Journal d'une SME

Dans la continuité du post de Nuts pour le chushing de Polish, j'ouvre un "journal expérimental" pour une de mes juments dont on suspecte très fortement qu'elle soit SME.

Historique :
Née dans les plaines de la Crau, pas de signes particuliers à l'achat ni de retour sur d'éventuels problèmes passés. Depuis qu'elle est chez nous, son plus grave problème était une certaine sensibilité au niveau des pieds (on a des chemins particulièrement caillouteux, mais tous les autres s'y sont fait). Elle a aussi fait quelques conjonctives bénines, et deux épisodes assez impressionnant de quelques minutes de "colique-myosite" les lendemains de gros effort.

Depuis septembre l'an dernier, on a eu plusieurs épisodes de fourbures plus ou moins grave, d'abord mis sur le compte de l'herbe d'automne, puis sur un peu d'embonpoint (mais vraiment modéré par rapport aux 19 autres chevaux que je possède), puis finalement dernière fourbure en date alors qu'elle était dans un pré avec des copains pour alimentation spécial régime et très régulièrement travaillée.

Elle est donc depuis quinze jours en paddock au foin. Le problème est qu'elle devient vite très maigre même avec du foin à volonté, et pour autant les pieds sont encore affreusement douloureux, donc on ne peut rien lui donner à manger de plus. Elle est bien entendue soignée pour sa fourbure.


Elle a donc tous les symptômes d'un SME. Ce soir, nous la mettons à la diète pour pouvoir réaliser la prise de sang demain matin. Cette prise de sang servira à confirmer le SME, et surtout à avoir une mesure "étalon" qui nous servira de référence pour la suite des traitements.

Un petit article qui résume bien :

Lien intéressant pour le SME et CUSHING

Un complément qu'on a déjà donné en début d'année et qui a bien soulagé, et en plus de çà explique plein de choses sur SME, CHUSHING etc...

Complément REHE VITAL

Je vais suivre ça de près. Il est possible qu'Unica soit légèrement atteinte. Perso je n'y crois pas trop (ou plutôt, je n'ai pas envie d'y croire...), mais c'est vrai qu'elle a quelques dépôts adipeux qui refusent de partir même quand on la met un peu au régime et que le reste maigrit (notamment sur les épaules).

Je suis en train de jeter un œil du côté de l'homéopathie, mais je ne trouve rien de probant pour l'instant :-(

Notre EP a fait differents papiers, sur l SME et cushings...
j ai les pdf mais ne sait pas comment les attacher...

Napo: C'était exactement notre cas. J'ai découvert le mot SME y'a deux ans, en me disant que j'avais bien une jument pas si rondouilette mais avec un bon chignon... Tout l'automne on a essayé de se dire que çà ne pouvait pas être çà... 

Mais bon, Deux ans plus tard on y est en plein!

J'ai déjà quelques pistes de traitement "alternatifs", je suis partie dans un vrai truc expérimental pour essayer de la stabiliser, voir soigner...

Citation :

Napo: C'était exactement notre cas.

Tu dis ça pour me rassurer ?... loool ! (Enfin, non, pas loool, déjà que j'suis pas encore sortie des problèmes d'Unica, pitié, pas le SME en plus !!!)

Parage :
Depuis plus d'un mois, j'ai déjà pris en charge ses pieds. Chaque semaine je rectifie un peu le parage. Les fourchettes souffraient d'une pourriture profonde (parage du maréchal pas adapté voulant bien faire car fourbue et peu de mouvements) et la ligne blanche était bien étirée et abimée... Du coup, on baisse les talons, on combat les évasements (surtout en pince) et on roll à fond...

Les pieds sont maintenant esthétiques mais pas encore fonctionnels, les fourchettes métamorphosées (ce n'est qu'une question de patience et de pousse pour que la pourriture soit de l'histoire ancienne : merci aussi à l'huile de cade).

Et sinon, en phyto, s'il y a tendance à la fourbure, je pense qu'il faut taper dans les plantes drainantes et détoxifiantes, comme le radis noir, l'artichaut, le chardon-marie.

Napo: en fait juste que parfois les intuitions, ne sont pas mauvaises...

au cas ou ca t'interesse, mais c est en anglais... la derniere partie deal sur les complements alimentaires

Equine Insulin Resistance
As promised, following last month’s newsletter on Equine PPID, I am now focusing our attention on another common hormone imbalance that is known to trigger laminitis – Insulin Resistance.
Insulin Resistance is usually first suspected when a horse has a laminitis attack. As a result, the vet will carry out some blood tests to look for hormonal imbalances. If your horse displays “fat pads”, he will test for Insulin Resistance. These fatty deposits can appear anywhere, but the most common places are:
1. Crest
2. Shoulder
3. Belly
4. BaseoftheTail 5. Sheathorteats
The fat pads themselves cannot be relied upon to
diagnose Insulin Resistance because other hormonal imbalances such as PPID and EMS can also cause them to appear. Insulin resistant horses are often overweight, but not always. Sometimes, the ribs can still be easily felt and areas of the body between these fatty deposits are not carrying excess weight. In fact it is possible for an IR horse to be quite severely underweight, yet still carry these fatty deposits. It is also interesting to note that only 35% of overweight horses are insulin resistant.
Insulin Resistance often starts to develop after the horse finishes growing at 4 - 5 years but the condition can appear at any age.
As well as these fatty deposits, other symptoms which could point to your horse being Insulin Resistant are:
Lack of Energy
Being prone to laminitis – sometimes an acute attack, but more often chronic low grade laminitis
A cresty neck which often becomes quite hard to the touch
Fluid accumulating above the eyes Increased thirst and urination
Loss of body condition
Those of you who read last month’s newsletter
about PPID will recognise many of these symptoms already. Many PPID horses are also Insulin Resistant, but many are not and some of these symptoms in isolation may indicate a completely different disorder, which is why only your vet will be able to properly diagnose the condition with the help of some blood tests.
March 2016
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© 2016 Jayne Hunt Page 1
What is Insulin?
Insulin is a very important hormone that plays a big part in keeping blood glucose levels within safe limits for good health. This diagram shows how, when levels of blood glucose raise, it can help the cells to take up the glucose so that it can be used for energy. Any excess glucose can also be transported to the liver where insulin will help it to be converted, either for storage in fat cells, or for use by muscle tissue for instant energy, as shown in the diagram below:
It is important that, in the horse, blood glucose levels are always returned to a healthy range. Insulin Resistant horses are capable of doing this, but it involves producing extremely high levels of insulin to do it. If blood glucose levels cannot be maintained and begin to rise, this will lead to a diagnosis of Diabetes Mellitus. Diabetes happens very rarely indeed in a horse.
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In a healthy horse, insulin acts on a cell like a key to unlock a channel which allows glucose to enter, delivering instant energy to the cell as well as reducing the amount of circulating glucose in the blood.
When a horse is insulin resistant, the glucose channels become insensitive, meaning insulin is unable to open many of the glucose channels, resulting in the cell receiving less energy and circulating blood glucose levels rise.
When circulating blood glucose levels rise because it is struggling to enter the cells, circulating insulin also rises as it attempts to find ways to stem the rising glucose levels.
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As a result, insulin sends more and more glucose to the liver. Unfortunately, high levels of insulin will prevent the muscles from utilising glycogen, meaning it has to convert the excess glucose to lipoproteins which not only get stored as fat, but also act as an alternative energy source for the cells that cannot receive enough glucose.
As a result, the horse’s health is threatened by:
• An overloaded Pancreas secreting ever higher levels of insulin
• An overloaded liver trying to convert high levels of glucose into glycogen and lipoproteins
Constantly raised blood insulin levels (but blood glucose stays normal)
Kidneys begin to excrete glucose, leading to increased thirst and urination
The muscles are starved of energy
Ever increasing fatty deposits around the body which produce potentially harmful hormones
Increased cholesterol and lipids in the blood
This combination of factors dramatically increases the risk of developing laminitis.
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What Causes Insulin Resistance?
Honest answer? We haven’t a clue, but these are thought to be the most likely contributors:
Genetics
Chemicals
Lack of Exercise
Obesity
It has been proposed that maybe some horses are simply not genetically capable of eating a high carbohydrate diet. It is certainly true that modern methods of horse management have resulted in grasses (and therefore hays) that have been modified to provide more carbohydrate energy, and a wild horse would simply never be exposed to grain based, sweetened feed that has already been partially cooked to provide much faster glucose absorption.
Evidence is coming to light in humans of the link between agricultural chemicals and Insulin Resistance. To date, hardly any research has been carried out on horses but reducing access to chemicals has been found to significantly help horses showing signs of metabolic disorders.
Studies have been done on horses with Insulin Resistance to see if increasing exercise can improve insulin sensitivity. Results show that yes it can, and the effect can last as much as a week after the exercise was stopped. Exercise uses up circulating glucose more quickly, enabling the horse to bring high blood glucose levels to within normal range more easily and avoiding the need to convert that glucose into fat.
The most commonly accepted cause of insulin resistance is “letting your horse get fat”. There is actually very poor evidence that obesity causes insulin resistance. Only 35% of fat horses are insulin resistant. Interestingly too, these localised fatty deposits are not seen on horses who are merely overweight, and have not developed insulin resistance. The crest and other fatty areas are created by excess circulating insulin, not excess calories. However, if the horse is overweight and insulin resistant, excess weight will make the condition worse. This is because once fat cells begin to accumulate, they are capable of producing hormones and releasing them into the blood stream. This includes Leptin, which controls appetite (many insulin resistant horses are ravenously hungry), Adiponectin, which helps to control blood sugar levels and insulin sensitivity, Oestrogen – the female sex hormone, Resistin, which has been implicated in many obesity related disorders, and Cytokines – particularly pro- inflammatory cytokines that promotes inflammation in tissues leading to oxidative stress which makes the body less able to maintain its own good health.
Did you know that if you took the gut flora of a thin person and transposed it into an obese person’s body, that person would begin to lose weight? Similarly, a lean reciptient of a fat person’s gut flora would begin to gain weight despite no increase in calories? Over the last 5 years or so, focus has begun on equine digestive health since the discovery that an alarming number of horses have stomach ulcers.
This has led to a lot more research into equine digestive health and its effect on wellbeing.
We all know the phrase “no foot, no horse”. Well, evidence is beginning to suggest that “no gut, no horse” may be nearer to the mark.
Digestive Health
© 2016 Jayne Hunt
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Winter Feeding
A healthy gut wall is needed for good nutrient absorption
The gut is the biggest part of the immune system, trapping and excreting ingested chemicals and toxins
It produces its own hormones
It controls levels of hydration in the body
Feeding the wrong food can drastically upset gut function
When an EP visits a horse they are always conscious about looking for signs of poor gut health. We have found that evidence of gut problems are significantly more common in horses showing signs of hormone imbalances and this is an area that needs to be researched further. I will be writing a newsletter about digestive health soon.
We often hear about the dangers of letting your horse get fat, but we also feel pressure to not let our horse lose too much weight. In the wild, horses lose a significant amount of body fat during Winter months. In the absence of good quality carbohydrates, horses will begin to find food in the shrubs and hedges, eating tree bark, marsh grass, etc. This increases fibre intake, meaning much more of the energy will come from Volatile Fatty Acids instead of glucose, increasing insulin sensitivity. By feeding high quality hays and bucket feeds through Winter to ensure the horse maintains his weight can actually encourage insulin resistance. This does not mean you should starve the horse and let them become emaciated, but it does mean that you should allow them to drop weight a little over Winter.
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How is Insulin Resistance Diagnosed?
Care must be taken for a reliable diagnosis to be given. A horse who is stressed or in pain will always have raised levels of glucose in the blood and it is important to consider this when reading blood results. For instance, if the horse is being tested because it has laminitis, the pain from the laminitis will skew the results. Similarly, a horse who stresses when deprived of food will also have artificially high blood glucose after a 12 hour fast. Other factors can also raise blood sugar. The stress of transportation, infection and other illnesses, certain drugs and even pregnancy will have an effect on blood sugar.
The standard testing protocol is the Combined Glucose Insulin Tolerance (CGIT) Test and involves at least two blood samples being taken at least 12 hours apart. It goes something like this:
The horse is starved for a period of 2 – 12 hours 500g of fructose is fed to the horse
After a minimum of 2 hours, a blood test is taken
The blood test will measure how much insulin is produced by the horse in order to bring blood glucose levels back to normal. An insulin Resistant horse produces much more insulin than a healthy horse – sometimes over 100 times more than a healthy horse would produce. These elevated levels will also take much longer to return to normal in an insulin resistant horse.
There is a great deal of disagreement about what level of blood glucose is diagnostic of Insulin Resistance, and for good reason. Some advocate that any insulin reading above 40 units means the horse is insulin resistant, whereas other experts say that this figure is way too high. The reason for this is because a healthy horse on a high starch diet will have a much higher insulin reading anyway compared to a similarly healthy horse on a low starch, low sugar diet.
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Dr Eleanor Kellon, Equine vet and nutritionist who has spent many years studying endocrine disorders and laminitis, states that a more accurate test is carried out as follows:
The horse is not exercised for at least 24 hours before the test
They are not starved, but are left to graze, or given hay only before the test There is no need to feed glucose
After 24 hours, a blood test is taken
By giving the horse no starch (other than those available in the grass or hay), the resulting blood glucose reading should be 10 – 12 units. Any reading above that shows insulin resistance, and a reading above 20 units is way too high.
Eleanor carried out monthly blood testing in this way on a herd of 160 horses and ponies, 58 who had a history of laminitis. She found that this method of testing resulted in very stable and reliable blood profile readings.
Although the second option is definitely our preferred option, your vet may not be familiar with it, and it is important that you discuss any testing protocols with your vet. A good vet will listen to your concerns, but you must also remember that they are the experts here, and is important that they have faith in the testing protocol they use, which is often based on years of experience.
It is also worth noting that glucose and insulin levels can rise artificially in the following circumstances:
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Pregnancy
Exercise
Transportation
Fear
Excitement
Infection Drugs
Cold
A pregnant mare will have higher levels of circulating glucose and insulin
Make sure the horse has had no exercise for 24 hours before testing
If your horse was taken to the vets for blood tests this may raise insulin
A fear of vets with needles can be enough to raise insulin levels
If the horse is not calm when the test is taken it will skew the results
Inflammation increases insulin production
Some drugs (including Bute) can artificially raise insulin resistance, so if your pony is being tested because he has laminitis and he is being given Bute, this needs to be taken into account
Cold weather reduces blood insulin levels and could give a false negative blood profile
As with all blood tests, these are not 100% accurate, so if your horse is starting to lay down fat in localised areas, it is best to manage him as though he is insulin resistant, even if the blood tests say otherwise.
Drugs to Treat Insulin Resistance Metformin
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In the UK, the most common drug to prescribe to treat Insulin Resistance is Metformin. Metformin was developed for use on humans with Type 2 diabetes, but an equine study conducted at Liphook showed that Insulin Resistant horses who are on Metformin improve the sensitivity of their cells to the action of Insulin, and reduce production of Insulin from the Pancreas1.
However, there are many studies which found Metformin ineffective2 3 and the drug is unpopular in the USA because its effect is at best limited and it carries with it side effects, most notably increased risk of Azoturia (tying up) and gastro-intestinal problems such as colic and ulcers.
Levothyroxine Sodium
For many years it was believed that horses who showed signs of increased weight were suffering from hypothyroidism (an underactive thyroid). However, we have since learned that high levels of circulating insulin are the cause and these are not known to be affected by thyroid function. An American researcher, Nathaniel T. Messer IV, DVM, of the University of Missouri in Columbia, has been studying the equine thyroid. He states "In adult horses, thyroid dysfunction is generally felt to be uncommon, and while it has been associated with a variety of clinical signs, a definitive diagnosis is often difficult. One of the reasons for this is that many endogenous and exogenous factors can affect thyroid function and sometimes test results. Serum levels of thyroid hormones vary over a wide range, and low baseline levels may be misleading, which may result in many euthyroid (normal) horses being diagnosed as hypothyroid.”
It is generally accepted that primary hypothyroidism (where the thyroid cannot produce enough thyroxine) is rare. However, a form of secondary hypothyroidism has been noted in insulin resistant horses. This shows that even though the thyroid is functioning normally, the hormone needed to convert the relatively inactive T4 into the active T3 (Deiodinase) is underactive, which can cause the metabolism to slow, leading to weight gain. Therefore, a study has been conducted which tried to improve insulin sensitivity using synthetic Levothyroxine4. The study found that it did indeed improve insulin sensitivity, but the effectiveness and potential side effects of this drug need further testing before it can be considered a reliable treatment.
Management Strategies for the Insulin Resistant Horse
In the absence of reliable drug therapies for this condition, controlling Insulin Resistance in the horse is often down to good management strategies from the owner. It is even possible to reverse the condition completely in some horses, but even if you manage to reverse the condition, once a horse has been Insulin Resistant, he is more at risk from the condition returning.
Managing the Insulin Resistant horse, whether laminitic or not, involves taking the following steps:
1) Feedsoakedhayinthecorrectquantitiesforweightmaintenanceorloss depending on need
2) Ensurethehorsegetsasmuchexerciseasispractical(aslongastheyarenot footsore)
3) Balancevitaminsandmineralsbyaddinginagoodqualitysupplement
4) Add in additional supplements known to help with insulin resistance
5) Monitorprogressthroughrecordingcrestsizeandhardness
Managing the Overweight Horse
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Even if your horse has a large crest and fatty deposits, if you can easily feel the ribs, your horse is not overweight – he has a hormone imbalance. However, some insulin resistant horses are overweight, and carrying excess fat will make the problem far worse, so in these cases, weight loss is a priority. However, YOU MUST NOT STARVE YOUR HORSE. A starving horse can develop Hyperlipaemia which causes multiple organ failure and is often fatal. A starving horse will also downregulate their metabolism by decreasing thyroid output, meaning he will remain fat despite ever decreasing amounts of calories. It will also cause an increase in resistance to Leptin, meaning the horse will be so hungry that whenever he is turned out on pasture, he will gorge, causing the potential for a big spike in insulin, triggering laminitis and risking another complication - colic.
Weight control is about so much more than calories. You need to put several strategies in place to help improve the horse’s metabolism.
1) Exercise
Provided the horse is in good health, a progressive fittening programme to increase exercise, speed up metabolism and use up circulating glucose will help. Think about ways to increase exercise all through the day through clever management strategies such as:
Turn your horse out with other horses to encourage play and movement
Consider a track system – these can dramatically increase the number of footsteps your horse takes every day
If stabled for long periods, walk them out in hand as much as you can
Take advantage of a horse walker if your yard has one
If putting out hay, put it at the opposite end of the field to the water
Lunge, longline or walk in hand if your horse cannot be ridden
If you haven’t got time to ride your horse, consider finding someone who can
2) Diet
This is a huge subject in itself. I will go into this in more detail in a future newsletter, but meanwhile, remember the golden rule: feed fibre, fibre and more fibre
Fibre is filling, promotes intestinal health and more importantly, provides energy in the form of Volatile Fatty Acids rather than glucose. This therefore provides the horse with energy without making blood glucose levels rise.
If your horse is overweight, they should only be given enough bucket feed to enable them to eat any supplements you have added. Anything else is excess calories they do not need.
If your horse balloons on grass, try to find a way that he can be turned out with minimal access to grass and feed hay instead. Always try to feed hay ad lib. Reduce calories through soaking (for 30 minutes – no longer), and if this is not enough to cause weight loss, slowly mix in feed grade straw such as oat or barley straw which is much higher in fibre and lower in calories. You can increase the amount of straw over time until you are feeding 50 : 50 hay : straw. Always add in straw slowly to minimise the risk of impaction colic. Do not feed wheat straw (which is what bedding straw is). If your horse is eating a lot of his bed, switch to shavings. Bedding straw usually contains a huge amount of agricultural chemicals and wheat is known to cause all kinds of digestive upsets and may upset hormone balance further.
A big misconception about feeding an overweight horse is that they should have “old” hay which was produced the previous year. Old hay has very little nutritive value –
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from the moment you cut grass to make hay, nutrients begin to degrade. Vitamins will decrease within weeks, protein levels will take a nose dive after about 6 months and mould and dust spores will increase over time. It is always a good idea to feed second cut meadow hay (most hay is cut in early Summer and is significantly higher in carbohydrates than hay that has been grown again and cut in late Summer). Only ever feed hay from pasture that has not been chemically fertilised. This isn’t just because the chemicals could upset hormone balance, but the most common fertiliser only adds in 3 nutrients (nitrogen, potassium and phosphorous) which will cause the hay to be nutritionally unbalanced. Also try to avoid the use of chemical weed killers in your horse’s paddock. These have been found to significantly affect intestinal health and are being investigated in human health research because they have been linked to insulin resistance, diabetes and obesity.
Soaking Hay
Because many good quality hays are high in carbohydrates, digesting them will create a large amount of glucose in the blood which will exacerbate the insulin response. For several years now, it has been considered that hays below 10% NSC (Non-Structural Carbohydrates) are safe for the insulin resistant horse (the level of NSCs in your hay is obtained through having your hay analysed). Hay analysis can be costly. Every new batch will requre retesting as it will have come from a different field. Recently, new research has come to light that suggests NSC is not the best way to analyse the potential for increasing blood glucose. Instead, another formula (>10% ESC + Starch) is more accurate (ESC stands for Ethanol Soluble Carbohydrates). Once this information came to light, an American study connected to the Equine Cushings and Insulin Resistance Research organisation found that of all of the different batches of hays they tested, only 2% were found to exceed the recommended level of ESC + Starch, and these batches were from intensively farmed, chemically fertilised hays. Their advice was that instead of soaking hay, you should just make sure your hay comes from low fertility, unfertilised meadow pasture.
However, as EPs, we have been monitoring the effect of soaking hay and its influence on hormonal disorders and we have found that it does help, but NOT IF YOU SOAK IT FOR TOO LONG. The reasons why we believe it helps so much are because
1) 2)
It does reduce the amount of available carbohydrates in the hay, and every little helps.
It significantly reduces the amount of dietary potassium in the hay. Potassium is not even on the radar of most veterinary studies into laminitis, because the horse has an incredible capacity to excrete excess potassium. However, potassium levels in grasses can be as much as 18 times more than the horse needs, and high levels in the blood can overwork the kidneys and liver as it tries to filter out excess for excretion as well as disrupting the absorption of other important nutrients such as magnesium. It is a known fact that most laminitic horses are magnesium deficient.
A study carried out in 2003 by Katie Watts who researches grasses and its effect on equine health found that a 30-minute soak in cold water resulted in a 19% reduction in NSC and a 46% reduction in potassium. A 60-minute soak resulted in a 31% reduction in NSC and a 55% reduction in potassium. When you soak hay you are not just soaking out sugars and potassium, but all of the other essential vitamins and nutrients which the horse needs for good health. Therefore, soaking hay means striking a balance between reducing starch and potassium while not losing significant amounts of other nutrients. We find 30 minutes to be the optimum amount of time. Never soak hay for more than an hour.
Here are some general rules for soaking hay:
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Steaming hay will not reduce carbohydrates. Wetting hay by pouring water on it is also not effective although both methods are able to reduce dust
You must use fresh water EVERY time or the effect of the soaking will be significantly reduced
Hay water is full of nitrates, toxins, mould spores and bacteria which proliferate very quickly in water. In fact, technically, hay water is classed as effluent. The water authorities are aware of this but say that as long as hay water is not being thrown away on an industrial scale, their systems can cope with you throwing it down the drain, but don’t leave it hanging about in the bucket as it will become rancid very quickly and if you do, wash the bucket thoroughly before you reuse it.
Do not feed haylage if you can help it. There are lots of theories about why it is not suitable for laminitic horses, but whatever the reason, horses fed haylage are at significantly more risk of laminitis than those fed hay.
Bucket Feeds
Generally speaking, the insulin resistant horse should receive most of his calories from lightly soaked hay – the amount will be dictated by whether or not he needs to lose weight. If not overweight, feed ad lib. Grass intake will depend upon how much it affects his condition. You can monitor this by seeing what happens to the crest when he is turned out – if it makes the crest bigger and harder, you know you will have to limit grass intake. Access to hedgerows is a very good idea as it will enable him to pick at highly fibrous leaves and branches, many of which are known to be medicinal.
Try to avoid giving a hard feed at all, only feeding enough bucket feed to enable the horse to take his supplements. If unmolassed chaff is not tasty enough, you can safely add one of the following feeds just to make the bucket feed tastier:
Micronised Linseed (one mug a day for a pony, two for a horse). This is quite a high calorie additive, but it is also palatable and the amount fed is so small it will make only a small contribution to daily calorie intake
Unmolassed, quick soaking Beet such as Speedi-Beet or Kwik-Beet
Split peas are high in starch, but their starch is resistant to digestion. A small handful in the feed can make them a palatable but safe additive for the fussy eater.
Black Sunflower Seeds are also a high
energy feed. A 50ml scoop per feed will boost Vitamin E and Selenium levels which are important for stimulating a supressed immune system. Do NOT feed the striped seeds as they cannot be digested by the horse and do not feed sunflower oil, which can increase insulin resistance.
Oat hulls are pretty indigestible in terms of nutrition, but they are very appetising to the horse and can encourage a fussy feeder. Try to buy organic hulls because when oat crops are sprayed, the majority of the chemicals stay in the hulls and may make the insulin resistance worse.
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Vitamins and Minerals
The Insulin Resistant horse needs to have his nutritional needs met through supplementation to enable him to have the best chance of normalising his condition. Every field and every batch of hay will have a different vitamin and mineral balance. You can get your grazing and hay analysed but this can be costly and is often not necessary. Here is some basic information:
We are aware that there is not enough Sodium, Copper, Zinc, Magnesium, Methionine and Selenium in most UK grasses
We are also aware that there tends to be too much Calcium, iron, Potassium and Manganese.
Many feed supplements just add in the recommended daily amount of everything to make sure there are no deficiencies, but it is more about making sure we correct imbalances between minerals rather than just adding in more
Feed companies often use the cheapest versions of minerals which are often in a form that is difficult to digest and can irritate the lining of the gut.
A healthy horse does not have to have a perfect vitamin and mineral balance for good health. It just has to be good enough – they can regulate absorption and excretion rates very well as long as the imbalances are not too dramatic.
Horses who have little or no access to grass need Vitamin E to be supplemented as it depletes in hay very quickly. It is also needed to enable the horse to absorb Selenium.
Fortunately, there are now a couple of good quality feed supplements available that provide additional levels of minerals that are known to be low while making sure they don’t add in any extras of the minerals they already have too much of. They also ensure they use ingredients that are easily digested and won’t upset the gut. This can make a massive difference to a horse’s general health. We recommend you try either of these:
Progressive Earth Pro Mineral Thunderbrook Equestrian Daily Essentials
Etiher of these feeds will ensure your horse has a more balanced diet than he started with. This is usually enough, but if the horse continues not to thrive, it may be worth having your grass and hay analysed and talking to an Independent Equine Nutritionist such as Clare MacLeod.
Supplements known to Help
In addition to ensuring your horse has a balanced diet, there are some additional ingredients you could try that have been known to help the Insulin Resistant horse.
Dr Carol Michael has developed a natural plant based supplement called Phytolean Plus (available from Phytorigins) which has been found to have a dramatic effect in reducing fatty deposits. If you feed this, do not add in any other supplements (other than balancing minerals and vitamins) as they may interfere with the action of some ingredients.
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Jioagulan (a Chinese herb) has been shown to help with insulin resistant laminitis. It is thought to prevent constriction of the blood vessels which is thought to be a factor in laminitis. However, do not feed it to horses with sarcoids as it can make them worse. If the horse has PPID and is taking Prascend, Jioagulan can block some of the negative side effects of the drug, increasing appetite and energy levels. It is by no means a cure for laminitis or insulin resistance, but it can help.
Gingko Biloba can help deal with oxidative stress that happens during illness
We all know that Biotin helps with hoof growth, but it also helps to increase insulin sensitivity by helping blood glucose to transport into the cells – which also helps to increase energy levels. Biotin is a B vitamin that the horse is capable of obtaining from the bacteria in the hind gut, as long as the hind gut is healthy. As synthetic biotin is poorly absorbed, it is more effective to improve hind gut health than simply to feed biotin.
If you want to use Turmeric as an anti-inflammatory, you will need to feed 100g daily (50g for a pony) to see an effect. This needs to be fed with black pepper (which contains curcumin) and a small amount of oil. Turmeric fed at high levels like this can irritate the gut lining, so if your horse shows signs of gut problems, it is best avoided.
Things to Avoid Feeding
Even if your horse is underweight, do not feed oil. High oil diets are known to induce Insulin Resistance. In one study, the addition of 240ml of oil daily saw a 25-fold increase in insulin resistance.
Cinnamon does improve insulin sensitivity in humans, but has been shown to have no effect on horses – although I guess it might make the feed taste nice.
Some people have considered human anti-diabetic medication. These drugs are aimed at lowering blood glucose. Insulin resistant horses have normal blood glucose levels so the medication is inappropriate.
Because Chromium seems to help human diabetics, many people have tried it to control equine Insulin Resistance. To date no studies have shown it to be effective.
Avoid feeding Glucosamine if your horse is Insulin Resistant. It is capable of shutting down glucose metabolism and will make insulin resistance worse.
Some people believe that because oats are safe to feed to a diabetic human, they are OK for horses too. This is simply not true. In fact they are 52% starch and have been shown to digest very quickly in the horse.
Reducing the Crest
A simple way that the owner can monitor how progress is going is by monitoring the size and hardness of the horse’s crest. Owners who have begun a daily diary to montor neck measurements and hardness have begun to find patterns in their management that affect it. Often when horses come in from the field, their neck is really solid to touch, but after a night in the stable, it is significantly softer by morning. As many insulin resistant horses are not overweight, but they all have a crest, this is a far more reliable method of monitoring insulin resistance than using a weight tape to measure overall body fat.
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The reason why the cresty neck varies in hardness is poorly understood. We know that it is a layer of “metabolically active fat” – a hormone factory if you like. One chemical produced from the fat cells in the crest - MCP-1 - is known to attract white blood cells into the crest causing the fat cells to grow and swell making the crest bigger and harder and is a warning sign that laminitis is beginning to develop. The next stage is when these white blood cells react with another chemical in the crest – TNF-1, which creates a low grade inflammatory state throughout the body. This triggers the release of more insulin which creates greater insulin resistance.
Therefore, it is really important that we work to reduce the crest and other fatty deposits in order to bring the insulin resistance under control. However, it is important
to remember that the fatty deposits are caused by hormone imbalances and not by excess calories.
1 Durham, A E; Rendle, D I; Newton, J E The effect of metformin on measurements of insulin sensitivity and beta cell response in 18 horses and ponies with insulin resistance Equine Vet J. 2008 Jul;40(5):493-500
2 Hustace, J L; Firshman, A M; Mata, J E Pharmokinetics and bioavailability of Metformin in horses Am J Vet Res. 2009 May;70(5):665-8
3 Timworth K D; Edwards S; Noble G K ; Harris P A; Sillence M N; Hackett L P Pharmacokinetics of metformin after enteral administration in insulin-resistant ponies Am J Vet Res. 2010 Oct;71(10): 1201-6
4 Frank, N; Geor, R J; Bailey, S R; Durham, A E; Johnson, P J Levothyroxine reduces body fat mass and improved insulin sensitivity in horses Journal of Veterinary Internal Medicine Vol 24, Iss. 3, p467-475
© 2016 Jayne Hunt Page 14

Merci Josette! J'ai tout traduit avec Google, intéressant!

Du coup je suis tombée sur ce complément, parait il hyper efficace :

Phytolean plus

As-tu fait une analyse pour l'insulinorésistance?

C'est la principale cause du SME.

Dans ce genre de cas, c'est surtout le soutien du corps qui est important.