Diet: Best Hay, Grain, and Amounts
The key is to control carbohydrate metabolism by eating the right foods in the proper amounts.  HEIRO™ will greatly assist your horse in this project by helping to manage Insulin.

Your horse ideally will get: some fresh grass, some hay, some grain, and some snacks.  Often the scenario is the horse gets too much of one item and it causes a Laminitis trigger.

We will go over several items:  Grass intake management, hay to feed, fats/oils, good and bad snacks, hay testing.
Goal:  Practical, straight forward, understandable items to stop Laminitis and help your horse live a good life.

In the past, (2006, 2005, ...) you would see the term NSC standing for non-structural carbohydrates. This term is still used by feed companies to categorize low carbohydrate feeds of about 10-15% NSC. When you test your hay or fresh grass you will not see this NSC listed any more due to recent changes in the way sugars are categorized. The new category for sugar content of hay/fresh grass is called ESC because it contains sugars and a partial amount of fructans.

The starch category is the same as always.

This new category can not be compared to your past analysis. Know that NSC is not ESC and that past sugar tests can not compare to ESC.

A.    Hay - Goal - slow, sustained release of nutrients all day long with no long periods of fasting.

Hay has many benefits.

1.   Hay is essential in helping prevent Laminitis.  Your horse can not be on grass all day and can not get grass in the winter/bad weather.  Hay provides fiber to steady Glucose levels.  Hay provides eating activity for your horse (they eat 70-80% of the day).  Hay decreases stress which can steady stress hormones.  Hay stimulates the gut tone and motility. Steady hay eating avoids a problem. If the horse has fasted several hours and then is fed, can get Insulin surge beyond the normal which can be harmful. We want a slow, constant, low level of hay moving through.
2.   Spread the hay — make horses walk to multiple small piles in the field to increase exercise.
3.   Soaking hay— this can lower Carbohydrate levels and as a bonus has been shown to decrease allergens in “heave” horse reactions.  At times this is not practical in cold weather — you get a “hay sickle” in the bucket — the water freezes into ice.  This is a great time to test hay in fall when you are stocking up to feed it in the winter.  If it has low ESC/sugar/starch you will not need to soak it.  Also, test your horse’s Insulin level after a few days on the new hay.  This will let you know if all is Ok.  Most Laminitis is via fresh grass and not hay.  Pasture associated Laminitis accounts for 54% of equine Laminitis. (USDA Lameness and Laminitis National Health System 2000) Dr. Watt’s work on grass/hay sugar levels has been very helpful.
4.   What hay to feed and what levels do I look for if tested?

A. Timothy Grass Hay – Good choice, easy to get.  If tested, want 8-12% protein, low end of normal range of ESC (Simple Sugars) that is 4.7-10.9%, and low end of normal range of starch that is 1.5-4%. Example: If 15% ESC and 6% starch, do not buy it - probable Laminitis trigger. If it is 5.7% ESC and 1.8% starch is Ok to buy and no need to soak.

B. Alfalfa Hay - Can mix with Timothy up to a 50:50 ratio. It has a slightly lower ESC, starch, and sugar than Timothy Hay. The Equi-Analytical web site has a print out showing its safety. If someone tells you Alfalfa is a problem in Insulin Resistant horses, they do not have the facts. ESC is 4.2-8.2% Starch is 0.8-3.2%. I usually will not go above a 50:50 ratio because higher amounts of Alfalfa seems to cause more gas and runny manure.

C. Orchard Grass Hay - Very similar to Timothy Grass Hay.

D. Bermuda or "Coastal" Hay - These have double the starch of Orchard or Timothy, so you would need to soak these overnight and during the day prior to feed. 6% starch average, range 3.1-9.0. Since most Bermuda Hay is fed in the south, freezing "hay sickles" will not factor in. Timothy, Orchard, Timothy/Alfalfa, Orchard/Alfalfa are better choices.

E. Avoid Totally: Wheat hay, Oat hay, Barley hay - all very bad. Huge starch.

5.   Your horse, if not getting any fresh grass, will need 2% of body weight in hay daily.  In most Insulin Resistance horses, we want to reduce weight, so will feed less hay.  A normal 1,000 pound horse needs 20 pounds of hay.  To assist your horse in weight loss, instead of feeding the normal horse 2%, feed 1.8% or 18 pounds of hay.  To slow him down on eating, we covered the ways of putting in a field alone, blocking their view if in a stall.  A new way is to put the hay in a hay net.  The net will slow their ability to get big mouthfuls of hay.  At times, a horse may still go through his hay too fast even with a hay net and hence get stressed, get Insulin surges due to fasting.  Put the net into another net.  This is your plan B, because it will really slow the rate of eating down.  Perhaps do a double net in the night and a single during the day — your horse will talk to you.  To weigh hay, now is the time to get the bathroom scale to weigh a bale.
6. Avoid feeding Blue Seal's Hay Stretcher - it has molasses and a NSC of 22%. It comes in a large pellet.

Equine Insulin Resistance puts your horse on the edge of a cliff. Any stress such as surgery, vaccines, mild colic, diet change, weather changes, or infections can push them off the edge into laminitis. By being proactive, you guide them away from the edge.

 

B.     Fat/Oil Supplements

1.  Do NOT use in Insulin Resistance horses. 
A study by the University of Kentucky's Dept. of Veterinary Science in 2002 by Dr. Fitzgerald showed that an infusion of fat actually induced Insulin Resistance in horses in less than 2 hours time. This can lead to a Laminitis trigger. High fat diets can cause a crisis.

2.  High Insulin levels already are promoting fat which in turn release toxins to further cause more and more Insulin. This cycle is not helped by promoting more fat with a high fat diet.

3.  What to avoid:

NO OIL! NO BRAN!

A. NO OILS - No corn oil, no rice bran oil, no wheat germ oil.

B. NO RICE BRAN - two big reasons.

1. According to a USDA study by Dr. Marshal in his 1994 Rice Science Study (465 page report), it is approximately 16% fat. This is going to promote fat on your horse, add weight, and cause problems.
2. Rice bran is loaded with starch. Dr. Marshal has it at 16% and Equi-Analytical Labs at almost a 20% average. This is 5 to 7 times more than timothy/orchard hay or beet pulp. Rice bran has an NSC level of about 25 which is extremely high.
3. Rice bran's NSC is very close to that of Wheat bran (30). Both need to be strongly avoided in these horses.

4.  High/increased fat is great in tying up horses, EPSSM, horses needing weight, but not in Insulin Resistance.

5. On the bag of ingredients of many low carbo, low fat feeds you may see rice bran. DO NOT panic. They put in an extremely small amount for flavor. These products have low NSC values (10%) and low fat values (3-5%). The main point is not to add more of rice bran or wheat bran to the diet.

C.     Grain — yes, you will feed grain to an over weight Insulin Resistance horse. Why?

1.   An all-hay diet will lead to problems due to vitamin/micro-nutrient deficiency.  If you hear that the solution to Laminitis in an Insulin Resistance horse is feeding it just hay and keeping it on a dirt lot, you are getting inadequate and incorrect information.

Again, our goal: some grass, some hay, some grain, some snacks.

In the winter, grass options are lost, so grain is even more important at this time.

2.   What type to feed my horse?

a.   You want a low NSC pellet feed which will provide vitamins/micro-nutrients and a high amount of protein.  These special feeds are very concentrated so you will only feed a small amount to your horse each day.  Normal horses can get up to 1% of body weight in grain a day for maintenance — that is 10 pounds of grain in a 1,000 pound horse.  With a low NSC concentrated feed, that same horse gets only 1-2 pounds a day.  You will mix the HEIRO™ in with the morning feed.  With Insulin Resistance horses, we want to reduce weight, so we will feed grain only once a day in the morning — your horse’s natural circadian rhythm has Insulin highest in the morning and we want HEIRO™ working then to control Insulin all day.
b.   There are many low NSC/low carb pellet feeds on the market but they are not all good for an Insulin Resistant horse because they may also have high fat. We want a low carbohydrate (low NSC), high protein, and low fat diet. To compare, sweet feeds have a NSC of 40% due to the sugars/starch of lots of corn, oats, and molasses and some feeds have 12-30% fat.

Good Choices:

Name of Feed	Company	NSC %	Protein %	Fat %	Approx. Cost of 50 lb. Bag
Enrich 32	Purina	10	32	5	$21.00
Grow N Win	Buckeye Feed	10	32	5	$28.00
Triple Crown 30	Triple Crown	13	30	3	$28.00

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i. Why These?

1.Low carbo, high protein means you can provide essential nutrient while avoiding unwanted carbohydrate. For example, other lite feeds are low carbo but 12% protein which means you are directed to feed up to 4 pounds a day. With a low carbo, high protein feed like the three mentioned in the chart above, you feed only 1 pound once a day.

2. Economics - This means in a one-year period, you will feed 1,095 pounds of feed less a year or 22 bags of feed less a year for a $400 savings. This helps keep weight off your horse and has an economic advantage.

3. Higher protein meals decrease Insulin surges because it slows the release of nutrients from the stomach out into the small intestine. This slower release allows a slow, steady flow of nutrients instead of a sudden rush which would cause a sudden Insulin spike.

ii.  Which low carbo feeds to avoid? Ones with extra fat such as Purina Ultium, Ker Re-Leve, and Blue Seal Carb-Guard. These are great options in tie up, PSSM, and Cushings horses with no Insulin Resistance.

Summary: Not all "lite" feeds are best for Insulin Resistant horses. You will feed a very small amount of one of these three in the morning along with HEIRO™, beet pulp, and a handful of alfalfa pellets.

iii. An example of one of these feeds - Purina's Enrich 32.

1,000 pound horse gets1 pound feed once a day in the morning
Large pony gets ¾ pound feed once a day in the morning
Small pony gets ½ pound feed once a day in the morning.

1 cup of “Enrich 32” weighs 0.38 pounds
¼ cup of “Enrich 32” weighs 0.1 pound

1,000 pound horse – Feed 3 cups in the morning
Large pony – Feed 2 cups in the morning
Small pony – Feed 1 ¼ cups in the morning

What cup to use:  a kitchen measuring cup from the grocery store.  Not a scoop, not a coffee can, not your Snoopy coffee cup.

D.   Ways to help us monitor the right food needed:
There are 2 methods to choose the right foods and to monitor what is in the food.  The best way is to use both systems to plan the diet.  The systems to monitor are called the “Glycemic Index” and the “Carbohydrate Level test”.

1.   Glycemic Index of food
This compares food’s effects after eating to that of a similar amount of pure Glucose.  Glucose has a rating of 100 and the closer to 100 (higher the Glycemic Index) the faster that food delivers its Glucose into the blood stream.  We want low Glycemic Index foods to avoid Glucose surges which trigger Insulin surges.  Example:  A carrot has a high Glycemic Index number of 71, while peanuts have a low Glycemic Index number of 14.  Conclusion: avoid carrots, feed roasted peanuts in the shell as a nutritious snack to your horse.
2.   Carbohydrate Level Test
When you get grass or hay tested to see if it is safe, there are two items to look at to see Carbohydrate levels.  They are sugar and starches. 

• The main nutrient of hay/grass is Carbohydrate.  As we went over earlier, sugar and broken down starch will enter the blood stream as Glucose.  We want to avoid high sugar/starch forage or, if we see it, monitor and manage the intake.

Grass will change during the season and if you have a concern, test the grass and test the horse’s Insulin together.  If the grass is high in sugar but your turn out time with a muzzle shows a good Insulin level, then all is well.  Just because the grass is high in sugar, does not mean you lock the horse in the stall; you just manage the horse differently.

Grass pasture — normal levels of:
ESC (Simple Sugars)   5-15%
Starch                         .5-6%

Timothy grass hay - normal levels of:
ESC (Simple Sugars)    4.7-10.9%
Starch                          .9-3.7%

Side note on fiber:
Fiber is also a Carbohydrate but it requires the bacteria of the large intestine to break it down.  The sugar/starch Carbohydrates go into the bloodstream at the small intestine.  Fiber rolls past the small intestine and goes down the tract. 

There are two types of fiber:
1.   Soluble fiber – bacteria break it down, nutrients absorbed
2.   Insoluble fiber – cellulose seen in stems, seed hulls

Is fiber important? Yes.

1.   It creates a sensation of fullness because it is not digested at the small intestine level, so your horse eats less due to not being as hungry.
2.   Assists in slow, steady delivery of Glucose to the small intestine due to its bulk — slows release out of stomach of sugars.
3.   Soluble fiber can account for 50% of the energy needs of your horse.
4.   Hay and beet pulp have excellent amounts of fiber.  Hay has about 30% and beet pulp about 20%.  For comparison, corn has only 2% fiber which means it is mainly sugar/starch— that is why corn is avoided in Insulin Resistance horses.

1. What is Insulin and Insulin Resistance?
2. Exercise.
3. Chromium, Magnesium, Pergolide, Thyroid powder and Metformin
4. Diet: Best Hay, Grain, and Amounts
5. Good and bad snacks, Horse Treats
6. Avoiding Glucosamine
7. Feeding Flax Seed
8. How to correctly test for Insulin Resistance
9. Farrier Schedule/Foot Trimming/Best Glue On Shoe
10. Vaccines
11. Results

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