Forget About Fructan and NSC

Some beliefs simply will not die, no matter how incorrect they are.

Horses, ponies, donkeys/mules and minis which are prone to high insulin levels are at risk of developing health problems. For example, it has been clearly demonstrated that high insulin may trigger laminitis and is the cause of around 90% of cases. To keep insulin controlled, a key step is to limit those things in the diet that trigger insulin release.

Insulin rises because of sugar and starch, not fructan

The AAEP’s Laminitis Working Group did a four year study with the goal of identifying laminitis risks. Other than diet, EMS pattern obesity, known EMS or PPID and use of corticosteroids within 30 days were identified. All relate to equine metabolic syndrome [EMS] and elevated insulin.

A 2006 field study performed by a group from Virginia Polytechnic followed a herd of 106 mixed breed ponies on pasture for a year, performing pasture analyses and monitoring the ponies using proxies of insulin resistance they had developed from the results of intravenous testing. They found both prior laminitis and development of acute laminitis correlated well with indicators of insulin resistance. There was no increase of  fructan in the pasture when laminitis cases appeared, no indication of diarrhea or hind gut upset.

In a 2016 study, Menzies-Gow at al followed 446 animals on pasture over a period of 3 years. They found the most reliable indicator of risk of laminitis was basal insulin levels. Also significant were low adiponectin and high insulin response to dexamethasone. Fructan does not increase insulin. There was no indication of the diarrhea or hind gut upset that accompany fructan overload.

A 2019 study by de Laat et al looked at 301 cases of naturally occurring laminitis and found EMS and/or PPID in 94%. They were also careful to point out those that did not have elevated insulin at time of testing may have been reflecting their  current diet rather than their state at the time of acute laminitis. No diarrhea or other indication of hind gut distress was reported.

There are many other studies and they all come back to insulin. Very large doses (over 8 lbs  for a 500 kg horse) of pure fructan by stomach tube, a highly unnatural scenario, can experimentally cause laminitis by resulting in extreme hind gut acidity, damage to the intestinal lining and absorption of bacterial products in the same way gorging on grain can. This hind gut upset is accompanied by diarrhea, septicemia and fever. These horses are clearly sick. None of that happens with naturally occurring laminitis.

Not only are there zero documented cases of high fructan in pasture causing laminitis, the levels of fructan naturally found in a whole day’s worth of eating pasture grasses almost never come even close to the amount needed to cause laminitis. Could laminitis prone horses be more sensitive to fructan?

Nope. Borer et al 2012 found virtually no insulin response to fructan in ponies whether they had a past history of laminitis or not.  Crawford et al 2007 fed a moderate fructan dose to normal and laminitis prone ponies and looked at the changes in fecal pH and fermentation products. They found that pH and fermentation products did change but none of that was reflected in blood levels so wasn’t absorbed. There was also no difference in documented changes between normal and laminitis prone ponies.

Only simple sugars (ESC fraction on analysis) and starch can increase insulin. Those two things should be less than 10% combined [ESC + Starch less than 10%] for at risk horses.  You may see fructan described as a sugar. It is not a sugar.  It’s a complex carbohydrate that cannot be digested by the horses enzymes – like fiber. NSC, nonstructural carbohydrates, equals ESC + starch + fructan. The fructan is irrelevant and using NSC can lead to people overlooking hays that are safe.

The greatest danger in perpetuating the fructan myth is that owners will rely on supplements designed to control pH or alter hind gut fermentation to protect their horse or pony from laminitis.  They won’t help if your animal is in the high risk group with endocrine disease, which accounts for 94+% of laminitis cases.

There are no magic bullet supplements to protect from laminitis. Only an appropriate basic diet can help.  For a good review of the most current science see Patterson-Kane et al.  You won’t find fructan mentioned even once.

Eleanor Kellon, VMD

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Myths and Truths About Alfalfa

Like many issues in equine nutrition, there are strong opinions both pro and con regarding alfalfa.  There is also much misinformation.

Arabians are prone to developing enteroliths when fed only alfalfa

One thing everyone can agree upon is that horses love alfalfa.  However, horses also love grain and left to their own devices would consume enough to cause laminitis, severe colic and potentially death.  We can’t take their preference as meaning something  can be fed with no limitations.

Some claim the high protein in alfalfa causes developmental bone/joint diseases in young horses.  This is not true.  Protein deficiency is far more likely than excess to cause problems in growing horses.  A much more probable connection is the very high calcium content of alfalfa which throws the Ca:P ratio way out of the ideal balance.  It take 4 to 4.5 grams of phosphorus to balance just one pound of alfalfa.

The high calcium to phosphorus ratio can also cause problems for endurance horses.  High calcium diets can cause sluggish responses by hormones needed to mobilize calcium ions quickly in times of need, like exercise.  This can contribute to metabolic problems in endurance horses.  As a result, riders limit or eliminate alfalfa from the daily diet but do feed it during competitions.

Alfalfa has also been implicated in enterolith formation in horses. Enteroliths are stones in the intestinal tract composed of primarily magnesium, ammonia and phosphate.  The high ammonia (from protein metabolism by the microbiome) and magnesium can come from alfalfa.  However, this is primarily an issue in California and with Arabian horses.  There are many horses in the West/Midwest on full alfalfa diets that do not have this issue.  Something else is going on beyond the alfalfa but it remains true that horses, especially Arabians, on alfalfa only diets with no grain are at risk for enteroliths.

It has been said the high protein in alfalfa can strain or damage the kidneys. This is not true.  In fact, young growths of grass pasture can have even higher protein levels than alfalfa.  The kidneys do process the breakdown products of excess protein but they have no trouble doing this as long as the horse has plenty of water.  The only adverse effect is a higher output of urine and obvious ammonia smell in the stall.

Alfalfa is said to be higher in calories than grass hays.  It is true that a very high quality dairy alfalfa, with soft stems and few blossoms, may be as much as 20% higher in calories but an early cutting of grass hay will be a lot closer.

Alfalfa also has a reputation for making horses “hot” in a behavioral sense.  This is far from true for every horse but some horses do indeed seem supercharged when fed alfalfa.  The reason is unknown.

The main drawback to alfalfa is the very high calcium level. The high calcium:phosphorus ratio is potentially harmful to growing horses and endurance horses. Since horses have high calcium absorption, the excess is excreted in urine and contributes to urinary tract sludge or even stones which is particularly an issue for older geldings.

As a rule of thumb it is best to limit alfalfa to 10 to 20% of the diet.  It’s very difficult to  correctly balance larger amounts. Alfalfa tea, made by steeping it with boiling water or in a large jar left on the windowsill in full sun, is also a useful addition as a taste tempter for horses with picky appetites. It harnesses the appeal without the excessive protein and calcium.

Eleanor Kellon, VMD

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Peak Allergy Season Is Almost Here

Spring is just around the corner and with it all the plants, molds and insects that can spell allergy.

Studies in several species and different equine breeds have uncovered a genetic predisposition to develop allergies and even which genes are involved but destiny does not have to be ruled by genes.  The same tendency for allergy to run in families has been observed in dogs.

Allergy can be described as an unbalanced or exaggerated immune response to a normally encountered challenge. The body will be reacting to a specific protein, called the allergen, in pollen, mold or insect saliva. Seasonal allergies can involve the skin, eyes or respiratory tract with all the familiar signs. Allergy is even behind some cases of seasonal headshaking.  While horses are more prone to allergic reactions affecting the lung, in dogs it is more likely to be the skin with flea bite allergy being the most common.

Multiple drugs are available to treat allergy signs, and very effective when needed but the most effective, corticosteroids, come with the risk of significant side effects. There is also much you can do nutritionally to support the immune system’s ability to function in a healthful way.

A balanced diet is the first step because the minerals most likely to be deficient or negatively affected by imbalances are also those involved in homeostatic inflammatory pathways (magnesium, iodine) or have considerable antioxidant functions (copper, zinc, selenium).  Horses not on pasture have low levels of vitamin C and vitamin E as well as the critical omega-3 fatty acids which the immune system needs to maintain homeostasis. These nutrients put a strong foundation under the immune system, giving it the tools it needs to function properly.

When more support is needed there are many ways to boost the antioxidant  capacity of the body including supplemental glutamine, N-acetyl cysteine, MSM, bioflavonoids (e.g. quercetin), Turmeric, Ginger root, Green Tea, White Pine extract, alpha-lipoic acid, Grape Seed and Skin meal, Gingko biloba, Boswellia and Jiaogulan.  Gentle immune system support in the form of both pre and probiotics is indicated. Spirulina may be particularly useful as it supports the body’s normal beneficial antibody activity instead of the antibodies of allergy.  Spirulina also helps the body maintain normal histamine levels.

For best results, start your seasonal allergy support program at least 30 days in advance of allergy season.  This gives your animal’s body the best chance of functioning at its smoothest.

Eleanor Kellon, VMD

 

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The Great Bran Mash Debate

Warm bran mashes have a very long history of use in equine feeding, especially in winter.  Is this the yummy comfort food it has been claimed to be, or actually potentially harmful?  As is usually the case, the truth is in between these extremes.

A properly balanced bran mash is energy, protein and mineral rich.

There is no denying the palatability factor.  Any horse with a healthy appetite will dig into a bran mash.  The simple mash recipe of bran, water and salt is a warming and hydrating meal.  So what’s the problem?

“Bran Disease”, aka Big Head, Miller’s Disease, nutritional secondary hyperparathyroidism, is a metabolic disorder of bone caused by a long term intake of a diet higher in phosphorus than calcium.  Bran is very high in phosphorus and contains phytate which can make the situation worse by binding calcium to some extent and preventing absorption.

If you only feed a bran mash occasionally, this really isn’t an issue.  If you want to feed it regularly, the solution is easy.  Feed 1 1/4 pounds of alfalfa for each pound of bran (be sure to actually weigh it) to correct the imbalance.  A hearty bran and alfalfa mash is an excellent way to help meet the very high protein, calcium and phosphorus requirements of pregnant or lactating mares and growing horses. Alternatively, use  9 grams of calcium per pound (dry weight) of bran to balance. If your hay is low in phosphorus, adjust accordingly.

You may have heard or read that the phytate in bran will also bind phosphorus and zinc, making them unavailable.  This is true in humans but not in horses.  Horses can ferment the phytate, releasing all minerals.  Only calcium is affected because the fermentation takes place in the hind gut, where calcium is not well absorbed but other minerals are.

Finally, detractors say that the laxative effect sometimes seen with bran is actually harmful because it means the organisms in the hind gut have been disturbed.  However, the same thing can happen with grain, change in hay or too rapid an introduction to pasture.  It’s not a reason to avoid bran.  Like anything else, bran should be introduced slowly in gradually increasing amounts.

When care is taken to keep minerals in balance, bran is an excellent feed for horses.  It has a caloric content equivalent to oats but with only half as much starch.  Protein is high at 17% and it is an excellent natural source of phosphorus which is low in the majority of hay types.  The high palatability makes bran mash a great addition for picky eaters and the texture is ideal for older horses with chewing issues.

Edit:  Within 24 hours of publishing this post I received an inquiry from an owner of a young horse with possible “big head” so am adding a bit of additional information. One prominent sign you will see is widening of the facial bones

from: Equine Action QLD in AU

There may also be lameness, weak tendons, muscle twitching, loose teeth and trouble eating. Diagnosis is by blood tests showing elevated phosphorus, decreased ionized calcium and high parathyroid hormone (PTH)  PTH testing is available through Michigan  State https://vdl.msu.edu/Bin/Catalog/Catalog.exe . Treatment is correction of the diet.

Eleanor Kellon, VMD

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How To Get Drug Information and Report Reactions

In this information age you have several options if you want details regarding a drug.  Your veterinarians are always a good source but may not have some of the details you want immediately at their fingertips.  You could always do an internet search but the reliability of many sources could be questionable.

A good stop for brief general information on mechanisms of action, dosages and precautions is the drug monograph index from elephantcare.org:

Drug Index

Although their focus is elephants, the information on this site is heavily equine since there is more detail available on horses.  To use this list you will need to know the generic/chemical name of the drug rather than the brand name.  For example, ivermectin rather than Zimecterin.

An excellent source of information is the FDA’s NADA (new animal drug application) database.  This contains material submitted to the FDA to fulfill the requirements for drug approval and will have information on things like effectiveness and safety.  To find this, do a Google search for:  [drug name] + species + NADA.  

You can also search the FDA’s site to retrieve this information using the NADA number, drug chemical name or brand name:

https://animaldrugsatfda.fda.gov/adafda/views/#/search

The FDA additionally maintains a database of adverse drug experiences, listed by the drug’s chemical/generic name:

https://www.fda.gov/animal-veterinary/product-safety-information/adverse-event-reports-animal-drugs-and-devices

There are many limitations to these adverse event reports, including that they are only suspected, not actually proven, reactions to drugs.  Also, for the FDA to list it, it has to be reported.  There are likely many, many more adverse reactions than ever get reported.

If your horse has a bad drug reaction (which by definition also includes the drug not working), the FDA suggests you first contact the manufacturer so they can fill out a reporting form for the FDA.  You can also request that your vet file a report.  However, you can report the reaction yourself and I strongly suggest that you do so to make sure it gets done.  Instructions are here:

https://www.fda.gov/animal-veterinary/report-problem/how-report-animal-drug-and-device-side-effects-and-product-problems

The internet has made it possible to access drug information in more detail than ever possible before.  Pay it forward by taking the time to report any suspected negative drug reactions.

Adverse reactions to vaccines, aka biologics, can also be reported.  The USDA has jurisdiction over vaccines:

https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/veterinary-biologics/adverse-event-reporting/CT_Vb_adverse_event

Eleanor Kellon, VMD

 

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Can Butyrate Supplements Fix Free Fecal Water Syndrome?

The interactions between the horse’s body and the estimated quadrillion organisms in the intestinal tract is incredibly complex and we are light years away from really understanding it.

No simple fix for Free Fecal Water syndrome

With Free Fecal Water Syndrome, the horse has normally formed manure but also passes liquid before, during or after bowel movements. Other than possible skin irritation, the horse is normal and healthy otherwise.

Butyrate is one of the major volatile fatty acids (VFAs) produced when foods are fermented in the hind gut/large intestines. It is a preferred energy source for the cells lining the hind gut. When the gut is functioning normally, butyrate also has the ability to modulate inflammatory reactions.

When butyrate is added to intestinal cells in culture in the laboratory it has beneficial effects, which should be no surprise since it is an essential nutrient for those cells. When colonic damage is induced with chemicals in pigs and mice, butyrate has some benefits but attempts to duplicate this with cultured cells had mixed results. Too much butyrate was actually found to be harmful. The same harmful effect of too  much butyrate has been found in live animal models.   A 2019 review article, Nguyen et al, concluded butyrate is not helpful in inflammatory bowel disorders.  Rotting et al 2004 used isolated equine colonic cells to study the effects of various substances on recovery from oxidative stress. Glutamate was helpful but butyrate was not.

In contrast, when increased butyrate occurs naturally along with increases in the other VFAs as a result of prebiotic or probiotic supplementation , beneficial effects on colonic disorders have been found (Valcheva 2019, Amer 2018),  Supplementing butyrate to horses does not change the levels of other VFAs (Kujawa 2020).

Perhaps even more to the point, there is no evidence that Free Fecal Water Syndrome is associated with inflammation or any disease state. Horses with inflammatory bowel disease are ill and have signs such as colic, feed intolerances, true diarrhea and weight loss – even fever. None of those are seen with FFWS.

Butyrate is a fuel for intestinal cells and  does have antiinflammatory properties but it  doesn’t work in a vacuum.  It is the combination of all organisms working together and the effects of all their fermentation products that characterizes normal bowel function.  The best way to support this is with pre- and probiotics https://wp.me/p2WBdh-Xt .

Eleanor Kellon, VMD

 

 

 

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Wound Healing In Winter

Even though the days are lengthening, we’re still locked into winter. I hope you never have to deal with it but wound healing can be affected by the cold weather.

Winter weather poses unique challenges for wound healing

The cold, dry air in winter leads to a major cause of delayed healing – dehydration of exposed tissue. A moist environment is important for cells to migrate across the wound and for white cells to do their work cleaning it up. Suturing wounds that warrant it, and keeping other wounds covered with a protective salve, will guard against dehydration.

The cold itself can also be a problem because blood flow is decreased to the skin in cold weather. Inflammation helps counteract it in the early stages of healing but once that calms down, in 3 to 5 days, blood flow is not as good as in warmer weather. This slows healing by inhibiting cell migration and can also mean the difference between death or survival of areas of skin that have a damaged blood supply from the injury.

Because of the detrimental effects of cold, dry weather, wounds need more protection. Even small skin breaks in areas with a lot of movement, like the heels and pasterns, can quickly become painfully deep cracks.  Keep an eye out for wounds on your small animals too and regularly check their paws for cracking.

Good choices for holding in moisture on wounds are ointments and salves without a water base. Look for petrolatum, beeswax and oils.  Help with temporary irritation and discomfort comes from ingredients like Arnica, Chamomile,  Comfrey, Calendula, Witch Hazel, Plantain, White Willow Bark, Golden Seal and Vitamin E.  Natural ingredients with antiseptic advantages include Tea Tree Oil, Oregon Grape, Echinacea, Gentian, Sodium Copper Chlorophyllin and all essential oils.  Protect delicate new skin with the antioxidant benefits of  Chaparral, Burdock and St. John’s Wort.

For wounds on the lower legs, apply a generous amount of salve after cleaning gently with warm water then cover with several layers of gauze (never use cotton on open wounds) and a standing leg wrap over that. To avoid having your gauze slide down inside the wrap, use a dab of your wound dressing to hold the gauze layers together and also to hold it where you want it inside your leg cotton wrap, then apply the wrap as usual. Check and rebandage once a day for the first few days, or until drainage has stopped.

Tip: For ease of use and your horse’s comfort, do not store wound products in the cold – including in tack trunks.  Keep them in a heated room and when working on your horse place them inside your clothes as close to your body as possible until you are ready to use them.

On the nutritional end, there are two very common winter deficiencies that can interfere with wound healing – vitamin A and zinc.  Zinc is the #1 mineral deficiency in forages. Vitamin A is abundant in fresh pasture but levels decline after drying and storage.  Consult your veterinarian or nutritionist for supplementation guidelines for your situation but commonly used amounts are 20,000 to 40,000 IU of vitamin A and 250 to 450 mg of zinc.

Eleanor Kellon, VMD

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Weight Support for Senior Horses

Winter weather and loss of good pasture make all owners of thin senior horses anxious.  Some things to consider when a horse is underweight span all age groups, but seniors have additional considerations.

Senior horses face many weight challenges

Older horses need frequent, but not necessarily aggressive, dental care. Problems such as worn teeth, loose or missing teeth, abscesses and gum irritation from food packing into diastemas (gaps at the gum level) are common older horse issues which interfere with effective chewing and/or cause pain. Wear also changes the angle of the chewing surface which reduces the effectiveness of chewing.

The goal of dentistry should be to remove pain, not necessarily “fix” things. Horses with significant dental issues reap the most benefit from a wet, if not soupy, diet. Hay cubes or pellets can be thoroughly soaked, as can complete feeds,  beet pulp and bran. Get professional advice in formulating the diet.

I commonly recommend incorporating psyllium into these wet senior diets. It further increases how easily they are swallowed (choke is a concern with seniors) and is an excellent prebiotic. Use 1 to 2 oz of psyllium husk fiber per meal.

Older horses often have reduced natural immunity to parasite infections and may even become positive for parasites normally only seen in foals, like roundworms. This is one cause of weight loss you can control. Keep an eye on fecal egg counts and work with your vet on developing an individual deworming program for your  senior.

Supplementing fat, up to 0.5 kg/day, considerably increases the caloric density of the diet. Begin with a flax based supplement like CocoOmega to replace omega-3 fatty acids if the horse is not on fresh grass. Use at least 0.15 kg/day of this or even up to 0.5 kg/day.  If feeding less than the full 0.5 kg/day of flax based supplement I recommend making up the difference with something that will not upset the omega-3:omega-6 ratio, like Uckele’s CocoSun.

Senior citizens of all species may suffer from reduced  digestive efficiency. Even the diversity of the microflora in the large intestine of the horse decreases with age.  A supplement with both high digestive enzyme activity and good numbers of live probiotic organisms can be very helpful for seniors.

Vanishing toplines is a common complaint with older horses. When this is seen the horse should always be checked for PPID – pituitary pars intermedia dysfunction, aka Cushing’s Disease – because high cortisol activity in these horses causes muscle loss. There may also be a factor of poor protein digestibility and/or inadequate key amino acid intake.  Supplementation with the triple combination of L-lysine, D,L-methionine and L-threonine is an inexpensive safeguard on the nutritional end.

Problems such as heart failure, kidney failure, liver disease or malignancies are rare in younger horses but anything goes with a senior. All of these may have weight loss as a component. It’s always wise to involve your veterinarian when having weight issues with a senior.  Odds are one or more of the factors mentioned earlier will be the explanation but keeping your vet informed of the issue and what was tried will save precious time in deciding on diagnostics and treatment down the road.

Eleanor Kellon, VMD

 

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THE ROLE OF THE GUT IN THE IMMUNE SYSTEM

The function of the immune system is to protect the body from outside organisms and substances that may harm it.  It should be no surprise then that mucus membranes lining all the portals of the body open to the world have high immune capacity.  The most important of these is the digestive system.

The immune system of the intestinal tract is called GALT – gut associated lymphoid tissue.  Throughout the intestinal tract there are immune system cells, macrophages and lymphocytes, under the intestinal lining cells. Structures called Peyer’s patches are very similar to lymph nodes and are located in the small intestine. They have been called the tonsils of the intestinal tract.  Specialized immune cells also line the liver

The immune system communicates with all body systems, especially the gut.

Microfold cells, or M cells, are located over collections of lymphoid tissue along the intestinal tract. The M cells reach out to engulf bacteria and other material from the intestinal tract then pull it inside and present it to immune system cells. This material is processed through T and B lymphocytes, eventually resulting in the production of IgA antibodies, which remain in the local tissues to protect them. However, it doesn’t stop there.

The lymphocytes that will eventually produce local IgA antibody are released into the bloodstream before they come back to home in the intestinal lining again. In the process, they can share this information with the entire body’s immune system so that the rest of the body can produce circulating antibodies (IgG, IgM) to the same organisms the local IgA targets.  A good example of how GALT interacts with the rest of the body is oral vaccines. Several human oral vaccines have been developed, including against polio and malaria. Oral rabies vaccines in bait have been used to successfully battle rabies in wild animals.

Research has found that interactions between the immune system and the bacteria colonizing it can have profound effects. Probiotics are defined as bacterial strains capable of colonizing and surviving in the gut which have a beneficial effect on their host by suppressing the growth of harmful bacteria and interacting with the immune system.

Documented effects of probiotics to date include directing activity of immune cells, encouraging production of protective mucus, reducing inflammation and increasing the production of IgA antibody, which in turn decreases the risk of allergy related IgE antibody forming.

Prebiotics support the growth of probiotic strains of bacteria by feeding them or maintaining an environment in the gut that is favorable for proliferation of probiotic strains. Some also have direct immune system effects.

The diet itself plays a major role in the health of the intestinal tract and the beneficial probiotic strains inhabiting it.  Quality hay free of mold and other easily fermentable dietary ingredients like beet pulp feed these beneficial strains.  Avoid overfeeding of grains as this can bypass small intestinal digestion to upset the balance of organisms in the hind gut.

In summary, the intestinal tract is a major player in the immune system. It has been estimated that 70% of the body’s immune system cells originate there. Immune activity in the gut has a body-wide effect. One of the best ways to boost and balance the immune system is through the oral administration of probiotics, prebiotics and other substances documented to support and balance immune function.

Eleanor Kellon, VMD

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Insulin and Mineral Nutrition

High insulin in horses  does not have the clear inflammatory component documented in people but there is increased oxidative stress.

The size of the upper legs is a good indicator of what this high insulin pony’s body should look like

Building the horse’s own antioxidant basic defenses is most effective. This includes the SOD, catalase and glutathione peroxidase enzyme systems, as well as the antioxidants glutathione, CoQ10, carotenoids and vitamin A, flavonoids, vitamin E and C. Glutathione is particularly widely distributed. SOD absolutely requires copper and zinc.

Glutathione reductase and peroxidase depend on selenium, a very common deficiency. Selenium  is also essential for the generation of the thyroid hormones active T3 from T4. Selenoproteins, important to normal immune function, are just beginning to be looked at in depth.

Zinc is a widely deficient mineral. It is critical for SOD enzyme. Low serum zinc is associated with metabolic syndrome in humans and rats. It is known that zinc is important on several levels, involved in insulin release and sensitivity, as well as being an antioxidant. Like zinc, copper is critical for SOD function. Copper deficiency causes high insulin and fatty liver in rats.

Phosphorus is required for activation of the tyrosine kinase enzyme after insulin binds to its receptor. This triggers glucose receptors to  move to the cell surface to bring in glucose.

Hundreds of human papers over the past 4 decades have linked poor magesium status and high insulin.  Magnesium is not a treatment, but by correcting a deficiency, it helps promote normal response to insulin.

Magnesium increases insulin receptor number and sensitivity in experimental rodents. Magnesium deficiency interferes with insulin signaling. Deficiency has also been linked to altered immune function.

Iodine is essential to production of thyroid hormone. Low iodine status has been identified in human patients with elevated insulin. Normal thyroid function is required for insulin sensitivity. High insulin horses may also have low thyroid hormone levels. This is probably euthyroid sick syndrome. In most of these horses, with correct levels of selenium and iodine, and control of insulin, the levels will rise again.

Chromium has been important for people probably due to processed foods being stripped of many essential minerals. It is important for normal response to insulin in other species, likely horses as well, particularly on high carbohydrate diets. The exact requirement is unknown, but supplementation in horses is usually not helpful. Hay absorbs chromium very efficiently and soil levels are abundant in most areas. Low levels are only potentially found when horses are eating hay grown on alkaline soils.

Properly supplementing horses for balanced and adequate mineral intake is an inexpensive way to support normal insulin action and response. I formulated Uckele GlycocemicEQ as a first step approach to minerals in horses with high insulin https://uckele.com/glycocemic-eq-pellet-8lbs.html .

Eleanor Kellon, VMD

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