as ascending placentitis.
• Aspiration of air and faeces into the vagina can occur in mares with poor conformation or injury to the cervix or vulvar opening, further contributing to/exacerbating the problem. 

What is less commonly accepted or adequately addressed is that:

• The infection breaching the cervical barrier involves the presence of abnormal bacteria in the reproductive tract. Production of enzymes by these bacteria is thought to degrade the mucus lining the vagina and cervix (which serves to provide a protective barrier mechanism) allowing bacteria access to the placenta.

Whilst these bacteria may be ‘held at bay’ through antimicrobial use, the use of these drugs alone, without adequately addressing and facilitating optimal microflora balance post using them sets up a self-perpetuating and vicious cycle. Whilst the use of antibiotics eliminates the pathogenic, harmful bacteria, they also eliminate any helpful and favourable bacteria and microbes too. This is compounded by the use of NSAIDs. In reality, what this means, is that unless actions are taken to promote and sustain a favourable microbial balance, as soon as the mare comes off medications, a compromised micro-environment is set up, which in theory puts her at greater risk of infection. Mares then cycle on and off these medications or stay on them- further compromising microflora balance and vaginal and cervical epithelial integrity. 

Add to this the fact that neither the antibiotics nor NSAIDs directly provide substrates needed to restore optimal vaginal and cervical mucosal lining and function. 

If this isn’t enough cause for concern- keep in mind that the foal’s immune system is largely influenced by the microbial population it comes into contact with as it passes through the birth canal of the mare. Remember, this mare has an unfavourable microflora balance- thereby essentially programming the foal’s immune system in a way that does not set it up for the best health for life.

We need to break the cycle. We need to change our approach. We need to adequately address contributing factors rather than just suppressing what is there and resigning to the fact that placentitis is a major problem that is hard to treat.

Doing the same thing over and over again and expecting different or improved results is madness. If your mare is worth spending all the time and cost of a conventional treatment regime for placentitis, she sure as hell is worth spending the time and money on addressing the causes and providing effective solutions.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

In barn settings, ammonia is produced when the urea in urine hydrolyses (breaks down) through the action of the enzyme urease. Urease is a protein found in bacteria associated with faeces and stable flooring materials that have been fouled with faeces.

Ammonia can cause inflammation and irritation of both the upper and lower airways and can lead to the development of pulmonary oedema. Horses which are stabled have demonstrated more signs of respiratory inflammation than horses turned out at pasture.

Ammonia sets up an inflammatory cascade in the respiratory tract: increasing mucous production; interfering with the action of cilia (microscopic hairs which line the airways and help to prevent dust and debris from going further down the respiratory tract); and adversely affect immune function and health in the horse.

The negative effects of ammonia are further compounded by poor ventilation in the barn, dust and other particulates inhaled by the horse.

The good news is there are many practical strategies which can be employed to help reduce ammonia build-up in the stable:

• Provide excellent barn ventilation and where possible, avoid closing up the barn.
• Ensure stalls are cleaned once or twice daily to remove all urine-soaked bedding. Ensure stalls are stripped at least twice weekly.
• Ensure horses are removed from stalls whilst mucking and cleaning to minimise exposure to ammonia gases that are stirred up with pitching the bedding and raking.
• Use highly absorbent bedding materials.
• Mix an ammonia-neutralising product with clean bedding.
• Provide good drainage in stables and barn aisle ways to facilitate exit of urine. If matting is used in stalls, regularly clean under the mats when possible.
• Open windows where possible.
• As much as possible, keep horses outside or turn them out regularly to offer a clean air environment.

Treating horses with specific therapeutic herbs and nutrients can help to reduce inflammation and mucous production, in addition to supporting immune function. The most effective results are obtained however, when therapeutic intervention is used in conjunction with addressing the causative factors (such as ammonia and environments high in dust and other particulates). If the cause(s) is/are not addressed, then the initiating factor(s) of the irritation remain….

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Whenever any medication is used, the systemic effects the drug has on the horse should always be considered.

Adverse effects of glucocorticoids are well known, yet we don’t always stop to think what this can mean for the horse in front of us. The immunosuppressive effect of this class of drugs has been demonstrated to predispose horses to bacterial and/or fungal infections, decrease wound healing and increase the risk of insulin-resistant laminitis. Other less severe but important adverse effects include muscle wasting, hyperglycaemia (high blood glucose levels), polyuria (excessive urination), polydipsia (excessive thirst) and gastric ulcers.

Corticosteroids also effect the nutritional status of the horse, as they influence the synthesis, absorption and/or excretion of key nutrients including: zinc, magnesium, calcium, selenium, vitamin C and vitamin D.

Horses receiving glucocorticoids are known to have decreased immune response to infection and vaccines. Whilst some conditions may necessitate the use of these drugs, in the best interests of the horse’s health, performance (physical and/or reproductive) and wellbeing- addressing WHY the drugs are needed in the first place is paramount. Should the use of glucocorticoids be strongly indicated, then concurrently addressing specific nutrient requirements is paramount.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Vitamin D is produced by the horse when their skin is exposed to sufficient sunlight. Rugging a horse interferes with this natural process. Whilst forages do contain some vitamin D- it is not in a readily bioavailable form for the horse to use. 

Adequate Vitamin D is essential for optimal bone health and strength, immune function and modulating inflammation levels. Studies have even shown adequate vitamin D to play an important role in preventing inflammatory airway disease.

Whilst supplementation of this nutrient in a highly bioavailable form and in appropriate dosages can be crucial to make up shortfalls in the horse, naturally exposing our horses to the sun in the first instance is a free and logical step to take to help optimise their health.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

However, just because garlic is ‘natural’ and has health-promoting properties, doesn’t make it safe or suitable for all horses and ponies. When garlic is fed in high doses and/ or for extended periods of time, it may result in haemolytic anaemia (destruction of red blood cells). Garlic is also high in fructans, a carbohydrate which has poor digestibility in the equine. This must be kept forefront in mind before feeding to horses and ponies prone to or at risk of colic or laminitis.

As with any supplement, it is vital to consider the needs, characteristics and intricacies of the horse or pony being treated. Just because a supplement is beneficial for one horse, doesn’t make it suitable for all.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

It is concerning then, that recent research has shown that a number of US equine veterinary hospitals do not have specific nutritional protocols in place for conditions such as colic, laminitis, tying up, and post surgery. Many equine patients receive the same diet regardless of their state of health and the reason for their hospitalisation. Whilst the study was conducted only in USA equine hospitals, it is likely that similar practices may exist globally.

If all the money and effort is invested to help a horse through major medical intervention, surely adopting feeding and nutritional practices to OPTIMise their recovery is plain, simple commonsense.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Whilst iron deficiency in humans is an all too common problem, in our horses it is fairly rare. When it occurs, it is not usually due to an insufficient intake of iron in the diet. Instead it generally occurs due to low-grade, longterm blood loss (the causes of which deserve to be written about in a separate post). Losing large amounts of blood in an acute injury/health complication are also a cause.

One of the most commonly seen scenarios I see in practice is when trainers and riders give horses iron supplements in response to a horse performing poorly or a horse which has had an infection (viral or bacterial).  Iron is perhaps the most important micronutrient required for bacteria to proliferate and cause disease. Viruses also depend on iron in order to efficiently replicate.

It is important to remember too that iron is needed by inflammatory cells. Any condition a horse has where there is significant inflammation (Equine Asthma, placentitis, sesamoiditis, ligament or tendon damage, endometritis- just a few examples!) could be further worsened by iron supplementation.

Takeaway messages:

• By supplementing iron in the poor performing horse/horse that has a ‘virus’ or infection, or any significant inflammatory process, chances are you are making the condition worse.
• ‘Natural’ supplements aren’t always safe/appropriate/indicated
• Get professional advice to help identify and address the cause(s) of the poor performance/challenging health condition in your horse.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Human research has clearly linked periodontal disease with systemic inflammatory conditions and illnesses such as arthritis, insulin resistance and metabolic syndrome, recurrent infections, infertility and adverse pregnancy outcomes. Some real food for thought (excuse the pun  ) given these are some of the most common health concerns experienced in the equine patient.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

Administering more or a higher concentration of antibiotics is ineffective and compounds the problem, likely contributing to further antimicrobial resistance.

The goals in treating biofilm associated infection are multifaceted. Whilst conventional approaches largely focus on ‘killing’ the pathogenic bacteria, the biofilm MUST be disrupted for any antimicrobial treatment to be effective.

Furthermore, effective treatment involves repopulating the vaginal tract with bacteria and microbes which provide a line of defence against pathogenic bacteria, inhibiting pathogenic bacterial (and/or fungal) colonisation and releasing byproducts which help to prevent pathogens adhering to the endometrial lining.

Judiciously employed specific herbal medicines and nutraceuticals can play an invaluable role in helping achieve successful outcomes.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.

More obvious ridges, grooves, or bulges in the hoof wall may be signs of a health problem that occurred at some time in the past few months. Illness which has resulted in temperature, infection, or inflammation changes blood flow and has the potential to affect hoof growth. The ingestion of toxic plants, spoiled feeds, excessive (toxic) intake of particular nutrients (even those that are essential for normal health) and any poisonous substance that influences a horse’s metabolism may result in hoof ridges. These defined grooves in the hoof wall are also common in horses who have suffered from laminitis, with the ridges to take on a V-like appearance toward the toe in chronic cases.

Optim Equine

Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.

As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.