Originally published on TheHorse.com
Editor's note: This article is part of TheHorse.com's ongoing coverage of topics presented at the 2012 Kentucky Equine Research Conference, held May 17-18 in Lexington, Ky.
When a horse is sick or recovering from illness, feeding choices can either help him on the road to recovery or send him further down the path of distress. Therefore, it's important to know what feeds and forages are better for sick horses and which ones aren't recommended.
Bryan Waldridge, DVM, MS, Dipl. ABVP, ACVIM, a veterinarian at Kentucky Equine Research (KER) in Versailles, Ky., presented a lecture on feeding sick and hospitalized horses at the 2012 KER Conference, held May 17-18 in Lexington, Ky.
He first discussed several reasons horses could cause a horse to stop eating before reviewing a few specific disorders and illnesses that can greatly benefit from careful nutritional management.
Why Aren't They Eating?
Waldridge first discussed some of the causes of anorexia in horses:
Goal No. 1: Keep Them Eating
The number one goal when feeding a sick or hospitalized horse is to keep the horse eating to maintain body condition, Waldridge said. Thus, it might be necessary to feed horses a less than desirable food choice in moderation if the animal will not consume anything else, such as alfalfa hay rather than grass hay, he said. While discussing individual illnesses, Waldridge made recommendations on how to handle "picky eaters."
Next, Waldridge recommended feeding practices for horses with some specific conditions, recovery of which can be either helped or hindered by feeding decisions.
Hepatoencephalopathy--Brain and nervous system damage as a complication of liver disorders is referred to as hepatoencephalopathy. It typically occurs when the liver is damaged to the point it cannot remove gut-derived toxins, such as ammonia, from the horse's system. Clinical signs of hepatoencephalopathy include head pressing, changes in mentation or behavior, seizures, and neurologic deficits, and are more likely to occur after the horse eats, Waldridge said. A combination of clinical signs, blood work, an ultrasound examination, and a liver biopsy will aid in diagnosis, he added.
Along with medical and supportive treatment, horses with hepatoencephalopathy require special dietary management, Waldridge said, specifically a reduction in the amount of ammonia in the animal's body. To accomplish this, reduce horses' dietary protein to as little as 8% of their diet by feeding grass hay or pasture. Avoid offering horses forages high in protein, such as alfalfa or clover, he said. Additionally, he recommended spreading the feedings out over the course of the day to reduce large volumes of protein the liver needs to filter.
If a hepatoencephalopathic horse will only consume a high-protein legume forage, Waldridge said it should be fed in small quantities in moderation to keep the horse at a healthy body condition.
Hepatic Lipidosis--This life-threatening condition, which involves fat building up in the liver, is most commonly found in Miniature Horses, ponies, and donkeys, but can affect all horses. Waldridge explained hepatic lipidosis occurs during periods of severe inappetance or energy restriction, so it's crucial to get affected horses eating again. The condition is diagnosed by evaluating the horse's blood serum triglyceride concentration, the serum appearance, and liver enzyme activities.
Treatment is largely nutritionally based. To encourage food consumption, Waldridge recommends offering the animal different feed options and hand grazing, if possible. In some cases, nasogastric tube feeding or parenteral feeding might be required if the animal refuses to eat, he said.
Waldridge stressed that it's vital to treat the condition which caused the hepatic lipidosis aggressively to promote a full recovery.
Chronic kidney disease--When treating a horse with chronic kidney disease, Waldridge said, it's essential to keep the horse eating and drinking normally. Diagnosis of this disorder includes identifying elevated renal indices, hyposthenuria (excretion of dilute urine or water loss), casts (kidney cells accumulated in the tubule) in urine, and an ultrasound exam.
When feeding a horse with kidney disease, aim to avoid dietary protein, which causes the horse to urinate excessively and further damages already ailing kidneys, Waldridge said. Also, restrict calcium intake to reduce the amount of the substance the kidneys must extract into the urine, he said. This can be accomplished by feeding high quality grass hay or pasture, and avoiding legume forages with high protein and calcium concentrations. Again, the most important point is to keep the horse eating to maintain a healthy body score; use legumes sparingly if the horse will not eat anything else.
Waldridge also noted providing the patient with one to two ounces of salt, once or twice daily could encourage the horse to drink more, and supplementing his diet with omega-3 fatty acids could aide in reducing renal inflammation.
Respiratory disease--Horses with respiratory ailments--such as recurrent airway obstruction (RAO, also known as heaves) and inflammatory airway disease (IAD)--have special dietary needs as well, Waldridge relayed. Since the clinical signs of both RAO and IDA are intensified by inhaled particles, Waldridge stressed the importance of reducing particles in the horse's breathing zone. Most irritating particles, he said, can be found in the horse's hay. Thus, when feeding affected horses, it's important to consider either taking steps to reduce hay dust or alternative forage sources:
Nutritional choices can either help or hinder a horse's health problems, diseases, or ailments. By understanding why certain feeds are recommended or not for a certain condition and working with a veterinarian, horse owners can help their horses on the road to recovery.
Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.