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LAMINITIS - continued from part 2.

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THE LAMINITIS DIET (also good for arthritis)
The reason this diet has been described in volumes and proportions instead of by weight, is because not many horse people use scales. Every horse is an individual and the amount of feed required by two horses of the same weight may vary dramatically. With this diet you may vary the volume of feed for energy and roughage while the minerals and supplements remain constant, as suggested.    

This diet is a guide to feeding generally, it is also used for feeding severe cases (no grain) and for feeding race horses showing laminitic symptoms or arthritis. The roughage is made up by volume per feed - most horses require to eat 1.5 - 2.0 % of body weight as roughage e.g., 20 - 40 liters (2 large buckets) per day plus hay. The greatest risk factor for ulcers is to confine a horse and only feed it twice a day. These feeds could be divided to make 4 - 6 smaller feeds which is a better way to feed horses and reduces the risk of ulcers. A recovering horse has a better attitude and greater desire to get well if it is fed little and often because while it is eating, the body produces many "happy hormones". Only dampen each small feed as it is fed. Many horses fed this diet start putting on weight. This is a good sign and shows that you can reduce the energy with lower quality roughage (hay) or by soaking hay, while retaining the additives, to stabilise body weight. This is low protein, low carbohydrate, highly nutritious feed to maximise hoof growth and repair and increase well-being. For larger horses this diet would supply a minimum of 60 grams of dolomite a day. For some  warmblood and draught horses > 650 kg  this could be increased to 90 grams. For ponies divide the supplement volumes by half or a third or make one feed and divide this into multiple smaller feeds for the day. To make sure that a laminitic equine gets enough magnesium have some dolomite available in a dish so that it can lick if it wants to. The same can be done with kelp and salt in a separate container.

MINIMISE OR CUT OUT ALL GRAIN DURING THE ACUTE STAGES OF LAMINITIS BECAUSE; MALDIGESTION OF GRAIN OR GRASS MAY BE A FACTOR IN THE CAUSE OF LAMINITIS AND GRAIN INCREASES THE BODIES INFLAMMATORY RESPONSE.
Race horses - after 2 - 4 weeks with low or no grain, it is slowly reintroduced into a race horse's diet and the volume of grain replaces part of the volume of bran. Exercise is continued gently when possible.

Some laminitic equines are really miserable at being taken off what they are used to eating, even if it was killing them. Pain is a primary cause of laminitic equines not eating many sick animals are fussy and it is more important to eat something than nothing! You must prevent hypoglycaemia and hyperlipidemia in ponies. Treating any nutritional deficiency that is exacerbating the condition is vitally important. You and your vet can discuss minerals, magnesium, vitamins C and B etc. However, if the patient does not like the taste of the supplements but will eat the feed without them give a small feed with nothing in it. Do not wait hours to make this decision, the horse will eat it or it won’t. Find something the patient likes. It is better to feed a litre or less of mixed feed each hour or two as long as it contains a thimble full of the supplements as well. Than to give the whole lot and have the horse eat nothing. Use very small amounts of honey and water to damp the feed or add a little more of the lucerne chaff if it likes that. Small amounts of feed through the system regularly decrease the risk of ulcers and other digestive problems associated with microflora imbalances, anorexia and anti-inflammatory drugs.

Pain-relieving anti-inflammatories should be prescribed by a veterinarian and the dose varied from day to day, usually decreasing the dose steadily. Too little prolongs the acute phase; too much allows the patient to move around in a state of masked pain, aggravating the damaged laminae. Gastrointestinal side effects can be severe if overdosed repeatedly.

DIETARY SUGGESTIONS

• Feed roughage (bulk) to keep the patient happy, lower gastric and hind gut pH and for  healthy gut flora. For most laminitic ponies hay (sometimes chaff too) should be soaked in warm water for 1 hour to release sugars from the plant matter prior to feeding. The water is discarded and the hay can be spread out to dry or fed immediately. Oaten hay, oaten chaff, grass hay even lucerne can all be soaked. Shake the seed heads and grain out of grass/oaten hay. These extra steps can make a great difference in chronic cases.
• Include essential vitamins and minerals.
• Grain should be avoided and only reintroduced in small amounts, when the acute stage is over. Not in high risk cases such as ponies.
• Avoid all legumes (peas, beans, or excessive amounts of lucerne, clover etc.) which are high in protein which requires metabolism by the liver which is already under great stress and legumes depress iodine uptake. Some ponies should avoid lucerne altogether as many are very sensitive to even small amounts such as 1 handful in a feed. Horses are less sensitive but in some cases where the horse fails to improve eliminate it from the diet for 2 weeks as part of a diet trial and feed soaked hay (as above) only.
• Lucerne is a legume and should be kept to less than a quarter of the roughage in the diet of laminitic horses or 1/3 of the roughage of normal horse and avoided for most ponies. Use seedless grass hay or oaten hay, chaff and bran for the other three quarters of the roughage in the diet.
• VITAMIN C: (30 grams daily for horses) helps eliminate free radicals as it is an important antioxidant and supports the body's immune system. Vitamin C is necessary for connective tissue (collagen) and cartilage formation in joints and assists with detoxification and strengthening of small blood vessels.
• CIDER VINEGAR: (1/4 cup daily) is a source of potassium and an organic anti-inflammatory, it is good for arthritis, however this should not be included while the patient has an acidic pH in the caecum and large intestine. In most cases horses prefer it mixed in with bran and water to make a mash (not too wet, not too dry). Some ponies are sensitive to this small amount of very weak acid and therefore, it may be better left out for the first week or two or altogether if an adverse response continues to occur.
• SULFUR: Required for healthy keratin (skin, hooves, hair etc.). Sulfur is necessary for absorption of selenium and a deficiency can lead to anorexia, weight loss and poor digestion.
• SEAWEED MEAL/LIQUID (Kelp): is an economical source of minerals e.g., natural selenium which is an essential antioxidant mineral and iodine which is essential for metabolism and is now being used as potassium iodide in the treatment of some infectious and inflammatory conditions, amino acids (precursors of proteins) and other elements. If feeding powdered kelp free choice access is ideal as equines will help themselves to what they require, consuming large amounts or leaving it alone as they choose. It is no longer advised to give it in feed unless for the short term, giving only a dessertspoon full to an average sized horse every other day for 2 - 4 weeks. Liquid kelp can be fed according to the manufacturer’s recommendations. Kelp will increase appetite, promote detoxification, increase metabolism and well-being.
• DOLOMITE: The most important supplement. Make sure your horse gets this as a source of magnesium and calcium carbonate and small amounts of other minerals. A ratio of Ca 60%:Mg 40% is ideal. Quality dolomite is very fine to aid digestion and the carbonate acts as an antacid in the digestive tract which is beneficial during lactic acidosis and feed induced laminitis. All equines can be fed dolomite in the long-term as an alternative to calcium carbonate. Quality varies shop for the best. Giving free choice as for kelp may be the answer.
• EPSOM SALTS: Magnesium sulphate is mixed with bran and fed to a laminitic horse as a mash or can be mixed with water and administered by stomach tube by your veterinarian. In acute cases this will help to move the offending feed through the gut quicker by the osmotic effect of the salts drawing water into the gut during feed induced laminitis (0.5 - 1.0 g/kg). Therefore, make sure plenty of water is available. It also supplies magnesium to the system as it is depleted during illness and stress (all cases of laminitis). Epsom salts can affect the kidneys and should only be fed during the short term, less than 10 days.
• BICARBONATE: an antacid and buffer found in blood, it may be beneficial in feed induced cases to help neutralise acid in the hind gut. Give 30 - 60g daily during the acute phase.
• THIAMIN (vitamin B1): Essential for normal glucose metabolism and the oxidation of amino acids and fatty acids to produce energy. Thiamin as thiamin triphosphate has a direct role in nervous tissue function. Growing horses require 3 mg/kg of thiamin per day. Adult horses receive their thiamin as a product of digestion of the hard hull of whole grains, bran etc., by the microbial population of the caecum. High grain diets and fermentation lead to low pH in the caecum which favours proliferation of bacteria which contain type II thiaminases which break down thiamin. Therefore, during laminitis horse may benefit from B group supplementation, especially B1. Thiamin is high in brewers yeast, rice bran, wheat bran and is low in dehulled grains. Deficiency signs include anorexia (not eating) and incoordination.
• SELENIUM: This element is constantly excreted from the body and must be supplied in trace amounts every day. It is used in the pathway which protects cells from free radical damage and is therefore an essential antioxidant nutrient along with vitamin E, C, copper and sulphur which is required for its assimilation. Selenium is also required for fertility in both sexes. It is found in a bio-available form in kelp. In some high rainfall and coastal areas deficiency in soils is so profound that other supplementation is also required. Supplementary vitamin E may help to treat a mild deficiency. Some commercial products contain enough to treat a deficiency. Many horses with stiff muscles and chronic soreness respond to selenium supplementation and boron. A response to Vitamin E indicates that supplementation would be beneficial. Therefore, feed the whole diet to get best value from your supplements.
• VITAMIN E: is incorporated into cell membranes and functions as an antioxidant protecting them from free radical attack. It is directly linked in the antioxidant pathway with Vitamin C and the selenium and copper containing enzyme glutathione which removes free radicals via the liver. A lack of any of these elements can lead to muscle and nerve damage and a weaker immune system. Vitamin E is found in green grass and is renowned for its healing properties. many commercial supplements are available. Refer to manufacturer’s feeding instructions.
• BORON: A trace mineral required for the correct utilisation of calcium, magnesium and the absorption of selenium. It may be used in the dietary treatment of arthritis and  laminitis. Boron is often referred to in gardening programs for the health of soil and plant growth. Deficiency is common in Australia. A small amount is fed 1 - 2 x per week.
• COPPER SULPHATE: Always in the same feed as dolomite to decrease any risk of toxicity. Horses have a higher copper requirement than much of the literature states. Many sources quote 6 - 10 parts per million (ppm), horses actually require 25ppm. Check your feed and pasture as you may need to supplement this essential mineral. Deficiency signs include rough, yellow coat with hair that curls back at the ends, OCD in young horses and arthritis in all ages. Abnormal intestinal parasite burdens and diarrhoea are symptoms of deficiency. Leave copper sulphate out of the feed if the patient is anorexic (not eating). Small amounts of copper e.g., 6.5ppm are found in kelp and this can supply some copper safely. Do not give if there is risk of liver disease, hyperlipaemia or a history of toxic plants such as Patterson’s Curse or lupinosis as copper is stored in the liver and in these cases the organ is chronically diseased. In these cases offer kelp. Over supply of copper is toxic. Therefore, it should be fed at all times with dolomite which helps to neutralise any excess.
• HERBAL PREPARATIONS: For relief of pain and inflammation e.g., Devil’s claw. Consult any promotional literature and follow feeding instructions accurately.
• COD-LIVER OIL:  Supplies vitamins A, D, E and omega 3 fatty acids. Cod liver oil can be mixed 50:50 with linseed oil or another omega 3 and 6 supplement. This can be administered separately to the feed if the horse does not like the smell or taste. Try mixing it with a little honey if your horse won’t eat it.
• LINSEED OIL: One of the richest sources of omega-3 fatty acids which play a role in decreasing inflammation but, it does not replace the fat soluble vitamins found in Cod Liver Oil (CLO).
• CORN OIL: Has high energy (4 x the energy of grain per gram) for a low volume and is digested from the small intestine without the risk of carbohydrate overload in the large intestine. Feed small amounts and build up over 3 weeks to larger volumes of 1 cup per 100 kg body weight per day for horses in training that require high energy such as race horses that are prone to exercise induced myositis / tying up syndrome, laminitis etc., on a grain based diet. You must feed enough roughage with the large volume of oil.
• HONEY (natural): is a preferred sweetener and molasses should be avoided.
• SALT:  Sodium chloride (sea salt). Feed ad-lib rock salt, loose sea salt in a container, or as a salt block. Do not mix in the feed. Horses will seek salt when they want it.         
• PROBIOTICS: Live beneficial bacteria which help to restore the normal bacterial flora of the caecum and colon (hind gut). Not useful while on antibiotics and should be fed immediately after. à Refer to the manufacturer’s instructions for dose rates.                   
• VAM paste (originally for injection) is an ideal way to give vitamins, mineral and aminoacids. Available from NATUREVET.

SUMMARY;

30 grams (g) is approximately equivalent to one rounded dessertspoon (dsp) or one level tablespoon or one ounce (28.4 grams). 10 grams is equivalent to 0.35 ounces 1/3z (oz) or a small rounded teaspoon (tsp.). 3.5 grams is equivalent to ½ a level teaspoon.

• WATER: clean water ad lib at all times.
• GRASS HAY/OATEN HAY: Ad lib grass hay or large amounts of moderate quality. Do not feed a lot of top quality hay or lucerne as it defeats the purpose of a low energy, low protein diet. Grass hay can contain very high amounts of fructans so choose the quality carefully. If in doubt feed oaten hay. The aim is to get low energy roughage and fibre into the hind gut where it will promote a healthy gut flora to re-establish after digestive upset. Lucerne should not exceed 1/3 of the total roughage of the diet. Some horses and ponies are very sensitive to lucerne and any adverse effect should be noted and avoid lucerne  completely in these cases.
• ROUGHAGE: By volume 1/4 lucerne chaff, 2/4 wheaten chaff or oaten chaff, 1/4 bran.

ADDITIVE	Adult Miniature pony, less than 150 kg	Shetland & Medium ponies, 150 - 250 kg	13 - 15 h.h. Large pony or small horse 250 - 400 kg	15 - 16h.h. 400 - 500 kg	16 - 17h.h. + > 500 - 650 kg
DOLOMITE Twice per day or in every feed. It is better to slightly overdose than under dose.	1 level teaspoon or 10 grams twice daily	1 rounded teaspoon  or 15 grams twice daily	One level dessertspoon or 20 grams twice daily	One level tablespoon Or 30 grams twice daily	One rounded tablespoon or 50 grams twice daily
KELP POWDER Free choice from a feed bin. If adding to feed give every other day and stop after 2 - 4 weeks.	A-lib access or 1 level teaspoon or 10 grams.	Ad-lib access or 1 rounded teaspoon  or 15 grams.	Ad-lib access or 1 rounded dessertspoon or 20 grams.	Ad-lib access or 1 level tablespoon or 30 grams.	Ad-lib access or 1 rounded tablespoon or 50 grams.
BICARBONATE For short term use only (1-3 days). Bicarb can be mixed into a paste & squirted into the mouth ½ an hour before feeding if the laminitis was feed induced or if the patient is acidotic.	1 - 2 rounded teaspoons or  20 grams twice per day	2 - 4 rounded teaspoons or  30 grams twice per day	1 - 2 rounded dessertspoons or 40 grams twice daily	1 - 2 level tablespoons or 60 grams twice daily	1 - 2 rounded tablespoons or 100 grams twice daily
SULFUR (sulphur)	1 level teaspoon or 10 grams once daily	1 rounded teaspoon  or 15 grams once daily	One level dessertspoon or 20 grams once daily	One level tablespoon or 30 grams once daily	One rounded tablespoon or 50 grams  once daily
COPPER SULPHATE Minimise the risk of toxicity by always mixing into the same feed as dolomite. Can offer ad-lib (free choice) with dolomite.	¼ teaspoon  or 0.8 gram once per day	1/3 teaspoon or 1 gram once per day	1/3 teaspoon or 1 - 1.5 grams once per day	½ teaspoon  or 2- 2.5 grams once per day	½ - ¾ of a  level teaspoon or 2.5 - 3 grams once per day. Blacks and chestnuts may require the higher dose rate.
BORON As sodium borate  or boron sulfate. Borax is available from the supermarket cleaning aisle.	¼  teaspoon or 0.85 grams once daily for one week then ¼  tsp. once only per week.	¼  teaspoon or 0.85 grams once daily for one week then ¼  tsp. once only per week.	½ level teaspoon or 3.5 grams once daily for one week then ½ tsp. once only per week.	½ level teaspoon or 3.5 grams once daily for one week then ½ tsp. once only per week.	½ slightly rounded teaspoon or 4 - 5 grams once daily for one week then ½ tsp.. once only per week.
SELENIUM Supplementation is dependent upon local deficiency. à Refer to laminitis diet notes above.	Ad-lib kelp powder . If severe deficiency occurs in your area research additives carefully.	Ad-lib kelp powder If severe deficiency occurs in your area research additives carefully.	Ad-lib kelp & vitamin E If severe deficiency occurs in your area research additives carefully.	Ad-lib kelp powder ± vitamin E   If severe deficiency occurs in your area research additives carefully.	Ad-lib kelp powder ± vitamin E If severe deficiency occurs in your area research additives carefully.
CIDER VINEGAR 1 ounce = ~ 30 ml = 1 tablespoon. 60 ml = ¼ cup.	20 ml per day Mix with bran, honey and water until just damp, use to carry the other minerals	30 ml per day	50 ml per day	60  - 70 ml  per day	80 ml per day
COD LIVER OIL  Vitamins A, D, E & fatty acids.	5 - 10 ml once per day for 7 days then 1-2 times per week.	10 - 15 ml once per day for 7 days then 1-2 times per week.	20 ml once per day for 7 days then 1-2 times per week.	30 ml once per day for 7 days then 1-2 times per week.	40 ml once per day for 7 days then  1- 2 times per week.
LINSEED OIL Omega 3 fatty acids. Can be mixed with CLO (as above) 50:50	5 - 10 ml daily   reduce to every other day after 2 weeks.	10 – 15 ml daily reduce to every other day after 2 weeks.	20 ml daily   reduce to every other day after 2 weeks.	30ml daily   reduce to every other day after 2 weeks.	40 ml daily   reduce to every other day after 2 weeks.
VITAMIN C Sodium ascorbate powder. Decrease dose over several weeks or can be a part of ongoing diet.	5 - 10 grams or 1 - 3 level teaspoons per day.	10 - 15 grams or 3 - 5 level teaspoons. per day.	20 - 30 grams or 1 - 2 level dessertspoons per day.	30 - 40  grams or 1 - 2 rounded dessertspoons per day.	40 - 50 grams. Or 1 - 2 level tablespoons per day.
SALT Sodium chloride Unless in hard training salt should be by free choice separate to the mixed feed. Horses will select how much they need.	Free choice from a dish or as a block of rock salt.	Free choice from a dish or as a block of rock salt.	Free choice or as rock salt. Horses in heavy training may require 1 rounded tsp. in feed after strenuous exercise.	Free choice or as rock salt. Horses in training may require 1 rounded tsp. in feed after strenuous exercise.	Free choice or as rock salt. Horses in training may require 1 - 2 rounded tsp.s, in feed after strenuous exercise.

Home made mineral mix
USING A STANDARD CUP. ALL MEASURES ARE LEVEL.
2 CUPS OF DOLOMITE
1 CUP OF SULPHUR
1 CUP OF KELP POWDER
1 DESSERTSPOON OF COPPER SULPHATE
1 SMALL TEASPOON OF BORAX
1 HORSE = 8 DAYS SUPPLY
2 LEVEL DESSERTSPOONS PER FEED, TWICE PER DAY OR 1 TABLESPOON TWICE A DAY / 450kg HORSE

SALT is free choice e.g., a block of rock salt.

SUPPLIER
EQUINE SUPPLIES
P.O. Box 182, Pendle Hill, NSW.Australia. Phone 02 9688 3220 Fax 02 9636 9146
ASK FOR BARRY OR RICHARD GARFORTH AND TELL THEM I SENT YOU.
ASK FOR A CATALOGUE AND SHOP FROM HOME.

Natural Horse Care by Pat Coleby.

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