Plenty has been written about the prevention, causes, and treatment of founder, but less information is available on whether or not afflicted horses will “successfully” recover. The answer, despite the availability of clinical exams to guide prognosis, is not as straightforward as it may seem. Here, two leading experts in their fields, as well as the owner of two horses stricken with founder, weigh in.

Diet & Equine Metabolic Syndrome

Raul Bras, DVM, CJF, APF, a shareholder and practicing veterinarian at Rood & Riddle Equine Hospital in Wellington, Fla., has extensive experience treating horses experiencing laminitis and founder. He says that diet and its relationship to equine metabolic syndrome (EMS) is likely the most common contributing factor.

“A very high percentage of laminitis and foundering of horses is due to equine metabolic syndrome,” he explains. And changing the diet, once EMS has been identified as the cause, can be one factor that contributes to whether or not your horse will recover.

“If the owner is not willing to put the horse on a weight loss plan, there is nothing you can do to the foot that is going to fix it or stop it,” says Travis Burns, M.S., CJF, TE, EE, FWCF, and associate professor of practice and chief of farrier services at the Virginia-Maryland College of Veterinary Medicine in Blacksburg, Va.

Since it is very easy to slip back into old habits and patterns, you should continue to diligently manage your horse’s diet going forward after receiving such a diagnosis.

“You have to keep the horse at an appropriate body condition score and have his metabolic profile within normal limits, or you are just fighting an uphill battle,” Burns adds.

Identifying Problems Early

While most horse owners are vigilant about having their veterinarians out to administer yearly vaccinations and dental exams, fewer have diagnostic tests, such as annual X-rays and barn-side insulin testing completed. This is particularly important with horses and ponies that are genetically or otherwise predisposed, in order to seek out possible problems before they arise.

Regarding insulin testing, Bras initially likes to test as much as possible to achieve a baseline.

“You have four seasons of the year. If you [test] in the winter, spring, summer, and fall, you can see how [insulin levels] fluctuate,” he says. Once the baseline has been noted, your vet can monitor for increases to it on an annual basis and make changes to the horse’s diet well before he experiences laminitis or founder.

Knowing if your horse is predisposed to a condition such as EMS goes well beyond making dietary changes. It can also help guide you in avoiding over-supplementation and in the treatment of other medical conditions your horse may develop.

For example, in some instances treating with steroids can trigger the development of laminitis. Bras advises that rather than helping, both over-supplementation and over-medicating can make laminitis and founder more difficult to treat.

Using a Venogram

Venograms, a type of contrast radiograph study, play a critical role in assessment, as early identification is a top contributing factor as to whether or not your horse will make a successful recovery.

“It all comes down to blood supply,” says Bras. “That’s why I am a proponent of the venogram.”

He likens venograms to weather reports because they give you time to prepare and potentially even prevent problems before they arise. By knowing that the blood supply to the foot has been compromised before a problem has already presented itself, you can take a proactive rather than a reactive approach to certain elements (such as farrier and dietary modifications) of your management plan.

Corrective shoeing, for example, can work to counteract mechanical failure, while dietary changes can address weight and metabolic issues before problems occur.

Aggressive Treatment

Should your horse experience laminitis or founder, immediate, bold treatment can play a key contributing factor in whether or not your horse will recover. Bras advises avoiding a “wait and see” approach. Instead, he recommends assessing the damage and determining how much blood supply is present, and using that knowledge to make decisions as to how to proceed.

While it may seem logical to think that a horse who experiences a high degree of rotation will be unlikely to recover, Bras explains that this may not be the case.

“You might have a horse that has equine metabolic syndrome and has an acute foundering that doesn’t rotate much or another with a lot of rotation,” he says. “Even if you have a lot of rotation, if you have identified it right away, there’s a strong chance you can save a horse.” He emphasizes that each case is individual.

Emergency Treatment

Should a horse experience laminitis but rotation has not yet occurred, Bras recommends the application of the NANRIC Ultimate cuff shoe as long as the bone alignment matches the shoe.

“That shoe gives the horse 18 to 20 degrees heel elevation,” he says. “The heel elevation helps to optimize the blood supply to the hoof, thereby increasing the chances for a successful outcome.”

Because it doesn’t have to be glued or nailed on, any veterinarian, farrier, or owner (under veterinary supervision) can apply it simply by wrapping it on to secure it to the hoof.

Monitoring sole depth, degree of rotation, and the amount of blood supply during this process are all factors that will guide your veterinarian in directing treatment options, including making the call in extreme cases as to whether or not the deep digital flexor tendon (DDFT) should be severed to relieve tension and prevent rotation of the coffin bone.

Signs Indicating Outcome

According to Burns, marked improvement in the horse’s comfort, the return of vascular perfusion and growth of the horse’s foot—specifically in terms of sole depth—are all signs that your horse may make a recovery and return to his previous level of performance, or at least a modified version of it.

As a referral farrier making recommendations to help achieve successful outcomes for farriers in the field, Burns recognizes the need to work within principles rather than methods. Understanding that varying methods can all reach the same goal, he says that the first and foremost guiding principle he would like to achieve is recruiting the frog and sole into load-bearing.

This can be accomplished by any number of methods preferred by the horse owner’s farrier, including pads, heart-bar shoes and clogs, all aimed at meeting the needs of both the horse and the owner’s management situation. No matter the method, Burns likes to see a shoe that relieves tension on the laminae when the horse is moving even when he is turning.

Burns also recommends principles to realign the hoof capsule around the distal phalanx (P3 or coffin bone).

“If a horse can’t or won’t show growth, particularly under the tip of P3 or sole depth region, that is a bad sign,” he says.

As treatment progresses, Burns recommends lowering the heel to an appropriate palmar angle for the individual horse without causing increased tension on the DDFT, which results in increased tension on the laminae.

Finally, he advises dressing the hoof wall back to match the dorsal surface of the coffin bone. He says that if the bone stays healthy, you’ve got a much better prognosis for a return to athletic performance.

In the end, both Bras and Burns recommend the combined efforts of a veterinarian/farrier team.

“It’s not a good idea to think that your farrier can handle it on their own,” says Burns.

This article about treatment and recovery of founder appeared in the April 2023 issue of Horse Illustrated magazine. Click here to subscribe!

The post Treatment and Recovery of Founder in Horses appeared first on Horse Illustrated Magazine.

Researchers from the University of Kentucky were looking for an effective way to reduce inflammation in horses suffering from equine metabolic syndrome (EMS), characterized as overweight and insulin resistant. EMS is generally treated with one of two pharmaceuticals—metformin or levothyroxine. However, there are questions about their efficacy and long-term usage. In humans, supplementation with the long-chain omega-3 fatty acid docosahexaenoic acid (DHA) has been shown to improve insulin sensitivity, promote fat loss, and reduce inflammation. The purpose of this study was to determine if DHA supplementation would have the same beneficial impact on horses, especially metabolic horses.

In a natural setting, pasture grasses provide the omega-3 fatty acid known as alpha linolenic acid (ALA). ALA is one of two essential fatty acids, meaning it cannot be produced, and hence, must be in the diet. Within the horse’s tissues, ALA is converted to DHA, which has potent anti-inflammatory properties. However, the conversion rate is not efficient enough to offer significant potential for the horse already suffering from high levels of inflammation. Consequently, the researchers chose to supplement DHA directly.

Fish oils are high in DHA and another omega-3 known as eicosapentaenoic acid (EPA). However, horses may have a palatability issue with many fish oils. Also, DHA has been shown to be more readily incorporated into tissues than EPA. Because of these factors, the researchers decided upon a DHA-rich microalgae for their study. Ten mixed-sex and mixed-breed horses with EMS were fed 16 grams of DHA per day for 46 days. Inflammatory status, glucose, and insulin were measured before and after the experiment.

The results showed a remarkable reduction in inflammatory markers. And interestingly, horses fed DHA-rich microalgae showed a lower insulin response to oral sugar administration than the control group experienced.

Implications of DHA Supplementation for Your Horse

Insulin is highly inflammatory, and can be elevated with Cushing’s disease, metabolic syndrome, and stress. It can lead to increased fat storage and leptin resistance, creating a vicious cycle of overeating and obesity. Reducing insulin, and hence, inflammation, can do wonders for a horse with metabolic conditions. Omega-3 fatty acids can assist with this.

Adding ground flax seeds, chia seeds, and hemp seeds to the diet will offer the two fatty acids that are considered essential: ALA–an omega-3, and linoleic acid (LA)–an omega-6. And for most horses, these feedstuffs will meet their needs. (Keep in mind that hay has virtually no essential fatty acids left.) But in circumstances where a horse has high levels of inflammation, the addition of DHA is a better approach because it is far more effective at modulating insulin and inflammatory markers than ALA.

Though not specifically tested in this experiment, the researchers also commented on how high-DHA microalgae can improve glucose and insulin response after dexamethasone administration. This is a significant piece of information for horse owners who may be reluctant to used dexamethasone on a short-term basis for allergies or other minor disorders when the horse also has metabolic issues.

Bottom line … consider high-DHA microalgae supplementation to help your horse recover from insulin-related metabolic conditions.

The post DHA Supplementation May Reduce Inflammation in Metabolic Horses appeared first on Horse Illustrated Magazine.

The relationship between iron levels and insulin sensitivity has long been recognized and studied in humans and other animals, but largely ignored in the equine population, including in horses with equine metabolic syndrome (EMS). With the knowledge that elevated circulating insulin is the direct and most common cause of laminitis associated with equine metabolic disorders, the association between equine insulin and iron dysregulation needs further investigation.

Eleanor Kellon, VMD, and Kathleen Gustafson, PhD, of the Equine Cushing’s and Insulin Resistance Group (ECIR) performed a retrospective analysis of lab results maintained in the group’s database and data from the only controlled feeding study in horses. The ECIR Group is the largest field-trial database for Pituitary Pars Intermedia Dysfunction (PPID) and EMS in the world and provides the latest research, diagnosis, and treatment information, in addition to dietary recommendations for horses with these conditions.

The latter study was specifically designed to substitute horses as a model for captive black rhinos, a cousin of the horse, because the researchers recognized the relationship between metabolic disease and iron overload in rhinos.

Equine Metabolic Syndrome and Iron Levels

All animals from the ECIR database had abnormally elevated insulin (hyperinsulinemia). Ferritin, a measure of body iron stores, also exceeded the published reference range in all animals, and there was a tendency for iron levels to increase with age. Likewise, data from the previously published report showed that ferritin was significantly elevated in the group with confirmed hyperinsulinemia when compared to the group with a normal insulin response.

Kellon and Gustafson suggest that these results indicate possible similar interactions between hyperinsulinemia and body iron burden in the horse and that iron may be a modifiable risk factor for hyperinsulinemia. They emphasize that iron is unlikely to be a primary causal factor, but that the interaction is worth scientific investigation in controlled studies. Studies investigating the bidirectional relationship between iron and hyperinsulinemia in horses are extraordinarily limited, despite considerable scientific inquiry in other species. The goal should be to increase awareness of the potential for iron overload in horses with hyperinsulinemia and stimulate further study.

The full study, “Possible Dysmetabolic Hyperferritinemia in Hyperinsulinemic Horses,” can be found online.

About the Equine Cushing’s and Insulin Resistance Group

The mission of the ECIR Group Inc. is to improve the welfare of equines with metabolic disorders via a unique interface between basic research and real-life clinical experience. Prevention of laminitis is the ultimate goal. The ECIR Group serves the scientific community, practicing clinicians, and owners by focusing on investigations most likely to quickly, immediately, and significantly benefit the welfare of the horse.

For more information, please visit www.ecirhorse.org.

The post Equine Metabolic Syndrome Cases Demonstrated Increased Iron Levels in Recent Study appeared first on Horse Illustrated Magazine.