By Nikki Alvin-Smith

If you own a horse that has suffered in the past with metabolic health issues and is seemingly recovered, then you are probably feeling a bit down about how to find a meaningful and affordable way to mitigate the chance of repeat incidents.

Flare ups of equine health concerns such as laminitis, cause emotional anguish, inconvenient changes in routine, expensive vet bills for treatment and may sideline your equine partner from the life you hoped he’d live with you.

Extreme weather changes cause extra health stress on the horse. Periods of extreme heat and humidity challenge even the healthiest of equines to stay fit and well.

Regions of the country such as the Northeast U.S.A., have recorded their own record-breaking weather metrics. In 2023, upstate New York has seen the wettest July in a 100 year+ history, causing pastures to stay a vibrant lush green all summer long mirroring the landscapes of the Emerald Isle, Ireland.

Not ideal turnout conditions for horses that suffer from bouts of laminitis or showcase metabolic disturbances.

There are many proven methods to assuage the likelihood of flare ups of metabolic disease in the horse, pony, donkey, or mule, depending of course on the exact and correct diagnosis and degree of debilitation suffered. But there are also many ‘not so proven’ suggestions that do the rounds online making it hard for the concerned horse owner to discern what actions to take to protect their beloved equine’s good health.

The usual recommended remedial actions for horse’s that suffer from Equine Metabolic Syndrome, Insulin Dysregulation or Pituitary Pars Intermedia Dysfunction, are extensive. Add in a horse that has suffered from laminitis induced by these diseases, and the list grows exponentially.

The goal is always to avoid laminitis, though laminitis is not always caused by one of these metabolic melt downs. Tick-borne diseases such as Anaplasmosis, and other bacterial or viral infections, and poisoning, can often induce fevers, thus can all be causative factors in laminitis. Once an equine has suffered from a laminitis episode, he will be more prone to suffer a repeat incidence of the problem.

The list of actions often advised from our esteemed veterinary colleagues to mitigate or control laminitis is as long as the horse trailer packing list for a 3-day show and is likely to include:

• Control a horse’s nutritional intake with turn out in dry paddocks free of forage
• Offer no turnout
• Adopt strict diets including limited grain intake
• Test all forage for non-structural carbohydrate levels (or NSC which is fructans, sugars and starches) so these may be restricted
• Treat hay or forage by soaking or steaming it to limit its nutritional value and lessen NSC presence
• Artful administration of ‘special’ supplements that often the horse does not wish to ingest
• Specifically designed shoeing protocols
• Application of protective soft hoof boots and deeply bedded stalls.

On the one hand these recommendations may make sense, but on another hand they can compromise the equine’s health in other ways.

And we all know it’s tough to manage obesity which predisposes the equine to metabolic issues in the first place, if they cannot freely exercise or be longed or ridden. 

But over and above all that, what can you do to set your equine up for success to help support an optimal health status, given the metabolic concern that is hopefully correctly diagnosed at the outset? Perhaps to even to have your horse return to a more normal existence in due course post recovery and rehabilitation from an acute episode?

The Answer Is Simpler Than You May Think

Consider the adoption of a two-pronged approach to help defray the upsets of metabolic disease and improve their management.

Equines that are prone to laminitis flare-ups often experience some level of inflammation in the laminae of their hooves during any major blip in their insulin levels. Obviously building a good hoof structure is a good starting point for soundness. Correct trimming/shoeing practices and the right nutritional support mean at least the horse is starting off on the right hoof.

Most horse owners are familiar with the ‘Holy Grail’ of ingredients that are recommended for use when feeding a hoof supplement, namely biotin, methionine, zinc, and copper. But to address the likelihood of slight inflammation in the hoof laminae that can occur during laminitis flareups, a formula that includes MSM is a good idea. Consider a supplement that contain 5000 mg of MSM in addition to the four recommended constituents mentioned above, to assuage the inflammation nemesis.

In addition, the use of the right postbiotic supplement can also aid the horse in maintaining their metabolic balance. How?

Metabolic disease issues in the horse starts with inflammation, and this is caused by a rise in cytokines.

What is a cytokine?

Principally the cytokine is a chemical messenger protein in the immune system, that tells the body’s immune cells what to do and when. While there are several types of cytokines that regulate different cell functions, they are extremely important in the manner they message cells to boost inflammation when a threat is perceived such as a bacterial invader, or healing of damaged tissue is required. 

Cytokines can be pro-inflammatory types that trigger a boost in inflammation, or anti-inflammatory in nature that signal a reduction in inflammatory response. Bearing in mind that excessive immune responses will damage tissue, lowering the inflammatory cytokine activity that has gone awry is something that can help mitigate the health risks associated with the excessive inflammatory responses, such as we see in metabolic diseases.

Anything that can be done to lower the level of these over-zealous inflammation messaging cytokines benefits the overall health of the horse and reduces the inflammatory aspect of the metabolic upset.  Interestingly, there is good research to show that horses fed a proven and test postbiotic show a statistical drop in cytokines when tested.

Bear in mind that not all postbiotic products are created equal, so just throwing your money at anything on the market labelled postbiotic is not going to cut it.

I’ll be delving into the subject of product integrity and postbiotic benefits in more detail in future blogs, so stay tuned. Including lots of other information on effective postbiotic ingredients and also the checks and balances to consider that will optimize the holistic approach to caring for our equine partners, including ways to save much money.

But for now, be aware that the right supplement, one that has been proved to help lower the cytokine level that signals inflammation, is a good place to start.

Set Your Horse Up For Success

If you can get ahead of the inflammatory flare ups and extinguish some of the nefarious unbalanced behavior going on in the metabolic upset or imbalance, then you can set your horse up for success.

If you’ve ever had to stable a horse for months on end then you know how mind-blowingly hard it is to keep such a horse mentally stable and fit during the process. Remember those days and nights filled with following strict timelines to administer medications every few hours. The endless rituals of changing ice boots, and other equipment or topical applications to reduce symptoms of metabolic disease.

Once you’ve witnessed first-hand the toll these and other treatment modalities inflict upon both horse and caregiver physically, emotionally and on the human side, financially, then you know how important preventing or controlling metabolic disease flare-ups is and appreciate any rational methods you can employ to help prevent them.

Obviously, simple solutions such as administering proven horse supplements aren’t going to bring the risk of flare-ups of laminitis in the horse to zero. Neither are they likely to completely control health issues caused by metabolic diseases. But doing every bit you can to help minimize any negative impact from metabolic disease and laminitis, however the latter is induced, makes sense.

In my career as a horse breeder and Grand Prix international level competitor, I’ve had horses suffer from a variety of metabolic issues and sidelining a horse from living a ‘normal’ equine lifestyle and of reaching its full potential is heartbreaking.

Each individual equine presents a different challenge to ensure it receives the best supportive and preventative health care protocols. The research into solving these issues is always ongoing, but if we can positively influence and thus improve a single aspect of a horse’s chance to stay healthy or get healthy, then as horse owners, we are all going to try. It’s reassuring to have more ‘tools’ in the toolbox to help us keep our horses as happy and healthy as possible.

About the author:

Nikki Alvin-Smith is a seasoned freelance writer who loves to share her lifelong experience with everything horse, rural lifestyle, and travel. Her works have been printed in more than two hundred fifty equestrian magazines worldwide and her published articles number in the thousands.

A Brit who has called New York home for more than 40 years, Nikki brings a unique perspective to her writing.Her experience as an international level Grand Prix dressage competitor, coach, and worldwide clinician, with a youth spent showjumping and foxhunting, provides lots of educational truths and fun moments to share with the reader. Additionally, she has been a horse breeder and importer of Hanoverian, Dutch and Iberian horses for more than 25 years. Together with her husband Paul Alvin-Smith, who is also a Grand Prix rider, operates Willowview Hill Farm, an organic hay farm and private dressage yard in the beautiful Catskill Mountains of New York.

Visit nikkialvinsmithstudio.com or horseinakiltmedia.com to learn more.

Learn the real facts on horse ulcers and why they happen

Do you have any supplements for horse ulcers? We are asked this question on a daily basis.

The fact is we have a systemic problem with gastric ulcers in horses. An estimated 65 – 70% of performance horses and over 90% of race horses are affected by ulcers.

This is exactly why you need to read this blog. You need to know what we know about horse ulcers.

Horse Ulcer Myths Debunked

Myth #1: digestion supplements do not fix ulcers.

Even though there are companies who claim this to be a fact, it is simply not true.

There is a long list of horse digestion supplements with ingredients such as slippery elm, licorice, marshmallow root, gamma oryzanol, aloe vera, aluminum phosphate, and more.

These ingredients are used in an attempt to help your horse recover from ulcer treatments or to potentially reduce the risk of ulcers occurring in the first place.

However, these digestive supplements do not prevent or cure gastric ulcers.

Myth #2: feeding your horse Gastrogard^TM or UlcerGard^TM does not prevent ulcers from developing.

These two products are drugs specifically designed to treat gastric ulcers and are the only research-backed products shown to effectively treat ulcers.

Unfortunately, there is a tendency for riders and horse owners to use these two products on a preventive basis.

At Grand Meadows, we strongly urge against this practice. Prolonged usage of drugs like these can play havoc with your horse’s microbiome, impacting your horse’s immune system health, energy metabolism, and fiber digestion.

Plain and simple, if a gastric endoscopy has not definitively shown your horse has a gastric ulcer – you need to stop using these products. And yes, a gastric endoscopy is the only way to prove your horse does in fact have an ulcer.

Okay, now that we have debunked these two horse ulcer myths, let’s focus on the facts about horse ulcers – so you can do your best to keep your horse feeling their best and prevent ulcers from occurring in the first place.

What is Equine Gastric Ulcer Syndrome (EGUS)?

Equine gastric ulcer syndrome (EGUS) is an umbrella term used to describe erosions, ulcerations, and lesions in the terminal esophagus, nonglandular squamous, and glandular regions of the stomach, and proximal duodenum. Performance horses and foals are at greatest risk to develop EGUS. Clinical signs are vague, and treatment requires pharmaceutical agents that increase gastric pH and foster an environment conducive to ulcer healing.
(Source Merck Manual Veterinary Manual)

We like this definition of EGUS because it highlights some key points:

• Performance horses are at increased risk of developing gastric ulcers
• Diagnosis can be challenging
• The horse’s environment is essential to recovery from and prevention of gastric ulcers

What Causes Horse Ulcers?

Equine ulcers are caused by a combination of modern feeding and lifestyle practices:

Twice daily feeding or limited feeding approaches

Horses evolved to graze for a significant portion of the day. Over a 24-hour time period the glandular or lower portion of the horse’s stomach secretes hydrochloric acid that mixes with feed, helping to break it down before it enters the small intestine.

When a horse is able to eat slowly and throughout the day, the stomach works as designed, buffering and protecting the stomach lining from acid.

However, modern feeding practices mean horses are left with empty stomachs, exposed to naturally occurring gastric acid. With nothing to protect against or buffer against this acid, ulcerations may easily develop.

Stall confinement

Horses are designed to need both consistent exercise and grazing opportunities.

When horses are confined to stalls, a collision of factors occur, including an empty stomach, elevated acid levels, isolation, stress due to limited exercise, and a tendency to feed too much grain – this creates the ideal scenario for equine gastric ulcers. 

Elevated levels of stress

Performance horses are subjected to excessive levels of transport, exercise demands, performance expectations, and stall confinement. Additionally, horses are sociable animals and depend on herd time spent grazing, running, and playing with their friends to relax and enjoy life.

Trailering, stall confinement, limited time with horse friends, changes in routine, and performance expectations all contribute to elevated levels of stress. The reality is –  stressed horses are more prone to developing gastric ulcers.

Overuse of NSAIDs

The prevalence of prolonged or excessive use of NSAIDs in horses is shown to contribute to gastric ulcers, right dorsal colitis, and renal papillary necrosis.

Research shows that NSAIDs can disrupt the gut microbiome, with trickle-over impacts to immune system health, fiber digestion, and further complications. Foals are particularly at risk of equine ulcers when given NSAIDs.

Always discuss NSAIDs with your veterinarian.

Change

Horses do not like change. Changes to routine such as a new stable, travel, new people, changes in training intensity, new herd members or loss of a herd member, changes in feed and grazing patterns, and more may seem small to us – but for your horse, these are big changes.

For your horse, change equals stress, and stress can result in increases in stomach acid production – resulting in greater risk of ulceration.

What are the Signs and Symptoms of Gastric Ulcers in Horses?

The signs and symptoms of gastric ulcers can be subtle, making it easy to miss the signals your horse is giving you when they are unwell.

Be aware of these signs and symptoms of gastric ulcers in horses:

• Changes in appetite
• Behavioral changes
• Lack of interest in training, exercising, or playing
• Changes in coat or skin condition
• Weight loss
• Muscle loss and other signs of changes in body condition
• Digestive problems including chronic diarrhea or recurrent colic
• Girthiness
• Teeth grinding
• Ignoring food and walking away from it
• Laying down more than usual
• Excessive drooling or saliva
• Changes in performance

In foals, signs of gastric ulcers can include diarrhea, pot-bellied body shape, changes in nursing, recumbency, intermittent colic, teeth grinding, or increased drooling and salivation. If your foal shows these signs, contact your veterinarian immediately.

If you notice any changes at all in your horse – contact your veterinarian. Remember, your horse uses their behavior and body condition to communicate with you – telling you when they are both unwell and happy. Do not ignore changes, regardless of how subtle they appear to be.

How are Gastric Ulcers Diagnosed in Horses?

The only way to definitively diagnose gastric ulcers is with a gastroscopy or gastric endoscopy.

How to Treat Ulcers in Horses

Gastrogard and UlcerGard are the only treatments for equine ulcers approved by the FDA.

Along with administration of these prescriptions under supervision of your veterinarian, your horse’s recovery can be supported with:

• A reduction in training intensity
• Increased pasture turnout
• A cautious return to intense training levels
• Ensure your horse’s stress level is reduced
• Reducing the amount of grain in your horses diet

Typically, Gastrogard or UlcerGard are prescribed for four weeks. However, do not assume after four weeks your horse has recovered and is healed. A gastroscopy should be done for a clear picture of your horse’s health and recovery status.

How to Prevent Ulcers in Your Horse

While there is no sure fire way to prevent ulcers in your horse, the following horse care practices may help reduce risk factors and support your horse’s overall health and happiness:

• Reduce the amount of grain you feed your horse and focus on feeding your horse high quality forage free from pesticides, chemicals, and irritants.
• Limit travel, intense training, trailering, stall time, and isolation.
• Give your horse ample herd and grazing time.
• Feed your horse smaller and more frequent meals.
• Make it easy for your horse to see, interact, and communicate with other horses.

Admittedly, it can be challenging in urban environments to give your horse the freedom and socialization they need to graze freely and interact with other horses. In these situations, it’s important to limit other risk factors such as reducing the amount of grain, making it easy for your horse to eat throughout the day, limiting travel and training intensity, and reducing stress overall.

Final Words on Gastric Ulcers and Your Horse

Unfortunately, there isn’t a magic bullet for the epidemic of gastric ulcers in horses.

Sadly modern day challenges including limited grazing land for horses, the punishing training and showing regimen for performance horses, and the overfeeding of grain, make it is hard to see the epidemic of gastric ulcers abating anytime soon.
While horse digestion supplements may help in reducing potential problems, risk factors will always be present for most horses.

As a horse person, the onus is on you to be aware of the risk factors, to pay attention to all the signals your horse is giving you, and to always contact your veterinarian should there be any changes to your horse’s behavior or condition.

Learn the facts on your horse’s digestive system

Should I feed my horse grain? How much grain should I feed my horse? What do I feed if I don’t feed grain? What are the issues with feeding grain?

These are just a handful of the questions we hear about feeding your horse. Grain is a hot topic – and for good reason.

To put it bluntly, your horse does not need grain. Your horse needs calories, a balanced diet, and roughage – all of this can happen without feeding your horse grain. In fact, grain can have serious implications for your horse’s digestive system.

Controversial statement? Maybe – but we stand by it. Keep reading to learn the facts on the horse digestive system and how grain impacts your horse’s health.

Understanding Your Horse’s Digestion System

When it comes to your horse’s digestive system, it really is all about balance and getting the little things right.

Feeding your horse too much or not enough, making errors in nutrient ratios, changing the feed, or feeding too much grain (or any grain at all) can have large consequences for your horse’s sensitive digestion system.  

How your horse’s digestion system works:

1. Stomach: chewed food is broken down by gastric acid so it can be released into the small intestine and pepsin is released to aid in protein digestion. In relation to their size, horses have a very small stomach, requiring frequent small meals throughout the day.  
   
2. Small Intestine: starches, proteins, and fats are digested by enzymes and absorbed. It can be difficult for the amylase enzyme to digest starch in cereal grains due to the protective shell/layer on most grains.
   
   Undigested starch can create issues in your horse’s hindgut, leading to excess lactic acid production and accumulation, which in turn may cause conditions such as colic, laminitis, or metabolic acidosis.
   
   It’s important to remember that food moves through your horse’s small intestine very quickly (45 minutes after eating), making it difficult for horses to digest and absorb large volumes of food.
   
3. Hindgut: microbial digestion breaks down fibrous materials including structural carbohydrates. The horse digestion process relies on this fermentation for maximum absorption of nutrients and energy conversion from feed and supplements. During fermentation, fiber and short chain fatty acids are converted into carbohydrates, providing energy for your horse.
   
   The hindgut is made up of the cecum, large and small colon, and the rectum. The hindgut, particularly the cecum and large colon are at risk of developing impactions and digestive upset. Impaction occurs when your horse eats large amounts of dry feed, such as grain, which can result in bowel obstructions, ultimately leading to colic.
   
   When fermented and digested food enters the small colon, this organ absorbs as much water as possible from this material and fecal matter is created which is ultimately released as feces.

Gastric Ulcers, Colic, Laminitis and Other Horse Digestive Disorders

Your horse is what they eat and when you feed it a diet lacking in balanced nutrients or too many hard-to-digest grains – your horse is at risk for a long list of digestive disorders.

• Gastric ulcers: 50 – 90% of horses experience gastric (stomach) ulcers. Too much gastric acid in the stomach can cause the protective mucosa layer to break-down, causing lesions or ulcers.
  
  High grain diets, not enough roughage, restrictive feeding (prolonged empty stomach), stress, some medications, and intense exercise demands may all contribute to gastric ulcers. Did you know that performance horses are at higher risk of developing gastric ulcers?
  
• Colic: is a general term to describe abdominal or stomach discomfort in horses. Colic is extremely common and is the leading cause of death of horses. Colic can be hard to diagnose and find the root cause.
  
  Experts do agree that risk factors including large amounts of grain, not enough forage, hay quality, dehydration, too much stall time, and changes in activity levels may contribute to colic.
  
• Laminitis: is the inflammation of the tissue (laminae) between the hoof and coffin bone. This condition can be extremely uncomfortable and debilitating.
  
  There are several causes of this treatable condition including underlying endocrine diseases, a diet high in sugars, grain overload, too much work on hard surfaces, or the stresses placed on limbs due to excess weight or injury.

Excess grain, poor nutritional balance, insufficient forage, and poor gut health can lead to other digestive disorders, such as colitis, dysbiosis, enteritis, hindgut acidosis, colonic ulcers, and right dorsal colitis.

How to Feed Your Horse for Beneficial Digestive Health

Your horse has a complex and sensitive digestive system. Get the balance of nutrients, hydration, and feed sources wrong, and your horse is at risk for illness and poor performance.

Keep in mind these feeding guidelines to support your horse’s digestive health:

1. High quality forage free from pesticides, chemicals, and irritants should be the foundation of your horse’s diet. Forage is a reliable source of calories, carbohydrates,  roughage (fiber), vitamins, protein, and minerals.
   
2. Remember balanced nutrition is critical. Make sure your horse is getting enough carbohydrates, fats, proteins, minerals, vitamins, water, and electrolytes to meet their unique needs. Everything from immune system health, performance health, muscle development, and digestion is tied to what and how you feed your horse.
   
3. Feed your horse small meals frequently throughout the day. Ideally, your horse should be able to graze all day – just as nature intended. Feed passes through your horse’s stomach and small intestine very quickly. This can cause feelings of hunger, triggering your horse to eat too much at the next opportunity and it can cause a gastric acid build-up contributing to ulcers.
   
4. Hydration and electrolytes are essential to supporting digestion, energy levels, and overall horse health. Your horse needs one gallon of water for every 100 pounds of body weight daily. If your horse has a high sweat rate, does a lot of exercise or work, or you live in a warm climate – pay extra attention to electrolytes.
   
5. Think twice about grain and why you’re feeding it to your horse. All too often, grains are overprocessed, hard to digest, and lack the nutrients your horse needs. Some people choose to feed grains in an effort to meet caloric demands – however, your horse can meet their energy demands from high-quality forage and a consistent feeding schedule. Remember, your horse is designed to eat forage – not oats, barley, and rye.
   
6. Prioritize pasture turnout, giving your horse ample time to graze and chew their food properly and ensuring a constant intake of forage to support consistent acid production and movement through the hindgut.
   
7. Learn about the horse microbiome and its critical role in horse digestive and immune system health. The health of your horse’s microbiome is integral to the breakdown, fermentation, and absorption of nutrients.

Every horse is unique – what works for your friend’s horse may not work for your horse. Always consult your veterinarian and trainer before making changes to your horse’s diet, exercise routine, and general day-to-day routine. Your horse’s digestive system is so sensitive that a small change can have large ramifications.

Keep Learning About Grain, Horse Digestion, Nutrition, and Performance

The good news is there is so much information available about horse digestion, performance, and nutrition. But it can be difficult to know who to trust or to find clear information.

Start with watching these videos, you will learn a lot and be entertained. We promise these horse videos are not boring!

• To Grain or Not To Grain – That Is The Question
• Digestion Primer
• The Horse’s Stomach
• The Horse’s Small Intestine
• The Horse’s Large Intestine
• Horse Digestion Wrap Up

And then read these Grand Meadows articles about the horse digestive system, equine microbiome, and horse health in general:

• Your Equine Microbiome and Digestion FAQ
• Feeding Your Horse: 5 Horse Nutrition Tips and Advice for a Healthy Horse
• Horse Digestion and Immune System Science
• Postbiotics for Horses FAQ: Answers to Your Questions About Postbiotics for Horses
• How Do Horse Supplements Work With Forage?

As always, the Grand Meadows team is here to answer your questions about how you can support your horse’s overall health and wellness. Contact us with your questions.