Laminitis is a topic that has received significant attention, and we're constantly learning more about the factors involved. Think of it like a domino effect: when too many factors pile up, they reach a tipping point, resulting in laminitis. What makes it tricky is that these factors can vary from horse to horse. For some, the presence or absence of just one factor can make all the difference. There are primary causes that lower the cascade threshold, leading to laminitis. These causes can be grouped into three main areas:
Internal or endocrinopathic dysfunction
Gut dysfunction
Blood flow issues
Let’s break these down a bit further.
Internal or Endocrinopathic Dysfunction This category includes conditions like Cushing’s Disease (PPID), Equine Metabolic Syndrome (EMS), and Insulin Resistance (IR). These conditions impair the horse’s ability to regulate blood glucose. For example, with PPID, increased ACTH levels or reduced insulin sensitivity can prevent blood glucose from being absorbed into cells for energy or storage. When the lamellae cells in the hoof don’t receive enough oxygen due to high glucose levels, they begin to die. At the same time, elevated glucose levels can exacerbate low oxygen conditions, worsening the problem.
Gut Dysfunction Too much soluble carbohydrates (like glucose, sucrose, fructose, and starch) can disrupt the hindgut’s microbiota and fermentation process. This leads to the release of lactic acid, amines, nitrites, and endotoxins—all of which increase inflammation, oxidative damage, and other harmful effects. These issues can weaken the lamellae and contribute to laminitis.
Blood Flow Issues Healthy blood flow is crucial. Blood pressure decreases the farther it is from the heart, and the hooves are at the farthest point. Slow blood flow can cause toxins and inflammatory factors to build up. Interestingly, research shows that laminitic horses often experience increased vasodilation, meaning blood flows in but struggles to flow out, compounding the problem.
Feeding Strategies for Laminitic Horses Feeding a laminitic horse can be challenging since sugar is a common factor across these issues. The question is, how much sugar is too much? Recent studies suggest that horses with insulin dysfunction should consume less than 0.1g of non-structural carbohydrates (NSC) per kilogram of body weight per meal. For a 500kg horse, that means no more than 50g of starch and sugar per meal. For healthy horses, these thresholds can be higher, but it’s best to err on the side of caution.
Horses with gut dysfunction also benefit from a diet with less than 10% NSC. Additionally, ensuring good cardiovascular health can improve blood flow to the hooves. Including omega-3 and omega-6 fatty acids in the diet can help maintain vascular health, though many diets lack the proper balance of these essential fats. High-quality sources are available to help with this.
Protein Considerations Overfeeding protein can also contribute to laminitis. Excess protein can disrupt hindgut fermentation, leading to the production of endotoxins like amines. A target of less than 12% protein in the diet is ideal for laminitic horses.
A Practical Diet Plan For laminitic horses, a diet should be low in protein and sugar (or NSC), with small, frequent meals for insulin-dysfunctional horses. Oil can be added as an energy source to replace starch while also providing essential omega fatty acids.
Horses don’t need large amounts of glucose in their diet because their bodies can produce it from propionic acid, a by-product of fibre fermentation in the hindgut. This process bypasses the insulin system and provides energy as needed.
Forage should form the foundation of the diet. Depending on the horse’s sensitivity, the hay may need to be soaked to reduce its starch and sugar content (typically around 10% in hay). Supplementing with low-NSC products like Speedi-Beet (5% NSC) or Barastoc Fibre-Beet Mash (8% NSC) can provide additional energy without increasing the risk of laminitis. Adding a small amount of cooked linseed can boost omega fatty acid intake and improve vascular health.
The beauty of this approach is that it works well even for horses that are not currently at risk of laminitis. With its versatility and nutritional balance, this diet is a win-win for equine health.