The gut microbiota (the community of bacteria, fungi, viruses and other microorganisms living in the digestive tract) plays an important role in a foal’s development and health.

Increasingly, research is showing that what happens to this microbial community early in life may be associated with health and performance later on.

One factor that can significantly disrupt the developing gut microbiota is antibiotic use.

Antibiotics can be life-saving when they are genuinely needed, and responsible antibiotic use when treatment is indicated is important.

At the same time, antibiotics alter the developing microbial community, and those changes persist beyond the initial treatment period.

Interestingly, research has found that foals given antibiotics during their first month of life had a higher risk of respiratory disease later in life. They also went on to have poorer athletic performance compared with foals that had not received antibiotics.

This highlights just how important the early-life period may be, and how much we still have to learn about the relationship between the gut microbiota, disease and athletic performance.

When antibiotic treatment is necessary, considering what happens to the gut afterwards is incredibly important.

Supporting the gut and helping to optimise digestive health following antibiotic treatment is an area I work closely with as an equine naturopath and clinical nutritionist. Every horse is different, so the approach needs to be individualised rather than simply reaching for a generic “gut supplement”.

The decisions we make for a foal in those first few months of life may have consequences that extend much further than we realise.

When antibiotic intervention is necessary, supporting the horse through the recovery that follows is in the best interests of both its long-term health and performance.

Have you considered gut health when managing a foal after antibiotic 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.

Magnesium is one of the most commonly used supplements in horses, which when used appropriately, can be significantly beneficial. Yet often little consideration is given to important specifics around the use of this mineral. These generally overlooked nuances can help to determine how effective the magnesium is and if it is actually helpful or harmful to give your horse.

Magnesium plays many vital roles in the body. It is needed for over 300 enzymatic processes. From helping ‘wired’, reactive or anxious horses to reducing inflammation, supporting fertility, promoting bone health, metabolic function, and insulin regulation, magnesium has a wide range of applications.

Because magnesium is a naturally occurring nutrient, it is frequently assumed to be completely safe and free from side effects. Yet in reality, it isn’t quite this simple. Like many other supplements and nutrients, there are many factors which determine the safety and effectiveness of magnesium: how and what it is used for, the quantity of magnesium a horse is given, the duration of supplementation, the form of magnesium used, a horse’s overall diet and intake of other specific nutrients, exercise and activity levels, breed, sweat rate, any health conditions a horse may have, the state of its gastrointestinal health and any medications a horse is on. 

If you’re already supplementing or considering using magnesium for your horse, here are some key things worth considering.

Not all magnesiums are created equal

Magnesium comes in a variety of forms, depending on what it’s bound to. This refers to the chemical structure of the magnesium, not just whether it is in liquid or powdered form. The most commonly used forms of magnesium (which also tend to be the cheapest forms of magnesium) in equine supplements include:

• Magnesium oxide
• Magnesium chloride
• Magnesium sulphate

Each of these forms differs in terms of absorption, bioavailability, and how they interact with the digestive system. Yet they are generally not the most clinically effective forms of magnesium to use.

This matters more than many people realise.

Magnesium can irritate the gut

Some forms of magnesium, particularly at higher doses can irritate the digestive tract.

Clinically, this may present in our horses as:

• loose and/or more frequent manure
• gassiness/excessive passing of wind
• changes in gut comfort and/or signs of mild colic
• worsening of existing digestive sensitivity

This is often dismissed or overlooked, especially if magnesium is being used for behavioural reasons.

Over-supplementation can disrupt the gut microbiome

High doses, poorly absorbed forms of magnesium or long-term over-supplementation may contribute to gut dysbiosis (an imbalance in gut bacteria). This can have wider consequences, including:

Magnesium can help to promote a healthy gut microbiome and reduce gastrointestinal-associated inflammation, but more is not always better.

• negative impacts on immune function
• altered nervous system function
• changes in neurotransmitter production and function

Our horses’ digestive systems can play a significant role in their behaviour, anxiety levels and learning capacity, thanks to the role of the gut-brain axis. Ironically, this means that excessive magnesium use may actually make some horses more reactive or sensitive, not less.

Magnesium can interfere with other essential nutrients, causing relative nutrient deficiencies

Magnesium doesn’t work in isolation. It interacts closely with other minerals including:

• calcium
• phosphorus
• zinc

Excess magnesium can interfere with the absorption and utilisation of these nutrients, which are critical for:

• bone strength and development
• proper neuromuscular function
• healthy immune function
• healthy nervous system function
• reducing oxidation and inflammation 
• muscle, tendon and ligament health

Calcium and zinc in particular, play key roles in the synthesis and function of neurotransmitters such as:

• Dopamine
• Serotonin
• GABA

Imbalances in these neurotransmitters can directly influence behaviour, sensitivity, pain perception, reactivity, learning ability and response to training.

Magnesium and behaviour: not always a simple fix

Magnesium is often used to help calm or relax our horses, and in some cases, when used appropriately it can be most beneficial. When magnesium doesn’t help to address the underlying cause(s) of anxious or excitable behaviour however, the effects of supplementation will be minimal.

The effectiveness of magnesium supplementation will also be minimal and may compound behavioural issues if the delicate balances of other minerals are disrupted, magnesium is overused, poorly bioavailable forms of magnesium are employed, or the gut microbiome is negatively impacted. In these cases behavioural issues may actually worsen rather than improve.

It is important to remember that many things can contribute to adverse behaviour in our horses, and in the vast majority of cases, there are multiple causes at any one time, not just one single factor. Whilst diet, nutrient deficiencies and gut microbiome all play an important part, it would be remiss to overlooked issues such as pain, learned conditioning, side effects of other medications used (if applicable) and other underlying health issues. Supplemental magnesium will be of very limited benefit if the issues causing a horse’s poor behaviour are not properly addressed.

This is why a blanket approach to supplement with magnesium doesn’t always deliver consistent results.

Where magnesium can be highly beneficial

When used appropriately, magnesium can be valuable, particularly in horses with:

Metabolic Challenges

Magnesium plays a role in regulating blood glucose and insulin levels. It can be especially supportive in horses with:

• insulin resistance (IR) or insulin dysregulation (ID)
• equine metabolic syndrome (EMS)
• laminitis or at risk of laminitis

Increased Physical Demand

Horses lose magnesium through sweat, and in the case of broodmares, through their milk. Requirements may increase in:

• horses in intense workloads
• hot and/or humid climates
• lactating mares
• during travel

In these cases, intake may increase in the range of 1.5 to 2 times maintenance levels.

Diet still matters: natural sources of magnesium

Like many minerals, magnesium naturally occurs in feeds commonly given to our horses. Lucerne (alfalfa) hay is a useful natural source of magnesium. Fortified concentrate and balancer feeds have varying levels of magnesium.

However, it is not always quite as simple as relying on feed alone (or even, relying on nutritional information on a feed bag or product label).

Feeds or supplements which contain high levels of calcium (such as lucerne/alfalfa) can inhibit magnesium absorption to some degree. This highlights the importance of looking at the whole diet, not just individual nutrients or feed components, nor relying on feed programs or calculators alone.

Medications can change magnesium requirements

Many commonly used medications in horses can alter magnesium absorption, metabolism, or excretion, meaning their requirements may shift.

These include:

• corticosteroids
• proton pump inhibitors (the include the most commonly used ulcer medications which contain omeprazole)
• antibiotics
• non-steroidal anti-inflammatory drugs (NSAIDs)
• antihistamines
• clenbuterol  (β2-agonists, which are often sold under names such as Claire Gel, Broncopulmin, Airway Gel, Ventipulmin, Equipulmin, etc).

If your horse is on medication, magnesium supplementation should always be considered more carefully. Dose, form, timing and duration of magnesium supplementation is crucial to take into account.

In summary: use magnesium strategically, not automatically

Magnesium is a powerful and valuable tool in equine nutrition and medicine, but it’s not without its limitations.

Used well, it can support:

• metabolic health
• muscle function
• nervous system balance and in turn, behaviour 
• skeletal health
• fertility
• gastrointestinal (‘gut’) health

Used poorly, it can:

• disrupt gut health
• create mineral imbalances and relative nutrient deficiencies
• contribute to ongoing behavioural issues
• interfere with normal bone development and health

The key is not just whether your horse is supplemented with magnesium, but what their actual requirements for it are. The form of magnesium used to supplement, the reasons to supplement it, the duration of supplementation, factors which increase requirements or interfere with magnesium absorption and metabolism should all be taken into consideration.

Take home message

Good equine nutrition is never about using a single supplement in isolation. Assessing the unique needs of the individual horse in front of you is crucial.

Before supplementing magnesium, it’s always worth asking:

• does my horse actually need it? And if so, how much?
• is the diet balanced overall? And what role would supplemental magnesium potentially play in this?
• could there be deeper underlying causes contributing to the reasons which are prompting me to supplement magnesium?

The safest, most effective and sustainable results come from a thoughtful, tailored approach.

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 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.

However, the use of intra-articular steroids come with risks to our horses and ponies. Particularly those with insulin dysregulation, insulin resistance, equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID) or those who are at risk of, or have previously had laminitis.

Intra-articular corticosteroids have been shown to increase blood glucose and insulin levels and increase the risk of laminitis, particularly in susceptible horses. The risk may be further increased in horses receiving high-grain or high-starch diets.

When giving our horses any medication or supplement, whether natural or pharmaceutical, both the potential risks and benefits should be taken into account.

For the horse with osteoarthritis or any other degenerative joint disease, diet, exercise (load) management, weight and body composition should all be taken into account. Overweight horses or those with insulin resistance may be at an increased likelihood of developing osteoarthritis due to higher levels of systemic inflammation associated with excess body fat. This highlights the need to be particularly mindful of the risk in these horses and ponies if the use of corticosteroid injections are being considered.

Many nutraceutical and herbal medicine supplements can safely and significantly help horses with osteoarthritis, when selected and used appropriately.

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 one factor which is commonly overlooked is hydration in our horses. Even subtle dehydration may increase their chances of developing gastric ulcers. But why is this?

Dehydration leads to reduced saliva production in our horses and ponies. Saliva plays an important role in protecting the stomach. Saliva is alkaline and rich in bicarbonate ions. Bicarbonate helps to buffer gastric acid, especially in the squamous (non-glandular) region of the stomach.

Dehydration also results in reduced mucosal blood flow- that is, blood flow to the lining of the stomach.  Compromised blood flow weakens natural mucosal defence and repair mechanisms making the stomach more susceptible to inflammation and ulceration. It’s commonly believed that horses only become dehydrated in hot weather, yet this isn’t true. Dehydration is common in very cold weather: research has shown that horses may drink less water when it is very cold. This can be compounded by a reduction of fresh pasture intake, when grass is under ice, snow or  its availability is sparse.

Inadequate salt in the diet is a common cause of dehydration in our horses.  As is the reliance upon the use of automatic watering troughs. Studies have shown that horses may not consume enough water due to the slow refilling time, small trough size, fear of the device, stray voltage which can give them an electric ‘shock’ when they go to drink or the unnatural drinking posture it requires.

Whilst ensuring our horses are consuming adequate water is essential to help promote proper hydration, it is vital to be aware of factors which may increase their loss of water and hint..it’s not just hot weather and sweating!

A horse who has diarrhoea or regularly has loose manure, has an increased likelihood of being dehydrated- even when their water consumption seems adequate. Medications such as furosemide (Lasix/Salix), ‘Kidney Flush’ products for horses (which are sometimes promoted as ‘urinary buffers’) and ertugliflozin (a drug which is very commonly used in cases of equine metabolic syndrome (EMS), insulin resistance (IR) and laminitis) may also cause dehydration in our horses.

From a management perspective, travelling our horses (even when the weather isn’t overly hot) and over-rugging/blanketing our horses can lead to significant fluid losses. As can diets excessively high in protein.

Being mindful of hydration,  particularly in horses with loose manure or those receiving certain medications, may be another simple but important step in reducing ulcer risk. Is hydration part of your horse’s gastric health checklist?

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.

Mares and fillies who exhibit overtly hormonal behaviour can be a real challenge and frustration for riders, trainers and owners. At the other end of the spectrum, broodmares who fail to maintain their pregnancy can cause significant financial loss and disappointment for owners and stud managers.

In both instances, one of the first things many do is use the drug altrenogest in their fillies or mares.

Altrenogest, commonly referred to as Regumate or Readyserve (two of its trade names) is a synthetic progesterone product used to suppress oestrus in mares (and often used with the intention to help ‘maintain’ pregnancy in ‘problem’ pregnancy mares). It is the first choice by many horse people to help ‘control their marey-mare’.

Whilst the health issues associated with the use of altrenogest in horses are extensive, it’s well worth being aware of health implications in humans.

Scarily, altrenogest is routinely viewed and handled as a relatively harmless substance. Yet this drug can cause significant hormonal and health problems to humans who come into contact with it. Altrenogest has been widely reported to the Food and Drug Administration (FDA) for its adverse effects in both men and women.  Exposure is most commonly reported following drug contact with the skin, but it is important to note that some reported exposures occur in conjunction with touching product residue on barn surfaces, equipment, and treated animals. Put simply, you don’t even directly have to handle the drug to suffer adverse health effects from it.

The most significant noted health implications of human exposure to altrenogest involve reproductive system issues, including abnormal menstrual cycles in women (changes in bleeding frequency, pattern and amount). Girls as young as 14 years old have been effected- an alarming consequence. In men, decreased libido has been reported. Headaches, fever, abdominal pain, nausea, diarrhoea, vomiting and skin rashes have also been associated with exposure to altrenogest.

The labelling for all altrenogest products include warnings against human exposure as the hormone is readily absorbed through intact skin. 

It’s easy to think that wearing latex gloves will protect us from the harmful effects of this medication. But this is a misconception: latex allows the passage of altrenogest through it, which can then penetrate the skin. Once altrenogest has been spilt on the gloves and soaked through, it is then more readily absorbed by the skin rather than passing back through the glove. Essentially this practice creates an ‘altrenogest patch’.

When it comes to the use of altrenogest in fillies and mares, it is important to remember that the causes of hormonal problems and imbalances may be due to many factors. As too is the failure to maintain pregnancy.

Feeding practices, nutritional status, inflammation, body composition, the use of certain medications, gastrointestinal health and stress levels all play very important roles, yet are commonly overlooked. 

Appropriately prescribed herbal medicines and nutritional supplements, alongside sound dietary and management practices can significantly help the ‘hormonal’ mare or filly and her behaviour. For the mare to be bred, they can also help to support conception and healthy foetal growth and development.

Understanding why a mare or filly exhibits overtly ‘hormonal’ behaviour is really important to promote overall best health and performance. In the case of pregnancy loss, identifying and addressing contributing factors specific to each individual mare can help result in the best possible outcomes.

Simply manipulating hormone levels through the addition of synthetic progesterone rarely helps to address the causes in either case: it just ‘bandaids’ them.

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.

It occurs in susceptible horses and ponies when phototoxic or photoactive substances accumulate in the skin and interact with sunlight. This can result in severe itchy, crusty and often painful dermatitis. It generally occurs in non-pigmented (i.e. white) skin and skin with little hair cover (such as the muzzle, eyelids, ears and coronary bands).

Equine photosensitivity may be caused by the ingestion of plant or fungal products, chlorophyll metabolites, or other chemicals. It can also occur in conjunction with the use of some medications.

Effects of ingestion of the offending substance may be cumulative and a horse may not develop signs of photodermatitis immediately.

Using lucerne/alfalfa or clover as an example, horses may not develop any clinical signs of photosensitisation until weeks after initially consuming the hay, chaff or pasture which is causing the reaction. We can be feeding our horses this feedstuff for quite some time without any issues, before seemingly all of a sudden, photodermatitis occurs. This can be difficult and confusing, as we often expect clinical signs to appear immediately or very soon after consumption of the offending feed. This can lead to constantly changing our horse’s feed, in attempt to identify the culprit. As a result, this may significantly increase a horse’s risk of developing colic or laminitis.

Other recognised potential causes of photosensitisation include gluten sensitivity; reactions to drugs such as tetracycline antibiotics and phenothiazine tranquillisers; exposure to certain chemicals; and consumption of pastures rich in phosphorus fertilisers.

These are commonly overlooked, but in the author’s experience, generally contribute to photosensitivity reactions more commonly than consumption of lucerne/alfalfa and clover alone, which are often thought to be culprits.

Photosensitisation may also occur as a result of impaired liver function in a horse (known as secondary photosensitivity/photosensitisation).

For these reasons, the effective prevention and treatment of photosensitisation should involve thorough analysis of diet, management, pasture, supplement and medication use in susceptible horses. In many cases, there may be more than one factor contributing to photosensitisation.

The complexity of the condition can also help to explain why simply applying topical creams or lotions and/or simply removing lucerne/alfalfa from the diet or adding a mycotoxin binder to our horse or pony’s feed often doesn’t provide a long-term or effective solution.  Removing certain feeds from a diet can also contribute to nutritional insufficiencies or deficiencies, which can sometimes further compound the problem.

It is critically important to address the underlying cause(s) of the photosensitivity if we want treatment to be effective and to prevent recurrence.

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.

Salt (sodium chloride) is absolutely essential for our horses and ponies. Salt helps to promote: thirst response (so our equines remain adequately hydrated); fluid balance; healthy blood pressure; and normal muscle and nerve function; and is needed for healthy digestion and gastrointestinal (GI) function.

Salt toxicity is extremely rare in horses, provided they have access to unlimited clean water. 

Research conducted in other animal species and humans has shown that excessive intakes of salt, however, can cause dysbiosis (adverse changes in GI microflora). 

Although currently there is no equine specific research on the topic, it does pose the question ‘can we give our horses too much salt?’  

Whilst this is unlikely, it is possible: an example may be where multiple and/or high dose electrolyte supplements are used, particularly in relatively inactive horses and/or those who don’t sweat much.

In clinical practice, I rarely see horses who have excessively high salt intakes: it is very common however, that I see horses who do not receive sufficient salt in their diets.

Furthermore, horses who are receiving ulcer medications (those containing omeprazole, in either oral or injectable form) can have changes in sodium chloride levels. These drugs interfere with salt absorption- meaning our horses aren’t able to utilise all the salt we are feeding them. This can have repercussions in terms of both health and performance.

Ensuring our horses receive adequate salt relative to their individual requirements and taking into account factors such as medication use is crucial for their wellbeing 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.

Poor fertility rates or sub-optimal fertility in stallions can be one of the most financially costly and frustrating challenges for breeding studs and managers.

Sometimes the cause(s) of poor fertility rates can be obvious. Yet, more often than not, the contributing factors may not be clear.

Stress is something which can be easily overlooked, yet plays a fundamental role in the reproductive health and performance of stallions. Stress has been found to reduce luteinizing hormone and testosterone pulsing, leading to reduced spermatogenesis and sperm quality.

The presence of stress in a stallion can be deceptive…When we think about stressed horses, we may commonly think of an outwardly anxious horse; a horse who is always alert and ‘on edge’; one who is reactive and sensitive to changes in their environment; who doesn’t settle easily; and who may walk or pace their paddock. Whilst these are all easily recognisable outward signs of stress, a horse can be under significant stress yet paradoxically appear calm and relaxed.

Some less commonly considered sources of stress to our stallions which may impact their fertility include:

• Nutritional deficiencies and/or insufficiencies;
• The side effects of many commonly used medications;
• Irregular feed regimes
• Insufficient grazing and/or provision of roughage in their diet
• Shuttling and extended travel
• Changes in a stallion’s environment
• Pain- some examples include musculoskeletal pain when covering or gastric ulcers
• The presence or absence of other horses in their immediate environment
• Excessively hot environmental conditions

Even the way a stallion is handled can impact his stress levels. On busy studs, it is not uncommon to be in a rush to complete coverings within a certain time frame. If handlers are stressed, anxious, rushing or feeling pressure to complete breeding sessions, this can raise cortisol levels and heart rates in our stallions, leading to a physiological state of stress.

Whilst we certainly can’t control all the factors which contribute to stress in a stallion, there are many aspects which are modifiable through the way we look after and manage our breeding stallions. Furthermore, the strategic use of appropriate nutritional supplements and herbal medicines can help to mitigate some of the negative effects of stress and help improve testosterone levels, sperm count, sperm quality, sperm morphology and progressive forward motility.

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.

Whilst we are always aiming to do what is best for our stallions, sometimes commonly used medications, supplements and routine management practices can hinder the very outcomes we are trying to achieve.

One such example is the use of gastric ulcer medications in our stallions- whether for the treatment of existing ulcers or with the belief that the use of such medications will help to prevent gastric ulcers.

The drug omeprazole is considered the gold standard pharmaceutical treatment of equine gastric ulcers- and is the key ingredient of the vast majority of ulcer medications on the market.

Research has demonstrated that omeprazole can reduce male fertility through multiple mechanisms: impaired sperm quality, abnormal sperm morphology, reduced sperm motility and reduced sperm count. Omeprazole may also cause a reduction in serum testosterone levels.

When every pregnancy counts and significant revenue is at stake, critically reviewing the use of such medications should be forefront.

There are other effective alternatives available to aid in healing and/or preventing gastric ulcers in horses. Furthermore, through individualised application, the potential exists to also concurrently significantly enhance stallion fertility and overall 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.

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.

If we choose to longe our horses or ponies, it’s important to consider how this form of exercise impacts their joint health.

When a horse is exercised on a circle, they push off with their outside limbs and catch the force of that push with their inside limbs. The joints in a horse’s lower limbs (the fetlock, pastern and coffin joints) have evolved to move in only a front-to-back plane. When exercising a horse, it is natural for their foot to land flat on the ground. For this to occur when they are being exercised on a circle, compression occurs in the medial (inside) aspects of the joint and extra tension is placed on the lateral (outside) of the joint. This causes uneven loading through the joint. The compression on the medial side of the joint impacts articular cartilage; the strain on the outside of the joint puts more tension and ‘wear and tear’ on the ligaments of the outside limbs.

If longeing is performed regularly, it may increase the risk of chronic injury from the stress of the repetitive uneven loading. If we think of this in a more holistic nature, musculoskeletal structures throughout the whole body must compensate for this uneven loading: potentially having a significant impact on a horse’s biomechanics. Even if we only longe our horses or ponies infrequently, there’s still the risk of injury. This is more likely to occur when a horse isn’t properly controlled when being longed (think of a young horse, or a ‘fresh’ horse who we are aiming to ‘calm’ down with longeing).

The negative impacts of longeing can affect horses of all ages. Young horses tend to naturally have less strength in bones and ligaments, potentially increasing their risk of injury from longeing. Cartilage is also susceptible to damage. Further injury can occur in young horses with open growth plates: excessive longeing can potentially cause growth plate damage. This may affect a horse’s long-term conformation and limb alignment.

Whilst older horses are likely to have stronger bones and ligaments from more exercise, they are also susceptible to negative effects from longeing.  Osteoarthritic changes to joints, decreased collagen production, accumulated micro tears and loss of elastic properties in ligaments may increase their risk of injury. 

If we choose to longe our horses and ponies there are a few key considerations to help reduce the potential negative impacts of this form of exercise:

• Avoid longeing young horses, particularly those with open growth plates. These horses are in developmental stages where cartilage may be more susceptible to uneven loading.
• Longe at lower speeds: this helps our horses and ponies to distribute weight more evenly through their joints.
• Of all the gaits, trotting is likely to load the limbs in the most balanced fashion and promote the most even loading.
• Exercise on large circles. Forces on the joint are magnified when working on small circles.
• Only ever longe a horse when they are under control.
• Where possible, longe in a large round pen where the footing is banked. It allows the hooves to have a flatter interaction with the ground.
• Ensure the horse is engaging its body correctly and moving soundly.
• Where possible choose other forms of exercise to work your horse.

When it comes to joint health in our horses and ponies, sometimes we can be quick to want to add a joint supplement to their regime; put them on a IM joint medication and/or medicate their joints, I recommend reading Bisphosphonates (Tildren & Osphos): Understanding how they work and their role in bone health; and Joint Injections in the Horse- Important Considerations. Before doing any of this, there are several incredibly valuable aspects to stop and consider if we want to promote soundness and longevity in our horses. How do we exercise our horses?Is their overall diet one that supports bone, cartilage and joint health, whilst meeting their key nutrient requirements and reduces inflammation? Are our horses on a regular trimming/shoeing schedule which takes into account their biomechanics, conformation and workload? Addressing these factors as part of an holistic approach can help to promote sound, healthy horses and promote the best joint health possible.

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.

A study published in 2015 found that both phenylbutazone (bute/PBZ) and meloxicam (Metacam) interfered with pre-ovulatory follicle development. 

Mares treated with phenylbutazone or meloxicam failed to ovulate, with the development of hemorrhagic anovulatory follicles (follicles that didn’t release eggs). 

These same mares ovulated normally when not treated with NSAIDs. 

This is something worth keeping in mind with any broodmare.

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.

Many factors can potentially contribute to idiopathic colic episodes: consumption of tainted/mouldy feed or hay; diets low in roughage (hay and/or fibrous feeds); high grain diets; sudden changes in feed; high parasite burdens; excessive stress; and long-term use of NSAIDs (such as flunixin, ‘bute/PBZ’). 

Whilst all these factors play a unique role in their contribution to increasing the risk of colic in the horse, they all share a commonality: they significantly alter the microflora balance of the gastrointestinal tract (GIT) of our horses. This in turn can play a key role in the development of colic. To read more about the effect of NSAIDs on GI health, visit the article: Inflammation & Non-Steroidal Anti-Inflammatories in Horses

In light of this, it is important to consider other factors which unfavourably alter gastrointestinal (GI) microflora (such as the use of antibiotics and corticosteroids) when evaluating the cause of colic. 

In the case of influences such as the aforementioned medications, it is important to remember that colic is unlikely to result from immediate use: it may be some time after that the horse has a seemingly ‘unrelated’ or ‘inexplainable’ case of colic. This is due to the increasing imbalance in GI microflora, which was first initiated by the medication.

In clinical practice, I see many referred cases of horses who have repeated idiopathic colic episodes who have been on long-term ulcer medications (generally those containing omeprazole, and sometimes those containing ranitidine). These medications interfere with proper digestion of feed, commonly resulting in fermentation of starch and grains in the hindgut, resulting in excessive production of gas. The use of these medications can also significantly impact a horse’s natural, healthy balance of GI microflora. To read more about the effects of ulcer medications on GI health see articles: Hindgut (Colonic) Ulcers in Horses and Ponies; Ulcers in Horses: The importance of understanding how medications work; and Ulcer Medications: What Nobody Tells You and What You Need To Know.

Colic can be a fatal condition in our horses and ponies, and it can be frustrating when the cause of colic is unknown. Taking the time to assess potential contributing factors, including those which influence GI microflora are important steps in helping to prevent colic episodes.

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 horse that fails to thrive can be one of the most frustrating challenges for owners, trainers, breeders and riders. The horse who no matter how much you feed it, how many times you drench (worm) it, how long it stays on medications for gastric ulcers or how many supplements you add to its feed- it still fails to put on significant weight, looks lacklustre and just doesn’t thrive like it should. Not to mention costing you an absolute fortune to keep! It’s common (and reasonable) to think that the more you feed the horse (particularly high energy grains and/or concentrates) the more weight and body condition it should gain. If a horse consumes excess calories (energy intake) relative to energy expenditure (calories out) then we would expect weight gain to occur.  And whilst the energy equation is an important consideration in such horses, if it was the sole reason in all cases, then horses that fail to thrive would be in the minority. The number of clinical cases where the primary reason for the owner contacting me is to help their horse gain weight suggests that this certainly is a common complaint. So why does it occur and what can we do to help these horses put on condition and thrive?

Potential contributors to failing to put on weight/condition

Like many health challenges and conditions in our equines, there are multiple factors which can contribute to failure to put on weight. Generally, it comes down to a combination of factors, not just one single reason. In the absence of a serious health condition in our horses, which should be ruled out by a thorough case history and veterinary diagnostics if indicated, the below are the most common reasons I see in clinical practice contributing to horses failing to thrive:

• Poor gastrointestinal (GI) health
• Insufficient fibre (particularly long-stem fibre in the diet)
• The volume of ‘individual hard feeds’ (ie grains and concentrates) too large per feed
• Horses being fed the wrong ‘type’ of feed
• Nutritional insufficiencies/deficiencies and imbalances (largely minerals and sometimes protein) which influence metabolic function (for example thyroid function)
• Side effects of certain medications (such as antibiotics, non-steroidal anti-inflammatories and corticosteroids)
• The use of gastric ulcer medications
• High stress levels in the horse
• High levels of pain in the horse
• High levels of inflammation in the horse
• Poor dental health
• High parasite load
• Inappropriate/insufficient exercise stimulus
• Windsucking/Cribbing

Poor Gastrointestinal Health

This is by far the most significant contributing factor relating to failing to put on/maintain weight in clinical cases I see. Poor gastrointestinal health can relate to compromised integrity of the cells lining the GI tract (gastric mucosa), imbalances in the microflora (the population of microbes, largely bacteria) of the GI tract and inflammation of the GI tract. These issues generally occur together. Gastric and/or colonic ulcers are also relevant in many cases, as a result of changes in the aforementioned factors. Many things can contribute to poor GI health (such as insufficient long-stem fibre in the diet, the use of certain medications- including ulcer medications, stress, travel, dehydration, just to name a few). To read more on these topics see articles:Hay, Stomach (Gastric) & Hindgut (Colonic) Ulcers; Hindgut (Colonic) Ulcers in Horses and Ponies; Inflammation & Non-Steroidal Anti-Inflammatories in Horses; Ulcers in Horses: The importance of understanding how medications work; Ulcer Medications: What Nobody Tells You and What You Need To Know; Fibre, Chewing and Gastrointestinal Health.

Insufficient Fibre

Sufficient dietary fibre is crucial in the diet of our horses’ and ponies’. In addition to promoting good GI health (see paragraph and articles above), fibre also serves as an important energy source in our horses. It’s easy to think that a horse who needs more condition needs more calories (the relative energy content of fibrous feeds such as hay is much lower compared to grains and most concentrates). Yet in addition to promoting healthy GI microflora, fibre serves as an important energy source for these microbes. They ferment the fibre to produce short chain fatty acids (SCFA) also known as volatile fatty acids (VFA). These fatty acids are a valuable ‘cool’ energy source for our horses, in addition to producing important anti-inflammatory compounds and promoting and maintaining a healthy GI tract. If we don’t feed our horses sufficient fibre, the lose out on these benefits. We can’t successfully ‘out-supplement’ insufficient fibre in our horse’s diets!

Volume (size) of ‘hard’ feeds

Horses have very small stomachs relative to the size of the animal, accounting for only 10% of the volume of the digestive system. Our horses are designed to be constantly ‘grazing’, which allows optimal digestive function. When our horses are fed large meals, which require relatively little chewing (such as grains and concentrates) the food passes through their stomach quickly. This results in the feed entering the small intestine largely undigested. Consequently, the horse isn’t able to extract the energy and nutrients from the feed properly, and the undigested feed enters the hind-gut, where it ferments and causes changes in the pH and microflora population. Whilst fibre passes largely undigested into the hindgut and is naturally fermented here (and provides significant benefits because of this), no other feed should be fermented in the hindgut. In a mature horse, individual meal sizes should be no more than 2.3kg (5 pounds) in volume.

Horses being fed the wrong ‘type’ of feed

Feeding horses a commercial pelleted or mixed concentrate feed can be an efficient way to help meet nutrient requirements. However, not all pelleted or commercially manufactured feeds are created equally. They vary vastly in ingredients contained, nutrient and energy content. Feeds on the market range from low calorie mineral balancers to high energy concentrates. Feeding a low calorie balancer (even in large quantities) won’t significantly contribute to energy intake in our horses. Hence, selecting an appropriate feed is really important to help the horse failing to thrive.

Feeding large amounts of hard-to digest grains or concentrates is also a common occurrence in the horse failing to thrive. On paper it can make logical sense to feed the lightly conditioned horse plenty of grains as they are generally high in calories. Yet these grains aren’t always readily digested, and feed that isn’t digested properly won’t help to condition our horses well. For example corn (even cracked/rolled corn), despite being relatively high in starch and calories has very poor digestibility. This means our horses are not able to efficiently utilise the calories in it, in addition to it also adversely effecting GI microflora, compounding the whole problem. Remember that many high calorie concentrate/manufactured feeds contain large amounts of grains.

Nutritional insufficiencies, deficiencies and imbalances

In addition to sufficient energy (calories), our horses need protein (made up of amino acids), fats, vitamins and minerals to serve multiple different functions in the body. Sufficient protein is needed to aid in muscle hypertrophy (growth) thus plays an important structural role in conditioning horses. Additionally, the amino acids found in protein are needed for the production and activity of digestive enzymes. Digestive enzymes help our horses to properly break down their feed, allowing for the absorption of energy and nutrients. Along with fats, vitamins and minerals, protein also plays key roles in supporting metabolic function and the production of key hormones needed to promote healthy growth in our horses. Insufficiencies or relative imbalances in these key nutrients can both directly and indirectly affect a horse’s ability to put on body condition.

Side effects of certain medications

Particular medications commonly used in our horses have the ability to impact their body condition. Antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs) such as phenylbutazone (bute) and flunixin (Banamine), and corticosteroids all impact a horse’s GI microflora and the integrity of their stomach lining. Lesser considered medications include omeprazole and ranitidine (the key active ingredients in most ulcer medications), which interfere with a horse’s ability to properly digest and absorb their feed, and also impact their GI microflora. Other medications such as diuretics (Furosemide/Lasix) influence the absorption, metabolism and/or excretion of key nutrients needed for healthy metabolic function and conditioning in a horse. Medications such as Clenbuterol (Airway Gel, Claire Gel) and synthetic thyroid hormone (L-Thyro) directly influence metabolic rate in a horse, commonly resulting in weight loss or inability to put on sufficient condition.

The use of gastric ulcer medications

It can seem quite ironic- medications commonly used to help aid in healing of gastric ulcers can actually compound the challenge of gaining condition in the poor doer. Gastric ulcer medications work by shutting down the production of hydrochloric acid. Yet without adequate hydrochloric acid our horses can’t properly digest, absorb and metabolise their feed and nutrients in it. As a result, feed passes largely undigested in to the hindgut, adversely impacting GI microflora. To learn more about the actions of ulcer medications, visit the articles: Ulcers in Horses: The importance of understanding how medications work; Ulcer Medications: What Nobody Tells You and What You Need To Know

High stress levels and/or high levels of pain

High and/or continued levels of stress and/or pain in our horses results in changes in the production of the hormone cortisol and chemicals which promote inflammation in the body. This in turn commonly results in the breakdown of muscle tissue, leading to difficulty putting on/maintaining condition- largely lean muscle mass (the kind of condition we want on our horses). Changes in GI blood flow and microflora balance also commonly occur as a result of stress, further impacting digestion. Additionally gastric and/or colonic ulcers, which frequently develop as a result of chronic stress, can further compound the problem. To read more on the systemic effects of injury and pain, see the article: Injury and Pain in our Horses and Ponies

High Levels of inflammation

Long-term (chronic) inflammation in horses reduces the synthesis of muscle protein. It also increases the rate at which muscle proteins break down. Special types of molecules called inflammatory cytokines, which are  involved in cell signalling during inflammation, trigger the release of cortisol and particular neurotransmitters (chemical messengers in the body). The combination of cortisol and these neurotransmitters disrupt cellular metabolism and alter a horse’s metabolic rate, which can heighten the breakdown of muscle tissue.

Poor dental health

Dental health can influence a horse’s ability to put on and/or maintain body condition in several ways. Sharp edges on teeth, loosened teeth, tooth infections, tooth loss or uneven wear of teeth can contribute to pain and compromised ability to chew feed well. Properly chewing feed is an important part of initiating digestion in the horse, allowing it to adequately utilise feed.

Less commonly considered aspects of dental health in our horses are 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). These conditions 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. 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. This can result in high levels of systemic inflammation and adverse changes to gut microflora, thereby influencing overall health and digestive function. To read more on the systemic effects of dental health in horses, visit: Bad Breath in Horses

High parasite (worm) load

Did you know that there are more than 150 types of parasites that affect horses? The four most common types are strongyles, ascarids, tapeworms and bots. High numbers of parasites (a high parasite load) can contribute to inflammation throughout our horses’ digestive tracts, damage to the lining of the stomach and intestines and gastric and/or colonic ulcers. These inhibit our horses’ ability to properly digest and absorb their feed.

Simply drenching/worming our horses more frequently is generally not the answer. This can contribute to increased parasite resistance to anthelmintics (drugs used to help kill parasite), in addition to impacting a horse’s GIT microflora. Best practices involves the use of appropriately timed faecal egg counts, assessing parasite burden in the horse, and strategic drenching using appropriate anthelmintics. For more information on best drenching/deworming practice visit: Drenching/Deworming with Panacur

Inappropriate/insufficient exercise stimulus

For our horses to develop and maintain muscle mass and body condition there are several important components. Good GI health to properly digest, absorb and metabolise nutrients needed for protein synthesis and muscle cell growth (hypertrophy) are essential. Our horses also need to be fed a diet which meets both their protein and calorie requirements. An easily overlooked factor is appropriate type and quantity of exercise. Our horse need to be engaging the correct muscles in the correct frame to develop good muscle growth and conditioning. Horses who are not exercised adequately, and/or not engaging the correct muscles when working will fail to capitalise on their ability to develop good muscle mass. Horses who are spelling, injured or on box/stall rest will likely not maintain their best muscle mass. A useful analogy can be to think of a person who wants to gain muscle mass or muscle definition. If they eat plenty of protein and calories, yet spend their day largely inactive, sitting on the couch and not exercising, they will fail to properly develop optimal muscle strength and definition. On the other end of the spectrum, someone who trains really hard in the gym, but fails to eat enough quality food to fuel their training will not maximise muscle development gains. It takes a combination of both training and proper fuelling! To read more, visit: What Supplements are best for building Topline?

Windsucking/Cribbing

Windsucking (also known as cribbing or crib-biting) in horses is a stereotypy, or repetitive behaviour which can significantly impact a horse’s ability to put on or maintain weight.

In addition to weight loss and overall poor condition, wind sucking can result in abnormal development of muscles in the neck, and excessive wear of teeth- affecting a horse’s ability to chew properly. Cribbing can interrupt a horse’s daily routine, occupying several hours per day. This reduces time spent grazing and foraging. Cribbing is commonly associated with digestive discomfort, gastric ulcers and imbalances in specific neurotransmitters- all factors which are known to influence a horse’s ability to properly digest, absorb and metabolise their feed. To read more about windsucking/cribbing visit: Why do horses wind suck and crib bite?

The horse who fails to gain or maintain adequate weight and muscle mass can be frustrating. Whilst it is common to look at one likely reason for their weight struggles, there are generally several factors contributing to the state of the horse’s health. The good news is that when contributing factors are properly identified and addressed, the horse who once had difficulty putting on and/or maintaining weight can flourish. Additionally, by correcting the underlying issues, you are helping to facilitate the best health and performance 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.

Altrenogest, commonly referred to as Regumate or Readyserve (two of its trade names) is a synthetic progesterone product used to suppress oestrus in mares (and often used to help ‘maintain’ pregnancy in ‘problem’ pregnancy mares). It is the first choice by many horse people to help ‘control their marey-mare’.

Whilst the health issues associated with the use of altrenogest in horses are extensive, it’s well worth being aware of health implications in humans.

Scarily, altrenogest is routinely viewed and handled as a relatively harmless substance. Yet this drug can cause significant hormonal and health problems to humans who come into contact with it. Altrenogest has been widely reported to the Food and Drug Administration (FDA) for its adverse effects in both men and women.  Exposure is most commonly reported following drug contact with the skin, but it is important to note that some reported exposures occur in conjunction with touching product residue on barn surfaces, equipment, and treated animals. Put simply, you don’t even directly have to handle the drug to suffer adverse health effects from it.

The most significant noted health implications of human exposure to altrenogest involve reproductive system issues, including abnormal menstrual cycles in women (changes in bleeding frequency, pattern and amount). Girls as young as 14 years old have been effected- an alarming consequence. In men, decreased libido has been reported. Headaches, fever, abdominal pain, nausea, diarrhoea, vomiting and skin rashes have also been associated with exposure to altrenogest.

The labelling for all altrenogest products include warnings against human exposure as the hormone is readily absorbed through intact skin. It’s easy to think that wearing latex gloves will protect us from the harmful effects of this medication. But this is a misconception: latex allows the passage of altrenogest through it, which can then penetrate the skin. Once altrenogest has been spilt on the gloves and soaked through, it is then more readily absorbed by the skin compared to being able to pass back through the glove. Essentially this practice creates an ‘altrenogest patch’.

When it comes to the use of altrenogest in fillies and mares, it is important to remember that the causes of hormonal problems and imbalances may be due to many factors. Feeding practices, nutritional status, inflammation, body composition, gastrointestinal health and stress levels are all very important, yet are commonly overlooked. Appropriately prescribed herbal medicines and nutritional supplements, alongside sound dietary and management practices can significantly help the ‘hormonal’ mare or filly. Understanding why a mare or filly exhibits such behaviour is really important to promote overall best health and performance. Simply manipulating hormone levels through the addition of synthetic progesterone rarely helps to address the cause: it simply bandaids it.

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 many cases, the source of pain in our horses can be diagnosed and attributed to a specific injury or degenerative process such as osteoarthritis. Yet the pain itself rarely occurs in isolation. Other physiological changes occur which influence the sensations our horses experience and their perception of pain.

In the case of acute injury in our horses (think muscle, tendon or ligament damage) there is associated inflammation and commonly oedema (swelling). There are also changes in the types and balances of neurotransmitters produced (chemicals which influence temperament, mood, behaviour and pain perception) and alterations in cortisol levels. These initial changes occur to help the body facilitate healing of the damaged tissue- and to a certain extent are desirable and necessary.

When injury or inflammation becomes prolonged however, the body’s responses become dysregulated. What started out as a normal healing response becomes dysfunctional and can lead to chronic pain and tissue degeneration. Further alterations in neurotransmitter production and function occur- resulting in heightened pain perception in our horses. There is often a concurrent increased production of neurotransmitters associated with anxiety: think of the horse in pain who is always on edge. The anxiety experienced with chronic pain can lead to the experience of greater pain intensity: physiologic changes within the neurological system cause a phenomenon of central sensitisation to pain. Furthermore, stress and anxiety can promote the release of pro-inflammatory mediators, which cause further damage to tissue and more pain.

Contrastingly, it is common to see horses in chronic pain who experience depression. These are the horses which become withdrawn. The ones who you can look at their eye and know they are not ok. As a result of chronic pain, neural pathways in the brain change. Even when tissue damage is resolved, our horses can still experience real pain. The use of NSAIDs cannot help with this.

In the case of injuries- particularly those that are long-standing, horses can ‘guard’ the painful area, hold excessive tension in muscle, fascia and other tissues and change their biomechanics and movement patterns to cope with the pain. Appropriate body work and rehabilitation exercises are an important part of an integrated approach to help facilitate healing and prevent further compensation or injury moving forward.

Pain and inflammation may contribute to certain nutritional deficiencies and/or insufficiencies in our horses and ponies. This is particularly true of chronic pain. Both excesses and insufficiencies of specific nutrients can also increase pain perception and inflammation and are a key consideration to address.

Whilst providing appropriate pain relief is absolutely paramount when indicated, it is important to remember that in many cases, the use of anti-inflammatories alone will not adequately address all the causes of the pain. We also need to be aware of the changes these drugs make to the integrity of the gastrointestinal tract and associated microflora, which in turn influence inflammation, pain perception and systemic health (to read more see articles: Inflammation & Non-Steroidal Anti-Inflammatories in Horses; Anti-Inflammatory Drugs and Recovery). 

Effectively helping horses or ponies in pain, particularly long-standing or chronic pain should encompass a multi-faceted approach. Addressing neural pathway involvement should be a primary consideration, in addition to identifying and rectifying imbalances in specific neurotransmitters. Appropriately prescribed herbal medicines and nutraceuticals can help to facilitate this. The role of nutrition in the equine suffering from pain is also important: ensuring that no nutritional excesses, deficiencies, or insufficiencies are increasing their pain experience. Where appropriate, body work and rehabilitation exercises should also be incorporated. Unless the causes of pain are properly addressed, our horses will potentially continue to go through the cycles of discomfort. Understanding how and why the pain has occurred is important to help effectively treat and resolve it.

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.

It is well known that stress, nutrition (including both excesses and/or insufficiencies of specific nutrients), body composition, light exposure, certain medications and fitness levels are just some of the important factors which influence testosterone levels, sperm count, motility and morphology in our stallions.

When a stallion has a period during the season where his fertility is sub-par it’s easy to focus on what is happening for the stallion at that point in time. If a bunch of mares are returning negative 14-18 day scans, it can be easy to even consider what happened in the 2-3 week period prior (ie around the time when the mare was covered). Yet, likely the most important question to consider is what was happening for the stallion 55-57 days prior to the day of cover of those mares returning negative scans?

Spermatogenesis is the process of sperm cell development, and in the stallion takes around 55-57 days. That means, things which negatively impact sperm cell production and development may not be reflected in fertility parameters until nearly two months afterwards. For a stallion that may struggle with fertility rates mid-season, we really need to be considering what was happening for that stallion around two months prior.

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 many cases, a non-steroidal anti-inflammatory drug (NSAID) such as phenylbutazone (bute/PBZ) is used with the belief that it may help our horses. Other NSAIDs that may be used include flunixin (Banamine), meloxicam, aspirin or firocoxib.

When our horses undertake hard exercise, micro damage occurs in connective tissue (bones, muscles, tendons, ligaments). This micro damage is normal and is an important part of how our horses get stronger, fitter and adapt to training. Natural prostaglandins (special hormone-like compounds produced by the horse’s body) are produced in response to exercise and help to promote blood flow and to heal connective tissue after exercise. These prostaglandins play a key role in inflammation. We tend to think of inflammation as ‘harmful’ and excessive inflammation can negatively impact our horse’s health. There is a happy medium, however, and our horses need a certain amount of inflammation, particularly post-exercise to promote healing and recovery. When our horses are given NSAIDs, the production of these important prostaglandins is inhibited, in turn reducing our horse’s normal healing capacity and adaptation to training.

Furthermore, we know that the use of NSAIDs has adverse effects on gastrointestinal (GI) health. These drugs can cause damage to both the lining of the stomach and intestines, contribute to ulcers (both stomach and colonic) and cause undesirable changes in GI microflora (to read more, visit Inflammation & Non-Steroidal Anti-Inflammatories in Horses). The effects of NSAIDs on GI health can further compromise recovery and adaptation to exercise in addition to the direct effects of impaired prostaglandin synthesis.

Whilst excessive levels of inflammation in horses can contribute to poor health, a certain amount of natural inflammation, particularly post-exercise is absolutely key to optimal recovery and improving fitness and strength.

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.

This, combined with a want of drenches with a better ‘safety’ profile has led to an increase in the use of drenches with a single and/or a lesser-used active ingredient. One of these ingredients is the anthelmintic drug Fenbendazole such as that found in Panacur products. Whilst in many cases using such a drench has its advantages, it is important to remember that it is NOT effective against both tapeworms and bots.

Routine faecal egg counts are a most useful tool in helping us drench our horses and ponies both responsibly and effectively. It is crucial, however, to be aware that when conducting faecal egg counts that both bots and tapeworms aren’t routinely tested for. This can lead to a false sense of security that using Fenbendazole or other similar active ingredients alone is a fail-safe method- particularly when faecal egg count results are low.

Globally, there is a strong emphasis placed on parasitology research- which means what we employ as best practice may change in coming years. The take-home message is that for now, sound husbandry practices (ie regular manure pickup and responsible disposal), routine faecal egg counts and knowledge of what your drench/dewormer is effective against are important factors.

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 signs and symptoms of both gastric and colonic ulcers can be very similar, and both can be very general and non specific. In the case of gastric ulcers, vets are able to perform a gastroscope to confirm (or exclude) the presence and severity of ulcers. Unfortunately, the tools available to diagnose hindgut ulcers are limited and don’t necessarily give us the same definitive answers.

Something that is really important to be aware of is that when colonic ulcers are suspected and stomach ulcers have been ruled out, the use of ‘ulcer medications’ (oral medications containing the active ingredient omeprazole or ranitidine and injectable esomeprazole) are NOT indicated. Ulcer medications stop or significantly reduce the production of hydrochloric acid in the stomach. These medications may actually contribute to worsening of the problem through interfering with proper digestion and causing more undigested feed (which should begin digestion in the stomach both directly and indirectly through the action of hydrochloric acid) to enter the hindgut and ferment. The only thing that should ferment in the hindgut is fibre! Other feeds fermented in the hindgut can contribute significantly to inflammation, damage to cells lining the hindgut and adversely impact delicate balances of microflora.  Hydrochloric acid is NOT produced in the hindgut and does NOT contribute to hindgut ulcers.

It’s worth remembering that both gastric and colonic ulcers can exist concurrently, and that simply ruling out gastric ulcers as a cause of a horse’s signs and symptoms doesn’t necessarily mean that their gastrointestinal (GI) health is good. The successful treatment of gastric and/or hindgut ulcers should involve a comprehensive dietary and management plan (both during the healing phase and long-term), and identify and address the factors which have contributed to the development of poor GI health in the effected 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.

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.

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.

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.

Managing energy intake is certainly a critical strategy in successfully preventing and/or managing these conditions in our horses. It’s important to remember that there are numerous other highly influential factors on body weight, body composition and metabolism. These include exercise and activity levels, various hormonal levels, the effects of specific medications a horse may be on, and specific vitamin, mineral and other nutrient levels.

One of the most fascinating, yet less appreciated influences on a horse’s metabolic rate and body composition are the types and balances of bacteria that reside in their hindgut. Specific types of bacteria in a horse’s hind gut produce short chain fatty acids (SCFAs) also known as volatile fatty acids (VFAs) through a process of fermentation. Short chain fatty acids help to reduce the development and accumulation of fat cells, promote the breakdown of fats and reduce pro-inflammatory cytokines (thereby reducing inflammation). Short chain fatty acids may help to reduce body weight and improve insulin sensitivity- extremely important factors in managing the overweight horse and preventing further complications.

These bacteria need plenty of fibre to survive and thrive. This is one of the many reasons why starvation diets for overweight horses are not suitable. Severely restricting an overweight horse’s fibre intake often compounds the metabolic problems.

In order to successfully manage the overweight horse or pony (or prevent at risk equines from becoming overweight) we need to address all the contributing factors which influence their metabolism. Whilst energy (feed) intake is one of these components, the type of feed is just as important. Appropriately addressing activity levels, specific nutritional components and promoting optimal hindgut microflora are 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.

For the purpose of this article, we will focus on IA: where the solution is injected directly into the joint itself. In this category of joint injections, there are several types of substances which are commonly injected into the joint: hyaluronic acid (HA); polysulfated glycosaminoglycan (PSGAG); and corticosteroids. In many cases, these joint injections are given in conjunction with an antibiotic, most commonly amikacin.

With any IA injection there is risk of harm involved in the procedure. Joint cartilage damage and septic arthritis are serious complications. A common practice is to combine an antibiotic with the medication injected into the joint, with the belief that it may help to prevent infection and subsequent septic arthritis. Yet, the inclusion of antibiotics in joint injections has not been shown to reduce the risk of infection following injection. Furthermore, use of antibiotics in joints is ‘off-label’, with no data currently supporting the doses of antibiotics equine vets use in joints.

Recent research has demonstrated that higher doses of the antibiotic amikacin used in IA injections causes increased levels of inflammation within the joint, in addition to clear evidence of cartilage damage. Of the multiple antibiotics evaluated in the research, amikacin was the most cytotoxic (harmful) to chondrocytes (cartilage cells), rapidly inducing their death. Remember, this is the antibiotic most commonly used in joint injections.

Damage to the joint may be more profound when corticosteroids are the medication used in the joint: research has demonstrated that even a single intra-articular corticosteroid injection can cause irreversible damage to articular cartilage and underlying bone. Combining both IA corticosteroids and amikacin can potentially compound the detrimental effects to joint integrity.

Whilst there may be instances where the use of corticosteroids in the joint are well indicated, we need to stop and ask the question as to why we are injecting the joints in the first place. Routinely injecting joints with medications including corticosteroids and/or amikacin are unlikely to promote long-term soundness in our horses, and indeed may be doing them more harm than good. Using IA joint injections containing corticosteroids and/or antibiotics as a ‘preventative measure’ in horses who are sound and have no joint pathology should be seriously questioned.

Before joints are injected, a comprehensive assessment should be carried out in order to determine reasons for lameness and/or poor performance in the horse. Joint pathology should be thoroughly assessed by the veterinarian. Is joint pain the actual cause of the pain or poor performance in the horse? Feeding factors should be reviewed (is the horse consuming a diet that promotes inflammation)? Are the feeding of accessory nutrients known to promote cartilage, bone and joint health and integrity indicated? And are these being fed in appropriate doses and highly bioavailable forms to the horse? Workload and work surfaces should be assessed: is the horse following an appropriately periodised training program, and are the surfaces being ridden on conducive to soundness? Consideration of the horse’s build and bodyweight should be taken into account: more weight equates to more mechanical stress and wear and tear through a joint. Furthermore, excessive levels of body fat in a horse increase inflammatory mediators, heightening any joint inflammation. Trimming and shoeing practices can significantly influence the force going through a horse’s joints, thus appropriate farriery is an essential component of promoting soundness in the horse.

Joint health is one of the most significant concerns in working horses. Management, exercise, farriery, nutritional and therapeutic factors all play an important role in promoting optimal joint health and soundness in our equines. Serious consideration needs to be given to the use of IA corticosteroids and/or antibiotics as they may significantly compromise cartilage, bone and joint health and integrity in our horses.

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.

What is laminitis?

Laminitis is a painful, often devastating inflammatory condition affecting the lamellar tissue of the foot. Each hoof contains 550-600 primary laminae, and each of those consists of 150-200 secondary laminae. The laminae connect the hoof wall to the coffin bone and function to provide shock absorption during locomotion, holding the coffin bone in place and supporting the horse’s entire body weight against gravity during movement. Laminitis results in the separation or failure of the laminae, causing permanent structural changes in a horse’s foot, often leading to repeated bouts of the condition and lasting lameness. In severe cases, the pedal (coffin) bone in the hoof can rotate and/or sink downward (this is termed founder). The devastating end result can be the coffin bone protruding through the sole of the hoof.

Clinical Signs of Laminitis

Laminitis most frequently occurs in the front hooves, which carry the majority of the horse’s weight (about 60%), although it can affect the hind hooves as well.

Common clinical signs include:

• Reluctance or inability to walk, and/or looking very footsore or ‘toey’ when walking;
• Weight-shifting between legs;
• Increased respiratory rate and frequently increased heart rate;
• A glazed, painful expression;
• When front feet are affected, a stance with the hind legs camped under the body and forefeet camped out;
• Bounding (throbbing) digital arterial pulses; and
• Increased heat of the feet (this can be felt by touching the horse’s effected hooves).

It is extremely important to note that structural damage to the laminae can occur before obvious clinical signs are noticed.

Causes

Laminitis can be caused by several different factors, many of which can overlap or occur concurrently. At this time of year, the primary focus is on laminitis which results from eating grass rich in NSC. These NSC can cause blood glucose and insulin levels to skyrocket, resulting in excessive inflammation and damage to the lamellae. Fructans (a particular type of of NSC, often high in grass at this time of the year) pose a further risk to horses. Fructans are largely indigestible to equines, causes undesirable changes in gastrointestinal (GI) microflora and the integrity of the cells which line the GI tract. This is a significant risk factor in the development of laminitis.

Horses and ponies most at risk of laminitis at this time of year include those that are overweight and/or have metabolic syndrome, those with Pituitary Pars Intermedia Dysfunction (PPID) (which is often referred to as Equine Cushing’s Disease) and those that have previously had laminitis.

Prevention

Prevention is key to ensuring your horse’s best health and welfare- and requires a diligent and holistic approach. Providing sufficient roughage (such as soaked hay) which is low in NSC and minimising grazing of grass high in NSC are key. One thing which can catch many people out is that even grass which is not lush and green can be high in NSC. It is imperative to note that the common practice of locking susceptible horses up and giving them minimal hay and/or feed has deleterious health effects on the horse and can actually increase the severity of laminitis.

Exercise is often overlooked, but is imperative in the prevention of laminitis. The effects are multiple: exercise itself has a direct effect on utilising energy, thus helping with weight management of the horse. It also helps to reduce fat tissue and promote lean muscle mass, thereby increasing energy utilisation at rest. But by far the biggest benefit comes from regulating blood glucose levels, through a mechanism that can only be facilitated during exercise.

Treatment

In the early stages of an acute episode of pasture-associated laminitis, the horse should immediately be removed from the affected pasture. Soaked hay (ensure that the water it is soaked in is discarded away from where the horse can graze it) should be the primary feed source provided until further nutritional advice is sought. Icing the hooves may slow down inflammatory processes and may also impede enzymatic processes associated with the deterioration of the laminar attachments. Icing should be employed for the first 72 hours.

Treatment of the horse with laminitis needs to be tailored to the individual horse and the the factors which have contributed to its condition. Specific feeding plans, combined with appropriate exercise (at a stage where the horse is able to safely and comfortably move), and strategic nutritional and herbal medicine supplementation are imperative. This should only ever be prescribed from someone suitably qualified and experienced. Whilst immediate pain relief may be required for the horse’s welfare in the case of an acute laminitic episode, the use of non-steroidal anti-inflammatories (NSAIDs) such as ‘bute’ must be judicious. Such drugs may actually worsen the condition by further compromising GIT integrity. Additionally, the pain relief provided by these may allowing the horse to move more than appropriate at that stage of its recovery, thereby further damaging the hoof laminae.

Conclusion

Laminitis is a serious, yet largely preventable condition in our equines. Through appropriate dietary and management strategies, and the use of specific nutritional and/or herbal medicine where indicated, a horse’s risk of developing the condition can be minimised. In the horse that has developed laminitis, appropriate early intervention improves the outcome for the 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.

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.

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.

Joint Structure

The equine lower limb joints are a type of joint known as a synovial joint. Of the three types of joints found in the equine skeleton, synovial joints are the most likely to suffer from disease and injury due to their high degree of activity and relative strain and repeated load they undertake.

Synovial joints consist of two bone ends covered by articular cartilage. Healthy articular cartilage is important for enabling frictionless movement of the joint. Articular cartilage is comprised of a dense extracellular matrix (ECM) and highly specialised cells called chondrocytes. The ECM is primarily composed of water, collagen and specific proteins called proteoglycans. It also contains other proteins to a lesser extent.

Cartilage is surrounded by soft tissue, including ligaments and a fibrous supporting joint capsule, which provides both structural integrity and stability. Lining the joint capsule is a layer called the synovial membrane. The synovial membrane secretes synovial fluid, which provides lubrication within the joint itself.

Joint cartilage does not have a blood or nerve supply and relies on the synovial fluid for the nutrition of its cells, glycosaminoglycans (GAGs) and collagen contained in its structural surface tissue and joint matrix material. Healthy synovial fluid is highly viscous and lubricates the cartilage surface, minimising friction within the joint. It also serves an an important ‘barrier’ to minimise the influx of damaging inflammatory enzymes which are released in response to joint injury. It is most important to note that joint cartilage does not regenerate- it is only able to repair itself to a limited degree after being damaged.

Joint Injury

Abnormal loading, overloading and sprain forces physically disrupt joint structural components, and are generally the initiating factors of joint injuries. High impact and repeated overloading on joints results in reduced concussion absorbing capacity of cartilage and the underlying subchondral bone. These both become less resilient and more brittle, making them less able to withstand loading and recover between exercise. Injury to joint cartilage surfaces if often the initiating factor in ongoing joint deterioration and eventual joint breakdown. In exercising horses, the direct mechanical stress from concussion and repetitive overloading leads to physical damage of the joint cartilage; erosion of the cartilage by inflammatory enzymes; or collapse of the underlying subchondral bone support structures. Inflammatory enzymes dilute the nutritional and lubricating function of synovial joint fluid and damage the cartilage surface, setting up a cycle of progressive deterioration of the joint.

Signs and Symptoms of Joint Disease

Early signs of joint unsoundness include:

• Stiffness and a longer warm-up time when starting exercise
• A ‘scratchy’ gait
• Heat in the effected joint(s)
• Swelling of the effected joint(s)
• Favoured resting of effected leg(s) after exercise

How to Avoid/Manage Joint Disease

Whilst there are some known contributing factors to joint disease, which to some extent are unavoidable (such as conformational abnormalities and genetic defects), there are many practical applications that can be employed to reduce the incidence and severity of joint disease, and effectively manage existing cases.

Riding/Exercise Factors

Undertaking a progressively loading exercise program is important- especially when bringing a horse back into work from a spell or when starting a young horse into a training program. It is helpful to liken exercising a horse to undertaking a fitness regime yourself: you wouldn’t go from months of doing no exercise to undertaking full marathon training in a week! Gentle, incremental increases in exercise properly condition the body and help to protect against injury. Excessive muscle fatigue results in compromised movement, altering biomechanics and potentially increasing the load placed on joints. Remember that competition is a significant stress too- so ensure horses are properly fit for events.

It is also extremely important to consider the role of weight in joint injury- both the body condition of the horse and the rider. The more weight a horse has to carry, the more force is put through the joints and the increased subsequent wear and tear. Additionally, heavy loads placed on the limbs interferes with normal nutritional function in the joints: the rebound of cartilage and joint fluid redistribution that provides nutrition to the cartilage layer is less able to recover.

Avoid working your horse on overly compacted (hard) surfaces- as these result in excessive concussive forces being put through the joints. On the other end of the spectrum, avoid working in overly soft, deep surfaces, as these can strain the ligaments surrounding the joints.

Always ensure to adequately warm-up your horse before moving into demanding exercise. This optimises blood flow, and ensures muscles, tendons and ligaments are ready for the impending activity.

Management Practices

Regularly check your horse’s joints for signs of swelling, warmth and restricted mobility. The use of magnetic pastern and fetlock wraps in stabled horses may help to promote improved blood supply to the joints and hence facilitate the repair process.

Hoof Maintenance

Another highly preventable contributor to joint disease is hoof imbalance. Allowing a horse’s toes to grow too long and/or having low or uneven heels alters biomechanics and puts undue stress through joints. The importance of good farriery cannot be emphasised enough. Ensure that the horse remains on a regular trimming and shoeing (where appropriate) schedule. Although this is individual for each horse, every four weeks is generally an acceptable period of time.

Medications

Different oral, intravenous (IV), intramuscular (IM) and intra-articular medications may all be used in the treatment and/or management of joint disease- with variable effects and results. The repeated use of NSAIDs (such as ‘bute’) and intra-articular corticosteroid injections are not advisable. ^[1]Studies have shown that even a single intra-articular steroid injection can cause irreversible damage to articular cartilage and underlying bone.

Pentosan polysulphate (commonly sold as Cartrophen, Athropen or Pentosan Equine) may help to prevent joint degeneration through several mechanisms: stimulating cartilage repair; promoting healthy synovial fluid and exerting a strong anti-inflammatory effect.

Hyaluronate (such as Halo) is given IV to horses to help promote healthy synovial fluid, thereby helping to minimise joint friction and damage, and limiting the influx of inflammatory enzymes which degrade cartilage.

Joint medications should always be prescribed by your veterinarian, ensuring the most suitable treatment regime for your horse, correct dosage rate, and correct route of administration are employed.

Dietary Factors

The importance of diet in joint conditions cannot be underestimated. Diets which contain high levels of omega-6 fatty acids without significant omega-3 fatty acids (such as many high fat ‘cool energy’ feeds and oils) promote inflammation. Additionally, unbalanced high-starch diets can significantly contribute to the deterioration of joint health. Diet must also be considered alongside exercise in the effective weight management of the horse (as discussed previously).

Nutritional Supplementation

Therapeutically, there are many nutrients which are extremely helpful in minimising inflammation and hence destruction of the joint; promoting optimal bone matrix composition; promoting collagen synthesis; repairing joint cartilage; and protecting against oxidative damage. Nutrients such as B group vitamins; Vitamins C, D, E; Chondroitin; Glucosamine; Zinc; Omega-3 Fatty Acids; Calcium; and Copper all have important therapeutic roles. Due to their specific actions, potential for nutrient toxicity and imbalances, and specific dosage ranges, these supplements should only be prescribed according to professional recommendation and tailored to each individual horse’s needs. Oral hyaluronic acid (HA) supplements (not to be confused with HA injections) are becoming increasingly popular, however, their bioavailability (how much the horse can absorb and subsequently use) and efficacy is questionable.

Herbal Medicine

The principle aims of herbal treatment in joint disease are to reduce inflammation and oxidative damage to joints; and promote circulation to the joints. The judicious use of specific herbs to provide significant pain relief is also commonly employed- but this must be part of a holistic plan. Some of the most commonly used herbs for joint problems in horses include: Devil’s Claw; Boswellia; Tumeric and Guaiacum. As with nutritional supplements, herbs should only be used under the guidance of a suitably qualified and experienced practitioner. This ensures safe and effective prescribing. Furthermore, it is important to note that some herbs have restrictions upon use in competition.

Conclusion

Joint health is one of the most significant concerns in working horses. Management, exercise, nutritional and therapeutic factors all play an important role in the prevention and management of joint disease. It is important to note that much pre-existing damage in joints is irreversible, hence the importance of preventative measures. In horses with joint disease, appropriate management and therapeutic interventions can minimise further damage and promote optimal health, wellbeing 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.

Supplements. They can be a contentious topic. Yet nearly all horse owners, trainers and riders use them at some stage in one form or another on their equines. As a naturopath, I am sometimes asked that if a horse is fed ‘properly’ then does it really need supplements? The answer is both no and yes! Horses have evolved to live outdoors, on natural land which hasn’t been over-farmed and/or over-grazed, eating a diet of natural forage and plant matter, roaming considerable distances each day, with their primary stress in life to stay alive and outrunning predators. In this case, there would be little need for supplementation. Today’s horses however, generally live in stark contrast to this: most often they spend time in small areas of turnout (many spend considerable time in stables), having minimal access to pasture (which is often over-grazed, and in some cases tried to be compensated by commercial fertilisers); exposed to toxic metabolites such as medications and environmental chemicals (insecticides, herbicides, pesticides, xeno-oestrogens); expected to be trucked all around the countryside to events; exposed to stressful situations; undertaking rigorous activity through training and competition events; often eating highly refined and processed diets; living outside of a natural herd environment; and in many cases developing illnesses, injuries and diseases, often as a direct result of these practices. It is for these reasons that yes- most horses will benefit immensely from appropriate supplementation, even more so if we want our horse to enjoy the very best of health and perform to their full potential.

Types of supplements

Supplements most commonly come in oral or injectable forms. For the purpose of this article, we will focus on those taken orally (either eaten or syringed directly into the mouth). Equine supplements can fall under several broad categories:

General nutritional – most commonly complex vitamin and mineral supplements (similar to multivitamins for humans). The vast majority of processed equine feeds also have extensive vitamin and mineral fortification, so this should be taken into account too.

Single or specific combination nutritional – examples include mineral supplements (such as magnesium) and vitamin supplements (such as vitamin E) or combinations (such as selenium + vitamin E).

Supplements for specific conditions – may be a combination of nutritional and/or herbal products. Supplements for joint health; gastric health; immune health; metabolic health; calming supplements; hoof growth and strength; and ‘blood tonics’ commonly fall under this category.

Herbal – may be dried herbs, tablets, powders or liquid products. Sometimes individual herbs (such as chamomile) or a combination of products (for example an ‘immune mix’ containing Korean Ginseng and Echinacea).

Homeopathic – prescribed in pillules or drops, this form of therapy isbased on the concept of ‘like cures like’. It is guided by the principle that minute concentrations of a particular toxin cure the very same symptoms it would cause in larger doses. Homeopathic remedies contain no traceable amount of the original substance (ie homeopathic arnica does not contain any measurable amount of arnica or its active constituents).

Choosing a supplement- Important Considerations

Purpose for use

When choosing supplements to use, it is of key importance to remember that supplements should not replace a balanced diet. The first step is to evaluate and optimise dietary practices. There are instances where supplements are needed to correct shortfalls in nutrient requirements in an otherwise balanced diet, but they are not an excuse to continue poor feeding practices. An example of appropriate supplementation to correct a dietary shortfallth is the use of selenium in horses maintained on pasture in selenium deficient soils.

Supplements should also not be used to replace poor management practices. A classic example of this is the overuse of ‘nerve/calming’ supplements. Before using such a supplement, the following needs to be asked and addressed: does the horse have good gastric health; is the horse being exercised frequently; is the horse in pain; does the saddle fit correctly; do the horse and rider capabilities match; is the rider relaxed when riding? Without addressing primary root causes, truly effective results will never be obtained. Any benefit derived from the supplement will be a poor ‘band-aid’ fix.

When selecting a supplement, the question needs to be asked ‘why are you adding it?’. Was it because someone said ‘your horse needs it’ or ‘its good for them?’ Supplements added to the diet should only be done when you can confidently answer the question as to why you are using them, with specific modes of action and therapeutic goals to be achieved.

Horses with elevated requirements beyond dietary intake.

Horses at risk of, or with specific health conditions may require elevated levels of nutrients to help optimise health. For example, a horse with insulin resistance (IR) may benefit greatly from appropriate magnesium and/or chromium supplementation to help increase insulin receptor sensitivity and thereby reduce and stabilise blood glucose levels.

Another classic example is a horse with an active infection. The need for particular nutrients during times of infection (such as zinc and vitamin C) are elevated, and the judicious use of indicated supplements can help to hasten and improve recovery from illness.

Interactions

Most nutrients and herbs have the ability to interact with other nutrients, drugs and herbs to some degree. Some of these interactions are beneficial (for example, the use of pre and probiotics together to optimise microflora colonisation), some are harmful, and some negate the benefit of each other (concurrently feeding iron and zinc supplements, which impairs the absorption and uptake of both minerals). For this reason, it is vitally important to seek professional advice when using herbs, minerals and medications: both to minimise risk, and optimise efficacy and safety.

How/when they are given

Some supplements are most readily available to the horse when given in conjunction with feed (for example vitamin E is best absorbed when given with a fat source in the feed), others are best given away from main meals (for example glutamine). Following specific guidelines for individual nutrients allows optimal therapeutic and nutritional effect to be achieved.

Contraindicating conditions

The use of some nutrients is contraindicated/unadvisable in certain circumstances- as it may slow recovery or put the horse at risk of harm. An example is the use of iron supplements during infection or inflammatory conditions, which may worsen or prolong the infection and/or inflammation.

Quality

Supplements given to a horse should always be from a respectable and trusted source, with clearly labelled packaging and full list of ingredients- stating both their form and quantity. This is especially important with herbal and combination products. Supplements which don’t meet this criteria should not be used.

Available nutrients per serve

A very important consideration is how much of the actual nutrient(s)/herb a horse receives per serve of the product. Unfortunately, many products contain such small doses of the actual active constituent they are advertised to have (for example the actual amount of magnesium in a magnesium product) that they are of minimal if any therapeutic benefit to the horse. Another common example of this are expensive products such as omega-3 oils. These products often contain high amounts of vegetable and other omega-6 containing oils (which promote rather than reduce inflammation).

Bioavailability

Bioavailability refers to the actual amount of a nutrient that can be digested and utilised. For example, a product may contain 400mg of elemental zinc. Zinc may be found in many forms including: zinc chelate; zinc proteinate; zinc sulphate; zinc citrate to name just a few! The amount of zinc which the horse is actually able to absorb and metabolise depends largely on what form that zinc is in. Therefore, if the product mentioned in the example above contains a poorly bioavailable source of zinc, the actual amount the horse is able to use is far less than the 400mg.

Toxicity

Some minerals and fat-soluble vitamins have the potential to be harmful (and even fatal) when given incorrectly and/or in large doses. This is especially important to consider when giving fortified feeds, then additionally feeding supplements. The importance of correctly measuring supplements cannot be overstated.

Absorption

A supplement can only be effective if it is absorbed and metabolised properly. This depends on horse having good gastric health. It also means supplements must be given under conditions that allow for absorption (ie a horse on an ulcer medication will not be able to properly utilise supplements fed at the same time!)

Summary

The appropriate use of many supplements can provide outstanding results in a myriad of health parameters in the equine. In order to ensure safety and optimise efficacy all supplements should:

• Have a clear and definite reason for use in the diet
• Have a clear timeline for use in the diet
• Contain highly bioavailable ingredients in therapeutic dose amounts
• Be clearly labelled stating exact ingredients, quantities and dosage rates
• Be used in conjunction with holistic feeding and management practices- NOT used to replace them!
• Be given under conditions which optimise absorption and metabolism
• Be prescribed under qualified guidance and tailored to each individual horse’s needs.

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.

Since that time, some veterinarians have used these products off-label to treat other equine bone issues including osteoarthritis, bucked shins, sesamoiditis and subchondral bone cysts. Bisphosphonates are thought to provide significant analgesic effects and may even help improve radiographic images of conditions such as sesamoiditis. The provision of pain relief can be beneficial in appropriate situations, but we also need to consider the fine line between relieving pain and masking pain. Furthermore, we need to account for the additional risks associated with bisphosphonates.

With our current level of knowledge and understanding of the actions of bisphosphonates, we should seriously question their use. Normally in horses, bone turns over continually (remodels). This is due to the activity of specialised cells called osteoclasts and osteoblasts. Osteoclasts break down (resorb) old bone while osteoblasts create new bone. This ensures bones remain strong and healthy and allows them to adapt to changes in exercise level or mechanical stress placed upon them. This adaptation and strengthening is an important mechanism in protecting against stress-induced bone injuries. Increased bone fragility has been seen in animals given high doses or long-term doses of bisphosphonates, a likely result of the inability to repair micro-damage within bone.

Bisphosphonates inhibit osteoclasts, thereby blocking excess bone resorption. But they’ve also been shown to be anti-angiogenic (preventing new blood vessel growth). New blood vessel growth is an essential component to repair the normal micro-damage that naturally occurs during training, competition and racing. It is important to remember that this normal repair and recovery of this micro-damage actually make bones stronger. Furthermore, curbing the action of osteoclasts interrupts the remodelling process: the activity of osteoblasts and osteoclasts is a finely balanced process. Inhibiting the activity of osteoclasts interferes with the osteoblasts, therefore they don’t kick into gear to build new bone.

It can be easy to skim over the fine print on pharmaceutical labels and pamphlets, yet it is important to note that the FDA clearly outline some of these risks. They declare that bisphosphonates inhibit osteoclast activity and decrease bone turnover, thereby potentially affecting bone growth. Ultimately, this inhibition of bone remodelling can place racehorses and performance horses at greater risk of more frequent and serious injuries.

Whilst the medication is approved for use in controlling clinical signs of navicular disease in horses four years and above, it is important to remember that the action of bisphosphonates is systemic: that is, it affects the whole skeletal system, not just the navicular. We also need to remember that in many horses, some bones (particularly of the spinal column) aren’t fully developed until ages five to six or older.

Athletic performance aside, the safe use of bisphosphonates has not been evaluated in breeding horses or pregnant mares. Studies in laboratory animals have demonstrated bisphosphonates to cause abnormal foetal development, likely due to drug-induced alterations in maternal and foetal bone uptake. To compound this issue further, bisphosphonates have a very long half-life (meaning they can stay in the horse’s system many years after cessation of treatment). As a consequence, they can affect the health of both mare and foal long after the use of the medication has stopped.

When considering the risks of bisphosphonates in lactating mares and nursing foals, we need to be aware that metabolites of these pharmaceuticals may be excreted in milk and absorbed by nursing animals. This has the potential to negatively impact the bone development of the offspring. Again, given the extremely long half-life of bisphosphonates, these effects may still occur years after bisphosphonates were last used in the mare. The use of the vast majority of pharmaceuticals comes with side effects which we need to consider in the context of a horse’s long-term health, performance and potentially reproductive life. Before rushing to ‘treat’ a health, injury or performance issue, we should first address why the health or injury concern has occurred. This requires honestly and critically reviewing training, feeding/nutrition, recovery, medication use and management practices. If a horse has excessive inflammation and/or soreness in an area, it is a sign that things aren’t right. Without identifying and addressing the underlying cause of bone inflammation and injury the problem persists.  To try and rectify the problem with the non-discriminate use of drugs with known serious side effects is risky at best. Whilst providing pain relief can be beneficial in appropriate situations, masking pain and accelerating bone damage and loss is not.

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.

Understandably, much emphasis is placed on the vendor’s side in realising maximal monetary value for their yearlings. From a purchaser’s point of view, finding a top class racehorse is prime priority.

This poses the question…are we creating (and purchasing) resilient racehorses or superficial sales horses?

When producing and purchasing a sales horse, both the vendor and buyer should never lose sight of the bigger picture. In order for even the most impeccably bred and conformed racehorse to realise its full potential, it must be healthy and sound, and remain so when put through the rigours of training and racing. Given the crucial role that management practices from conception through to yearling age (and beyond) have on horses in relation to health and soundness- intelligent vendors and purchasers will keep this in mind.

As bloodstock agents and trainers inspecting yearlings on farms- how much are you considering the routine and the environment the horse is bought up in? How much time is the horse spending (if any) being out in the paddock just being a horse? What feed it is being given? Certainly, when you’re looking at a yearling, assessing its conformation, its walk, its demeanour are all important, but you looking beyond that? As stud owners and yearling managers- you worry about how well the horse is groomed, turned out, presented, walks, how tidy the barn is. Yes these are important, but what is far more important in terms of athletic potential and health and development is the daily routine that goes on behind the scenes…

The astute agent and buyer will look well beyond the horse parading in front of them if they truly want an athletic, resilient horse.

So what impact can a sales prep have on a horse…..

Firstly, lets look at routine stabling of horses for yearling preps. Stabling (and the associated lack of incidental activity, even with the addition of regular handwalking/exercise on the walker), leads to reduction in peak bone strength and development. The lack of continual grazing which would normally occur whilst out in the paddock has significant impacts on gastrointestinal health, in turn influencing immune function, metabolism and behaviour. I’m a realist. Very few studs (if any!) are going to prep sales horses completely out of the paddock. So then consideration needs to be given to next best options. In terms of musculoskeletal health and development and gastrointestinal health, small paddock turnout is definitely far preferable compared to stabling full time. Large paddock turnout with other horses is even better.

Next consider nutrition. Rapid weight (even muscle gain) and the associated spikes in insulin and growth hormone levels are likely to increase a horse’s risk for OCDs and musculoskeletal developmental problems. Having the biggest, strongest horse (with rapid weight gain and growth, whilst in a confined environment, in around a 12 week preparation), does not make for a resilient, healthy athlete long term.

Whilst on the topic of nutrition, the vast majority of diets fed to horses in sales preps are of a pro-inflammatory nature. High fat diets are often used (with many of the belief that they are healthier and help to promote a better behaved horse, being a ‘cool’ source of feed). So often these diets are comprised heavily of omega-6 fatty acids. Which drive inflammation. High levels of inflammation in a young developing horse do not bode well for long-term soundness.

Then how about the consideration of medication use in the sales horse? Routine use of antibiotics, bute and other NSAIDs, ulcer medications all have the potential to influence long term soundness and performance. Each medication has its own specific implications- but put simply, they will all alter the production, absorption, and/or metabolism of various nutrients critical to optimal musculoskeletal health and development, not to mention immune function.

Corticosteroid joint injections which are used in some yearlings throughout their preps are an important consideration. Studies have shown that even a single intra-articular steroid injection can cause irreversible damage to articular cartilage and underlying bone.The reason these are so often used in yearling prep is to reduce puffiness in joints, before even considering or addressing the effects of the horse’s current diet and management on this issue. This includes reducing the inflammatory components of the diet; assessing the diet for excess energy; and looking at ways to reduce time spent standing in stables, which promotes swelling of joints in susceptible horses.

The smart consigners/breeders/managers have it fundamentally right. The astute buyers, trainers and agents have it right. Yet there is always room for improvement and more to learn.

Even changing one or two factors can have a significant positive impact.

The choice is yours. Just because you have always prepped yearlings a certain way, doesn’t mean you can’t change aspects for the better.

When preparing and buying yearlings, keep the long term goal in mind. Are you after an athlete or sales horse? Short term gain or long term success? Because no matter how good the horse looks, how nicely he is conditioned, how well he walks, how impeccably he is bred: If he can’t remain sound and healthy in training, then his odds of return on the track are poor.

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.

Chewing results in the production of saliva. Forages and fibrous feeds require more chewing than grains and processed feeds. On a dry matter basis, twice as much saliva is produced when horses eat grass or hay compared to grains and other concentrate feeds. This production of saliva plays an essential role in promoting a healthy gastrointestinal (GI) system: Saliva is rich in bicarbonate, which helps to buffer the acid secretions produced by the stomach. Diets high in grain and low in forage result in a lower saliva flow and thereby lower gastric pH values. This is one important risk factor for the development of gastric ulcers.

Before being quick to use omeprazole or ranitidine based ulcer medications (which come with their own health risks for the horse, not to mention the high $$$$$ on the hip-pocket), take a step back and evaluate the basics. Is your horse consuming a diet which promotes gastric health? Is the basis of your horse’s diet one which is built upon sufficient forages

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.

A vital consideration in bone and joint health is bone density. Bone density refers to the amount of bone mineral in bone tissue and plays a significant factor in bone strength and durability (and hence resistance to injury).

Many factors influence bone density- and many of these factors can be positively or negatively influenced by feeding, management practices and medication use. Put simply, owners and caretakers of horses have the ability to positively or negatively influence the bone density and hence resilience and strength of a horse’s bones….

Sufficient minerals and vitamins in a horse’s diet, in appropriate proportions are important. These include (but are not limited to): calcium, phosphorus, zinc, vitamin D, copper, magnesium, manganese, vitamin K. Appropriate energy availability is also crucial in helping ensure adequate bone development.

Many medications have the ability to negatively influence bone density through various mechanisms: increasing the excretion of key minerals needed for bone structure; altering the gastrointestinal microflora balance (in turn impairing the body’s ability to synthesise some key vitamins needed for bone health); and altering the absorption of essential minerals for bone health.

Keeping horses in stables/box stalls is an often overlooked consideration in regards to bone health. Several studies have documented a substantial decrease in bone mineral content in horses kept in stables/ box stalls.

Think about foals, weanlings and yearlings, confined to stables in order to ‘keep them out of the elements’ or for sales preparations. These horses are going through crucial stages of bone development and laying down bone mass. The practice of keeping them stabled may hamper their ability to be strong, resilient performance horses.

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 case of race and performance horses, levothyroxine is commonly supplemented to help strip weight off horses and/or to help horses ‘perk up’. Yet research indicates that in fit horses- supplementing with thyroxine actually resulted in the horses fatiguing quicker. Its use was also associated with an increased risk of cardiac arrhythmia- hardly performance enhancing! In cases of respiratory infection, the use of levothyroxine may actually prolong the infection.

Supplementation of synthetic hormones in horses is not something which should be taken lightly. True hypothyroidism in horses is a rare condition- and when it does occur, reasons as to WHY it has occurred should be addressed first, or in conjunction with appropriate treatment. Thorough assessment of thyroid function MUST extend beyond just testing thyroid stimulating hormone (TSH). Testing T4 levels alone (or in conjunction with TSH) is also insufficient to provide reliable information to determine the true state of thyroid function. T3 also needs to be included. As does a thorough physical assessment and case history, analysis of the horse’s diet/nutritional intake, current medication and/or supplement use.

It also needs to be remembered that abnormal thyroid hormone concentrations can occur after a high grain diet meal, after extensive travel, training stress, or if a horse is ill.

In cases of sub-clinical hypothyroidism, specific nutritional insufficiencies/deficiencies are commonly implicated. Similarly overtraining without sufficient rest/recovery/adaptation periods can lead to impaired thyroid function. No amount of levothyroxine supplementation can rectify these performance and health limiting factors- thus without addressing the causes, the problems 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.