As most of you know, about a year and a half ago, I stumbled onto the whole Insulin Resistance concept because I was looking for a reason for Frosty's behavioral problems and weight issue. I was very excited to finally have a logical reason for why this horse was acting the way he was and could not seem to improve.
There are several different recognized metabolic disorders and in fact a few genetic disorders have metabolic consequences (think HYPP).
One of the most commonly recognized ones is Cushing's disease...which by the way has been renamed, Equine Pituitary Pars Intermedia Dysfunction, aka PPID, to more accurately reflect the exact condition that affects horses. PPID primarily affects older horses...but that does not mean that that these horses did not suffer from metabolic problems years before full onset of the condition.
Equine Metabolic Syndrome is another condition that is affecting more and more horses. Same as people, diets and work loads have changed and equines are struggling with weight issues, which lead to metabolic and health problems.
And of course there is Insulin Resistance. A horse can suffer from Insulin Resistance alone, but horses that suffer from EMS and PPID almost always suffer from IR along with the other problems associated with their particular condition. So, I think it is safe to conclude that problems with insulin regulation is where it all starts.
Okay...I had to include this link...It's pretty basic...but I got quite a laugh out of the photoshopping...If nothing else, give yourself a giggle...
Feeding The Metabolic Horse
That's some funny stuff right?
Now, even if you didn't read the whole thing...I'm sure most everyone at least looked at the list of symptoms and the one thing that is very prevalent is the fact that chronic laminitis and/or founder is a real problem with these horse. In a lot of cases, changes in the feet can be the very first indication that something is going on internally.
Changes in gait length, undiagnosable lameness issues, stretching of the lamina and/or even event lines on the hoof wall are all indicators. Or can be in lu of any other reasonable explanation, even if your horse is not unreasonably 'fluffy'...but chances are, weight control is an ongoing issue.
For all of the in-depth hoof practitioners out there...the following link is for you. I'm not even going to pretend that I understood everything in it...my eyes glazed over a few times...but I got the gist and I think those of you who are interested enough will too...
Endocrinopathic Laminitis In The Horse
In the simplest terms, problems in the metabolism lead to problems in the hind-gut and problems in the hind-gut lead to problems in the feet.
There is that wretched hind-gut thing again!
That does not mean that all horses that suffer from laminitic episodes are automatically insulin resistant. It is the imbalance of sugars and starches in the hind-gut that can cause laminitis. Insulin resistance (and other metabolic disorders) are just likely to be contributors to the problem, since the body's ability to balance insulin and utilize sugars and starches properly are compromised, resulting in a higher load of them being dumped into the hind-gut.
The basics of 'fixing' an IR horse are quite simple;
Reduce starch/sugar intake levels
Add a feed supplement that helps the system manage insulin levels
Increase exercise to aid in weigh loss
Sounds easy right?
Sometimes Yes, sometimes Not so much.
I did everything they said to do for Frosty;
Restricted his grazing time and made sure that he was not out when the sugar levels were high in the grass
Put him on strictly grass hay
His grain intake was very, very low
Added a beneficial supplement
And put him to work
It all helped. At least it got me to the point where he was not globby fat, his focus improved and life got better. But in an entire year...we never really got over that hump...you know, where he turned into the kind of horse I knew was lurking in there and for all the riding and hauling that horse saw last year...his saggy belly never went away. There was nothing helpful in all of the IR articles that I read that really went beyond the basics of how to care for these horses. No what-to-do's for the horse that just can't seem to get completely healthy.
I believe I underestimated the impact of insulin resistance on the system...the entire system. By the time a horse starts to show symptoms of IR, they are already negatively affected on a cellular level. In layman's terms, cells have become resistant to absorbing glucose out of the blood, the pancreas produces more and more insulin because the body is telling it is low, the thyroid becomes out of whack with the rest of the system (typically it starts to underproduce as it is robbed of vital nutrients) and the colon is left to deal with exaggerated levels of glucose (sugar), which causes inflammation.
The same phenomena affects people affects people and dogs.
I even ran into an article on dogs suffering from Cushing's Disease, which made me think of Nuzzling Muzzles' little Midge-excessive drinking, excessive urination, repeated intestinal infections and erratic behavior. I will have to remember to ask her about that when she comes online again after her move. There are good vets in AZ, that are probably more likely to be helpful than what she has experienced.
So anyway, back to the horses...
If you are googling IR info on horses...pay particular attention to the date of the article. Articles from 2009 (and before) will give you the basic info, but feed recommendations are a bit outdated and conflict with more current thoughts on the subject.
One of the things I noticed about poor Frosty when he was on the older version of the diet, is that he seemed so unsatisfied. Spooks, who I would not consider a full-blown IR case, but still showed some tendencies, also seemed to suffer from the 'I'm starving' mentality. Even upping their hay intake a bit more did not seem to help the hunger issue and of course, by last fall, Frosty had started to get peaked through the hips. The horse was getting 'thin', but that ungodly belly was not budging. Spooks really doesn't have problems with losing weight...he loses it just fine...but he suffers from other symptoms; overall body soreness, tender-feet, lethargy, does not come into condition well and has an insatiable appetite. He is also prone to a cresty neck and fat deposits on his rump...even when the rest of him is garnering on 'thin'-looking.
It was while I was researching and reading all of the colonic stuff for Moon and decided that the addition of alfalfa might help with his ulcers, that I got the surprise on Frosty. Since my grass hay supply was dwindling, I decided to add a few pounds of alfalfa to all of the horse's diets. Previously, legume hay was considered a no-no for IR horses. Mostly because of it's higher caloric value, which made weight loss harder. But, I figured...'Hey, the horses are on pasture, green grass hasn't started to come yet, he's getting rode and a few pounds a day shouldn't hurt.' Imagine my surprise that after just a couple of weeks on the alfalfa...Frosty's sagging belly started to pull up. It was like magic.
Of course, newer research reveals that alfalfa can actually be a more ideal feed for IR horses than certain grass hays. Most alfalfa is lower in the sugars and starches that horses with metabolic and colonic problems are so sensitive too. Without a doubt...amount of consumption needs to be a consideration. I followed the 3lbs per day recommendation as sited as a sufficiently beneficial amount to reduce ulcer problems.
Now...alfalfa may have been a boon for Frosty's digestive system...but it's not for everyone. It had a wickedly adverse affect on Moon's respiratory system and about the same time I noticed a marked improvement in Frosty, I noticed that Spooks was starting to move stiffly. Particularly in his hips.
More research ensued and those two went on an alternative...a high-fiber pelleted feed. I did not go fancy, I simply went with a low starch, low NSC, high-fiber pellet (It must be at least 20%, but 30% is optimal). There are a lot of fancy feeds out there, particularly formulated for horses with starch/sugar sensitivity, but they are expensive! I started with 2 lbs per feeding, along with 1 lb (weighted dry) of beet pulp shreds and a double handful of oats (for taste and texture) and soaked the mixture down. In the beginning, I would add a lot of water to the beet pulp, swirl it around and drain it immediately to rinse as much of the molasses off as I could. After the horses improved, I didn't bother rinsing anymore.
I also added 1 cup per feeding of low starch, low-sugar, high-fat supplement. It's mostly ground flaxseed with a bit of soybean added to raise the fat index. The lack of fat, according to the original IR diet I had the horses on, probably had a lot to do with their lack of satisfaction. The introduction of necessary fat in a horse's diet has become a big thing these days. The type of fat fed is vitally important, depending on what exactly is going on with a horse. As we have gotten wiser about what is good vs. what is bad, the options have become more limited. Many sites will recommend feeding a horse 1 cup of corn oil a day. Armed with today's knowledge...corn oil is not a good selection for horses that suffer from IR or colonic issues. Corn oil (and most other commonly used oils) are loaded with Omega 6 fats and are inflammatory inducers. Only Omega 3 fats are able to produce the beneficial anti-inflammatory response in the system. Obviously, this makes any fat that has MORE Omega 3's vs. Omega 6's the better choice. People have begun to feed their horses fish oil for the Omega 3 factor and I have not read where this has been a problem. Coconut oil is supposed to be quite beneficial and people who use CocoSoya swear by it. Soy is a better choice than most, but you should be aware that it is high in starch and for horses that are struggling with starch sensitivity, it may not be the best option at first. That pretty much leaves Flaxseed. Ground flaxseed is my personal choice as there is suggestions that the ground hulls have additional benefits that help sooth the intestinal tract.
In essence, I began to feed my IR horses exactly as I was feeding Moon, who has colonic problems.
Moon and Spooks get the high-fiber mix a.m. and p.m.. Frosty got the alfalfa in the a.m. and the high-fiber mix in the p.m. All three showed a significant improvement in their level of 'satisfaction' with their meals. Moon's appetite improved and he began to eat more hay. Frosty and Spooks' appetites actually decreased and instead of gobbling up their grass hay and looking for more, they slowly nibbled on it throughout the day.
So what does the high-fiber pellet do?
I don't think it does much more than reduce the sheer amount of roughage the hind-gut has to process. When the hind-gut is struggling and inflamed, it simply cannot cope with processing a large amount of dry roughage and no matter what you are trying to feed to rectify that, it just doesn't do any good. Introducing a significant amount of more easily digestible fiber, allows the colon a chance to rest and recoup. The good microflora are still provided with the kind of fiber they need to survive and thrive. The non-beneficial microflora...the ones that thrive on lactic acid and sugar complexes...end up starving out. This takes a few weeks, whether you are adding a probiotic or not. Nature doesn't work quickly in the hind-gut. :(
If a horse is struggling with insulin resistance, their bodies are not properly utilizing sugars and starches in the foregut and that excess gets dumped into the hind-gut, continuing the promotion of the non-beneficial microflora and inhibiting the ability of the beneficial microflora to thrive. That is where I think Frosty was. The supplements helped, but he was unable to complete the transition in the hind-gut.
Now...finally....supplements for IR...
There's a ton on the market. The most commonly accepted 'aids' include; magnesium, chromium and sodium (salt). Iodine may also be included.
Iodine is absolutely necessary for thyroid function and except for a few areas, it is a difficult nutrient to come by naturally. It is most abundant in seaweed (kelp) and some types of seafood. Iodine has historically been added to salt as a way to provide it on a regular basis....to animals and to humans. However, many people have switched to using different types of salt that do not contain the added iodine and are more lacking in it than ever. On average, horses are unable to attain enough iodine through salt blocks to meet their nutritional requirements...particularly insulin resistant horse.
Which brings me to salt...most horses simply cannot lick enough salt off of a salt block to meet ideal needs...particularly insulin resistant horses. There is debate though...In humans, a high salt diet, coupled with obesity is said to promote insulin resistance. Different studies show that a low-salt diet also has a propensity to promote insulin resistance. So what do you do? Well, since most of the commercial supplements come with sodium chloride as part of the combination...I would go with what is provided. I put out iodized (not mineralized) salt blocks for my horses and have taken to adding an ounce of loose salt in their feed. I have noticed my horses sweat easier and are drinking more. An ounce a day is well within recommended guidelines for a horse. At least I know they are getting some and it has significantly decreased how much the salt blocks are used.
Chromium...The function of chromium in the metabolism is huge. Insulin may be the 'master' behind metabolism...but chromium is what assists the glucose movement into the cells. Increasing the level of chromium definitely appears to assist the body in overcoming resistance at a cellular level.
Magnesium...affects both secretion and utilization of insulin in the body. Assisting the body to maintain a more level utilization of insulin will also help 'calm' many flighty/spooky horses. If nothing else is provided outside of dietary changes for IR horses, the addition of magnesium has been proven over and over to be beneficial. In fact, the addition of magnesium has been indicated to improve recovery time and reduce muscle soreness in performance horses as well.
In the course of researching and reading, I did come across this article that poo-poos pretty much every idea set forth about IR and related metabolic disorders. Apparently this guys' supplement is the ONLY thing that works and everything else is garbage...
LOL! Okay then...
Sooo...you think your horse has some IR issues going on?
Where do you start?
That depends on exactly what you are dealing with at the moment.
If you have an overweight horse that has resisted losing weight in spite of diet changes...Most likely the addition of a supplement...and an exercise program!!!!...might be all that is needed to help them recover.
If you are already noticing problems in the feet or have limited success with weight-loss after trying the supplement for a few months (Yes, months...remember we are dealing with problems on a cellular level and these cannot be rectified overnight)...it's important to put some focus on getting that hind-gut regulated as well. If green grass is not the likely culprit...then you might be surprised to realize it is actually your hay. Some types of hay are much higher in sugars/starches than others. You may have to resort to soaking.
Soaking hay leaches the sugars out of the hay...but you should be aware that it also leaches most of the other nutrients out of it as well. If you have to resort to soaking hay, find a quality vitamin/mineral supplement to help provide the missing nutrients. The warmer the water, the faster the sugars will leach, so if you use hot water...30 minutes is usually sufficient. Cold water usually requires about an hour of soaking. Drain hay, rinse and feed. Have fun with that...it's a pain in the ass and my horses did not like the wet hay. I had to resort to soaking a feeding ahead and letting it air dry somewhat before they would eat it.
Add a bit of alfalfa and/or a high-fiber feed. Beet pulp is a high fiber feed and can be used as well. I have no experience with the pellets...my horses would not eat them after they turned to mush from soaking, so I am all about the shreds, which I generously moisten and feed immediately. If you cannot get no-molasses beet pulp-rinse the excess molasses off and rewet when mixing the feed. I have found that my horses will only eat about 1-11/2 lb (dry weight) of the shreds per meal. Any more than that and they get full and will not finish the feed, which means the supplements usually get left in the bottom. :(
In which case, the addition of the high-fiber pellets comes in handy. One to two pounds of that per feeding with 1 lb of beet pulp (dry weight) will give the horse a comfortably full feeling. The high-fiber pellets are not as much of an energy source as beet pulp is either. So if riding or working a horse to reduce energy levels are not an option...the high-fiber pellets may be a better option than more beet pulp.
The addition of a good probiotic can be helpful...but is generally not a miracle cure. I personally feed a probiotic that also contains B-vitamins. Normally, the hind-gut produces the necessary B-vitamins through the fermentation process in the hind-gut...however, if the hind-gut is compromised, the B-vitamin production is compromised...which may actually be one of the reasons for problems in the feet. Maybe I've been lucky, because outside of a bit of tender-footedness and a smidgeon of stretched lamina (which could also be from weight distribution on barefoot horses), I have not had any laminitic problems...and maybe it is because I have used the Formula 7 probiotic long before I even knew what IR was. ???
Don't forget to add the beneficial fat. Omega 3's is where it's at! People may laugh when you tell them you are feeding an already heavy horse 'fat'...but the right kind of fat has anti-inflammatory properties and lends itself to making the horse feel full...something an IR horse has trouble recognizing. I start with 1/3 cup and will go up to 1 cup (per feeding) if necessary.
The primary goal is to reduce NSC to around 10% PER FEEDING. NSC's are non-structural carbohydrates. All horse feed is primarily carbohydrates...the difference is in the type. Structural carbs are complex and break down in such a way that is beneficial to the horse's digestive system. NSC's are simple carbs and break down in such a way that they produce higher levels of glucose. It is important to help the horse's system by regulating the NSC's EACH AND EVERY FEEDING until they are stabilized. Read the labels of any feeds you provide. You might be surprised to notice how many feeds and supplements add molasses to 'flavor' the feed. Molasses is very high in NSC's and notoriously difficult for horses to digest...but by golly...it's cheap and horses like the flavor. ;-)
And last, but not least...Does this problem go on forever? Are you looking at a lifetime of special feeds and feeding schedules?
Certainly, once a horse has become noticeably insulin resistant or suffered from chronic laminitis...the chances are that they will always be more susceptible to re-occurrances. Ideally, the goal is to get the body functioning properly again and learn what the triggers are. Some permanent dietary changes may be necessary...but that is because they are more in line with a horse's true dietary needs than what was previously fed. That doesn't always mean that the horse was fed 'wrong'...just that their systems need to be treated a bit differently. Supplementation should eventually vary depending on the time of year, level of use or re-immergance of symptoms. Figuring it all out will come. And that my friends is all I have on that.