Injuries in our horses can be frustrating and upsetting occurrences- and more often than not, they tend to occur when our horses are coming along really well. Ironically, although we may seem to have more time with missing planned races, events and competitions, rehabilitating a horse properly often takes more time and effort than riding alone.
Successful rehabilitation should certainly address physical aspects (farriery, bodywork, laser and other therapies where appropriate), management factors (restricted turnout, etc if relevant) and graduated exercise and training. Yet one of the most influential factors in a horse’s successful recovery is its nutrition- something which is often given very little consideration.
One of the primary concerns for many owners, trainers and riders are to stop their injured horse from getting overly fat- particularly in an extended layoff. As a result, many people understandably cut their horse’s feed right back. However, during the initial phases of healing post-injury- a horse’s energy and nutrient requirements are actually elevated. Healing of the body is an energy-requiring process. Structurally, bones, muscles, tendons and ligaments need specific nutrients to ensure their optimal repair and integrity. Thus, drastically cutting both their energy and nutrient intake can significantly impair, delay or compromise healing. It is important to note, however, that a horse’s energy and nutrient requirements will change throughout its recovery. After the initial phases of healing have occurred, there is generally a decrease in energy needs. Depending on the type of injury, nutrient needs (for example certain minerals, vitamins and specific nutraceuticals) often remain elevated beyond normal. This is where it is important to adjust a horse’s diet so that it still receives proper nutrition for continued good health, whilst also ensuring that it doesn’t get too heavy. In terms of musculoskeletal injuries, particularly of the lower limbs, weight is an important factor. More weight equates to more force going through the limbs, which can compromise healing. A healthy balance needs to be achieved between appropriate weight given the phase of recovery, whilst ensuring optimal nutritional intake.
Nutritional requirements are further compounded by the medications used in many cases of illness or injuries in our horses. Anti-Inflammatory drugs including NSAIDs such as phenylbutazone (‘bute’) and flunixin interfere with our horse’s ability to synthesise B group vitamins (including biotin) and vitamin K (essential for proper bone and connective tissue healing). They also adversely impact a horse’s gut microflora, which in turn is likely to result in increased production of inflammatory mediators (thus more inflammation, despite the use of anti-inflammatories). The effects of corticosteroids on nutritional status are more complex than NSAIDs: they are known to reduce the absorption and/or increase the excretion and/or impact on the metabolism of important nutrients essential for optimal healing. Some of these nutrients include magnesium, zinc, vitamin A, vitamin C, vitamin D, calcium and selenium.
Antibiotics also significantly influence the nutritional status of the horse. Through changes in gut microflora in the horse- the production of B group vitamins and vitamin K are compromised. Some classes of antibiotics also interfere with the normal metabolism of vitamin A, calcium, magnesium, zinc and iron. Similar to NSAIDs, they may also influence the production of inflammatory mediators through changes in gut microflora.
Ulcer treatments are another commonly used medication in the horse recovering from illness or injury. Those containing key active constituents of omeprazole (the ‘gold standard’ ulcer medications on the market) or ranitidine, drastically reduce the uptake of minerals essential for healing- including calcium and magnesium. These medications also may influence the production of inflammatory mediators: their mechanism of halting or drastically reducing hydrochloric acid production significantly changes the environment needed to promote healthy gut microflora in the horse.
So the effect of such medications during injury or illness is a double whammy: a horse already has increased nutrient requirements to properly heal AND many of these critical nutrients are at decreased levels because of the use of such medications.
Whilst pharmaceutical drugs are certainly indicated in the recovery from many illnesses and injuries, their use needs to be judicious. When they are used, the appropriate supplementation of specific nutrients is critical to firstly compensate for what is altered through medication use, and secondly to meet the body’s elevated needs of certain nutrients essential for optimal healing.
Illness or injury in the horse can be used as a most valuable opportunity to review your horse’s feeding, supplementation, management and riding practices. Whilst many injuries and accidents are unavoidable- there are plenty where appropriate dietary and supplementation practices tailored to the individual horse may have helped to prevent or reduce the severity of the setback. The same may be said of the review of medications used in the horse where relevant. These factors, combined with appropriately structured training and competition (which includes ‘down periods’ and rest days), farriery, and bodywork are keys to keeping our horses healthy, sound and well.
Camilla Whishaw is a highly regarded, experienced horsewoman and naturopath, helping to holistically treat and manage a broad range of equine health conditions and injuries, with a passion for mare and stallion fertility.
As a world-renowned practitioner, presenter, author, and consultant in the field of Equine Naturopathy, Camilla shares her knowledge through keynote presentations, interviews, lectures, panel sessions, and workshop training.