Horse eating out of a feeder with a NibbleNet
The other option, controversial though it may be, is to provide free and unlimited access to forage. Preferably more than the horse can consume. It may sound counterproductive but it’s important to consider that laminitis is a complicated physiological and anatomical condition that, in many ways, has been oversimplified. The problem has more to do with than just sugar intake.
It is absolutely true that a diet low in sugar and starch is essential, but the horse should still be permitted to behave instinctively and eat with regularity. In fact, reducing availability to food is laying the foundation for laminitis.
Horses have evolved to eat continuously throughout the day, in small quantities, moving as they chew. Today, we keep them confined to small areas and in many cases restrict their food consumption to 2 to 3 large meals a day, while feeding nothing in between. Then, the more weight they gain, the more we restrict their intake.
Research has shown undoubtedly that the primary cause of laminitis is raised insulin levels, and we know that insulin levels increase in response to the consumption of simple sugars. However, insulin levels are also increased by other factors—namely stress. Stress can occur as a result of travel, intense exercise, mental or physical discomfort, pain, and last but not least, an empty stomach. When an animal (or a human) experiences stress, the body responds by releasing cortisol and adrenaline. When the body has a stress response by increasing those hormones, glucose that was stored in the liver and muscle is released into the bloodstream in order to provide energy. More sugar in the blood results in greater secretion of insulin. So, the equation we’re working with is Stress = insulin = increased risk of laminitis.
The fact that they’re continual grazers makes an empty stomach a stress response situation for horses. A lack of activity in the gastrointestinal tract and ongoing production of digestive acid results in rising stress levels. The more a horse is starved, the more the body releases stress hormones and the more insulin continues to be secreted as a result.
Insulin resistance is a survival mechanism employed by the body to avoid starvation–an excellent evolutionary function. When insulin levels in the body are high, the cells of the body cannot release fat to be used up and burnt away. By restricting access to food, we are actually manufacturing a survival response in the horse. The outcome is more stress, reduced muscle, and an increasingly sluggish metabolism. It very quickly becomes a vicious cycle that seems nearly impossible to break. The good news is that it can be broken and with relative ease.
The research and experiences of equine nutritionist Juliet Getty (PhD) has demonstrated the complex workings of laminitis and other equine health conditions related to insulin levels, such as Equine Metabolic Syndrome and Cushings. Her teachings and philosophy are leading the way for this approach.
There is a wonderfully simple way to manage an equine with laminitis (or any other metabolic condition) and return their metabolism to a healthy state, ensuring that they can experience a lifetime of normal nutrition and eating routines. The answer is a free-choice forage approach.
Because they are foragers, horses need to be grazing almost continuously every day. When they stop eating for even a short period of time (15 minutes or so), the stress response is triggered. The equine gut produces acid constantly with the expectation that fiber will be continuously entering the stomach and require acid to begin the digestive process. When there is nothing to absorb the acid, the excess begins to cause pain to the unlined segment of the stomach, and the hind gut struggles to remain active and empty normally.
By providing ad-lib forage a horse can eat using the instinctive intake it has evolved to engage in, and, in the process recognize and restore the feeling of being satisfied. Many owners find this type of feeding a challenge because it is so difficult to watch a laminitic, overweight horse or pony wolfing down hay. The adjustment can take anywhere between one week to two months depending on how extensive the damage in the metabolism. Initially, the horse may gain some weight, as its instinct is to eat as it has been— to get enough as quickly as possible because it could be hours or even a day before it next gets the chance to eat.
As they come to realize that every time they feel the desire to chew, roughage is available for them, and that they can keep food flowing through the digestive tract continuously, they will consume less and the weight-loss process will begin. The horse will self-regulate its intake and the metabolism will adjust to a healthy state that allows the animal to burn fat and reduce the amount of insulin being secreted.
As unpleasant as it is to acknowledge, laminitis is a product of horse management practices and can be easily avoided and rectified by returning to a free choice forage diet.
In addition, there are a number of other key elements that will help to manage and/or eliminate laminitis:
1. Exercise - Exercise plays a crucial role in managing weight loss. Any amount of exercise is good and the more the better. Finding a way to get and keep your horse moving is essential to ensuring that repeated episodes of laminitis are avoided.
2. Keep dietary sugar and starch low - The best way to know the sugar and starch levels of your roughage is to have it tested. The simple sugars and starch should come to less than 12 percent when added together. The digestible energy (DE) of the roughage shouldn’t exceed 879 kcal/lb.
3. Monitor body condition score – In the early days of managing laminitis, check the body condition score * of the horse every 7–10 days. Once the severity of the situation lessens and the animal’s health normalizes, perform a monthly body condition score check.
Once the acute situation of obesity, insulin resistance, and laminitis has passed, it may be worth providing access to a vitamin and mineral supplements to ensure that the horse is getting its daily needs. It is crucial that feed doesn’t contain added sugars. A salt and mineral lick should be sufficient in the early days of the free-choice forage approach.
The most important thing to remember is that starvation is not the answer, and that when feeding your laminitic horse, simplicity is key.
Alexandra Frazer, Founder and CEO of EquiNutritive
Alexandra is an Equine Scientist and nutritionist. After spending several years in private consultation she developed her own brand of natural, herb-based equine supplements with a focus on supporting metabolic and gut health. She is especially fond of off the track thoroughbreds and their retraining for dressage.