Fall/Winter Laminitis: Why need Heiro Year Round

Fall/Winter Laminitis: Why need Heiro Year Round

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Fall/Winter Laminitis – Full Article

Fructans – What are they and Why are they a problem?

Neuritis – Why it is not Laminitis but Nerve Pain – Including medications to control pain and What to do if Bute does not help


There are two categories for this problem:

1.  Horses in continual warm weather in Fall/Winter.
2.  Horses in areas that get cold/snow in Fall/Winter.

Horses in warm weather areas are effected by the change in seasons while horses in cold areas are effected by both the change in season and the change in weather.

I.  First – Horses in Fall/Winter Laminitis by change of season (over 50°F year round).

calendarA.  Horse Insulin Resistance is year round – it does not go away.  At times, owners will “let up” on the Heiro program in November-March and suddenly find their horse foot sore.  Laminitis Veterinary calls are expensive (most over $1000.00) and you want to avoid further damage to your horse’s feet.  It is only $40.60 a month to keep on Heiro Program.  Also, many get surprised by Spring grass while not on Heiro and fall into Laminitis.

B.  Insulin Resistant horses are in a constant state of pre-existing pro-inflammation.  Constantly on the edge to tip into foot pain if any outside event occurs – colic, kicked by another horse…  “Higher TNF and IL-1 inflammatory cytokines in horses with Insulin Resistance.”  Treiber, 2009, Vet Immuno; Vick, 2007, JAS.

C.  Workload of the horse is reduced. There is less exercise with summer over.  Exercise lowers Insulin.  Heiro will help in this change.

D.  Trims and routine shoeing times elongated – mistake.  “When toes get too long, extra stress is put on the horse’s body and risk of lameness.” Farrier Matt Tiamuty, Holistic Horse, 2012.

E.  The horse has been in continual chronic Laminitis for years and finally is lame enough for a diagnosis, or body changes that are creeping up are now evident.  Chronic white line disease underlying cause is now seen on radiographs.  The reason for the radiograph might be a Pre-Purchase Exam or looking at another area can catch old founder evidence.

F.  Older horse in Laminitis as seasonal surge of ACTH tips the horse into foot pain.  All older horses have this increase in ACTH hormone from August (some late July) to November and, in some, will bring into recognition long-standing Equine Cushings signs.  Most horses with Equine Cushings also have Horse Insulin Resistance so need Pergolide and the Heiro program to control ACTH and to control Insulin.

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Studies show Prascend can’t stop seasonal ACTH surge.  . 2013 University of Kentucky study shows just being older ALONE (not Cushings) lowers Insulin sensitivity by 75% – So if older or older and Cushings, have Insulin problems needing Heiro program.  “Decrease in Insulin sensitivity might occur as a normal part of aging not directly associated with PPID (Cushings).” University of Kentucky, Gluck Institute, July 2013.

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G.  Older horses already on Pergolide go into Laminitis.  The Horse Cushing disease they had is now joined by Insulin Resistance.  Why?  High ACTH of Cushings leads to high cortisol – both ACTH and cortisol at high levels increase Insulin leading to foot pain. Also muscle loss due to high cortisol will elevate Insulin.  Muscle loss also leads to less exercise which will elevate Insulin.  Now need Pergolide and Heiro together.

H.  In many places with warmer weather, there are still cooler nights which will increase fructans in grass.  Cooler nights, extra rain or droughts can create Laminitis events by changing your grass.  bluestar See Fructan section in Cold Weather section.

I.  Dirt lot horses/horses on poor pasture due to year round grazing beating up the pasture.  Need Heiro program.

1.  Dr. Hinkley in England, 1996 BEVA proceedings, showed that 39% of horse’s laminitis was not on pasture at all.
2.  Weeds can lead to high iron intake leads to Laminitis.  bluestarClick here for our original study on why weeds cause Insulin Resistance.
3.  No/little fresh forage means a Vitamin E deficiency – either in a sunny, weedy lot in Florida or a snowy field in Pennsylvania (in cold weather areas, Vitamin E in grass is almost zero from November 1 – March 1).

 • Vitamin E in Heiro is over 2.5 times daily needs in order to combat inflammation of Equine Insulin Resistance.  If you pull off Vitamin E in Fall/Winter, you go Vitamin E deficient within 30 days in university studies.
• Vitamin E is the most important lipid (fat) soluble antioxidant responsible for integrity of biological structures such as cell membrane.  Dr. Coombs, 1975, Fed. Pox. 34.
• Heiro contains ester stable Vitamin E so good in heat/light/air – the one that works.  “Free Vitamin E compounds are particularly unstable, so ester stable form is a better form in supplements.” Gassman, 1979, MD Nut Food Res.
• Avoids neurological diseases – “Low Vitamin E is associated with EDM and EMND neurological diseases.” Goer, 2013, Equine App. Clin. Nut.
• Vitamin E supplement shown to help brood mares by increasing IgG antibody in colostrum and hence increased IgG in foal’s blood. Hoffman, 1999, Eq. Nutri Physio.
• Helps with immune function.  Antibody response to vaccines increased in horses supplemented with Vitamin E.  Balstrud, 1986, Eq. Vet. J.

bluestarClick here if you don’t have an Insulin Resistant horse but on dirt lot in summer or in cold weather area when there is no Vitamin E in grass.

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J.  2000 USDA Laminitis study showed that in the Winter, the area of the country with the largest percentage of lameness cases being Laminitis was in the South.

K.  Foot pain Neuritis Issues – can happen year round in any area, in any weather. On a good program and suddenly sore.  This is due to spontaneous firing of damaged nerve endings.  bluestarClick here to see: It is not Laminitis, but your horse is sore –why? Due to Neuritis.

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L.  Horses genetic component in Winter is in effect in warmer areas.  “Early Winter is a time of increased fat in the body, thickening of hair coat, increased appetite, and weight gain.”  Drs. Donaldson, McFarlane, Beech, 2005, J. Vet Int Med.   Body changing is due to less sunlight in order to store up for the Winter when food is scarce.  All over the country daylight is lessened in winter time and not just cold areas.

II.  Second – Horses in Fall/Winter Laminitis by change of season and also by colder change in weather.  These horses have all the problems of the change of season horses AND problems of colder weather piled on top of that.

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A.  Grasses change as daylight lessens and cold weather advances.  Why is this a problem? bluestar Click here for High Fructans.

B.  Less physical activity in cold/snow – they move less, exercise lowers Insulin, so less exercise means Insulin is up.

C.  Osteoarthritis is worse in Winter – people and horses are stiffer in arthritic joints in cold weather.  Less movement so Insulin is up.  If more painful, then remember Insulin also goes up with pain.

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D.  Less soaking of hay due to quickly freezing up. Many horses will not eat “Haysickles”.

heatedwaterbucketE.  Drink less – all horses drink less when it is under 45°F – When water gets to that point, start using heated water buckets.  Less fluids in your horse means less blood flow to the feet, which damages nerves.  Less fluids in your horse means the dilution factor of insulin drops so higher insulin concentration to the feet.  Less fluids means less flow of nutrients to the feet.

F.  Foot pain neuritis issues.  Some issues are due to cold weather inducing foot pain.  Not true Laminitis.  bluestarClick here to see about nerve pain issues.

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• High Insulin levels will cause vasoconstriction or less blood flow – this damages laminae and nerves
• Vasoconstriction due to cold weather
• Past Laminitis damaging vessels so tissue is not as vascular (fewer or inadequate)

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III.  High Fructans – Why a problem?

A.  In the Fall (September -  December), many weather changes create an increase in the Fructan level of the grass.  This same surge is also seen in rapid growing Spring grass, and is a reason why spring grass triggers many Laminitis cases.  On hay tests, Fructans are part of the WSC component.  Fructan % is approximated by taking WSC level and subtracting the ESC.  Dr. Getty 2010, Chpt. 2.

B.  Fructans increase several ways in the Fall:

• Drought – Often can go weeks with no rain.  This stresses the grass so it does not grow upward and so fructans build up higher and higher.
• Cooler weather – again, fructans level increase.
Frost – can create and three times increase in fructans in just a few hours.  Keep horses off early season frost grass until later in the morning (6:00-8:00 AM).
• Sun – direct sun increases fructans, so pastures in the shade or at night (after 8:00 PM) have lower fructans.  Dr. Byrd, 2006, JAS – Fructans lowest at 4:00-5:00 AM (15% WSC).  Fructans peak at 4:00-5:00 PM (22-24% WSC).  As you can see, fructans can jump up quickly within the day.  So night (after 8:00 PM) or early morning (up to 8:00 AM) will be a better time to graze.  If can only graze small amounts, do 6:00 AM – 8:00 AM or 8:00 -10:00 PM.

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• Mowing – Fructans in grass are at higher levels at the base than at the tip of the grass and higher in the stems than the leaves.  Smith, 1967, Crop Sci, Pavis, 2000, New Phyto.  So in August-September, you need to really make sure not to over mow the grass.  It is slowing on growth and you want to keep it at 4-5 inches.  This allows less fructans into the horse.  The base of the grass is super high in fructans so mowing like a lawn makes things bad for your horse.  4”-8” mowing, height lowers sugars in grass.  A. Cairns, Grassland Institute.
Soaking hay can bring NSC down 19% in thirty minutes and 31% in sixty minutes.  Equus, 2004.
• Cutting for Hay – cut late at night – Why?
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a.  If cut in bright sun, hay has higher sugar. Individual leaves remain alive for 50 hours after they are cut.  So if cut in the sun, still has photosynthesis and accumulate sugars.
b.  “Course stemmy hay can have high sugar, soft leafy hay can be low sugar.  It depends on if it was cut when stressed, or drought, or sudden cold spell prior to cut.” Dr. Pollitt, 2010, Aust. Gov.

C.  High levels of fructans can lead to Laminitis – this is why often after the first frost, grazing time is cut back to 4-6 hours with a muzzle until grass is dead, and grazing is kept to early morning or later at night.

Dead Grass?  Fructan levels in Winter will drop faster if it is a wet Autumn.  A drought/little rain Autumn means higher levels of fructans going into Winter.  Grass must be totally brown prior to increasing pasture time or removing the muzzle.  Brown and green grass mixes can be very high in fructans such as seen sometimes in December grass with mild weather.

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Once totally brown, rain and snow will leach out fructans from grass allowing muzzles to be removed.  “Sunny days, frigid nights with grasses in no way lush that dark green, half dead grass had very high sugars and fructans.” K. Watts, Rocky Mountain Research.

IV.  Steps in Fructan Laminitis

A.  The large intestine has a normal population of bacteria to breakdown food.  These bacteria can handle normal amounts of fructans seen in hay/grass.  The bacteria mix with the Fructan sugar and ferment, much like sugars and yeast coming together to ferment in making beer/wine.

B.  Food eaten by the horse will have simple sugars to be absorbed at the small intestine.  After that, the body’s pancreas notes this increase in blood sugar and Insulin pours out.  Pancreas to escort it to the cells.

C.  On the other hand, Fructans pass unaltered to the large intestine where it undergoes fermentation.  Longland, 2012, J. of Sci food/ag.re  Fructans are not degraded by mammalian enzymes but by bacteria.  Nilsson, 1988, J. of Nutrit.

D.  But too large a Fructan load creates too much rapid fermentation leading to problems.

• Disappearance of certain normal bacteria and mass overgrowth of strep bacteria that like fructans.  These strep create lots of lactic acid (Milinovich, 2006, Environ Microbio.) leading to:
• Lowering of pH in the large intestine – acids leads to death and breakup of many bacteria, so toxins released.  Pollitt/Visser, 2010, Vet Clin.

Acids damage lining of intestine also, so toxins now released into bloodstream.  Sprouse, 1987, EVJ.

E.  Now What?  Within 8-12 hours of Fructan overloads, strep exotoxins seen in blood.  Within 24-48 hours Laminitis.  Pollitt/Visser, 2010 Vet Clin.  Next can come Diarrhea, fever, shock, and death.

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V.  Fructans possible treatment

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In a 2013 study using sodium bicarbonate (baking soda), they demonstrated by tubing approximately 1 pound down of it with water could alkalinize (increase pH) of the large intestine. They study has huge possible therapy options for Veterinarians/owners trying to avoid or treat this type of Laminitis.  We highly recommend now if your horse is suspected of frost grass or spring grass Laminitis to have this baking soda treatment to help treat your horse.  We also recommend to try to help your horse in October/November and April/May by feeding a 1000 pound horse 2 tablespoons AM and 2 tablespoons PM of baking soda in the feed (add sugar-free pancake syrup to flavor).  This daily prophylactic attempt to alkalinize pH needs further testing to see effects, but it is an easy, simple step to try to avoid issues.

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