The role of nutritional therapy in the treatment of Equine Cushing's syndrome and laminitis - Equine Cushing's/Laminitis

Alternative Medicine Review, Sept, 2001 by Joyce Harman, Madalyn Ward

Human studies have linked "leaky gut" to various diseases, including arthritis, which is significant since NSAIDs are commonly used to treat arthritis in both human and animal populations. (38) Many horses receive phenylbutazone on a daily basis for weeks, months, or even years, potentially contributing to increased intestinal permeability.

The implications of the research are that high doses of NSAIDs could be detrimental to intestinal wall integrity, thus contributing to laminitis. Preliminary results from a well-established, human functional medicine testing laboratory support the hypothesis of poor intestinal function in some of the Cushing's and laminitis horses (Harman, unpublished data). Consequently, the use of NSAIDs in treating laminitis should be questioned.

Clinically, in the authors' experiences, discontinuation of NSAIDs is one of the most important aspects of the success of holistic treatment for laminitis. Symptoms are usually worse for three to five days after removing the NSAIDs, causing the horse to lie down more, which can be alarming to the owner and attending veterinarian. However, this is better for the horse, since lying down takes pressure off the feet and allows antioxidants to work. When the horse feels better with natural medicine it is because the horse is better, not because the pain is masked by a drug.

Repairing the Gastrointestinal Tract

The integrity of the gastrointestinal system is vital to preventing formation and release of exotoxins into systemic circulation. The authors have adapted many treatments that have been used successfully in humans.

The most important first step is to stabilize the intestinal wall and restore the beneficial flora. Antibiotic use leads to unbalanced intestinal flora that contributes to leaky bowel syndrome. (43,44) Probiotics may restore pH and gut flora to a healthier environment. Beneficial bacteria such as Enterococcus faecium, Lactobacillus acidophilus, L. casei, Bifidobacterium bifidum, and Streptococcus faecium are indigenous to the equine digestive system. These bacteria help maintain proper pH levels in the system, (45,46) manufacture vitamins such as biotin, and digest fiber. Supplementation using a variety of equine probiotics should be considered.

Glutamine is an amino acid that is a primary fuel for the enterocytes of the small intestine. Glutamine levels are affected by any decrease in feed intake, as well as by any stress placed on the intestine, such as sepsis or endotoxemia. (47) Glutamine has been shown to reduce bacterial translocation across the gut wall, (48) and should be considered in any horse not eating properly, and in any horse where intestinal wall integrity may be questionable. Doses range from 10 to 35 gm per day, depending on the size of the horse.

Processed grains and hays can lose key ingredients during manufacturing, since pellets and extruded feeds are made at high temperature. In some cases, a horse has difficulty digesting processed feed. In the authors' experiences, however, horses fed plain grains gain weight and are healthier. Some horses digest food better when digestive enzymes are added.