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

The Aphanizomenon flos-aquae strain of blue-green algae is high in chlorophyll and antioxidant nutrients such as beta-carotene. It may also contain active digestive enzymes to provide concentrated nutrition to help support healing, without placing additional stress on the digestive tract.

Aloe vera is an herb that has shown clinical efficacy in treating side effects of NSAIDs. Its anti-inflammatory effects are possibly from its inhibitory action on the arachidonic acid pathway via cyclooxygenase inhibition. (49) Studies on wound healing suggest Aloe vera modulates glycosaminoglycan levels in the wound, a factor that may enhance the healing of the basement membrane.

Slippery elm bark is another nutritional herb that protects and aids in healing the intestinal wall. Although it has a mucilaginous effect that would appear to soothe the intestinal wall, there is only anecdotal evidence to support its use. (50)

Nutritional Treatment of Laminitis

Nutritional support is critical in the laminitic horse and includes the basics of feed, water, and hay, as well as the addition of specific nutrients. The nutrients discussed below are those the authors have found clinically useful.

Feed

Once the digestive system is supported, high quality nutrients should be provided. The nutritional requirements for a horse with laminitis appear to be higher than for a normal horse. In the authors' experiences, a horse with Cushing's-based laminitis requires a high-fiber, low-carbohydrate diet. Wheat bran can be added as a source of fiber, taking care to keep the calcium:phosphorus ratio in balance in the overall diet (for most situations a 1.1:1 to 1.2:1 Ca:P ratio). Blue-green algae can be added to bran to provide amino acids and trace minerals. Grass or other lower protein hays can be given free choice. Some horses can tolerate an alfalfa/grass hay, especially if more protein is needed. Generally, alfalfa should not be used alone and should not be fed to the very overweight horse.

The feed should be low in sugar if the horse has signs of Cushing's syndrome with either altered insulin levels or diabetes. Sweet feeds should be avoided. In humans, increased insulin levels can begin in childhood. (51) Equine Cushing's may begin during a horse's younger years as well. Most prepared diets for foals and young growing horses are extremely high in sugar. Although the connection between feeding high sugar diets and Cushing's syndrome has not been proven in horses, there is a strong connection in humans between a high-sugar diet and insulin resistance. (52)

When evaluating the feeding program, treats being given should be examined. Many owners feed treats high in sugar, including large quantities of apples and carrots. Plain corn (25%), barley (35%), and oats (45%) makes a simple, clean grain mixture without sugar. Some of these grains may not be available or useable in certain parts of the country, depending on harvest situations. Some horses react poorly to eating oats; if that appears to be the case, barley and corn together are sufficient.