Digestive Health Webinar


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  • Horses need long-stem forage because:1. Increases the particle size of ingesta, thereby slowing the rate of passage (ie keeps food in the stomach longer and may help prevent ulcers)2. Increases dry matter intake, stimulating water intake3. Reduces behavioral problems since providing natural chewing
  • Duodenum, jejunum and ileum; cecum, large colon (ascending descending and transverse) and small colonCecumRight ventral colon to sternal flexure,Left ventral colon to pelvic flexure,Left dorsal colon to diaphragmatic flexure,Right dorsal colonTransverse colon
  • PrehensionMasticationEnsalivationHorses have low levels of amylase in saliva, an enzyme that breaks down carbohydrates
  • Hard for horse to expel gas or fluid forward;regurgitation, vomiting and belching are abnormal due to anatomy of esophagus and cardiac valve of stomach
  • Think of the stomach like a cement truck!Smallest stomach in relation to body size of all domestic animals
  • Pancreas and Liver (also makes Vitamin C) Feed no more than ½% body weight in grain per meal, feed 3-4 times daily instead of once or twice
  • Pancreas and Liver (also makes Vitamin C) The same enzyme is used to cleave animal fat as vegetable fat, so it is equally digestible to the horse, just not as palatable
  • Cecum is “fermentation vat”Large colon is 10-12 feet long, small colon is also 10-12 feet long
  • Dan Burke: it’s a party in the hindgut!Feed fluctuationsSternal, pelvic and diaphragmatic flexuresPathogenic = disease-causingLowering of pH favors pathogenic bacteria (“bad bugs”) which ultimately can lead to decreased appetite, colic, decreased feed efficiency, weight loss, behavioral problems (sour attitidue as well as stereotypies such as wood chewing, stall walking and weaving), poor performance and even laminitis
  • GI derangement
  • Simulated conditions representing activities typical in the recreational use of horses were determined to cause gastric ulcers in as little as five days. “The condition of erosions and ulcerations occurring in the lower esophagus, non-glandular and glandular stomach, and upper duodenum”Physical—acute and recurring colic, loss of weight and condition, reluctance to eat, poor hair coatBehavioral—attitude changes, irritability, resistance, dullnessPerformance—slower times, lead swapping, hitting jumps, reluctance to bend or collect, inadequate energyRisk Factors Intermittent feeding, intense exercise, high-grain diet, stall confinement (limited turnout and stress from lack of contact with other horses), transportation, NSAIDs, stress (illness and environment)CausesExcessive acidityImbalance of mucosal aggressive factors vs protective factorsTreatment and PreventionGoal is to create a permissive environment in the stomach for tissue healing, which requires a combined approach:Pharmacologic agentsNatural agentsDietary changesManagement changesRelieve pain, eliminate clinical signs, establish a healthy gastric environment (ie promote healing), and prevent subsequent recurrence. Because of high recurrence rate, important to change diet and management strategies. Some ulcers do heal spontaneously but most need pharmacologic therapy. Spontaneous healing does not occur in horses that continue intensive training.Limit fasting periods ie keep food in the stomach as much as possible (ad lib, free choice). “Pasture turnout is the best dietary method of controlling gastric ulcers.”
  • Pawing, looking at/kicking/biting side, stretching out as if to urinate, repeatedly lying down and getting up, rolling esp violent rolling, sitting in a dog-like position, lying on the back, not eating or drinking, lack of bowel movements, absent or reduced digestive sounds, depression, elevated pulse or respiratory rate, lip curling.Intestinal dysfunction (spasms, gas, impaction, ileus)Intestinal accident (entrapment, twist, infaction, clot, emboli)Inflammation or ulcer (stress, medication, infection, parasites)Causes/Risk factors:Abrupt changes in diet, large amts of conc, round bales, coarse hay such as Bermuda, certain pastures (fructan)Increased stall time, lack of access to waterIncrease or decrease in activityParasites (no deworming, recent deworming), dental care?CribbingWeather? Transportation?Sand (mineral oil)Previous colic
  • “The adult horse will NOT show diarrhea as a clinical signs unless there is colonic malfunction.”Psyllium as intestinal regulatorMention bio-sponge? Or say intestinal protectants like activated charcoal, bismuth subsalicylate, di-tri-octahedral smectiteAlso pain relievers, DMSO, pentoxyfylline, polymixin B, metronidazole, sucralfate, sulphasalazineSeek immediate veterinary care if:Blood, mucus or foul odor to fecesDiarrhea persisting more than 8-12hrsLoss of appetite, depression, or other deviations from normal behaviorFeverColicIncreased pulse rateLaminitisCauses:Infectious agentsAltered intestinal flora “persistent colonic floral disruption”DietInflammatory bowel diseaseNeoplasiaAltered organ function (heart, liver)ParasitesNSAID-induced enteropathyAntibioticsPeritonitisSandBlister Beetle (cantharidin irritant)ToxinsIdiopathic
  • SUCCEED Digestive Conditioning ProgramIn Pelligrini’s studies 44% of non-performance horses and 63% of performance horses had colonic ulcersDefinitionRight Dorsal Colitis—a life-threatening ulcerative and inflammatory condition of the colon (according to Frank Andrews, RDC and colonic ulcers are one and the same!)Clinical Signsrecurring colic, reluctance to eat, weight loss, lack of energy; also diarrhea, dehydration, edema, feverRisk Factors and CausesNSAIDs, stress; more susceptible if dehydrated or have pre-existing condition of colon (parasites? Hindgut acidosis?)TreatmentGoal is to remove the cause, rest the colon to allow it heal, and restore normal colon functionDiscontinue NSAIDsGradually decrease hay and replace with a pelleted complete feed (for 3 months!)Pharmacologic agents (sucralfate)Natural agents (psyllium, omega 3 fatty acids, other)Surgical resection less favored nowHindgut Acidosis Signs: Decreased appetite/inappetanceColicReduced feed efficiency/decreased fiber digestibility (and subsequent weight loss)Stereotypies such as wood chewing, stall walking and stall weavingMore susceptible to laminitis(poor performance and sour attitude)No surefire method to ascertain if a horse is suffering from hindgut acidosis
  • Digestive Health Webinar

    1. 1. Smarter Strategies forEquine Digestive Health Lydia F. Gray, DVM, MA Medical Director/Staff Veterinarian Jessica Normand Director of Supplement Marketing October 27, 2011
    2. 2. Your Presenters SmartPak.com 2
    3. 3. Agenda1. Digestive tract of the horse2. Common digestive problems3. What can horse owners do?4. Questions & Answers SmartPak.com 3
    4. 4. Digestive Tract of the HorseOverview• Type of Digestive Tract – Non-ruminant herbivore – Hindgut fermentor• Designed to graze 17 hours per day (per NRC*)• “Trickle-Feeders”• Needs at least 1% body weight per day or 50% of total ration as forage SmartPak.com 4 *National Research Council
    5. 5. Digestive Tract of the Horse1. Mouth2. Esophagus3. Stomach Foregut4. Small intestine5. Large intestine - Hindgut SmartPak.com 5 Illustration courtesy of Rick Gore Horsemanship, ThinkLikeAHorse.org
    6. 6. Digestive Tract of the Horse Illustration courtesy of Rick Gore Horsemanship, ThinkLikeAHorse.org Illustration courtesy of Ohio State University Extension, Bullet 762-00 6
    7. 7. Digestive Tract of the Horse: MouthAnatomy: Lips, teeth, tongue, salivary glandsMain Functions:• Grasp food• Chew• Moisten (horses salivate 5-10 liters per day)Management Suggestions:• Regular dental care, especially in older horses• Provide plenty of forage intake SmartPak.com 7
    8. 8. Digestive Tract of the Horse: EsophagusAnatomy: 4-5 feet longMain Functions: transport food from mouth to stomachRelated Issues:• Movement of food is one-way• “Choke” occurs when feed becomes lodged in esophagus (not in the airway)Management Suggestions:• Feed small grain meals frequently• Spread grain out in a shallow trough• Put large fist-sized stones in the feed tub• Wet grain or add chopped forage to grain SmartPak.com 8
    9. 9. Digestive Tract of the Horse: StomachAnatomy:• 2-4 gallons in capacity (10% of total tract capacity)• Residence time 30 min to 12 hrs depending on meal size/composition; average transit time is 2-4 hrs• First 1/3 is the non-glandular region where 80% of ulcers occur• Gastric acid produced 24/7 (10-30 liters of gastric juices secreted per day)Main Functions:• Regulates passage of feed into small intestine• Adds gastric acid to assist in chemical breakdown of feed• Secretes pepsinogen to begin protein digestion• Holding and mixing tank for food SmartPak.com 9
    10. 10. Digestive Tract of the Horse: StomachRelated Issues:• Small capacity is not suited for large, infrequent meals – Feeding large meals can lead to distension and colic• Secretion of gastric acid continues even when stomach is empty— contributes to development of ulcersManagement Suggestions:• Offer small, frequent grain meals• Have grass hay available at all times (unless obese) SmartPak.com 10
    11. 11. Digestive Tract of the Horse:Anatomy: Small Intestine• Approximately 70 feet in length (30% of total tract capacity)• Transit time is 30-90 minutes• Sections are the duodenum, jejunum and ileumMain Functions:• Digestion of proteins, simple carbohydrates and fats via enzymes from the pancreas and intestinal lining• Absorption of most of end-products of digestion: amino acids, glucose, vitamins, minerals and fatty acids (via bile from the liver) Illustration courtesy of Ohio State University Extension, Bullet 762-00 11
    12. 12. Digestive Tract of the Horse: Small IntestineRelated Issues:• Volume of feed consumed and rate of passage affect digestion and absorption of nutrientsManagement Suggestions:• Feed small grain meals frequently• Minimize Non-Structural Carbohydrate (NSC) levels in grain, depending on individual horse/activity level• Monitor pasture consumption to prevent too much intake• Make small changes in type and amount of feed gradually SmartPak.com 12
    13. 13. Digestive Tract of the Horse: Large IntestineAnatomy:• Cecum is 4 ft long/holds 8 gallons (15-20% of total tract capacity )• Colon is 20-24 ft long (40-50% of total tract capacity)• Total transit time is 35-50+ hoursMain functions:• Fermentation of dietary fiber (structural carbohydrates) via bacteria, protozoa and fungi into volatile fatty acids (VFAs)• Fermentation process also produces most of the B vitamins, Vitamin K and some amino acids• Other functions are water resorption and absorption of VFAs, B vitamins and some minerals Illustration courtesy of Ohio State University Extension, Bullet 762-00 13
    14. 14. Digestive Tract of the Horse: Large IntestineRelated Issues:• Passage of NSC to hindgut is undesirable; causes overproduction of lactic acid (“hindgut acidosis”)• Numerous turns and folds increase risk of intestinal dysfunction such as impactionManagement Suggestions:• Feed small meals frequently, with lower NSC %• Make feed changes slowly to allow microbes to adjust• Maintain regular feeding schedule• Avoid moldy feed or hay• Deworm appropriately SmartPak.com 14
    15. 15. Common Digestive Problems1. Gastric Ulcers2. Colic3. Diarrhea4. Colonic Ulcers/Right Dorsal Colitis and Hindgut Acidosis SmartPak.com 15
    16. 16. Common Digestive Problems: Gastric Ulcers• Up to 90% of racehorses and nearly 60% of active show horses have gastric ulcers• Please visit http://www.smartpak.com/webinars for our in-depth Gastric Ulcer presentation SmartPak.com 16
    17. 17. Common Digestive Problems: Colic• Responsible for more deaths in horses than any other disease• Proven causes include: – Hay and grain changes – Increased stall time – Dehydration – Change in activity – Parasites – Cribbing – Sand – Previous colic• Anecdotal causes: – Lack of dental care Cohen ND, Factors predisposing to colic, 8th Congress on Equine – Travel Medicine and Surgery, 2003 – Weather White NA, Equine Colic II: Causes and risks for colic, 52nd Annual Convention of the AAEP, 2006 SmartPak.com 17
    18. 18. Common Digestive Problems: Diarrhea• Definition: Abnormal frequency and liquidity of fecal discharges (from Dorland’s Illustrated Medical Dictionary)• A definite cause of diarrhea can be identified in less than 50% of cases• Acute vs. chronic The Treatment of Diarrhea in the Adult Horse. Naylor RJ and Dunkel B. Equine Veterinary Education, Sept 2009, vol. 21, No. 9; pp. 494-504. Adult Equine Diarrhea Workup. Merrit AM. 45th Annu Conv Am Assoc Equine Pract 1999:45:276-279. SmartPak.com 18
    19. 19. Common Digestive Problems: Colonic Ulcers/Right Dorsal Colitis and Hindgut Acidosis• Right Dorsal Colitis (RDC) and Colonic Ulcers are one and the same• Diagnosis can be challenging• #1 risk factor is NSAID use, also stress, dehydration and possibly parasites and hindgut acidosis• Treatment for RDC is NO FORAGE for up to 3 months so diagnosis is important Pellegrini FL. Results of a large-scale necroscopic study of equine colonic ulcers. J Equine Vet Sci. 2005: 25:3):113-117. Cohen ND, Carter GK, Mealey RH, Taylor TS. Medical management of right dorsal colitis in 5 horses: a retrospective study). J Vet Intern Med. 1995 Jul-Aug:9(4):272-276. McConnico RS, Morgan TW, Williams CC, et al. Pathophysiologic effects of phenylbutazone on the right dorsal colon in horses. Am J Vet Res. 2008 Nov;69(11):1496-1505. SmartPak.com 19
    20. 20. What Can Horse Owners Do?1. Diet2. Housing3. Activity4. Veterinary Care5. Supplements SmartPak.com 20
    21. 21. What Can Horse Owners Do?Diet• Forage-based (1-2% of horse’s body weight per day)• Limit grain (consider ration balancers and multi-vitamins as alternatives)• Change BOTH hay and grain gradually• Provide fresh grass (unless obese/metabolic condition) SmartPak.com 21
    22. 22. What Can Horse Owners Do?Housing• Provide adequate turnout• Offer socialization• Ensure access to clean, fresh water SmartPak.com 22
    23. 23. What Can Horse Owners Do?Activity• Provide consistent exercise• Change exercise gradually (duration, frequency, intensity)• Monitor your horse’s fitness level SmartPak.com 23
    24. 24. What Can Horse Owners Do?Veterinary Care• Annual physical exam• Body condition score and weight• Parasite control• Dental care SmartPak.com 24
    25. 25. What Can Horse Owners Do?Supplements for• Ulcers & Gastric Health• Digestion & Hindgut Health• Sand Colic SmartPak.com 25
    26. 26. Supplements for Ulcers & Gastric Health• Note the important role of prescription medications (omeprazole, ranitidine, cimitidine)• Natural agents available in supplements: – Antacids such as calcium and magnesium carbonate – Amino acids such as L-glutamine – Soothing herbs such as licorice – Soluble fiber such as pectin – Other Venner M, Lauffs S, Deegen E. Treatment of gastric lesions in horses with pectin-lecithin complex. Equine Vet J Suppl. 1999 Apr;(29):91-96. Aly AM, Al-Alousi L, Salem HA. Licorice: a possible anti-inflammatory and anti-ulcer drug. AAPS PharmSci Tech, 2—5 Sep 20;6(1):E74-82. Noe JE. L-Glutamine use in the treatment and prevention of mucositis and cachexia: a naturopathic perspective. Integr Cancer Ther. 2009 Dec;8(4)): 409-415. 26
    27. 27. Supplements for Ulcers & Gastric Health SmartPak.com 27
    28. 28. Supplements for Digestion & Hindgut Health• Ingredients include: – Probiotics (live beneficial bacteria) – Prebiotics (nourishment for the “good bugs” in the hindgut) – Digestive Enzymes (e.g. amylase, protease, lipase) – Oat Beta Glucan Immunomodulatory activities of oat beta-glucan in vitro and in vivo. Estrada A, Yun CH, Van Kessel A, et al. Microbiol Immunol. 1997;41(12):991-8. Glycemic responses of oat bran products in type 2 diabetic patients. Tapola N, Karvonen H, Niskanen L, et al. Nutr Metab Cardiovasc Dis. 2005 Aug; 15(4): 255-61. Pre - and Probiotics: Potentials for Equine Practice Jullian V, Proceedings of the 3rd European Equine Nutrition & Health Congress, Mar. 17- 18, 2006 28
    29. 29. Supplements for Digestion & Hindgut Health Effects of dietary short-chain fructooligosaccharides on the intestinal microflora of horses subjected to a sudden change in diet. Respondek F, Goachet Ag, Julliand V. J Anim Sci. 2008 Feb;86(2):316-23 Effect of live yeast culture supplementation on apparent digestibility and rate of passage in horses fed a high- fiber or high-starch diet. Jouany JP, Gobert J, Medina B, et al J Anim Sci. 2008 Feb;86(2):339-47.Effect of a preparation of Saccharomyces cerevisiae on microbial profiles and fermentation patterns in the large intestine of horses fed a high fiber or a high starch diet. Medina B, Girard ID, Jacotot E, Julliand V. J Anim Sci 2002 Oct;80(10):2600-9 29
    30. 30. Supplements for Sand Colic• “Monthly Purge”• Primary ingredient: Psyllium Seed Husk (as a source of fiber)• Other ingredients – Probiotics – Prebiotics – Chia Seed Fecal Sand Clearance Is Enhanced With a Product Combining Probiotics, Prebiotics, and Psyllium in Clinically Normal Horses, A. D. Landes, D. M. Hassel, J. D. Funk and A. E. Hill, 53rd Annual Convention of the AAEP, 2007 SmartPak.com 30
    31. 31. Questions & Answers SmartPak.com 31
    32. 32. Questions1. My Morgan mare becomes somewhat distressed when she goes to CDEs. I am concerned that she may develop gastric upset and be vulnerable to developing ulcers due to the stressors of being away from home and not having turnout. Any suggestions?2. Do senior horses have digestive issues?3. Does daily exercise play a part in equine digestive health...also how many times a day should you feed...what about deworming ?4. Do the different kinds of hay affect how the G.I tract works. Is one easier to digest?5. Does the use of probiotics aid in the prevention of ulcers?6. How should I deal with chronic low grade diarrhea?7. I am curious how my horse’s body processes protein.8. I am giving my horses a probiotic. Can you discuss the benefits/disadvantages of this. SmartPak.com 32
    33. 33. Questions9. I have 4 horses on small acreage. They get daily turn out in dry lots. I supplement them with the recommended dose of Sand Clear for seven days in a row, once a month as per directions. Any more suggestions for preventing sand colic?10. I have a 17 yo QH gelding. He has a lot of water in his bowels. Mostly when he passes gas the water comes out hits his tail and makes a mess. Of course he is a cremello! Worse when he is on hay than pasture.11. I have a QH Mare that has frequent stools that are very soft and occasionally watery. She eats well, keeps weigh well and is basically and easy keeper. She has been checked for sand and is wormed regularly. Any ideas?12. I have had a 5 year old colic twice, what can I do to help prevent it from happening again?13. I have heard so many different answers to this question: how long between meals and riding/ lunging/ etc? SmartPak.com 33
    34. 34. Questions14. I used to have a filly that ate dirt. Why is that?15. Are there any digestive supplements that help prevent a colic-prone horse from colicing?16. If you are daily feeding a horse a certain type of grain will it cause any problems to suddenly change the type of grain you are feeding them?17. Impaction colic due to lack of water in stall 2 years ago, should this horse remain on u-guard pellets BID indefinitely even though scope shows no ulcers?18. I’m interested in learning about hind gut ulcers, thanks!!19. Is it easy for a horses digestive tract to get off balance if measures arent taken to give them digestive health, especially with lots of showing?20. I have 1 horse that lives to eat. I put his hay in a hay bag and feed 3 times a day. He will colic if you are a bit late in feeding even 10 mins. what can I give him if anything that will help he with his colic? I do feed orchard with small amounts of alfalfa. SmartPak.com 34
    35. 35. Questions21. I have a horse who is sensitive to stress. He doesnt really show it outwardly just get a bit runny. What would a good food for a horse like him be. I have been thinking alfalfa and local and little grain. He is in regular work. 6 yrs old. Holsteiner TB22. Is it better to prevent sand colic through a daily supplement or one you feed 1-a few times a year? SmartPak.com 35
    36. 36. Thank you for attending our Webinar! Please visit us at SmartPak.comOr call us at 1-800-461-8898 if we can answer any further questions. ~ Your Friends at SmartPak SmartPak.com 36