Healing Laminitis (Grass and Grain Founder)
Laminitis - not just a hoof problem
Laminitis, especially as related to the over-eating of grass and grain, is actually a metabolic disease that affects the laminar tissue, a highly vascular layer of specialized tissue that attaches the coffin bone to the hoof wall. This tissue is highly susceptible to inflammation and damage as a result of digestive toxicity resulting from the over-feeding of starches and sugars.
When a horse eats excess carbohydrates in the form of starches and/or sugars in grass and grain, only a portion of them can be fully digested as determined by the efficiency of the digestive enzymes and levels of friendly bacteria (probiotics). Large numbers of probiotics are required to break down starches as well as fibre; the adequate digestion of fibre (cellulose) is particularly important since horses create most of their energy from fibre in the form of volatile fatty acids.
The undigested sugars then begin to ferment releasing gas (colic), heat, and lactic acid, all of which eventually damage the colon membranes creating an abnormal permeability known as "leaky gut syndrome". As the acid levels in the colon begin to rise, a condition known as cecal acidosis, large numbers of friendly bacteria, which don't tolerate high acid levels, begin to die off thus compromising the digestive process even further. Now unfriendly and pathogenic bacteria such as Streptococcus, E. Coli, and Salmonella, that prefer acid conditions, begin to thrive.
The resulting toxic cocktail of acids, yeasts, and bacterial toxins migrate through the damaged colon walls - the "leaky gut" - and are released into the bloodstream where they disrupt and derange the blood, nutrient, and oxygen supply to the hooves, and to the laminae that hold the coffin bone in place. If this hoof condition is not quickly relieved, the laminae become damaged to the degree where they cannot keep the coffin bone tightly attached to the hoof wall, resulting in painful founder - a rotated or sunken coffin bone. Improper trimming contributes to even further detachment, pain, and destruction.
Although grass and grain founder can affect all horses, overweight and Syndrome X horses are most susceptible. Syndrome X horses are those horses with an insulin resistance syndrome. Insulin is the pancreatic hormone that, in a healthy system, regulates blood sugar utilization by opening specific receptors in the liver, muscle, and fat cells, to allow the passage of sugar from the blood to these tissues. In Syndrome X horses, these receptors have become damaged from repeated exposure to insulin levels that remain high from the ingestion of excessive starches and sugars. Therefore, these horses adapt to storing excess blood sugar as fats in cresty necks, shoulders, tailheads, and pot bellies, becoming 'easy keepers' and sugar lovers - even though they are highly sensitive to it.
As resting insulin levels continue to rise in an effort to open up the receptors, the adrenal glands begin to produce cortisol, a stress hormone that catabolizes (breaks down) protein thus weakening and damaging the protein-rich hoof tissues even further.
Starch sugars, which are distinct from fructan sugars, stop producing when the plant is 'full'. However, fructans do not have this shut-off mechanism. That is how the seed producers get the grass richer and richer and richer. As for the continuing photosynthesis after cutting, perhaps these 'new' grasses don't shut off their sugar productions as quickly as the old grasses despite the arrest of growth. It's not always easy to predict the behaviour of plants (and animals) after genetic modification.
In the past, excess starch in the feed program was primarily associated with the intake of grain such as oats, corn, and barley. However, recent research on plant sugars has made some serious implications for feeding certain types of grass/hay to horses. For many years now it has been common practice for feed researchers to find ways of making the grass richer to enhance beef and milk production in cows. This led to a dramatic increase in the levels of fructan, a soluble plant sugar found in some grass varieties, an increase that might help cows but can be devastating for horses. Grasses and plants are photosynthetic and use light energy from the sun to convert sugars into energy required for growth. When a plant produces more sugar than what is required for the plant's growth, it is stored, and is therefore available to the grazer.
Fructan sugars are at their highest level in bright sunlight and cool weather since photosynthesis is at its peak in bright light and the plant's growth is slowed due to the cool temperatures. Consequently, the fructan levels continue to rise without being utilized by the plant. Sensitive horses and ponies should be kept off the grass in the morning (night-time grazing is best) and in sunny, cool fall weather until the grass is dead.
Fructan levels can also continue to rise between cutting and baling hay as the process of photosynthesis continues producing higher sugar levels as the hay sun-dries. Fructan levels in the hay can be reduced by up to 30% by soaking the hay in water for 20-30 minutes (expect to see the water turn brown with sugar). The soaking won't affect starch or protein levels, since they don't dissolve as easily. Despite the common belief that hay that's been rained on between cutting and baling is of inferior quality, it's the best hay (if adequately dried before baling) for sensitive horses, since the rainwater can rinse away some of the sugars. For the same reason, irrigated hay crops and adequate rainfall helps to lower sugar levels.
It can be difficult to determine which types of grass and hay have lower fructans since there are so many variables including grass species, maturity, soil content, precipitation, irrigation, and sunlight. I have found that many laminitic horses are highly sensitive to brome hay - orchard grass and/or timothy are better tolerated as some species are lower in fructans. I have a recovered Syndrome X Shetland pony who has typically foundered within 48 hours of eating non-irrigated brome, however he remains sound and happy on irrigated orchard grass.
Prevention and treatment
So we can see that a successful plan for preventing and treating laminitis involves lower dietary sugars, required weight loss, restoration of the delicate balance in the digestive system, appropriate hoof care, and appropriate exercise (especially for prevention).
An effective prevention and treatment plan is as follows (ready-made products from Riva's Remedies are available; see www.rivasremedies.com):
- The reduction of dietary sugars through the elimination of grain, lush grass, and grass and hay with high sugar content. Eliminate alfalfa as well due to its high protein content - excess protein can increase cortisol levels.
- Encourage plenty of exercise - a laminitic horse should not be confined - keep him moving to burn sugar for energy and to promote healthy hooves.
- Avoid the use of antibiotics, non-steroidal anti-inflammatories, and chemical dewormers, all of which either alter the probiotic balance or damage the intestinal mucosa.
- Supplement with probiotics immediately, if over-eating or laminitis is suspected, to ensure adequate digestion of fibre and starches and to discourage the proliferation of pathogenic bacteria and yeast. Probiotics will also promote gut motility and help the absorption of minerals and B vitamins.
- Use an herbal detoxifier to cleanse and heal the colon membranes.
- Supplement with vitamin B12, folic acid, and/or vitamin B6.
- The health of the horse's feet is paramount - those horses with poor quality feet and/or unbalanced trims are very susceptible to damage. Ensure adequate hoof mechanism and circulation by consulting a barefoot trimming specialist with experience in healing laminitis and founder.
- Use homeopathy to re-balance sugar and insulin levels, improve digestion, detoxify, repair damaged hoof tissue, promote healthy hoof growth, and more.
Homeopathic remedies for laminitis
In addition to the correct nutrition, exercise, and specialized trimming programs, there are homeopathic remedies that are very beneficial, when selected according to specific symptom pictures.
Nux-vomica - The is the main remedy for digestive insult - poisoning, over-eating grass/grain, or eating unsuitable feed. Digestive distress from breaking into the feed room and eating all the horse feed and/or including the goat feed is a typical example of the Nux-vomica picture. Grain founder symptoms often don't occur until 12-18 hours after the grain has been consumed so Nux-vomica should be administered immediately as a preventative.
Horses that have eaten poisonous plants or who have an adverse reaction to medication will also respond to Nux-vomica since this remedy addresses a toxic liver and other ill effects from drugs, chemicals, and other poisons. It should also be used in toxic bacterial reactions causing laminitis as seen in post-partum laminitis or general infections. Other remedies to consider for use in laminitic conditions are Aconitum, Belladonna, Arsenicum, and Lachesis.
Lycopodium - This is an excellent remedy for balancing blood sugar levels caused from high dietary starches and sugars, and can be used in most cases of insulin resistance. The digestion is generally poor with a sluggish pancreas and a weak and sensitive liver. It is especially useful for gas, bloating, and fullness with or without laminitic symptoms. The Lycopodium horse loves sugar, candies, and sweet feed which makes him feel worse. If ill, eating (even small amounts) makes him feel worse, even though he may be excessively hungry.
Sulphur - The Sulphur horse eats anything and everything, including sugar. An excellent remedy for exteriorizing deep-seated toxins including liver toxins. Releases excessive "heat". Sulphur should be used to cleanse the liver of unhealthy and excessive dietary fats and oils, as are often included in many feed programs. Skin problems are often present - dry, scaly, and itchy. Sulphur is helpful with inflammation of the synovia and helps to rehabilitate the feet during healing. Knees and pasterns are often stiff.
Insulin - In a homeopathic dilution, Insulin is very useful for re-balancing blood sugar due to hypersensitive insulin levels or resistant insulin receptor cells. Safe and free of side-effects. (The Riva's Remedies blood sugar formula contains Insulin, Lycopodium, and Sulphur.)
Ruta grav - Another good foot remedy - acts on sore or soft soles, coffin and navicular bone affections, fibrous nodules, and bone growths. Ruta has an affinity for the fetlocks and is therefore a good remedy for sidebone and ringbone. It is also useful for the overstrain and contracture of tendons.
Silicea - Silica, as a nutrient, is a vital mineral for healthy hooves. In homeopathic form, it helps poor quality hooves absorb nutrition. Sore soles, hoof cracks, infections, and abscessing can all respond to silicea. Also use to prevent and/or treat shin splints.
These are the remedies that I find have the most common application with good results. Generally any of the remedies can be used in a 30ch (Centesimal in the Hahnemann method) potency or 200ch, once or twice daily, until the symptoms are ameliorated.
For more information:
Marijke van de Water, B.Sc., DHMS
- Homeopathic Practitioner
- Equine Health Specialist
- Shamanic Practitioner
Equine Health Line: 1-800-405-6643