You Can Lead A Horse To Hay But You Can t Make It Eat

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You Can Lead A Horse To Hay But You Can t Make It Eat Dr. Nicola Pusterla, PhD, Diplomate ACVIM Department of Medicine and Epidemiology School of Veterinary Medicine, University of California, Davis

Outline Energy and nutrient requirements Obesity/malnourishment Geriatric horse/poor dentition Equine metabolic syndrome Organ-related dysfunction (liver, kidney, muscle, GI tract) Enteral feeding for sick horses Take home message

Energy and Nutrient Requirement Tools to remember (550 kg horse) DE maintenance = (kg BW x 0.03) + 1.4 = 17.9 Mcal = 33.3 kcal/kg = 18.3 Mcal DE resting = (kg BW x 0.021) + 0.975 = 12.5 Mcal (70% DE m ) CP maintenance = 40 x (DE Mcal/d) = 500-716 g/day = 1.36 g CP/kg = 748 g/day

Obese Horse Obesity is an under diagnosed condition Often seen in ponies, donkeys, small horse breeds Predisposition to laminitis, metabolic syndrome Doc, my horse is overweight, what can I feed him? Formulate a plan for overweight horse

Obese Horse Overweight assessment (BCS 7-9) Identify performance level Assess current diet and feed selection Determine the energy requirement for horse Determine the cause of obesity Formulate dietary and exercise plan

Obese Horse Dietary plan Adjust caloric intake (80% of DE at ideal body weight) Example: 14 yo QH, BCS 8/9, 490 kg (ideal weight is 450 kg) Current diet provides 17.5 Mcal/day Weight loss needed 40 kg (88 lb) DE at 450 kg is 14.9 Mcal/day; 80% of 14.9 Mcal/day (12 Mcal/day) Formulate ration with forage Grass hay 0.86 Mcal/lb 14 lbs Assess proper protein delivery Add trace mineral/vitamin supplement

Obese Horse Exercise plan Encourage owner to actively exercise horse Management factors Use of muzzle to prevent ingestion of grass Feed several times a day, use hay net Feed separated from other horses Use unpalatable bedding in stall Limit treats (low fat such as carrot/apple) Reassess diet once ideal weight is reached

Malnourished Horse Many causes for malnourishment Starvation due to ignorance and economic hardship Loss of body mass due to catabolic stage Starved horses have different responses to several diets Alfalfa hay (high protein, low CH starch) Oat hay (high fiber, low protein) Complete feed (high CH) best diet is frequent small amounts of alfalfa hay

Malnourished Horse Re-feeding recommendations Day 1-3: one pound (1/6 flake) of alfalfa q 4hr Day 4-10: slowly increase hay and decrease feeding times (by day 6 feed 4 lb TID) Day 10: feed hay ad lib into two feedings Provide clean, fresh water at all times Provide access to a salt block Do not feed grain until the horse is well

Geriatric Horse 15% geriatric horses in the USA Chronically low BCS is common problem in older horses Decreased intake (compromised ambulation, dentition) Reduced digestibility (crude fiber/protein) Environmental factors (weather) Ideally keep older horses in BCS 5/9 Feeding recommendations High quality forage (fiber/protein) Supplement vitamins/trace minerals

Geriatric Horse Ration for geriatric horse Horse with good health and adequate dentition ration similar to young mature horse Horse with various diseases or poor dentition use processed complete feed chopped hay/pellets/cubes/ensiled forage dietary fat as energy source mineral vitamin supplementation

Equine Metabolic Syndrome Fasting hyperinsulinemia, excessive insulin responses to ingested sugars and tissue insulin resistance risk of laminitis WSC in grasses vary with season, time of day, ambient temperature and grass species Ration goals Improve insulin sensitivity Diet low in NSC (WSC + starch) < 12% Follow weight guidelines Provide feed throughout the day (net, grazer)

Equine Metabolic Syndrome Feeding hay low in NSC Nutrient content of hay Legume Oat Wheat Grass Bermuda Teff Digestible energy (Mcal/lb) 1.2 0.9 0.9 0.9 0.9 0.8 Crude protein (%) 21.3 8.7 10.6 10.8 10.6 10.8 Acid detergent fiber (%) 30.3 37.4 36.9 39.0 35.6 40.2 Neutral detergent fiber (%) 38.7 58.8 60.0 63.2 67.2 71.1 Starch (%) 1.9 5.1 4.3 2.3 5.8 0.8 Ethanol soluble CHO (%) 7.4 11.9 12.5 7.5 7.4 4.3 Water soluble CHO (%) 9.1 16.8 16.5 10.9 7.4 6.1 NSC (WSC + starch) (%) 11.0 21.9 20.8 13.2 13.3 6.9

Equine Metabolic Syndrome Reducing the NSC in hay Soaking hay before feeding 30 min in hot water, 60 min in cold water Wide range of NSC reduction (23-53%) Supplement protein, vitamin and minerals Steaming 60 min at 212 F Reduce molds, NSC and retains other nutrients Commercially available low NSC complete feed

Feeding Horse with Liver Disease Nutritional management depends on severity of clinical signs Horse w/o sign of HE Ration should be highly digestible Feed maintenance level of protein to high, nitrogenous waste products to low, endogenous protein catabolism Feed frequently small amounts Beet pulp, oat/grass hay, cracked/flaked corn (2 parts beet pulp + 1 part corn in molasses)

Feeding Horse with Liver Disease Horse with signs of HE AAA promote increase of false neurotransmitters Use feed high in BCAA (beet pulp, corn, milo, oats) If hypophagia consider enteral/parenteral feeding Adequate vitamins and minerals Antioxidants (vitamin E and C) B vitamins

Feeding Horse with Renal Disease Goals of nutritional therapy Meet patient s energy and nutrient requirements Dietary restriction of protein (10-11% CP) Maintain electrolyte levels (avoid Ca and P) Decrease progression of renal disease Meet caloric requirements with fat Urinary stones (Ca-carbonate, alkaline ph) Urinary acidifiers Diet low in DCAB (< 500 MEq)

Feeding Horse with Renal Disease Diet and urinary ph Diet DCAB Urinary ph Oat hay + 4,316 MEq 7.71 Alfalfa hay + 1,406 MEq 7.79 Grass hay + 493 MEq 6.42 Grass hay pellets - 79 MEq 6.75

Feeding Horse with Muscle Disease Polysaccharide storage myopathy QH, Paint Horse, Appaloosas, Warmbloods and draft breeds Glycogen storage disorder (abnormal polysaccharide) Evidence of heritability for PSSM in QH and draft breeds Horses display frequent onset of rhabdomyolysis after exercise (exercise intolerance, weakness, stiffness, muscle fasciculation, myalgia, gait abnormalities, back pain, muscle atrophy)

Feeding Horse with Muscle Disease Diet recommendation Provide adequate calories Reduce carbohydrate intake (hay low in NSC) Fat-rich diet (vegetable oil, fat-rich commercial feed) Use antioxidants (vitamin E/selenium) Exercise recommendations QH 1,200 lb maintenance (17.6 Mcal/day) QH 1,200 lb light work (22 Mcal/day) Draft 2,000 lb moderate work (48 Mcal/day)

Feeding Horse with GI Disease Enterolithiasis Feed < 50% alfalfa diet, use vinegar, silage Sand impaction Feed off the ground, use bulk laxatives Gastric ulceration Feeding ad lib, remove grain, use vegetable oil Colitis Reduced forage, complete pelleted diet, fat

Enteral Feeding for Sick Horses For patients with hypophagia/dysphagia and functional GI tract Use complete pelleted diets (equine adult/senior diet) Use small NGT and blend pelleted feed Start slow and gradually increase over 7 days Add vegetable oil for caloric content (1.6 Mcal/cup) Enteral diet for 500-kg horse (DEr 11.5 Mcal/day) 7 lbs comp. feed (8.4 Mcal) + 2 cups oil (3.2 Mcal) Feed small amounts 2-3 times a day

Take Home Message Formulate a diet to meet energy requirement without exceeding it To avoid over-conditioning feed by weight and not by volume EMS horses should be fed a diet low in NSC (< 12%) Provide horses with organ-related disorders with a diet that supports organ recovery and does not exacerbate pathology Be creative when dealing with sick horses Enteral feeding of blended feed and oil is a cost-effective way to support an anorectic horse

Contact Information Dr. Nicola Pusterla Department of Med. & Epidemiology School of Veterinary Medicine University of California Davis, California 95616 Phone: 530 752 1039 E-mail: npusterla@ucdavis.edu