Dante Carrillo
Laminitis is a painful and debilitating condition that affects horses and ponies. It is caused by a systemic inflammatory response to certain conditions and is often associated with a genetic predisposition that makes them intolerant of diets high in sugar and starch. The condition can also be caused by an overload of carbohydrates, including non-structural carbohydrates (NSCs) such as starch and sugar, which are found in grains, oats, barley, corn, and molasses. Therefore, it is essential for horse owners to carefully manage their horse's diet and restrict access to grass pastures, especially during spring and autumn when the grass is stressed or has high NSC content. This involves providing a low-starch and low-sugar diet, as well as ensuring the horse receives all the necessary vitamins and minerals, and other nutrients.
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What You'll Learn
High-sugar and starch diets can cause laminitis
High-sugar and starch diets are a critical factor in causing laminitis in horses. This condition is linked to a genetic predisposition that makes certain horses intolerant of diets high in sugar and starch. It is estimated that 90% of laminitis cases are caused by high insulin/hyperinsulinemia in horses with metabolic syndrome or Cushing's disease (PPID).
Laminitis is an extremely painful and debilitating condition that can cause long-term damage to horses. It is the result of a systemic health issue that manifests in the hooves. The number one cause of laminitis is the overloading of the hindgut with rapidly fermentable carbohydrates, which causes an increase in lactic acid production. This, in turn, leads to acidosis, which kills off beneficial bacteria and releases endotoxins, reducing blood flow to peripheral tissues. The soft tissue in the hoof capsule is highly susceptible to damage from decreased blood flow.
Horses that break into the feed room and consume large amounts of starch and sugar are at risk of developing laminitis. Feeding plans should be designed to provide less than 10-12% HC (hydrolyzable carbohydrates), which include starch and ethanol-soluble carbohydrates (ESC). ESC represents the simple sugars that are easily digested in the small intestine and contribute to a sugar spike in the blood. A diet low in simple sugars and starch is critical for reducing the risk of laminitis.
To prevent laminitis, it is important to restrict grazing on lush pastures, especially during spring and autumn when grass is stressed or has high NSC (non-structural carbohydrate) content. Horses with laminitis should be removed from pasture immediately and provided with a vitamin and mineral supplement to support hoof growth. Hay is the basis of any diet for a horse prone to laminitis, and it should be low in sugar, starch, and NSC. Timothy, Teff, and Rhodes grass hays are safer forage options, while ryegrass, oaten, wheaten, and barley hays should be avoided due to their high fructan content.
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Non-structural carbohydrates are linked to laminitis
Non-structural carbohydrates (NSCs) are simple sugars, starches, and fructans that can induce laminitis. NSCs can accumulate to over 400 g/kg of dry matter in pasture grasses. Horses that break into feed rooms and consume large amounts of starch and sugar are at risk of developing laminitis.
Grazing on lush pastures can also lead to laminitis. It is important to restrict grazing during spring and fall by limiting turnout time or using a grazing muzzle. Horses should be removed from pastures by mid-morning through early evening to avoid overconsumption of NSCs.
The best forage for horses prone to laminitis is one that is low in sugar, starch, and fructans (NSCs). All forage intended for feeding should be tested for NSC levels and be below 10%. Safer forage options include Timothy, Teff, and Rhodes grass hays.
To reduce NSC content in hay, it can be soaked in water to leach out the sugars. Hay can be soaked in double its volume of water for a minimum of two hours with hot water or ten hours with cold water. The greater the volume of water used for soaking, the more NSCs will be removed.
Supplements such as Founderguard can also help reduce the risk of laminitis by manipulating the microbial population in the hindgut to reduce lactate production and the subsequent drop in pH.
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Insulin dysregulation is a risk factor
Horses with insulin dysregulation and hyperinsulinemia are at a greater risk of developing other metabolic problems, such as equine metabolic syndrome (EMS), and laminitis secondary to these conditions. EMS is a disorder associated with an inability to regulate blood insulin levels (insulin dysregulation) and increased fat deposition. It is often associated with \"thrifty\" equids such as ponies, donkeys, Arabians, and mustangs. Horses with EMS are at a high risk for laminitis, especially when provided with access to pasture or high-carbohydrate feeds.
Insulin dysregulation can be caused by an increase in fat stores in the liver, which can predispose the affected animal to insulin dysregulation due to the downregulation of insulin receptors. This can lead to decreased nitric oxide production and promote vasoconstriction. Altered glucose and insulin concentrations may also lead to altered epidermal cell function and glucose uptake by epidermal laminar cells. These effects predispose horses with EMS to develop laminitis.
To prevent laminitis, it is critical to reduce the risk of insulin dysregulation by feeding horses a diet low in simple sugars and starch. This can be achieved by providing access to grass at times of the day when NSC content is low, feeding a hay-only diet with a balancer supplement, or feeding grass hay that has been soaked to reduce NSC content. It is also important to determine the weight and body condition score (BCS) of the horse before making any dietary changes.
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Obesity and metabolic syndrome can cause laminitis
Obesity and metabolic syndrome are closely linked to laminitis in horses. Overweight horses are more likely to develop laminitis, a painful and potentially life-threatening condition. This is often due to abnormal fat deposits in certain parts of the body, known as "regional adiposity". Obese horses may exhibit physical signs such as a thick and firm neck, puffy tail heads, swollen mammary glands, and bulging eyes, all of which indicate fat deposition.
Horses with obesity may also develop insulin resistance, which is a key factor in the development of laminitis. Insulin resistance is caused by an imbalance of certain hormones, leading to abnormal insulin levels. This, in turn, affects the body's ability to regulate blood sugar levels effectively. Additionally, fat cells (adipocytes) produce substances that incite inflammation, further predisposing the horse to laminitis.
Metabolic syndrome, also known as Equine Metabolic Syndrome (EMS), is a genetic condition that predisposes horses to weight gain, even with appropriate feedings. Horses with EMS have a genetic disposition that makes them "easy keepers," meaning they tend to gain weight easily. EMS is characterised by abnormal control of carbohydrate metabolism, resulting in abnormally high insulin levels. This excessive insulin response to starches and sugars in the horse's diet can trigger laminitis.
The risk of laminitis is also influenced by the quality of pasture and grazing habits. Overconsumption of high-starch and sugar grains, either in a single meal or through unrestricted grazing on lush pastures, can lead to laminitis. Therefore, it is crucial to monitor a horse's diet and grazing habits to prevent obesity and reduce the risk of laminitis.
To prevent and manage laminitis in obese horses or those with metabolic syndrome, dietary modifications are essential. This includes reducing the intake of non-structural carbohydrates (NSCs) and providing access to grass at times when NSC content is low. A low-calorie, low-NSC diet, such as grass hay with less than 10-12% NSC, is recommended. Additionally, soaking hay in water can help leach out sugars and reduce NSC content.
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Forage-first diets are recommended for laminitis-prone horses
Horses prone to laminitis should be fed a diet that is low in sugar and starch, with a combined level of these nutrients below 10%. For this reason, forage-first diets are recommended for laminitis-prone horses. Forage should make up 80–100% of the horse's diet, depending on their workload, body weight, and whether they are being fed to prevent laminitis or are actively suffering from the condition. Fibre-rich forages, such as grass, hay, haylage, silage, beet pulp, soybean hulls, straw, and chaff, are broken down by microbes in the gut to produce volatile fatty acids (VFAs).
When selecting forage for a laminitic horse, it is important to choose a variety that is low in sugar, starch, and fructans (non-structural carbohydrates or NSC). Timothy, Teff, and Rhodes grass hays are safer choices, while hays containing high amounts of fructan, such as ryegrass, oaten, wheaten, or barley hays, should be avoided. If the NSC level of the hay or chaff is unknown, it is recommended to soak it in double its volume of water for a minimum of two hours (if using hot water) or ten hours (with cold water) to leach out the sugars.
In addition to choosing the right type of forage, it is crucial to provide the appropriate quantity. The amount of forage fed to a laminitis-prone horse should be based on their weight, body condition, and workload. These horses should not be fed less than 1.5% of their body weight in forage per day, unless advised by a veterinarian. Insufficient forage intake can lead to rapid weight loss and metabolic conditions such as hyperlipidemia.
To reduce the risk of laminitis, it is also important to manage the horse's pasture environment. Techniques such as strip grazing, bare/sparse paddocks, and track systems can help control calorie intake and encourage exercise. Laminitic horses should be restricted from grazing on stressed short grass, frosted, or drought-recovering pastures, as well as avoiding grazing in full sun during the day and during periods of high pasture growth, such as spring and autumn.
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Frequently asked questions
Laminitis is caused by a horse's diet being too rich in sugars and starch. This can be genetic or due to overconsumption.
A low-starch, low-sugar diet is best for a horse with laminitis. Teff hay, Rhodes grass hay, lucerne hay, beet pulp, or soaked grass hay are good low-sugar roughage sources.
Signs of laminitis include a slight reluctance to turn or shortening of stride.
To prevent laminitis, ensure your horse receives at least 1.5% of its body weight as forage per day and minimise or avoid cereal-based feeds.
The main cause of laminitis is an overload of non-structural carbohydrates (NSCs) such as starch and sugar.
