Digestive health in the horse is a growing concern over the past couple of decades, being readily evident in the high usage of ulcer medications, ulcer supplements, high rates of colic, allergies, skin issues, and metabolic problems. Depending upon how you look at the problem and what you ‘see’ as the main issue of concern, this dictates your approach, which then creates the result, be it positive or negative. Digestive health is not that complicated in the horse, but creating better results does require taking a different perspective and a certain level of understanding. Let’s dive into the concepts of dampness and ama from an alternative medicine perspective on digestive health in the horse.
Equine digestive health is connected with almost every health and lameness condition you can mention or imagine. It may not be readily apparent or obvious, but it is there on some level, and playing a role. How big of a role? That is dependent upon the horse as an individual, factors at play, and how long the condition has been present. It plays a part in every horse that I have personally interacted with and consult with via the owner, so much so that every horse has this issue addressed as a part of their therapy to some degree. It doesn’t matter if it is a stifle issue, a back issue, a foot issue, allergies, or metabolic related problem, digestive health in the horse is addressed as it is VERY important.
Okay, so why is digestive health in the horse THAT important?
Let’s step back and look at the average scenario in the horse, choosing ulcers, repeat colic episodes, and maybe laminitis as the examples. In all of these scenarios, treatments are put into place for the horse and create short-term or acute resolution to the problem, but none of these treatments provide long-term results. This means the horse continues to suffer from the malady, making no progress in their health, and as a result, the owner continues to put out money in search of a solution. In these scenarios, the question is why don’t those treatment options offer long-term resolution?
I’ve talked about the importance of digestive health in the horse in many articles, but this topic is so important, that I feel the need to dig a little deeper. We can talk about the digestive microbiome and the impact on health and inflammation, which is real, but in truth, this upset in the balance is a result of something else, something potentially bigger than what we may believe. Many horse owners may be aware of digestive health problems in their horse, usually because they have obvious signs such as colic, gas, ulcers, or loose stools, then use various ‘stomach’ remedies which may or may not benefit the animal. Many choose probiotics, which again may be a short-term remedy if that, but rarely provide the long-term benefits. In truth, probiotics are a short-term fix, aimed to re-establish balance, and are not a long-term remedy. If they are relied upon long-term, then the underlying cause of the imbalance has not been addressed, thus, the problem still exists.
To understand where I am coming from, you have to take a walk on the ‘wild side’ and look at the problem standing outside of traditional western medicine.
Alternative Concepts of Digestion in the Horse
Alternative medicine differs from traditional or allopathic medicine in one main way. Western medicine views a disease as being an entity of its own, while many alternative medical traditions view that disease as being an ‘effect’ of a greater problem, an imbalance within the body as a whole. This is putting it very simply. Alternative medicine generally views the body as being healthy when in balance, and when out of balance, disease is a result. The body is one big unit, with all organ systems not only working together for the greater good and health, but also reliant upon one another. If one system is out of balance, another is impacted, then over time if this persists, health can be impaired on many levels.
For me, two main forms of alternative medicine exist and are recognized, which include Ayurvedic and Traditional Chinese Medicine (TCM). Both of these philosophies or approaches view the body as a whole as mentioned above, and both are very similar to one another on a basic level, but tend to use different herbs based on the geography of the philosophies. When it comes to disease in both philosophies, it is due to an imbalance within the body, and digestive health is one key and very important area of concern because it is so interconnected with the other organ systems. Interestingly enough, emotions are also a key player in both Ayurveda and TCM, which are viewed as major contributors to the imbalance creation, including digestive health.
Now, before you dismiss emotions as being a contributor in the horse, take a moment and reflect on that, thinking about your horse, other horses in the barn, how they act, how they interact, and how they respond to various things that happen to them or in their environment. Those responses in the horse are emotions, plain and simple, but the emotional response can be typical of their constitution (TCM) or dosha (Ayurveda) and further amplified by an imbalance in the body. These emotions are also heavily linked to the stress response, which in alternative medicine impacts energy flow (Qi) and can then impact the act of digestion. Think about the last time you were heavily anxious and how that impacted your digestion, often speeding things up. Then think about the last time you were maybe sad or depressed, and how this likely slowed down digestion. The same things happen in the horse as they too experience emotions. That is the impact of emotions on energy flow in the body, specifically impacting digestive function.
Both Ayurveda and TCM place heavy importance upon digestion, not only recommending various herbs for daily usage to support this natural act and the importance of a proper diet, but also various meditative practices including yoga and other exercises. All of these things impact digestion and energy flow in the body, which is connected with health, hence why they are heavily recommended and relied upon.
When digestion goes wrong, bad things happen in the horse, and you and I for that matter. This goes beyond eating a meal and having your horse experience loose stools or even gas colic. Most will recognize digestive upset in the horse when one of those two things happen, but what if your horse experiences allergies, skin eruptions, uveitis, joint lameness, metabolic issues, or even poor hoof growth? Not so obvious then, right? Despite, the problem is present.
Ama, Dampness, and the Digestive Fire in the Horse
To begin with, look at the digestive tract as being something more than a stomach, small intestine, large and small colon. Those are just organs within the system, each with their own purpose and function, but still organs. Look at the digestive tract as having a bigger purpose. See it as a black cauldron, being full of foodstuff with a fire beneath it, like in the image noted above. The black cauldron is the digestive tract, the contents within it are the food that is ingested, and the fire below is what is termed ‘agni’ or digestive fire, also referred to in the sense of Qi or digestive energy. This agni or digestive Qi is present within each horse, as it is a person, but is further created by various foods, herbs, and lifestyle events. In order for the food to be digested properly, there must be fire below to help the process of digestion and fermentation. If that fire is not present or very weak, proper digestion will not take place and could contribute not just to poor nutrient absorption but also other major problems.
In the world of Ayurvedic medicine, they use the term Ama, as being reflective of the accumulation of toxic buildup in the body as a result of poor digestion. In TCM, this is viewed as ‘dampness’. The word “Ama” and “dampness’ generally refer to the concept of ‘undigested’ and results in accumulation of toxic debris in the body of the horse. Under normal circumstances, with a healthy digestive process, the act of fermenting the food should create a clear mist or steam, which is literally energy being created out of the food. When digestion is not proper, this clear mist becomes cloudy, heavy, and like an oil. This byproduct is not conducive to proper energy production within the body.
This toxic debris can be seen as something ‘thick, heavy, oily, and cold’ which tends to then impact the normal flow of energy in the body, creating stagnation on various levels. This can be obviously evident in the horse with oily skin, a productive cough with mucous or phlegm, skin allergies with discharge, lymphangitis with drainage, and runny eyes as basic examples. All of those have some sort of discharge, which is ‘Ama’ in basic terms. However, many conditions have ‘Ama’ or ‘dampness’ present as a main contributor, but it is not so obvious. This may include the simply overweight horse, one with laminitis, poor circulation, joint issues, and metabolic concerns.
Don’t believe a simply overweight horse has ‘dampness or ama’? Fat accumulation is dampness and is ama by traditional standards. Fat is heavy, oily, thick and often contains many toxins present within it due to accumulation. Cut through the skin of an overweight horse and you will encounter a fat layer which will literally ooze oil. That is dampness and ama on a very basic level.
Indicators of Dampness or Ama in the Horse include:
- Overweight body condition
- Oily skin or dander with large flakes
- Eye drainage
- Cough or nasal drainage with mucous or phlegm
- Loose stools or firm stools with a mucous coating
- Gas accumulation and increased bowel sounds or grumbling
- Foul smelling odor from body, mouth, feces, or urine
- Cloudy urine
- Skin lesions with discharge
- Sluggishness and overall easily fatigued
- Lymphangitis or lymphedema (stocking up)
- Increased slimy saliva production
- Increased preputial discharge in geldings or stallions
- Increased vulvar discharge in mares
- Immune related issues (allergies, EPM, Lyme) in the easy keeper
- Health or lameness problems become more evident during high humidity and heat
Dampness in the Horse and Importance
Okay, so your horse is overweight or may have some of the problems mentioned above. What’s the big deal, right? Well, it’s actually a really big deal. The reason being is that if you have any of the problems mentioned above in your horse, and that is a short list, then your root problem stems back to digestion. You can chase the problem all day long with medications, improper supplements, or other therapies, but unless you aim to resolve the bigger problem, it will continue to exist and pop up now and again.
Dampness or Ama are extremely important in the world of alternative medicine, which is why they are often addressed in every patient. Dampness and Ama reflect not just toxic buildup and poor digestion in the body, but signals larger problems involving proper energy and blood flow in the body. This ‘fluid’ or toxic debris can settle into tissues throughout the body, which then becomes like a saturated sponge on a certain level. Energy cannot flow properly through that saturation and is impeded, creating stagnation. As a result, in the long-term, if energy flow is impaired, then circulation can also be impaired as it takes energy to move or circulate blood. In addition, think of the blood as become thick and oily. This becomes heavy and hard to move, which is associated with high lipid or fat levels in people and animals. This stagnation is not only associated with pain and cramping, but also bloating, and can impact nutrient delivery to tissue.
Now, think about that laminitic horse that is overweight. He may be in pain with his feet and is receiving specialized shoes and pain medications, helping on some level but not resolving the issue. Given what we have discussed, now look deeper. He is overweight which tells us he has dampness and poor digestion. This didn’t happen yesterday, but over time, so that dampness is well seated, enough so that it is now impairing circulation to the foot. In addition, it is impacting his gut, the microbiome is out of balance and likely there is increased bacterial shift or translocation into the blood stream, such as LPS, which is now equating to higher levels of inflammation. This then is also impacting his insulin function creating metabolic issues.
Also, look at the average COPD horse, maybe a barrel racing QH. He may have mild COPD with a productive cough with mucous when he works. The cough is not always there, but more present when he is worked heavily, and it impairs his energy and stamina. He is overweight as well or based on the breed, he is ‘heavy’. Simply put he has dampness and poor digestion, which is creating the phlegm in his lungs. This phlegm is also impairing energy circulation, reducing the ability of the lungs to function properly and reducing his energy levels. You can choose to use a medication, like Lasix, which does help to reduce moisture in the body, but it is not addressing the main problem, which is digestion, hence the constant need for the medication and often increasing doses.
These examples can continue on and on, going to the skin allergy horse, the uveitis horse, or even the warmblood that is heavier by nature and experiencing back or SI issues. The main point here is that unless you address the bigger problem, the root issue, you will likely continue to contend with those issues time after time. One major thing to point out is that the longer dampness or ama has accumulated, meaning the longer the digestive process has been out of kilter, the harder it is to eliminate or resolve. It is not impossible, but it takes more time. Think of it as being moisture in a basement carpet that has accumulated for months or even years. You can get rid of it, but it’s not easy and takes time. Or like grease that has splattered up from the stove onto the sheet rock wall behind it. That oil penetrates and is hard to remove, even hard to cover up at times.
It is much easier to avoid dampness and ama from the beginning by supporting proper digestion than it is to try to resolve. Prevention is always the best measure.
Improving and Supporting Digestion in the Horse
Digestion is of utmost importance in the horse, as it is in people. Considering that dampness or ama accumulation are very common in health and lameness conditions, the ultimate goal should be to support that digestion and minimize any accumulation. This can be done in a variety of ways.
First, look at the diet. Foods comes in all shapes and sizes, and no two foods are the same, not just in nutritional content but their energy and impact upon the body. Foods can be encouraging to the digestive process or they can discourage it just as well. If your horse is dampness prone, which many are, the diet is the first thing to evaluate. Grains can be very heating, which is somewhat beneficial to digestion, but they tend to also encourage dampness in the body as many can be hard to digest. The high carbohydrate loads in grains can also present problems to the digestive microbiome, easily encouraging negative shifts in the populations. Oils and even flax seed are also potentially problematic for the damp-prone horse. These types of foods are literally dampness in and of themselves, like dairy products to a person. Not only are they high in calories, but they easily contribute to the damp load in the horse, creating more of the same. They are heavy, oily, and hard to digest. It is not a good idea to give a damp forming food to a horse with damp issues, unless their digestive fire is really strong. This is akin to giving a person with sinusitis a bowel of yogurt or ice-cream. It will make matters worse. Different forages also present benefits and cons. Some forages can be hard on the digestive tract, due to high stem content, or in the case of Bermuda, little fibrous debris to stimulate proper colonic contractions. Many, such as alfalfa, are beneficial to the digestive process due to inherent phytochemical present, impacting the microbiome and supporting healthy liver function.
Second, look at supplements that are being given. Many supplements on the market are synthetic based and being that, they are naturally very bitter to the taste. In light of this, most manufacturers cover this with synthetic ‘all natural’ flavoring, which is artificial and loaded with sucrose or fructose. These can be heating to the digestive tract and can be quite irritating to the overall digestive process, influencing the microbiome.
Third, feed foods that are damp resolving and ‘clean and light’, not heavy. This would include all greens, such as alfalfa, spinach, clover, and even some forms of roots including yam and sweet potato. Grains, nuts, and seeds are heavy in nature, due to fat content. General rule of thumb is that if you ground up that food and added water, does it dissolve or make a thick paste? If it makes a thick paste, it is likely damp creating, rather than resolving. Heavy foods in that cauldron are hard to cook, they take more heat to get going, and the end result is often a sludge rather than a clear mist. That is your dampness.
Fourth, utilize various herbs to target the digestive fire. The digestive fire is what is needed to aid in the digestion and assimilation of all foods, whether if heavy or light and clean by nature. Many horses have a very strong digestive fire, which is typical of the leaner and high strung Thoroughbred, for instance. However, many others are lacking in this area which can be reflective in the dampness which is present, as well as a reduced overall energy and sluggishness. They may seem ‘cold’ at times, in energy and personality. The easier keeper type can go both ways, either too much or too little. Horses that have been dealing with a long-term health problem are often deficient, as their condition has literally sucked the life out of them, impacting their digestion. There are many herbs that can assist in this area, which will be discussed in another article. Overall, these types of herbs are warming in nature, with some being rather hot and others not so much.
In the end, dampness and improper digestion are a main root problem in many equine health and lameness conditions. No matter what the problem, whether it be allergies or stifle issues, always step back and look at the horse. There may be signs of a skin infection or even erosion of the joint cartilage on radiograph, which are both notable, but in many cases these are just ‘effects’ of a deeper underlying condition. Medications and even joint injections can be used, and benefit some horses in the short-term, but if you desire to truly resolve the issue and create a better future, digestion should be addressed. Just be patient and keep in mind that this ‘soaked sponge’ will take some time to dry out.
Author: Tom Schell, D.V.M., CVCH, CHN