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Digestive Health Webinar
1. Smarter Strategies for
Equine Digestive Health
Lydia F. Gray, DVM, MA
Medical Director/Staff Veterinarian
Jessica Normand
Director of Supplement Marketing
October 27, 2011
3. Agenda
1. Digestive tract of the horse
2. Common digestive problems
3. What can horse owners do?
4. Questions & Answers
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4. Digestive Tract of the Horse
Overview
• 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
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*National Research Council
5. Digestive Tract of the Horse
1. Mouth
2. Esophagus
3. Stomach Foregut
4. Small intestine
5. Large intestine - Hindgut
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Illustration courtesy of Rick Gore Horsemanship, ThinkLikeAHorse.org
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. Digestive Tract of the Horse: Mouth
Anatomy: Lips, teeth, tongue, salivary glands
Main 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
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8. Digestive Tract of the Horse: Esophagus
Anatomy: 4-5 feet long
Main Functions: transport food from mouth to stomach
Related 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
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9. Digestive Tract of the Horse: Stomach
Anatomy:
• 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
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10. Digestive Tract of the Horse: Stomach
Related 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 ulcers
Management Suggestions:
• Offer small, frequent grain meals
• Have grass hay available at all times (unless obese)
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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 ileum
Main 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
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12. Digestive Tract of the Horse:
Small Intestine
Related Issues:
• Volume of feed consumed and rate of passage affect digestion
and absorption of nutrients
Management 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
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13. Digestive Tract of the Horse:
Large Intestine
Anatomy:
• 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+ hours
Main 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. Digestive Tract of the Horse:
Large Intestine
Related 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 impaction
Management 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
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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
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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
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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.
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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.
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20. What Can Horse Owners Do?
1. Diet
2. Housing
3. Activity
4. Veterinary Care
5. Supplements
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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)
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22. What Can Horse Owners Do?
Housing
• Provide adequate turnout
• Offer socialization
• Ensure access to clean, fresh water
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23. What Can Horse Owners Do?
Activity
• Provide consistent exercise
• Change exercise gradually (duration, frequency, intensity)
• Monitor your horse’s fitness level
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24. What Can Horse Owners Do?
Veterinary Care
• Annual physical exam
• Body condition score and weight
• Parasite control
• Dental care
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25. What Can Horse Owners Do?
Supplements for
• Ulcers & Gastric Health
• Digestion & Hindgut Health
• Sand Colic
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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
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
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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
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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
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32. Questions
1. 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.
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33. Questions
9. 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?
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34. Questions
14. 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 horse's digestive tract to get off balance if measures aren't
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.
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35. Questions
21. I have a horse who is sensitive to stress. He doesn't 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 TB
22. Is it better to prevent sand colic through a daily supplement or one you
feed 1-a few times a year?
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36. Thank you for attending our Webinar!
Please visit us at
SmartPak.com
Or call us at 1-800-461-8898 if we can answer
any further questions.
~ Your Friends at SmartPak
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Editor's Notes
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
