EPSM/PSSM - A Quarter Horse Named Doc updated

Since I wrote this three years ago, there has been an increased awareness of equine neuro-muscular disorders by horse owners and their veterinarians. Draft-crosses are becoming popular - spurred by PMU mare/foal rescues many are being ridden by new or first-time horse owners - and their susceptibility to "traditional" draft horse neuro-muscular issues often forces their owners into a sharp learning curve.

go to the updated EPSM/PSSM and a Quarter Horse Named Doc

From Horse Apples to Poo Soup

To most horse lovers, Parfum de Pommes Cheval is part of the stable lifestyle. But what happens when those fragrant horse apples turn into poo soup?

Diarrhea in our horse is an indication that all is not well in his digestive tract and can have serious consequences. It may quickly lead to dehydration which can be a primary cause of colic. It's important to determine the cause but, while we're figuring this out, there are some steps we should take to avoid more serious problems.

• Monitor your horse's water intake. If you use an automatic waterer, turn it off and provide water in a large container (tub, tank or large, clean trash barrel). Make sure your horse will drink from this source.
• Provide a second bucket of water that has some salt added - a small handful of plain salt in a 3-gallon bucket is about right.
• Provide wet feed such as a beet pulp slurry or add water to his usual concentrate to make a wet mash. A benefit of beet pulp is it will also act as a "pre-biotic".
• Feed hay wet - either spray with water or dunk in a bucket.
• Watch that your horse is actually swallowing his water and mash - not just playing with it. Some illnesses can cause paralysis of the esophagus and prevent swallowing.

Call your vet immediately if:

• Your horse can't swallow.
• He has a temperature above 102F (or 1 degree above his "normal" temperature).
• Your horse seems dehydrated. Do a skin pinch test on the shoulder or neck - the tented skin should immediately snap back with no "wrinkles". Check his gums - they should be a healthy pink; press on the gum until it's blanched (white) - it should become pink again in less than 3 seconds.
• His resting heart rate is higher than normal (in the 30's or low 40's). You should have a record of his normal heart rate from doing "well horse checks" when your horse is healthy.
• Your horse seems depressed - standing with his head in a corner, not responding like he normally does or ignoring his surroundings.
• The diarrhea has a foul odor - not the normal fragrance of manure - or you can see blood or mucous.
• He acts like his tummy hurts - looking at or biting his sides, pacing, anxious look on his face.

If your horse is otherwise bright and healthy appearing and is eating and drinking normally, it may be safe to wait and watch a day or so to see if the diarrhea resolves on its own - like the "nervous squirts" many horses will have when trailering or after being moved to a new place. But if your horse seems off, it doesn't hurt to at least give your veterinarian a heads up - you and your vet may decide that some extra fluids (by IV or tube) might be appropriate to avert an emergency in the middle of the night.

With an acute, or sudden onset of diarrhea, trying to slow down or stop it is not always the best route. Diarrhea is one of the ways the body has to rid itself of pathogens in the GI tract. Some pathogens create toxins that can damage the intestines - if the body is kept from eliminating them the pathogens can multiply and continue to create toxins. "C. diff" (Clostridium difficile) is one example - this can cause painful cramps and serious damage to the intestines and requires antibiotics to resolve - your vet is likely to order stool cultures to determine the best treatment.

Recurring or chronic diarrhea may be caused by bacteria but may also have its root in poor gut function - poor fermentation of the fiber in his forage from a variety of causes, inflammation, poor immune function and fungal infection. If pathogens have been ruled out, there are several things you can look at -

• Evaluate your horse's diet for adequate forage (1.5 to 2% or more of body weight) and concentrates that may provide excess sugar or starch.
• Provide smaller, more frequent concentrate meals to lower the chance of undigested sugars getting past the cecum and small intestine to the hind gut.
• Examine your hay and feed for mold, insects or rodent droppings. If hay is of questionable quality, it can be tested for mycotoxins - see Equi-Analytical's web site.
• Add a pre-biotic or pro-biotic - such as Ration Plus, S. cerevisiae yeast, Forco or other quality product to your horse's ration. Pro-biotics in a feed or supplement may not be included in sufficient quantity to be effective in establishing adequate gut microbes. Beet pulp also acts as a "pre-biotic" - helping set up favorable conditions in the gut to encourage the "good" bugs to grow.
• Many people have reported success using human "over the counter" remedies to sooth and protect the GI tract. These include aloe vera juice, simethicone or antacids containing simethicone and kaolin/pectin (also available as a large animal preparation at some feed stores). As a rule of thumb, an equine dose is about four to six times the human dose - think "weight based" and consult your vet.
• There are also many products now targeted to the equine GI tract. Dr. Eleanor Kellon's Horse Journal Guide to Equine Supplements and Nutraceuticals has a complete section on Digestive Tract Aids.
• Ensure your horse is receiving adequate salt in his ration. Inadequate salt may lead to chronic dehydration at the cellular level which can affect all bodily functions. Horses are unable to get enough salt from a salt or mineral block. One to two ounces (approximately one to two heaping Tablespoons) of regular table salt is about right for an "average" size horse at maintenance.
• Evaluate your horse's deworming program, especially if his exposure risk has changed. "Natural" dewormers have not been shown to be effective and horses with lowered immune system defenses (including from age) are more susceptible to problems from parasites.

Don't give commercial electrolytes to a dehydrated horse - this can worsen any problems he may be having. A second bucket of water containing some salt can be offered and may encourage drinking but only if plain water is also available. Your veterinarian may want to give electrolytes in IV fluid but she will also ensure that adequate plain fluid (normal saline IV or plain water via stomach tube) is also given.

Most diarrhea in horses will resolve fairly quickly, but keep a sharp watch for dehydration or other signs that you need to call your vet.