Managing The Horse With Cushing’s

The vet has diagnosed it and the reality begins to sink in – your horse has Cushing’s disease. Now what?  Cushing’s is an endocrine disease caused by a tumor on the pituitary gland that is most often seen in older horses and ponies. This tumor results in high cortisol and is most often exhibited by  hyperglycemia (high glucose), excessive thirst, excessive eating, excess urination and a shaggy haircoat.  At this time there is no cure for Cushing’s but by keeping a close eye on nutrition and management, we can improve the quality and possibly lengthen the life span of a Cushing’s horse.

Routine is important to the Cushing’s horse because changes in diet, medication, etc. can have negative effects on health.  Cushing’s horses have a compromised immune system and for that reason, seemingly small or mundane parts of their care become very important.  There are a few management practices that are particularly important: 

  • Deworming – Cushing’s horses can be more susceptible to parasites because of their weakened immune system.  Work closely with your vet to develop a deworming schedule and program that is catered to your horse. Your vet should also be seen regularly for dental care and wellness exams.
  • Farrier Care– Regular farrier visits are important because certain types of leg and foot conditions are more likely with a Cushing’s horse, such as abcesses of the hoof and laminitis. Signs of laminitis can be a tender footed stance and the horse acting like he is “walking on egg shells”. 
  • Grooming – Hair coat and temperature regulation are problems in Cushing’s horses so you will want to help your horse as much as you can by preventative grooming practices. Consider body clipping in hot/humid weather and be mindful of temperature and weather changes. When blanketing, make sure the hair coat is dry and clean to help reduce the incidence of skin issues. Prompt treatment of any wounds or infections is essential.
  • Feeding– One of the main goals in feeding the Cushing’s horse is to control the starch + sugar (NSC) content per meal. This helps to regulate the blood glucose and insulin levels.  The NSC content of the concentrates fed to the horse is important, but even more so is the content of the hay /forage and the combination of the two together. Some guidelines have suggested an NSC maximum value of 10-13% based on the total diet (forage + concentrate). Testing your hay will give you a good idea of the NSC values.
  • Consider a feed that is fortified with lysine, methionine, biotin, vitamin E and complexed trace minerals (copper, zinc, manganese and selenium) to help maintain muscle mass, support hoof growth and support the immune system.

Following these tips will help improve the quality and possibly length of life for the horse diagnosed with Cushing’s.  If you have specific questions regarding your horse, please work with a qualified nutrition consultant or your veterinarian.

Pre and Probiotics in Horse Feed

While scanning information about various horse feeds, you may have come across the phrase ‘contains prebiotics and probiotics’….Hmmm, sounds impressive, but what are they, what do they do for your horse, and why are they important?  Pre- and probiotics are considered “functional ingredients” that are added to horse feed to provide benefits to your horse. Here is some information about them and what they can mean for the digestive tract and overall wellbeing of your horse.

Healthy, inside and out
Rosie shows a dappled coat, indicating good health shining from the inside out.

It starts with the gut. The environment of the intestine (a.k.a. gut) contains naturally occurring beneficial microorganisms commonly called  ‘bugs’. Gut bugs are found in all species, including humans, and are essential to the digestion process. For the horse, gut bugs work to break down components of forage and feed as they pass through the digestive tract.  The bugs deconstruct complex molecules within feedstuffs, which releases nutrients and allows the synthesis of energy substrates and important vitamins. Those nutrients are then absorbed through the intestines into the bloodstream, where they become available to cells in the body to support basic maintenance, growth and activity.

Feed that is broken down and digested more completely allows for more nutrients to be readily available for absorption.  This is essentially what probiotics do. Adding probiotics to a horse feed means adding more beneficial bugs to the existing population in the horse’s gut. Probiotics such as yeast culture, work with the naturally occurring bug population to enhance the digestive process, further breaking down complex protein and fiber fractions in the gut and making them more available for absorption into the blood stream. As a probiotic, yeast culture has also been shown to balance and stabilize the digestive microbial ecosystem in the cecum of the horse, as well as help prevent the colonization of bad bacteria in the gut.  A stable microbial ecosystem is beneficial to the horse beyond improvements in digestive and absorption efficiency, it also reduces the risk of digestive upset, such as gas colic, that a horse might experience with changes in feed or hay, or while under stress from transportation, shows, changes in weather or other.

Prebiotics can be thought of as an energy jolt for the gut bugs.  Prebiotics are a rich nutrient source for the gut bugs (e.g. lactobacilli, bifidobacterial) which in turn stimulates their growth and activity, making them more effective at their job. Research has shown that prebiotics help stabilize the population of gut bugs even through sudden changes in the diet, which helps to reduce incidents of digestive upset.  For performance horses who require energy dense diets that include higher levels of starches and sugars, prebiotics can help reduce the incidence of digestive disorders and support optimal performance.  Prebiotics such as inulin and oligofructose are selectively fermented by the gut bugs, stimulating their growth and activity, which benefits the horse by enhancing the absorption and retention of certain minerals, which in turn can support the immune system, skeletal tissue, and more.

The population of bugs in the gut are sensitive to changes in their environment brought on by stress, illness or the ingestion of undesirable materials .The addition of pre- and probiotics to a diet has been shown to be beneficial in reducing the incidence of digestive upset, namely diarrhea. For senior horses, the use of pre- and probiotics in feeds has been shown to improve the digestibility and absorption of nutrients, which can translate into an enhanced quality of life.  In summary, pre- and probiotics work with the naturally occurring gut bugs to support optimal gut health, aid in the digestion process, as well as provide a buffer against negative bacteria.

Laminitis in Horses – What can you do?

Many times when our animals are sick it can be hard to know what to do – how to feed them, how to help them, and how to make them feel better. With laminitis, the main thing you can do as a horse owner is to take steps to prevent it from happening. But if your horse does fall victim to this disease, knowing the appropriate diet and way to feed will help with the healing process.

Prevention of Laminitis
I’m sure you’ve heard the phrase “The best offense is a good defense.” That is certainly true with the hoof disease laminitis – here are some simple steps to improve your defense and help prevent this disease:

  • Keep concentrate meals at 5 lbs. or less to avoid overwhelming the capacity of the upper GI tract (prevent starch leakage to the hind-gut)
  • Restrict turn out time for those not used to spring grasses. This helps control intake of grasses that are high in sugar.
  • Sugar content (fructans) in grasses may be higher mid day & afternoon. Time turnout in the evening, nighttime and early morning hours

Closely monitor ponies and older horses, as they are often more prone to acute and/or chronic laminitis:

  • Restrict turn out time
  • Utilize a grazing muzzle when appropriate

Feeding the Laminitic Horse
For horses that are prone to bouts of  laminitis or  who are recovering from an episode with the disease, the overall diet is very important.

1. Feed a low-calorie, controlled carbohydrate feed

Turning horses out to pasture at the right time of day may help prevent laminitis

2. Feed smaller meals on a more frequent schedule

3. To aid in damaged hoof repair and growth, look for feeds that also contain guaranteed levels of:

For the laminitic horse, balance is key – once tissue damage has occurred it is imperative to provide a well balanced diet to encourage repair and healing. While it is important to manage calories closely, particularly calories from starches and sugar, we also have to strive to balance the overall diet for the best result.  Understanding the nutrient content of the hay your horse is eating is important to determine the nutrient content of the total overall diet (hay plus concentrate). It is a great idea to consider having your hay tested and factoring those results into your feeding program.

Warm Mashes for Senior Horses

Gayle's 32 Year Old Arabian, "Radar's Count"

I received an email from one of my clients asking for a recipe for a “Safe Warm Mash” for her senior horse.   She thought a bran mash would be a good choice, but was unsure as to ingredients or cooking instructions.  The particular horse is 23 years old and a body score of a solid 6. He is showing some early signs of Cushing’s disease. His current diet is grass hay and Nutrena’s SafeChoice Senior horse feed, as well as daily pasture turnout.

I have never understood why so many educated consumers, that take the time to transition a horse gradually from one feed to another over 5-7 day period would want to take this chance.  A one meal change in a horse’s diet may not cause colic or founder, but it can cause enough of a change in the microbial balance to cause diarrhea or gas, especially in a senior horse.   The fact that the calcium and phosphorus ratios in bran are also so out of balance for horses makes me uncomfortable, as we strive for a 1:1 or 2:1 ratio of calcium to phosphorus, not 1:12 as is in bran.   This is important for proper metabolic function and to maintain bone integrity.

The good news is that there is a safe alternative to making a bran mash!  I contacted my client and told her that she already had the ingredients to make a mash for her horse – his senior horse feed – and the most important nutrient in a horse’s diet – water.  Senior feeds are high in fiber, as well as properly fortified with calcium and phosphorus.  By simply soaking a serving of her horse’s senior feed with warm water for 5-8 minutes until it reaches a consistency her horse will enjoy, she will have a nice warm mash for her senior horse.

Feeding a horse with Cushing’s Syndrome

As the number of horses known to have Cushing’s Syndrome increases, questions on how to feed horses with this condition also increase.  As a starting management practice, your veterinarian may recommend pergolide as an added medication for your horse.  This is available from a number of pharmaceutical sources by prescription.

When it comes to feeding them, though, here are a few tips that may help make life a little easier:

  1. If your Cushing’s horse has some joint problems, you may want to also consider using one of the chondroitin sulfate + glucosamine products that are available in supplement form.
  2. Cushing’s syndrome horses require a hay or pasture source that is low in non-structural carbohydrates (NSC), so you might want to have your forage tested.
  3. They do well on senior feeds that are fortified with lysine, methionine, biotin, vitamin E and organic trace minerals (copper, zinc, manganese and selenium) to help maintain muscle mass, support hoof growth and support immune response.
  4. Feeding directions need to be followed to make certain enough senior feed is being fed as these older horses may not be able to utilize forage very efficiently.
  5. If your horse is not maintaining weight, you may need to increase the feeding rate of the senior feed or add a low starch, rice bran based high fat supplement.

Most senior horses with Cushing’s Syndrome do very well on a senior feed and appropriate medication.  Cost of pergolide can vary greatly and your veterinarian may be able to direct you to the best source.  Good luck, and please let us know if we can help!

Feeding Senior Horses

Gayle's 23 year old Arabian, Scooter

I recently visited a horse owner that wanted to know when it was time to start feeding senior feed to her horse. She currently had him on a 10% protein sweet feed mix. She said he was underweight and not sure why, as she was providing the horse about 20 pounds per day, but he was not eating it all.  I explained that we often begin to watch horses for signs of being a “senior horse” around age 15-18.  Some may go much later in to life before showing signs, but somewhere in this age range is when we watch for signs of decreased muscle mass, decreased quality of hair coat, and an inability to maintain weight on their “normal” diet.

With this horse, I found small clumps of chewed hay on the ground around his feeder, or “quids” as they are called. This happens due to dental deterioration or loss, which inhibits the horse’s ability to chew his hay. Upon examining the horses manure, we noticed a lot of undigested grain. I suggested that the owner have the horse’s teeth floated, as well as have blood work drawn to check for Cushing’s or other metabolic issues. Once the horse’s teeth were taken care of, and any metabolic issues ruled out, we could move toward a more suitable senior diet.

As horses grow older their ability to digest feed and absorb nutrients becomes less efficient. Senior horse feeds will generally have the following elements to make sure older horses are receiving all the nutrition they need:

  1. Increased protein level in order to provide proper amino acids, such as lysine and methionine, for metabolic functions, muscle maintenance and hoof quality.
  2. Elevated fat content to provide extra calories, with the benefit of Omega 3 and Omega 6 fatty acids.
  3. Yeast cultures & direct-fed microbials (more commonly known as prebiotics and probiotics, respectively) to support nutrient digestion.
  4. Organic trace minerals that are more highly bioavailable than traditional trace mineral sources.
  5. Enhanced calcium and phosphorus levels to help guard against bone demineralization.
  6. Manufactured as a soft, high fiber pellet that is easily chewed. In cases where dental loss is extreme, the feed can even be mixed with equal parts warm water to form a mash.

Also, with senior feeds, if the horse is unable to chew any hay, the diet can be adjusted to 4 or 5 feedings of senior feed per day, to meet caloric requirements.