Health and soundness in the horse is crucial to performance and overall longevity. The more time and knowledge that is soundly invested in your horse’s health, the less problems that will be present and inevitably, the lower your overall financial output on healthcare costs. Despite this concept of ‘preventative care‘ being known for decades, as horse owners and veterinarians we tend to fall back on medications to save us. Are these medications truly the end-all-be all? Or are there better options available, including herbs and proper nutrition?
There are two types of healthcare; proactive or reactive. The choice is entirely up to you, as a person and a horse owner. One relies more heavily on proper nutrition and herbal therapy, while the other on medications and surgical procedures. One takes the bull by the horns, aiming to prevent or minimize issues in their horse’s health, while the other expects problems to happen and looks to other things to resolve those issues. Even then, when looking at these two paradigms, the concepts utilized in proactive medicine can likewise be used to rescue you in the reactive phase additionally.
Veterinary medicine is not much different than human medicine. Both fields rely heavily on medications, either prescription or over-the-counter. If there is a health problem, chances are there is a medication to go along with it. As a student, we were trained to know drugs, how they work, and what conditions they might benefit the horse or other animal. In truth, as you go through a medical program, there is often so much emphasis on medications that one starts to feel like a pharmacist, rather than a doctor. This is even true after graduation and well into years of clinical practice. Medications are pushed on us by pharmaceutical representatives and sadly, are replaced in the coming years with newer and better versions. As soon as you get used to one medication, it is replaced by an updated version. This has always raised the question of whether or not these medications are truly the answer?
The reason there is so much emphasis upon pharmaceutical medications is because the field of medicine is more focused on the ‘reactive’ phase than the ‘proactive’ one. Disease and injury will always be a part of equine medicine, just as it is with humans. There will always be problems. However, you will always have a choice and in that choice you have more control than you believe, which can greatly minimize these issues and in some cases, prevent them from happening.
Acute versus Chronic Problems in the Horse
An acute condition is one that has been present for less than 30 days, happening quickly or suddenly. This can include a tendon injury, a wound or laceration, an infection of some sort or even a colic as examples. Essentially, an acute condition is one that just seemed to happen or appear, in a very short period of time. However, you have to be careful on what you classify as acute, as the time frame can be very misleading.
A chronic condition is one that has been present for more than 30 days, which usually involves a condition which continues to linger or has failed to respond to therapies during that acute phase. This category includes all metabolic syndrome horses, insulin resistant cases, Cushing’s disease (PPID), long-term tendon issues, foot problems, laminitis, uveitis, allergies, weight issues, COPD, inflammatory airway disease, joint degeneration and many other causes of health and lameness concerns.
Now, these definitions are helpful but can be very misleading. When I personally think of an acute condition, it may be a infection of some sorts or an injury such as a broken bone or injured tendon. Even then, with those examples, the waters are quite muddy and not very clear.
The reality is that many conditions, including infections, bone fractures, or even tendon injuries can be classified technically as chronic, especially if you look at cellular pathways that are involved. The reason being is that for some horses, yes, those injuries or problems did just happen and often a result of shear overload of a structure, resulting in damage. But, for many other horses, despite just happening in that acute phase, there are likely underlying cellular pathways that have been activated in the longer term, which have impacted the strength of those structures, allowing for an increased risk of fracture or injury. The same can be said regarding an acute infection of the respiratory tract, the eye, the skin, or even the uterus of a mare. Just because you now noticed clinical signs of a problem doesn’t mean that body or immune system hasn’t been healthy for a longer period of time, which opened the door for the more acute manifestation.
Time and Horse Health; Why it Matters
So, why the big fuss over whether if a condition is acute or chronic in the horse? In truth, the shorter the period of time that the problem has been present, generally the easier it is to remedy. This is no different than any other issue in life. The quicker you nip something in the bud, the less likely it will be a problem moving forward.
In looking at acute versus chronic, if you were to classify all health and lameness conditions in the horse, most would fall under that chronic category. They may have been acute at one point in time, but that time has past. You have now entered the ‘chronic zone’ and this should stir up a little bit of concern, because those conditions tend to never be cured and linger for months or years like a bad odor. These chronic conditions tend to fester, having good periods of time when they are well-managed, and then other times rearing their ugly head like a fire-breathing dragon.
This scenario is evident in the typical case of a tendon injury in the horse. For some, the horse is very healthy and slips or takes a bad step in mud, which creates tendon or ligament strain. The horse becomes notably lame with heat in the tendon, however, with appropriate therapy, they rebound very quickly, often requiring no stall confinement or medications. But, on the other side of the coin, you have a group of horses that are not very healthy on the inside. Inflammation is elevated, as is stress. Their diet may not be optimal and gut health is strained. They may strain a tendon in a barrel race or even over a jump, creating the same clinical scenario as above with lameness and heat. The big difference here is that this second horse will require more intensive efforts to produce a recovery. These are the horses that often linger for months on end, with some being retired. Their tendon injury is linked to a chronic ailment, which is not as easy to remedy.
The truth here is that most health conditions fall into this chronic category and the vast majority of medications that are used in the horse (and humans) are targeting this classification.
What does this tell us?
Well, to me as a veterinarian, it signifies that we are missing a bigger piece of the puzzle, specifically towards the preventative medicine side. The horse’s body, like ours, is limited in capability and despite its incredible power to regenerate and sustain itself, it will fail eventually. The aging process is one of the biggest contributors to chronic health conditions in the horse, but the kicker here is that many of the horses impacted by these chronic ailments are not aged. In fact, many are fairly young. This is also noted in human medicine. This should be a major cause for concern, but instead, this fact is often ignored.
As veterinarians, we have horses breaking down on the race tracks at the age of three. There are horses with metabolic syndrome and laminitis at the age of six and competitive dressage athletes being diagnosed with Cushing’s disease. Barrel racers are having their joints injected at the age of four or five, due to joint stiffness and early stage osteoarthritis. Then, we have allergies, uveitis, and asthma conditions impacting horses as young as yearlings.
What the heck is going on?
In truth, the appearance of these chronic health and lameness conditions in the ‘younger’ horses is a sign that the body is not healthy. Immune systems are out of balance. Digestive health is impaired. Tissues are not as healthy or strong as expected. Inflammatory responses are heightened and overall cellular signaling is altered.
Now, the question is how to you respond to these situations, as a horse owner?
Why Does My Horse Have Health or Lameness Problems?
This can be a complicated question, so let’s take a real-life example.
My wife and I are repainting our outside deck on the backside of our house. The wood deck is fairly large and was built about 15 years ago and still standing. Now, over the years, we have had to replace a few deck boards and even joists, but overall, it has withstood the test of time, but this did not come easy. Our wood deck is an investment, just like buying a horse. After it was built, having fresh wood, one has a few options. They could leave it bare and exposed to the elements over time, which would increase the chances of rot, warped boards and loose nails, thus necessitating costly repairs. Another option would be to put a typical ‘sealer’ on those boards and hope for the best, which may work for a short period, but not optimal in certain situations and needs yearly if not more often re-coating. The final option, which we chose was to use a solid sealer, a thick paint, to coat those boards properly and sealing out the elements. This third choice was more costly and labor intensive originally, but through that choice many years ago, our repairs have been minimal and recoating of the deck is not that frequent, being about every 6-7 years.
Your horse’s body is like that wood deck. Depending on what you put into it will dictate what you get out. For most owners, as I see it as a veterinarian, they are waiting for problems to arise then are at the mercy of medications or surgeries to correct the problems. In some horses, this route works, but in others, either the medications do not work or they need to be continually administered. Even then, if the medications are given for the long-term, the conditions are rarely cured, but more so tend to stay idle, becoming worse over time.
This is why you see so many medications advertised for chronic health ailments. Not only are these conditions so common in the horse (and human), but they are very difficult to treat. Thus, one medication provides benefits this year and soon, there is something bigger and better (but not really!).
Look at the average metabolic horse, especially with laminitis. Their condition lingers for years, being on one medication this moment and another the next, then special shoes and diets, usually with no benefit in the overall status of their health or soundness. Horses with allergies or COPD live in confinement, on special feeds, hays and medications, like they are in a bubble of sorts, yet fail to respond completely and linger. Horses with chronic tendon ailments are stalled for months on end, again with one medication or procedure after the next, with little ground gained despite the efforts. Then, we have the very young horse that breaks down on the track or in another discipline, failing to respond to medications or surgeries, and then forced to live a life of retirement and debilitation.
Are you treating the symptoms or the problem? In truth, with most medications you are treating the symptoms.
The true solution lies in asking the question, ‘why did this happen to my horse?’ Trust me, the reason that allergies happened is not because of a deficiency of a corticosteroid in the body. Furthermore, the reason your horse has metabolic issues is not completely because of sugar or carbohydrates. That tendon is not healing because it lacks stem cells, nor is that joint sore because it lacks steroids.
In order to understand truth, one must seek it and dive deeper. This is something that most of us do not want to do. I understand fully and we’d rather something just disappear than to take time to understand it. This is where the concept of being proactive versus reactive comes into play.
Proactive versus Reactive. Herbs or Medications in the Horse?
The wood deck analogy used above is not far removed in comparison to your horse’s body. I believe a piece of wood, like your horse’s body, is limited in life span, but there are things you can do to improve that longevity. This is the same for your horse’s body.
When I encounter a health or lameness issue in a horse, 99% of the time it is chronic. You can gather this information and come to this conclusion just by talking with the owner and reviewing the history. The main problem may have just popped up and became obvious, but the history notes other issues that were overlooked, being indicators that horse was breaking down slowly.
Medications or herbs?
That is a good question and for me, herbs and nutrition are the main course being served for that horse.
Well, for starters, most of the horses that we encounter have already been down the medication or surgery route, and results were less than optimal. So, in truth, I have no choice. Plan ‘A’ didn’t work, so plan ‘B’ is the next choice. Going further, despite being forced down that path, plan ‘B’ would have been my choice initially anyway.
I see things differently than most of my veterinary colleagues. I see the body as a beautiful and finely tuned living machine of sorts, that when it is out of balance, problems develop. So, my goal is to restore and maintain that balance. This will hopefully help the horse’s body to heal and ideally if the regimen is maintained, it will keep that horse healthier and sounder in the future. Medications do not allow me to restore balance, so, I personally chose herbs and proper nutrition, 100% of the time.
Proper herb and nutritional approaches should be a part of every approach in the horse to either help maintain health (proactive) or aid in the recovery from a health ailment or injury (reactive). The reason being is that your horse’s body needs to be supported and these therapies allow you to do that. Herbs and even specific foods enable us to impact cellular health and function directly, curbing inflammation, calming an overactive immune response or increasing an underactive one. They aid in restoring mitochondrial health, repairing DNA damage, altering circulation to feed tissue properly, an impacting a heightened stress response. Additionally, foods and herbs are the source of vital nutrients to aid in body healing and maintenance. You do not get those benefits from a ‘fortified’ commercial feed, nor from a lower quality forage. This is the concept of whole-foods and proper utilization of herbs, targeting specific problems in your horse.
Once again, pharmaceutical medications do not provide any of those benefits. They are used almost completely to chase down and address symptoms, not the root problem.
Your horse’s body shouldn’t break down before it’s time. We shouldn’t be seeing this huge surge in chronic health ailments in the horse. It is a sign of cellular damage and if you want to curb that damage, then you have to act sooner than later. This is not through ongoing use of medications. Ideally, your goal should be to minimize that cellular damage right from the start, the moment the foal is born, or that yearling begins to enter some light training. This is the optimal approach and being ‘proactive’.
Many chronic health ailments in the horse will respond very nicely to the right approach, but others may make some improvement and still retain some problems. This is evident in cases of scarring or calcification, as seen in joints and tendon issues that have festered for months or years. These are natural responses to the body to an injury that is poorly managed, and once these changes are set, they are like mortar or cement, almost impossible to reverse. This does not mean the situation cannot be improved though.
No matter what has walked through our clinic doors over the years, or what has been encountered in a remote consultation with a horse owner, two things stand very true.
First, every one of those conditions can benefit from herbs and nutrition when properly applied.
Second, the extent of the outcome is and always will be dictated by the owner’s willingness to comply, follow through, and understand what their end goal is and why.
There is no sure-fire way of accomplishing this goal of either prevention or treatment of a chronic health ailment in the horse. The only recommendation that I can make is to implement a strategy and assess its impact on your horse through a certain level of understanding. Do not go with a regimen or even a supplement just because others are using it. Do not go with a feed or grain just because marketing tells you that it will improve hoof health or make their coat shiny. Make a choice out of level of understanding based on what you wish to accomplish for your horse. More importantly, monitor and make changes if improvements or benefits are not seen in a month. Do not continue doing something just ‘because’. Have a purpose and with that purpose, have a certain level of expectations.
Most chronic health ailments, if the right regimen is applied, will show clinical benefit in 30 days with ongoing improvement in the months to come. You will not have a sound horse or a horse that is breathing better in just a few days, at least in most cases. These are chronic conditions, meaning that cells have been damaged, and that damage must be corrected in future cell lines. Recovery from a chronic health or lameness condition in the horse takes time and is expected, because after all, it took time to create the problem.
So, before you authorize that injection, that surgery, or even administer that medication to your horse, ask yourself a few questions.
- Why are you doing this?
- What truly caused this problem in my horse?
- Is this therapy really tackling the main problem?
- What do you expect from this therapy and how soon?
- What negative side effects could pop up that could make matters worse, not better?
- What is the long-term cost and time comparison between this approach and one that might actually benefit your horse’s body and overall health?
It is always much easier to prevent a health problem than it is to treat one once it has arisen.
Author: Tom Schell, D.V.M, CVCH, CHN