EGUS Series Part 3: Management of the horse with Equine Gastric Ulcer Syndrome (EGUS)

So, we now know how to recognize horses afflicted with EGUS and also the proven therapeutic methods used to treat such horses.  This begs the question, how do we manage these ulcer patients?   Numerous studies have shown that intense training and competition schedules, frequent shipping, high concentrate (starch) diets, decreased availability of pasture and insufficient ingestion of hay are all common contributing factors to the development of EGUS.  Our goals as veterinary professionals are multifaceted and include neutralization of acid, promotion of mucosal repair, and the improvement of management processes. 

Photo Courtesy Public Domain Photos via Flickr

Knowing that the equine stomach produces 1.5L of acidic stomach juices on an hourly basis, we can already begin to recognize the benefits of having a constant input of hay into the horse’s GI tract. Additionally, if your horse can handle some alfalfa in his diet, there are several benefits to ingesting this leafy legume.  When compared to timothy, brome and orchard grass, alfalfa is higher in calcium and protein, both of which act as literal chemical buffers to stomach acid.  Additionally, if we consider that alfalfa often has a coarser texture, this means the horse is required to take more chews before swallowing the feed.  As the horse masticates, he produces saliva.  This gooey substance is high in bicarbonate, a chemically basic molecule which also aids in the neutralization of stomach acid.  If your horse is an easy keeper or has some metabolic/nutritional restrictions, high quality straw can also be incorporated into the horse’s forage regime to provide valuable roughage without adding starch or calories.  

Why do we avoid diets high in starch?  As starch is broken down in the stomach, it is fermented by the resident bacteria into volatile fatty acids and lactic acids, all of which contribute to the already acidic environment of the stomach.  If your horse is in an intensive training program and consuming large amounts of grain, breaking the total volume of grain into multiple small feedings throughout the day will help to reduce the amount of acid produced at the time of ingestion.  Additionally, fats can be substituted for starches in the form of rice bran, bean meal, and oils as a means to provide calories without the detrimental by-products of starch fermentation. 

In addition to the continuous ingestion of fiber products, care should also be taken to reduce the stresses of competition and travel.  For those equine athletes where the stresses of competition are unavoidable, the use of PPIs or H2 blockers to prevent the development of gastric ulcers is highly recommended.  Finally, while there is no direct link today between the use of probiotics and the prevention of gastric ulcers, such products may be helpful in maintaining hindgut health in stressed equines. 

Other ulcer-inducing risk factors in an equine life may include aggressive pasture/stall mates, lack of turnout, consistent loud noises, persistent radios, systemic illness, chronic pain, long term use of NSAIDs (bute, banamine, etc), intensive breeding programs and routine training on an empty stomach. 

In conclusion, EGUS is a clinical condition requiring both medical and long term nutritional management.  The continuous ingestion of fiber products is by far one of the most important aspects to managing a horse with clinical signs of ulcers, and in achieving long term optimal GI health.

EGUS Series Part 2: Common (Proven) Treatment Methods of horses with Equine Gastric Ulcer Syndrome (EGUS)

Let’s say you’ve just indulged in a rich gourmet meal complete with red wine and a decadent chocolate dessert.  An hour or so later, you’re regretting that decision as some pesky heartburn keeps you awake.  Eventually you swallow some Tums©, Tagamet©, Zantac© or even Nexium© and breathe a sigh of relief as those clinical signs abate and you drift off to sleep.  Believe it or not, many of the medications we use to treat our own heartburn work on horses as well.  The goal of EGUS therapy is not to treat the ulcer itself, but to decrease the acidity of the horse’s stomach to allow its natural healing mechanisms the opportunity to repair the damaged mucosal lining.

The gold standard in the treatment of EGUS is omeprazole, sold under the trade name Gastroguard©.  This product stops the production of gastric acid at the immediate source, and is known in the chemical world as a proton pump inhibitor (PPIs).  By stopping the production of gastric acid, the mucosal lining of the stomach is allowed to heal, which can take anywhere from a couple days to multiple weeks, depending upon the size, severity and location of the ulcer within the stomach.  UlcerGuard© is another omeprazole product, given at a quarter of the dose of Gastroguard©, and utilized in the prevention of gastric ulcers.  Both of these products are given once a day, and elicit the best response when given in the morning on an empty stomach.  They are most effective in the first eight hours after administration.  It must be noted that long term use of PPIs has been shown to impair the digestion of protein, an integral component to a horse’s nutritional demands.  PPIs are safe for use up to 90 days (so your 4 weeks of omeprazole therapy is perfectly safe) but relying on them for longer periods of time is not recommended. 

Ranitidine (Zantac©) and cimetidine (Tagamet©) have also been used routinely in the prevention and treatment of gastric ulcers.  Both drugs are considered H2 receptor antagonists, or H2 blockers.  Where omeprazole prevents the production of gastric acid directly at the source, H2 blockers are one step removed from that process and prevent the H2 signaling molecule (histamine) from binding to the receptor which activates the production of gastric acid.  Sounds complicated, right?  My goal in providing readers with such information is not to overwhelm you, but instead, to illustrate why veterinarians consistently turn to omeprazole when faced with EGUS; it halts the production of acid at the source and has a longer duration of efficacy compared to H2 blockers.  Sometimes, though, weeks of omeprazole therapy are not a viable, financial option for clients, so we may turn to the H2 blockers to help try to achieve similar results in the reduction of clinical signs of EGUS.  For the best efficacy, H2-blockers must be given three times a day, making them slightly more challenging from a management perspective.

Sucralfate is another product occasionally used as a protective agent in horses with ulcers located in the glandular region of the stomach.  When exposed to such acidic environments, this fluid is converted into a sticky substance which coats the lining of the stomach and binds to preexisting ulcerations to form a protective barrier.  This product must be given on an empty stomach (which we try to avoid in horses with EGUS) and may prevent the uptake of other drugs administered simultaneously.  While effective, the size of the dosage and the duration of therapeutic programs often makes this product cost prohibitive. 

A phenomenon which must be mentioned in this discussion is that of rebound acid hypersecretion.  Long term use of PPIs followed by abrupt discontinuation of therapy has been shown to cause a consistent increase in gastric acid production, often worse than the initial stomach condition.  When using PPIs, it is important to wean the horse off of medication using progressively lower doses over the course of 10 days.  There are several studies demonstrating the beneficial effects of using sea buckthorn in the prevention of rebound acid hypersecretion. 

Stay tuned for Part 3 of Dr. Hartman’s blog regarding the management of horses with EGUS!

Equine Preventative Medicine Checklist

Along with spring comes vaccinations and preventative care appointments for our equine friends. We all understand the importance of preventative medicine, but it’s easy to miss things, so we’ve prepared a list of what you should be doing with your horse to make sure they’re healthy and prepared for summer riding season.

Vaccinations

We will start with the easiest – vaccinations. Vaccine protocol for the spring varies depending on your geography and your individual horse’s exposure potential and travel schedule. Always consult with your veterinarian if you are going to travel somewhere new with your horse. Here on the Front Range, we typically recommend a 5 way (eastern and western equine encephalitis, tetanus, rhinopneumonitis, and influenza) and a West Nile booster as the basic starting place for spring vaccinations. For a more in depth discussion of the vaccinations we recommended in Colorado and why, see the blog titled Why are the Vaccines we give in Spring So Important Here in Colorado?

Deworming

Deworming used to be easy – give your horse a deworming paste at set intervals and you’re done. But research has shown that deworming is certainly not as straightforward as we once thought it was. There are several options and differing approaches to deworming, and whether you opt to use a classical “rotational” deworming, or a more targeted “Fecal Egg count” approach, spring is a time to think about how to protect your horse from internal parasites. There are pros and cons to different deworming approaches, and we have complete articles on both of these regimes listed below.

Rotational Deworming – What’s the Right Choice?

The Scoop on Fecal Egg Counts

Dentistry

teeth

Although there is nothing tying teeth floating to vaccination, deworming or seasonality, most people (veterinarians included) like the convenience of combining all of the preventative medicine into a single visit. Spring is a critical time to have your horses’ teeth checked comprehensively. Tooth and other mouth issues can have a dramatic impact on your horses’ comfort, performance, and even lameness issues. Dental issues and questions like “Does my horse need a float?” are immense subjects and are covered in detail in previous issues of the blog.

Why is Regular Dentistry so Critical to your Horses’ Health?

How Do I know My Horse Needs a Float?

Why Do I Need to Float my Horses’ Teeth?

Physical Examination

A good general physical exam is a good idea for all horses this time of year so that we (both owner and veterinarian) are assured that there is no need for an alteration to the diet or that some insidious disease process is slowly creeping in unnoticed. It’s also very helpful to have a baseline of your horses’ health so when changes happen they can be noticed, and dealt with, quickly. Summer is riding and show season, and a physical examination will ensure your horse is at the top of their game, making your time together enjoyable for you both. An important aspect of the physical exam that often gets ignored is a very brief (just a few minutes) lameness exam. Whether you have noticed that your horse is tripping a bit more, or he just hasn’t been evaluated, a check of his legs could be invaluable in finding a mild issue before it is a major one. If this is something you are interested in, be sure to let the office know when you schedule your appointment that you would like the veterinarian to spend a bit of time with a lameness evaluation, so that a scheduling issue doesn’t arise.

Spring Preventative Medicine Checklist

Below is a quick reference for when your vet arrives for spring tune ups for the horses. I have had clients use this little outline as a basis for questions they have for the vet when he or she arrives. We all fall victim to “I forgot to ask while you were here” questions! Happy trails and enjoy the beautiful Colorado spring!!

Quick Checklist for Spring:

  • vaccines – 5-way and West Nile Booster
  • deworming or FEC – which is better for your horse?
  • Dental – Does your horse need a teeth float?
  • General Physical including weight evaluation, diet discussion, old age changes (ie cushings), and lameness evaluation

Feeding the Senior Horse

When feeding your senior horse, there are several important factors to keep in mind that can change their dietary requirements.

Dental Condition

Number one is the status of your horse’s teeth. You may have heard the term “expired” teeth when your veterinarian is examining your horse’s mouth. This term refers to the fact that horses’ teeth become worn down over time with all the grinding of their feed and can even wear all the way down to the gum line. These expired teeth can no longer effectively grind forage into the small pieces necessary for a horse to gain nutritional value.

The lack of effective grinding can also predispose horses to choke and impaction colic from swallowing long pieces of hay. As a result, we often recommend starting our senior horses on more processed diets, such as hay pellets, hay cubes, or complete senior feeds. These forage alternatives are already processed into smaller particles, making it much easier for the horses to digest. It is recommended to soak these types of feed in water to reduce the risk of choke. When soaking feed, it is recommended to use a ratio of 2:1 (water to feed), especially if the feed contains beet pulp, and allow it to sit for 30 minutes or even longer if the water is cold. The mash should ideally end up with an oatmeal-like consistency.   

GI Changes

In addition to the teeth, there are some age-related changes to the rest of the GI tract that can affect feeding protocols. There is an overall reduction in the absorption of nutrients in a senior horse due to changes in the microbiome and scarring of the intestines. Supplementing with a probiotic, such as Platinum Performance GI or Arenus Assure Guard Gold, can help regulate the microbiome and improve nutrient absorption.

Senior horses are also less efficient at digesting crude protein, meaning that their dietary protein requirement is higher – it is often recommended to feed 12-14% crude protein to older horses, as opposed to the 10-12% recommended for younger horses. Geriatric horses often tend to require more highly digestible fiber sources, such as beet pulp, to keep them healthy. It is important to keep the crude fiber content of their diet over 10% to meet their physiologic needs.

Regardless of age, horses require approximately 1.5 – 2% of their body weight in dry matter per day – whether that’s mainly hay or almost completely comprised of processed feeds, we need to make sure they are receiving the appropriate amount for their weight. Weighing your scoops of grain is very helpful in determining if your horse is getting enough food. For example, a 1000 pound horse being maintained entirely on Purina Equine Senior requires anywhere from 15 to 17 pounds of feed per day depending on their activity level per the label recommendations.

Metabolic Status

A third piece of the puzzle is the horse’s overall metabolic status. Older horses are much more likely to have PPID, or Cushing’s disease, which can make it difficult for them to maintain good body condition, even in the face of good nutrition. These horses need to go on the appropriate medication, Prascend, to allow them to thrive and keep weight on.

On the flip side, horses with EMS (Equine Metabolic Syndrome or Insulin Resistance) often struggle to get weight off. It is important for these horses to be kept on a diet low in non-structural carbohydrates to prevent large fluctuations in glucose levels and elevated insulin levels that can predispose them to laminitis.

Determining if your horse has a metabolic disorder involves running blood work that checks the levels of various enzymes and hormones within the system. ACTH (adrenocorticotropic hormone) is the hormone we look at in Cushing’s disease. In some cases, a horse may have a normal baseline ACTH level but still have Cushing’s disease. If there are clinical signs consistent with Cushing’s disease (muscle atrophy, weight loss, delayed shedding, etc.) your veterinarian may recommend a second test called a TRH stim test to more definitively determine if your horse has Cushing’s disease. Equine Metabolic Syndrome is characterized by insulin resistance, leading to elevated insulin levels, and often elevated glucose levels as well, which are reflected in the bloodwork.

For more information on these metabolic syndromes as well as other conditions that can affect senior horses, please visit our other blog articles:

Each horse ages differently, so it is important to have regular check-ups with your veterinarian to make sure you are meeting all their nutritional needs. Contact us at any time to schedule a check-up and nutrition consult!

Obesity in Donkeys – Why is it a big deal?

Possibly the most significant threat to the health and longevity of donkeys in the US is obesity. We love our long-eared friends and sometimes we dote on them too much with delicious, high-quality treats that donkeys are not equipped to metabolize.

My donkey’s fat? But he barely eats anything!

Donkeys are adapted to live in semi-arid environments, like the deserts of Nevada and Arizona. Because of this, their metabolism is significantly different than that of horses – think of them as the world’s easiest keepers. Donkeys are incredibly efficient at digesting tough fibrous plants and have a much lower energy requirement than horses. To put it in perspective, ponies and horses need 2-2.5% of their body weight in dry matter daily, whereas donkeys only need 1.3-1.8%.

The high fiber, low energy diet that donkeys have evolved to eat can be mimicked by feeding mainly straw (wheat, oat, or barley) along with a forage balancer to avoid micronutrient deficiencies. As an aside, you want to stay away from rice straw – for some reason it is the one type of forage that donkeys seem to have absolutely no interest in eating. If the only option is hay, it is recommended to soak the hay for at least an hour before feeding to your donkeys to remove most of the simple sugars.

So my donkey’s fat – what’s the big deal?

Adipose tissue – or fat – is not just a cosmetic issue. It is a very active tissue that produces inflammatory molecules that circulate throughout the bloodstream and can propagate multiple disease states, including metabolic syndrome and laminitis. Another life-threatening sequela of obesity is the increased risk of developing fatty liver. Fatty liver occurs when an obese animal goes through a period of anorexia – this could be a simple as a bout of gas colic that results in your donkey not eating his whole breakfast. When the body doesn’t get its normal amount of energy through food, it rapidly mobilizes and breaks down adipose tissue to use for energy instead. The resulting fat molecules (triglycerides) get filtered through the liver and overwhelm it, resulting in a liver that is clogged with fat. This can lead to liver failure, as well as damage to and failure of other organ systems. Donkeys are especially predisposed to this process, which is a major reason why we always recommend a call to your veterinarian for any donkey that goes off food, even if they don’t seem to be in overt distress.

Okay I’m convinced, my donkey’s fat – now what?

As discussed above, sudden reductions in feed intake can lead to life-threatening disease, so having a conversation with your veterinarian about safely putting your donkey on a diet is paramount. It may even be necessary to test the levels of triglycerides in the blood as a monitoring tool while your donkey loses weight. As with all our equine friends, a slow systematic approach to dietary change is the best way to reduce risk.

Hang on now Doc, is my horse really that chunky?

Sometimes when we as horseman see our horses on a routine basis, it can be easy to overlook that thickened, cresty neck or the fat pads that have developed on either side of their tail head.  We recognize that it has been quite a while since we’ve been able to palpate any evidence of their ribs, but what other physical indicators do we use as veterinarians to assess the body condition of our patients?  With the significant increase in metabolic laminitis cases seen on a national level, now more than ever, it is important to ensure our horses remain a healthy weight. 

As a veterinarian, the first indication that I may be dealing with a horse in metabolic crisis is not their enlarged abdominal girth but instead is the thickened, hardened appearance to their crest.  The crest is the region directly under the horse’s mane along the topside of their neck.  A normal crest palpates soft, fluctuant, and homogenous to the surrounding tissue and muscle.  The crest on a horse in metabolic crisis becomes hardened, like the density of cauliflower.  The crest can also become wider and more visually pronounced in severe cases.  As the metabolic disease process progresses, horses can develop regional adiposity, also known as the accumulation of fat pads throughout their body.  These pads of adipose tissue most commonly develop behind the shoulder blades on either side of the withers and on either side of the tail head.  In severe cases, adipose pads can develop along either side of the thoracolumbar spine and in the girth region.    A horse of a healthy weight has no evidence of regional adiposity, with rib coverage that allows for palpation of each individual rib but not the visual distinction of each rib. 

Body condition scoring in horses is commonly done using the Henneke System.  This scoring system was developed in 1983 and has been accepted throughout the international equine industry as a standardized means to assess adiposity in horses.  The scores range from 1 to 9 with a score of 1 being associated with extreme emaciation and a score of 9 correlating to extreme obesity.  Below is an outline of the individual scores:

Poor: Grade 1 – Extreme emaciation; no presence of fatty tissue, all bony prominences including withers, shoulder blade, dorsal spinous processes, ribs, pelvis and sacrum are all clearly visible.

Very Thin: Grade 2 – Emaciated; slight tissue cover over bony prominences but withers, shoulder blade, dorsal spinous processes, ribs, pelvis and sacrum are all clearly visible.

Thin: Grade 3 – Slight accumulation of adipose tissue; bony prominences are no longer clearly discernible; some fill over withers, shoulders and throughout the neck, ribs still visible.

Moderately Thin: Grade 4 – Ridge of spine and withers are still visibly pronounced, ribs still visible, some accumulation of adipose tissue over the shoulders and through the neck and tail head region. 

Moderate: Grade 5 – Spine and ribs cannot be visibly differentiated although ribs can be palpated, tail head is soft and squishy; withers, shoulders and neck are smooth and rounded.

Moderately Fleshy: Grade 6 – slight crease down the spine, tail head is still soft and squishy, regions of adipose accumulation are present on either side of the withers and through the crest, most ribs can still be palpated but not all of them.

Fleshy: Grade 7 – a crease is present along the spine, the ribs have fat filling between them, tail head is still soft, regions of adipose accumulation are pronounced through the crest and on either side of the withers. 

Fat: Grade 8 – a definite crease is present along the spine (aka. “drainage ditch”), it is difficult to feel any ribs, soft adipose tissue surrounds the tail head, the neck/crest is quite enlarged and there is adipose accumulation on the inner aspects of the hind limbs as well as behind the shoulder blades.

Extremely Fat: Grade 9 – the “drainage ditch” collects water when it rains, there is bulging adipose accumulation on top of the ribs, behind the shoulders, through the crest and on either side of the tail head.  Accumulated abdominal fat is also present on the underside of the flank. 

To confirm your horse is in optimal health, it is important to be able to accurately grade your horse’s body condition.  An ideal range is between 4-6, depending on the breed and usage of your horse.  If your horse falls outside of this range, it is important to discuss the nutritional components of your horse’s diet with your veterinarian to decrease the risks associated with equine obesity and ensure your horse isn’t deficient in necessary nutrients. 

How to Select a Concentrate for Your Horse

With the variety of different feed and supplement choices available, it can be overwhelming to make decisions regarding your horse’s diet. It is important to remember that horses are grazing animals, designed to spend much of their day eating forage. Forage (grass and/or hay) should comprise most of your horse’s diet, at a rate of about 2% of his body weight per day. Of course, the nutrient profile of different forage sources can vary as well, so a hay analysis can provide more detailed information about nutrient content. 

When selecting a feed, be sure to look for the feed tag or guaranteed analysis. This tag describes the composition of the feed, including protein, fat, fiber, and mineral content. You will also find guidelines for recommended amounts to feed your horse, depending on his weight, workload, and stage of life.

What kind of concentrate does my horse need?

If your horse is not in heavy work and maintains an appropriate body condition score easily, he does not need high levels of concentrate added to a forage diet. A product called a ration balancer is perfect for these horses. Ration balancers are designed for the easy keeper to be relatively low in calories but contain the vitamins and minerals that may be lacking in a forage-only diet. For these horses, daily forage intake at 2% of body weight per day, a ration balancer fed by weight as directed, and access to a mineral block may be all that is needed.

For horses in heavy training, those with a higher metabolism, or those with compromised teeth, more calorie-dense concentrates may be beneficial. For example, a Thoroughbred racehorse will need extra calories from a concentrate to take in enough calories each day for race training, while an aged horse unable to chew adequately will need a forage substitute.

Examples of horses with varying dietary needs



Red, a 16-year-old quarter horse gelding. 

Job: light trail riding 1-2 days per week, easy keeper. Because Red has a less demanding job and maintains his weight well on hay alone, he doesn’t need extra calories from high-energy feeds. A ration balancer is a perfect option to ensure Red has the appropriate vitamin and mineral balance in his diet, without supplying extra calories. 





GiGi, an 11-year-old TB mare

Job: upper-level eventer.  GiGi is a high-level athlete, and as a Thoroughbred, she has a higher metabolism. She is in intense training 4-6 days per week, eats free choice hay, and needs the extra calories from a performance feed to maintain her condition. Many performance feeds offer high-fat content in addition to protein and fiber, as a more calorie-dense option.





Jack, a 25-year-old appendix gelding

Job: retired, hard keeper with many missing teeth. Lack of teeth means that Jack has a hard time chewing hay efficiently, which also puts him at an increased risk of choking. The best feed for Jack is a complete senior feed. The “complete” description means that this feed is formulated to meet all of his nutritional and caloric needs in the absence of hay. Of course, this means that a much higher amount of feed must be fed daily. Regular (non-complete) feeds are generally not safe or nutritionally balanced to feed in such high amounts. If you’re feeding a horse like Jack, remember to check the label of the senior feed to be sure it says ‘complete’.



 Remember, ALWAYS weigh your feed- the label instructions on the bag will have recommendations based on weight (The weight is NOT 1 coffee can…) It is much easier to adjust your horse’s diet when we know exactly how much he is consuming. The easiest way to do this is to put your feed scoop on a food scale, tare it, add feed to desired weight, then draw a line on your scoop so you can feed consistently at every time. Another important note is that feeds are not all the same weight, so if you switch feeds, 2lbs of feed A is probably not the same amount in your scoop as 2 lbs of feed B. As always, if you have questions or would like help selecting a concentrate, consult with your veterinarian.

Deciphering GI supplements

Prior to picking out a GI supplement for your horse, I would highly recommend you refer to an earlier blog I wrote discussing how to go about picking a general nutritional supplement. The post contains some decent tips and tricks to better prepare you to find the best GI supplement for your horse.

Once you have a general idea of how to pick a bioavailable supplement, let’s dive into why you would want to supply a GI support supplement.

Does your horse need a GI supplement?

Some of the most common reasons I recommend a GI supplement include:
• Chronic, mild episodes of gas colic
• Chronic gastric ulcers
• Chronic diarrhea
• Sand accumulation in the hind gut
• Recovering from acute colic surgery
• Intoxication (plants, feed, GI disease, etc.)
• Long term use of Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

What ingredients should the supplement include?

If we’re looking to repopulate the equine GI tract with healthy bacteria, stick with a product containing Sacchromyces boullardi organisms. These bugs seem to be able to survive the incredibly acidic environment of the equine stomach so that they can make it to the hind gut to elicit a beneficial response. In addition, certain strains of microorganisms, like Lactobacillus, can also competitively disable pathologic bacteria within the GI tract to keep them from initiating a disease process.

As for the foregut, horses suffering from chronic gastric ulcers can usually benefit from long term supplementation of a product geared towards neutralizing the acid naturally produced in the stomach. This can include any kind of a chemical base but the key to delivering an efficacious response with these products is the consistency in which the supplement is delivered. Horses empty their stomachs every 10-15 minutes so direct buffering of the stomach contents must be an ongoing process. For best effect, these supplements are provided several times a day. There are also several plant-based products, like aloe vera, that some owners have anecdotally found to be effective.

What do the studies say?

In over the counter research studies pertaining to veterinary probiotics, label claims regarding the species and number of viable organisms in the product, appear to be quite inaccurate. As such, it is often more effective to focus on providing valuable prebiotics for the microorganisms currently residing in your horse’s GI tract. Many of the prebiotics on the market contain various type of high-value fiber products for the microbes to ferment. Since the forage and fiber in these products isn’t damaged by the acidic nature of the stomach contents, this is often a better approach to caring for the hind gut microbes.

Overall, there is a vast array of supplements on the market and most of them are not worth the investment. If you have concerns about the health of your horse’s GI tract, please reach out to your veterinarian and we will be more than happy to recommend products we have found to be most beneficial in each situation.

Caring for Your Senior Horse

At what age is a horse considered geriatric or senior? Does owning a senior horse mean that he must eat a feed labeled as a “senior” feed? As always, the answer is, it depends. Our horses are living longer lives than ever, thanks to an evolving understanding of the needs of geriatric horses and our ability to provide high quality care. There is no set age cutoff as to when a horse is considered geriatric, but most experts agree this can be around age 20. However, age is just a number, and many horses are still active and competing into their twenties, while others are happily retired. The main issues we see in our older horse population include dental disease, altered dietary needs, metabolic disease/PPID (Cushings), and arthritis.

 

Photo Courtesy PugnoM on Flickr

Dental Changes

The ideal time to begin focusing on your horse’s regular preventative veterinary care is when he is young. Horses receiving regular preventative care, especially veterinary dentistry, preserve their teeth longer and can age more gracefully. Waiting until signs of dental disease or difficulty chewing are observed often indicates advanced disease and more limited treatment options. Most horses benefit from yearly dentistry, which includes a thorough sedated oral exam with a dental speculum, light source, and mirror. A thorough oral exam is vital to accurately assess, document, and treat any issues.

Horses suffering from abnormal dental wear, cracked or missing teeth, or severe periodontal disease may require more frequent care. Even though horse teeth are described as “long rooted,” they do eventually wear out, so proper care ensures the longest possible life of the tooth. Common dental issues in older horses include fracture of cheek teeth, complete expiration or wearing out of cheek teeth, loose/painful teeth, and periodontal disease. The incisors can also be affected by similar conditions.

Staying on top of your senior horse’s dental care helps ensure that he gets what is needed from his diet. Sometimes severe dental disease and impaired chewing ability necessitates eliminating hay from the diet entirely. Complete feeds are formulated specifically for horses that can no longer chew hay effectively. These diets have greatly improved the quality and length of life for senior horses with compromised teeth.

Nutritional Changes

Nutrition recommendations for the geriatric horse are formulated around maintaining an ideal body condition. In the geriatric horse, this can be complicated by difficulty chewing, poor teeth, metabolic disease, and decreased ability to digest fiber and protein. For older horses in good weight and with adequate dentition, little dietary change may be required. For older horses who have difficulty maintaining weight and/or compromised teeth, complete feeds as mentioned above can help. These feeds are high in easily digestible fat, fiber, and protein, and are designed as easy-to-chew. They are formulated to replace hay entirely for those horses that can no longer adequately chew hay.
Adding water to soften the feed can reduce the risk of choke and ensure additional water intake. Feeding recommendations are often listed as pounds of feed per day depending on whether the horse is also eating hay, so it is important to weigh out your horse’s portion so that any necessary adjustments can be made more accurately.

Metabolic Changes

A curly haircoat and muscle loss over the back aren’t just signs of aging- They can indicate a common underlying condition: equine pars pituitary intermedia dysfunction, more commonly known as PPID or Cushings disease. This is a treatable (but not cureable) condition that is very common in geriatric horses, resulting in hormonal imbalances and symptoms such as delayed shedding, curly hair coat, muscle loss over topline, increased drinking and urinating, personality changes, and increased susceptibility to infections and laminitis. Diagnosis is made by a blood test as well as by history and clinical signs. Management involves daily administration of pergolide (Prascend) tablets, which help restore normal hormone levels and alleviate the clinical signs of the disease.

Equine Metabolic Syndrome (EMS) is a separate metabolic condition, but it sometimes occurs in conjunction with PPID. EMS horses typically show signs of being an “easy keeper”- cresty neck, regional fat deposits behind the shoulders and at the tail head. Horses with EMS are more susceptible to laminitis and usually have a higher baseline insulin level than normal. EMS horses are managed with strict attention to diet (minimizing sugar and starch) and exercise to help them maintain a lean body weight.

Joint and Muscle Changes

Just like us, aging horses suffer from daily aches and pains. An examination with your vet can help identify major and minor issues and

Photo Courtesy nikki_tate on Flickr

determine what treatment plan works best for you and your horse. Many options are available to keep our old horses comfortable.
Nutraceuticals (supplements) are very popular, although many of these products lack proof of efficacy and ingredients. More researched options include medications such as adequan (administered intramuscularly) and Legend (administered intravenously). These medications help provide the components necessary to keep joints healthy.

Joint injections target individual joints to reduce pain and inflammation and improve mobility. Non-steroidal anti-inflammatories such as Equioxx are also helpful, along with acupuncture and chiropractic care. Stable management is equally important- maximum turn out time allows horses to move at will, and monitoring herd dynamics ensures that older horses are not prevented from accessing food and water. In addition to these considerations, regular veterinary and farrier care will help your senior horse enjoy his golden years with you.

As always, if you have any questions about caring for your senior horse, please contact your veterinarian who can offer a personalized plan to help keep your geriatric horse happy, healthy, and comfortable well into their senior years.