by Dr. McCall | Mar 25, 2016
Equine Metabolic Syndrome (EMS) is a disease similar to Type 2 Diabetes in humans. Normally, when horses eat a meal, they absorb sugars from their intestines, causing an increase in blood sugar levels. In response, the pancreas secretes insulin, a hormone that helps glucose get into the cells where it can be used for energy. The circulating blood sugar thus goes back to a lower level. This is an active balancing mechanism.
In the EMS patient, the body becomes much less sensitive to insulin, and ever increasing amounts are required to return the blood sugar to normal. This lack of sensitivity to insulin causes a number of problems. First and foremost, there is significant evidence that chronically elevated insulin levels directly damage the lamina in the feet, causing founder. In addition, there is strong evidence of immune system damage, and increased fat deposition both externally (the crest, loin, and tail head), and internally, particularly in the liver. The internal fat is particularly damaging, because it releases various other compounds that amplify the insulin resistance.
Management of EMS in the horse is centered on dietary changes and increased exercise. Exercise is the best insulin sensitizer available. Riding 4-5 days a week for an hour is great therapy for both horse and owner. Each session should work up a sweat.
Modification of the diet to limit intake of soluble sugars is very helpful. There are broadly two types of sugars available in the horse’s diet. These sugars are classed as soluble and insoluble. Soluble sugars are things like glucose and fructose and taste sweet. Insoluble sugars are more like pasta. It is possible to measure the soluble sugars in hay and grain samples. The goal is to have less than 10% soluble sugars in the horse’s diet. Hays with more than 10% soluble sugars can be soaked for 30 minutes to remove the soluble sugars. Remember to pour out the water before you feed the hay! There are sources of low soluble sugar hay pellets and pre-formulated rations available from Purina, Nutrena, and others.
The other essential part of dietary management is total caloric intake. EMS horses need to be a little on the thin side. Normal recommendation for total caloric consumption is 1.5 pounds of feed (total hay and grain) per day per hundred pounds. If your horse is over weight, a weight loss program should be devised to get his weight down. Remember, less fat = less insulin resistance.
by Dr. McCall | Mar 25, 2016
My horse has a cut on his leg, what should I do?
This is one of the most common questions we hear. The critical things to know are depth, discharge, and whether important structures are involved. Wound depth can not always be determined by looking. In a typical wound, you can see hair missing, a raw spot, and maybe edges and deeper structures. If all you see is missing hair, the wound is not serious, and all that is required is to keep it clean with water. If you are able to identify complete edges on both sides of a wound, the wound is termed <em>full thickness</em>. Full thickness means that the skin has been cut clear through, and that structures inside are exposed to the outside. These wounds require inspection by your veterinarian, because they often are like an iceberg, bigger on the inside than on the outside. There may be tendons, ligaments, muscles or joints underneath that are damaged, and often there is debris like manure and hair packed inside. These wounds are likely to get infected and need medical management in order to get good healing. The last bit of information to process is whether or not important internal structures are involved. Wounds that involve joints, tendon sheaths, tendons, ligaments, or bone are particularly serious because infection or injury to these structures can become life threatening. These wounds can often be managed successfully if diagnosed early. Once infection has set in, it is much more difficult to achieve a good outcome.
A similar question is whether or not a wound needs stitches. Wound suturing is recommended for larger wounds, wounds with a lot of injury underneath the skin, if tendons, muscles, or joints are involved, and if a good cosmetic result is desired. Usually, sutured wounds heal faster than those left to heal by themselves, with less scarring.Wounds over joints can be successfully sutured, they just require specialized bandaging to limit movement while the cut heals.
My horse’s wound has pus coming out of it. What should I do
These wounds are infected, usually with bacteria and debris from the skin, as well as the barnyard. Infected wounds are swollen, red, have discharge, may or may not smell bad, and are painful. These wounds are treated in two ways. First, it is essential to decontaminate the wound. This is done by applying large quantities of hypertonic saline solution to the wound to dilute the discharge. The recipe for the solution is below. In a pinch, you can use a garden hose to decontaminate a wound. Do not apply Furacin, disinfectants, antibiotics, soap, bleach, Vetricyn, or other substances unless directed to do so by your veterinarian. Sampling of the wound for bacterial culture and determination of antibiotic sensitivity may be very important in order to get the infection resolved. Bandaging of draining wounds is helpful to remove discharge and protect the raw surfaces from recontamination by the environment.
Pain management for wounds is very important. Numerous studies have shown that adequate pain management speeds and improves the quality of wound healing. Minor wound pain is often well managed with anti-inflammatories like phenylbutazone, Previcox, or others. More substantial wounds may require opiates, local anesthetics, epidural, or other modalities to adequately control the pain.
