|
This article will cover
some of the basic treatments used by Harmany Equine Clinic, Ltd.
Introduction
Natural medicine provides another toolbox of treatments to help treat
chronic cases of laminitis. Several of the major factors in helping a
laminitis horse are to support their feet properly, correct the intestinal
health, provide nutritional medicine to prevent and reverse damage to the
lamina, and to return the horse's metabolism to proper balance. When managed
correctly, with patience and attention to detail, most chronic cases can
return to reasonable work. The poorly responsive cases can often be managed
and kept relatively comfortable without the use of drugs.
It is
important to remember when treating laminitis with natural medicine to
approach each case individually. It can be detrimental to any case to use
multiple supplements or treatment modalities without carefully evaluating
the case. Because a product is natural does not rule out harmful effects or
the negative effects of using too many products and overloading the body.
Difficult cases may require many products however, they should not selected
carefully.
Clinical signs
The
clinical signs most commonly associated with chronic laminitis is long hair
that does not shed out in the summer, weight problems (over- or underweight)
and other signs that many people and vets call Cushing’s disease. In my
opinion, these horses have altered glucose metabolism, similar to that of
human diabetics and not Cushing’s disease. Some of the symptoms that may be
seen in the chronic laminitis horse include those listed below. If your
horse shows any of these signs along with the laminitis, he is a good
candidate for the natural treatments in this article.
-
Long Hair
-
Not Shed Out Well
-
Difficult-To-Treat Laminitis
-
Winter Laminitis
-
Laminitis With No Outward Reason For Its
Occurrence
-
Weight Problems (Over- Or Underweight).
-
Sluggish Thyroid Glands
-
Insulin Resistance (See Below)
-
Muscle Soreness
-
Diabetes
-
Drinking Urinating Frequently
-
Collagen Breakdown, Or “Old Horse Sag”,
Especially When It Occurs Before Age 18-20 Years
-
Poor Hair Coat Despite Good Worming And
Teeth Care
-
Frequent Infections Of The Skin Or Other
Organs
-
Colic
-
Poor Teeth
-
Multiple Dental Abnormalities
-
Lowered Immunity To Intestinal Parasites
-
Infertility
-
Muscle Wasting
Insulin Resistance
A
relatively new condition is being recognized in human medicine, currently
called syndrome X. This is a group of symptoms related to insulin resistance
or hyper-insulinemia and an inability for the cells to transport glucose
into them. The disease commonly called “Cushing’s syndrome” in horses has
many of the same characteristics as syndrome X has in people.
Many
laminitis horses have elevated insulin levels in their blood. The reason the
insulin is elevated is that it is not able to get into the cells. Normally
when a sugar or carbohydrate is eaten, the blood sugar levels increase,
insulin is secreted by the pancreas, glucose is carried into the cells by
the insulin and the blood sugar goes back to normal. In insulin resistance,
the cell walls are too stiff to let the insulin do its job properly. So the
glucose, instead of providing energy for the cells, gets stored as fat.
People that are susceptible to syndrome X are from a genetic type considered
“thrifty” or in horse terms, “easy keepers.” In this type of individual,
horse or human, the body is very efficient at storing fat for times of need
and in fact, if fed less, they often become more efficient at storing fat.
In humans much of the fat stored from impaired glucose metabolism is
distributed centrally, especially around the abdomen. Many horses store
their fat in specific places; fat pads on their body and cresty necks.
The
basic protocol in treating people with Syndrome X contains many of the
ingredients used when treating the chronic laminitis horse. The idea is to
help make the cell walls more permeable to insulin and to provide nutrients
to help the insulin and glucose pathways function better.
Intestinal
Health
Horses with laminitis are often in extreme amounts of pain. Consequently
high doses of non-steroidal anti- inflammatories (NSAIDs) are used over long
periods of time. Research has been done regularly on NSAIDs effects and
toxicity in the horse as well as in humans. One recent equine study showed
inflamed small and large intestinal walls after 12 days of phenylbutazone
administration.
Since
high doses of the NSAIDs are detrimental to the integrity of the intestinal
wall the drugs may contribute to a leakage of bacteria across the wall that
triggers part of the breakdown of the laminae. Consequently, the use of
NSAIDs in treating laminitis should be questioned. Clinically, in my
experience the removal of the NSAIDs is one of the most important aspects of
the success of the holistic treatment. The horses' symptoms are usually
worse for three to five days after removing the NSAIDs, so they lie down
more. That can be alarming to the owners and attending veterinarians,
however, it is best for the horse, since the pressure is off the feet. The
antioxidants can then work. When a horse feels better with natural medicine
it is because he is better, not because the pain is masked.
Clinically
it has been found that laminitis horses respond best when an attempt is
made to repair the damage done by NSAIDs.
Nutrition
Nutritional support is critical in the laminitis horse. Nutrition includes
the basics of feed, water and hay as well as specific nutrients for
particular problems. As more experience is gained with new products,
additional helpful or even critical nutrients may be discovered. The
nutrients discussed here are ones I have found useful and are safe for the
owner to administer. Complex cases that do not respond to treatments listed
here, need the help of an alternative medicine veterinarian (see the links
for organizations listing practitioners).
Feed
Once
the digestive system is supported, high quality nutrients should be
provided. The nutritional requirements for horses with laminitis are higher
and often very specific. Horses with laminitis need high fibre, low
carbohydrate diets. Wheat bran mashes are good for overweight horses. The
small amount of bran needed for these horses may not upset the calcium
phosphorus ratio, though the entire diet should be evaluated to keep it
balanced. Blue-green algae can be added to the bran mash to provide amino
acids and trace minerals and support hoof growth. Grass or other lower
protein hays can be given free choice. The horse can have some alfalfa along
with grass hay, especially if more protein is needed, but generally alfalfa
should not be the only hay received.
The
feed should be low in sugar, so all sweet feeds should be avoided. Read the
label, if any sugar, corn syrup or molasses is present, do not feed it. When
evaluating the feeding program be sure to look at the treats being given.
Apples are better than most other treats as they contain fructose which is
less of a problem than other types of sugar. Carrots may be desirable for
some horses as a natural source of beta carotene. Plain corn (about 25%),
barley (about 35%) and oats (about 45%) make a simple, clean mixture without
sugar. Some of these grains may not be available or desirable to use in
certain parts of the country or in certain years depending on the harvest
situations. Some horses may not do as well on oats; if that seems to be the
case, just use barley and corn.
Higher levels of protein (up to 14%) and calories may be needed in the
horses with weight loss problems. Laminitis horses that are normal weight or
underweight often do well on the senior diets, which are high fat. Many
chronic laminitis horses lose weight due to the stress of walking in pain
and actually need increased amounts of feed. Since these horses did not
founder due to grain or carbohydrate overload, it makes no sense to restrict
their calories, when they actually need extra calories to maintain weight.
Increased calories can be given as fats (vegetable oils, rice bran oil, or
rice bran) and are well digested by most horses. Animal fat should not be
used due to the preservatives added in the processing and the fact that
horses are vegetarians and should not eat animal products. Increasing total
calories by adding oil and more grain may be preferred to using high-protein
feeds and hays, though some horses actually do need the higher protein.
Processed grains and hays may lose key ingredients during manufacturing
since pellets and extruded feeds are made at high temperatures. In some
cases horses have difficulty digesting processed feed, yet in my experience,
when horses are fed plain grains they generally gain weight and are
healthier. Some horses need digestive enzymes added to their food to aid
digestion.
Antioxidants
Laminitis is a classic example of free-radical damage. High levels of
anti-oxidants are needed until this process is reversed, then lower
maintenance levels can be used. Using low doses of antioxidants over time is
like trying to put out a forest fire using a garden hose. Over the counter,
combination antioxidant products rarely have enough of any one ingredient to
reverse free-radical pathology.
Co-enzyme Q10 is very valuable in reversing free radical damage. The
therapeutic dose is 300-600mg per day for the first week or two, then the
dose can be decreased slowly to a maintenance of about 100 mg per day.
Coenzyme Q 10 clinically seems to be one of the best antioxidants for use in
the horse, and in laminitis cases can be so effective that the horses become
more comfortable rapidly. Co Q 10 is most effective in laminitis cases when
non-steroidal anti inflammatories such as phenylbutazone (NSAIDs) are not
used. However, in many cases the owner is using the NSAIDs because the horse
is at home and the attending veterinarian prescribes them. CoQ10 can be
used with the NSAIDs but the results are not visible clinically.
Vitamin C is an excellent antioxidant and nutrient for collagen support as
well as organ and immune system healing. Doses range from 3 to 8gms per
day. Horses tolerate these doses well with few cases of diarrhea or stomach
irritation.
MSM
is a natural source of the antioxidant mineral, sulfur. It is also a mild
diuretic. Sulfur is important as it helps make up the disulfide bonds in the
laminae. The disulphide bonds are an important part of the connects the hoof
wall to the healthy lamina.
Other
antioxidant nutrients that can be useful are Vitamin E and superoxide
dismutase (SOD). These antioxidants are generally used in the more difficult
cases.
Minerals
One
of the most important aspects of any nutritional program for horses is the
use of free choice minerals, with the salt fed separately. If a commercial
salt-mineral block is fed (about 94% salt), the horses cannot consume the
amount of minerals they need. A laminitis horse will generally eat large
quantities of minerals, when the salt is removed, for extended periods of
time indicating their need for minerals. Sulfur may also be an important
nutrient for these horses and can be fed free choice or in a supplement such
as MSM.
There
are several key minerals needed for glucose metabolism that help the
Cushing’s horses. Magnesium affects insulin secretion and its action in the
cells. Magnesium also helps the cells be more flexible and permeable to
insulin. Chromium helps make muscle more sensitive to insulin so glucose can
be taken into the muscle cells more easily. Chromium is also related to
elevated blood sugar and has been shown to be effective in reducing fasting
blood sugar levels. Vanadium or vanadyl sulfate has actual insulin-like
effects on glucose metabolism which helps transport glucose into the cells.
Vitamins
It is
important to supply high quality supplements. Prepared foods cannot have all
the vitamins needed by a sick animal. However, formulated supplements which
contain low quality, synthetic vitamins, inorganic minerals, and fillers may
actually cause the horse's system to become more out of balance. Food-source
vitamin mineral supplements include: blue-green algae, kelp, apple cider
vinegar, carrots, and oranges. Several companies manufacture additive-free
supplements.
Essential fatty acids
Essential
Fatty
Acids (EFA’s)
are needed to help make the cell wall more permeable to insulin. The Omega 3
fatty acids are especially deficient in human diets and may be deficient in
many equine diets. Most of the high fat equine foods use animal fat that is
high in saturated fats and full of preservatives. Hemp oil (or untreated
Hemp Seed and Hemp Cake) provide plenty of Omega 3, Omega 6 and GLA fatty
acids that are palatable to the equine. Some horses’ symptoms improve with
just the addition of fatty acids to their diet.
Homeopathy
I use
constitutional homeopathic medicines selected according to the symptoms the
individual is exhibiting. Homeopathy is important to the success of the
treatment in many cases. You, as the owner, must be patient enough to work
through a case properly with homeopathy and it is necessary to work with an
experienced homeopath. Constitutional homeopathy needs be prescribed based
on the history, clinical signs and personality. It is not possible to cover
the details or remedies here.
Chinese Medicine
Chinese medicine, both with acupuncture and herbs can be used to help
laminitis horses. It is best to work with a veterinarian experienced in
either herbs or acupuncture. The International Veterinary Acupuncture
Society and the American Academy of Veterinary Acupuncture have lists of
qualified practitioners.
Western Herbs
Aloe
Vera
is a nutritional herb, which will support healthy bacterial growth and help
heal the damaged intestinal lining. Expect to pay $10.00-$12.00 a quart for
good quality aloe. Feed at a rate of 2-4 ounces each feeding for 2-4 weeks.
Slippery elm bark is another nutritional herb, which protects and aids in
healing the intestinal wall. It is especially useful with aloe vera to heal
the intestinal irritation secondary to the use of non-steroidal
anti-inflammatory drugs such as phenylbutazone.
There
are some formulas designed to improve circulation in the feet that may be
very useful. Some of the “Cushing’s” formulas may be helpful, but probably
are not as effective as many of the other therapies listed in this paper.
Vaccinations
It
is recommended not vaccinating or decreasing the vaccination program to the
absolute minimum for the chronic laminitis horse to decrease stress on the
body. Vaccine titers are available for most diseases, and most horses tested
seem to be maintaining good titers from previous vaccinations.
Environment
Many
horses are kept in high stress situations and it is important to decrease
environmental stress as much as possible. Some of these horses may be past
their high-stress years, and not be showing but the previous lifetime of
stress, over-vaccination, excessive drug use and poor nutrition are catching
up.
Pasture turn-out time is very important; however it is common for a
laminitis horse to be unable to have rich pasture without worsening
symptoms. Do not to fertilize your fields or mow and manage them too
carefully. Natural fertilization with trace minerals is a good practice,
though if grass becomes too rich even from good organic practices an
overweight horse will result. A few weeds (herbs) are a good thing. For many
horses a “fat pen” will need to be built, just a small area outside with
minimal grass so they can be out in the sunshine and near their friends, but
not have too much grass. Most horses will adapt to wearing muzzle, which
limits the amount of grass in each bite, yet allows more exercise and
companionship staying with the herd.
Conclusion
Prevention is still the best way to manage laminitis in horses however,
chronic laminitis cases can recover with a multi-faceted, long-term natural
treatment plan. Treat each horse as an individual and seek quality
practitioners to help you. |
