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Feeding to Avoid Laminitis
Sophie Edwards MSc, BSc (Hons), BHSSM, Nutritionist, Allen & Page

We are rapidly approaching the time of year when the prospect of laminitis begins to loom. But what exactly is this serious condition, what causes it and what are the best ways to avoid it? Understanding the problem is the most effective way of solving it, and here are the basic facts you will need to bear in mind this spring.

Laminitis is a very painful condition that affects the feet of both horses and ponies. It results from changes in the blood chemistry that lead to a restriction in blood flow to the laminae (the tiny interlocking structures that support the foot within the hoof capsule). Any or all the feet can be affected, but most commonly laminitis occurs in the two front feet.

The exact causes of laminitis are unclear, although there are several factors that may lead to the condition. The number of incidences increases dramatically in spring and again in late summer when there is rapid grass growth and the grass is particularly high in fructan (a type of soluble carbohydrate). This is considered to be a major contributing factor to the onset of laminitis. Also, feed overload when a horse breaks into a feed bin or when it is given very large meals can result in excess soluble carbohydrate and thereby trigger laminitis. Overweight horses and ponies tend to be more susceptible and trauma, toxaemia, stress and some drugs are also thought to play a significant part in the condition.

Only a vet can properly diagnose laminitis, but there are certain signs that should make you suspect a problem. The disease can vary in severity and thus the symptoms can also vary. In mild cases the horse may just be a little uncomfortable, shifting its weight from one foot to another when standing still. Many laminitic horses adopt a characteristic stance, with the forelegs stretched forwards and the weight borne on the heels to relieve pressure from the toes. In severe cases the horse may spend most of its time lying flat out on its side or may be reluctant to move and be lame, with very careful, 'pottery' strides, when he does. In some cases there may be a visible depression on the coronary band which indicates movement of the pedal bone. In most cases the feet will be unusually warm, and there will be a strong digital pulse just underneath the side of the fetlock.

If you suspect that your horse or pony is laminitic treat it as an emergency and call your vet immediately. If the horse is reasonably comfortable walking then bring him into a stable and provide a good thick bed (preferably shavings or paper) to ease the pressure on his feet. On no account should you allow him access to grass. Bear in mind that if he is in a lot of pain, it is better not to force him to walk - it could easily do further damage. In this case wait for the vet to arrive before moving him.

Too much lush grass or an overload of hard feed can set in train the chemical and physical process that results in laminitis. Large amounts of food in the stomach or an intake of high fructan grass causes an overflow into the large intestine. This means that soluble carbohydrate, particularly fructan, that should be digested in the small intestine overflows into the hindgut, undigested. This upsets the microbial balance in the hindgut, and bacteria that prefer soluble carbohydrate and fructan take over from the normal fibre-digesting bacteria. Undesirable metabolic compounds are then released into the gut, and from there enter the bloodstream. This disrupts blood circulation and pressure and laminitis is triggered.

So what exactly are these undesirable fructans? When plants photosynthesise, their leaves absorb carbon dioxide in the atmosphere and, in the presence of light, use it to produce sugar. The sugar can either be used to fuel the plants growth, or it can be made into larger storage carbohydrates for use later on. Initially the grass will store fuel as sugar, but once stores reach a certain level sugar is converted and stored as fructans. When the grass is using a lot of energy for rapid growth or flower development, sugar and fructans will be used up, so the amount stored will decrease. On the other hand, when growth is reduced but photosynthesis continues, fructan levels in the grass will increase. Most simple carbohydrates ('sugars') found in grass, other forages, and concentrate feeds, are effectively digested by enzymes in the small intestine. Fructans are simple carbohydrates which may be not be digested efficiently in the horse's small intestine but instead end up undigested in the large intestine, where they are then available for microbial fermentation, which will interfere with the normal digestive process.

There are a number of steps you can take, particularly concerning feed, that will reduce the likelihood of laminitis. An essential element of managing this condition and of minimising the risk of it occurring is to keep a close eye on your horse or pony's weight and ensure that he is in 'trim' condition rather than overweight. Starvation is not the answer, and reducing the pony's dietary intake too much can lead to hyperlipaemia. This occurs when high levels of fat are released into the blood in response to starvation. It is vital that a horse or pony with laminitis is fed a diet that is high in fibre and contains essential vitamins and minerals, or his metabolism will not continue to work properly. You may well find it necessary to change to a feed that is higher in fibre and lower in starch, without lots of cereals. As with any new feed, it should be introduced gradually, and this will allow the gut microflora time to adjust. It is also a good idea to feed little and often - the total feed amount is best split into at least three small meals. You can make hay last longer by using a net with smaller holes.

The main points to remember to avoid laminitis are that, naturally, prevention is always better than cure and you should endeavour to keep your horse away from the causes of laminitis. Do not allow your horse or pony to get too fat - if your horse is overweight reduce his feed or change to a low-calorie high-fibre feed such as Slim & Healthy or 'L' Mix. Do not "starve" your horse as this can lead to other problems - he should still receive a total of 1.5% of his bodyweight in feed each day.

Grazing should be restricted in some way, especially in the spring and again in the autumn when there is a second flush of grass - if you are unable to 'strip graze', you can use a grazing muzzle. If you do turn your horse out, it is best to do so late at night, bringing him in first thing in the morning; however, avoid turning out on days when there has been a frost followed by bright sunny weather. More fructan is found in the stem of the grass than the leaf, so do not graze horses on freshly cut stubble, for example, after a cut of hay. Ensure that your management strategy keeps grass short and leafy by regular cutting or grazing - this will help reduce the fructan level as it will be used to support the regrowth of the grass.

When deciding on what to feed your horse, remember to feed according to the work your horse is doing - increase work before you increase feed. It is best to use feeds that are high in fibre and low in sugars and starches, such as Allen & Page's Sugar & Cereal Intolerance Diet or Slim & Healthy. This will provide sufficient nutrients for most horses and ponies - an overfed horse is not a healthy horse. The best way to prevent an attack of laminitis is simply to be prepared! Get your horse to the correct physical condition before you turn him out in the spring.

For more information on Allen & Page feeds or advice on what to feed your horse contact: Allen & Page, Norfolk Mill, Shipdham, Thetford. Norfolk IP25 7SD. Telephone: 01362 822902, Fax: 01362 822910
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