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

Methyl sulfonyl methane (MSM) is a source of organic sulfur, an important component of disulfide bonds in the laminae. Disulfide bonds are key to connecting the hoof wall to healthy lamina. (62) Sulfur may be an important nutrient for these horses and can be fed free-choice or by controlled supplementation.

Essential Fatty Acids

Essential fatty acids are needed to make the cell wall more sensitive to insulin. (63,64) Omega-3 fatty acids are especially deficient in the human diet and may be deficient in the equine diet. Most high-fat equine foods use an animal fat high in saturated fats rather than vegetable oils. Flax and hemp oil provide palatable omega-3 fatty acids to the horse, although fish oils have an even better fatty acid profile. (63)

Chinese Medicine

Chinese medicine, both acupuncture and Chinese herbs, may be used successfully. The Chinese herbal formulas used are Rhemannia 14 (kidney yang deficiency), Mai Men Dong San (vacuum heat due to yin deficiency), and Rhemannia 11 (qi-yin deficiency), or other custom-tailored formulas as needed. These should be used with a correct Chinese diagnosis and, although there is not a large amount of research currently to support their use and inclusion in this review, clinical results have been very encouraging.

Other Treatments

The authors have used several other forms of complementary medicine when treating Cushing's cases, including homeopathy and glandulars. Inclusion is based on anecdotal support from clinical practice. Research on these treatments for laminitis is warranted.

The use of cold baths to cool the hoof has at times been advocated. In light of Pollitt's research, cold should be used regularly in the first 48 hours, especially in known grain overload or toxic case situations. (1) Table 3 summarizes a comprehensive approach to Cushing's/ laminitis.

Hoof Care

Damage to the hoof in laminitis cases can be kept at a minimum by following these guidelines:

1. Do not use drugs to mask the pain. If pain is masked, the horse will continue to walk on the damaged lamina and cause additional damage. Natural antioxidants will allow healing without masking the pain. A horse with severe laminitis should lie down to take weight off of the damaged legs.

2. Provide deep sand-bedding if possible, or use styrofoam taped to the bottom of the hoof (e.g., 2-inch thick, blue builder's styrofoam). Washed river sand will best shift under the horse's weight, allowing the horse to stand in the most comfortable position. It will also shift under pressure points to keep pressure sores to a minimum. A horse with tight tendons will often stand with its toes buried in the sand and its heels elevated. The way the horse stands in sand is a good indication as to how the horse should be shoed.

3. Keep hooves soft and pliable. Because the horse with laminitis generally has swelling within the hoof capsule, attaining soft hooves which expand to relieve pressure is desirable. If the hoof becomes too hard, a poultice can be applied overnight. Using a rasp to thin the hoof at the toe will also give relief.