Pictured Above: An excess or deficiency of vitamin A can result in poor hoof quality and predispose the invasion of microorganisms into the hoof wall, creating a hoof defect pattern in which the outer hoof wall flakes off.Photo:Life Data Labs

As horses age, they present new challenges to horse owners, as well as to farriers.

Because farriers are usually the equine professionals who see horses and owners most regularly, they are frequently the first person a horse owner goes to for advice when senior horses begin to have new issues.

That can put farriers in an uncomfortable position when those issues involve things such as arthritis and laminitis. While it’s important for a hoof-care professional to be able to offer clients sound advice regarding a horse’s overall health, they also need to be careful about overstepping their bounds and diagnosing conditions or suggesting treatments for conditions that fall outside their area.

Older horses become more susceptible to arthritis and may undergo metabolic changes that predispose them to laminitis. Laminitis, of course, directly involves the hooves. Arthritis can affect many areas of the horse’s body, but it’s frequently a problem in the lower limbs and affects how a horse moves. This makes it natural for horse owners to ask their farriers or hoof-care providers for advice.

Early Warning Signs Of Arthritis

Scott Gravlee, veterinarian and equine nutrition consultant with Life Data Labs, says recognizing arthritis in its early stages is important.

Farrier Takeaways

  • Arthritis and laminitis are not problems just for senior horses, but they can be more prevalent as horses age.
  • Hoof-care professionals are in a good position to spot early warning signs of arthritis or laminitis. They see horses more often than veterinarians, meaning they see warning signs sooner. But they also see the horse less often than the owners, making them better able to see slowly evolving symptoms, such as a change in hoof wear between appointments.
  • While there is no dietary silver bullet for treating laminitis or arthritis, diet can help to control obesity and body condition.

“Early detection of arthritis can help prevent or slow the progression of joint problems and arthritis,” he says. “Arthritis can occur in young horses; however, it is more commonly recognized in older horses due to wear and tear and previous injuries. Older horses also tend to have lost strength and elasticity of the tendons surrounding the joints.

“Often the first symptoms may be a shorter stride, head bobbing, swelling of the joint or increased warmth surrounding the joint. The joint may have a limited range of motion. Lameness is associated with arthritic pain, which often gradually improves with exercise.”

By the nature of their work, hoof-care professionals are in a position to be the one to first detect the early symptoms of arthritis.

“Farriers are in a unique position to notice signs of arthritis because they are asking a horse to stand on three legs for a fairly extended period of time, so even minor or milder signs of arthritis may manifest as they work,” says Katherine Williamson of Edmond, Okla., senior veterinarian, equine technical solutions for Purina Animal Nutrition. “Because of the flexion of the joints that is required for farriers to do their work, they may notice a horse resisting flexing an area, particularly in the knees, hocks or fetlocks.“

Williamson notes that an owner typically picks up a hoof just long enough to pick it out, usually just a matter of a few seconds. That means they’re very unlikely to notice minor changes in how a horse is moving or reacting.

Hoof-care providers are also much more likely to flex the shoulder of a horse, another area where an arthritic horse may be resistant to movement, Williamson says.


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Eleanor Kellon, staff veterinary specialist for Uckele Health & Nutrition of Blissfield, Mich., suggests keeping an eye out for a number of symptoms or behaviors that may indicate a senior horse is suffering from arthritis. They include:

  • An abnormal posture/stance.
  • Reluctance to flex a leg.
  • Reduced range of motion in a joint.
  • Reluctance to hold up a leg (usually it’s the opposite one that hurts).
  • Uneven or abnormal hoof/shoe wear.
  • Progressive contracture of a hoof (pain in that limb, usually the foot).
  • A hoof or limb area that is obviously warmer than the other legs.
  • Pivoting around a leg (or both front or hind legs) when turning rather than picking them up.
  • Loss of muscle mass in one or both front or hind legs.
  • A rigid head carriage when walking.
  • Personality change (this is an individual thing, from depressed to aggressive, nonspecific).
  • Bite or kick marks (loss of status, nonspecific).

Kellon says a horse’s feet can also provide clues to problems in a horse’s diet.

“The health of the feet is often the best indicator of the overall sufficiency of the diet,” she says. “Issues with hoof quality such as overly dry or soft hooves, chipping, cracks, flares, widened white line, recurrent abscesses, crumbling of white line below the live tissue plane and frequent thrush can indicate problems with inadequate protein or amino acids (lysine, methionine), fat, deficient zinc and copper.”

Horses supplemented with excessive selenium develop a lack of structure in the hoof horn. The excess selenium replaces the stronger sulfur bonds resulting in weak hoof horn.  Photos: Life Data Labs

When To Call A Vet

Because arthritis is often seen as an unavoidable symptom of the aging process, horse owners may be reluctant to seek a veterinarian’s help. Williamson believes that’s understandable, but says it can also be a big mistake.

“If a horse is getting a bit stiffer in winter, or a bit slower in movement, that’s one thing,” Williamson says. “But if they truly are painful, you’ll find that they lost body condition pretty quickly.”

When that happens, Williamson says it’s important to get a vet involved. Treatment options might be as simple as putting the horse on a high-quality joint supplement. Joint injections of hyaluronic acid or steroids are another possible treatment, and in very severe cases, a neurectomy or long-term nerve block might be called for.

“There is such a spectrum of arthritis, from mild to severe, that I believe each case needs to be taken individually,” Williamson says. “You need to look at how much joint damage there is, how much pain the horse is in, and how that’s affecting the horse’s overall quality of life.”

Flagging Down Laminitis

Laminitis of course, can occur in horses of any age, but it becomes more of an issue as horses age, perhaps because some underlying health issues become more serious or are less under control.

“It occurs most frequently in obese horses, easy keeper breeds and older horses,” Gravlee notes. “Horses with equine metabolic syndrome, insulin resistance or Cushing’s disease have a considerably increased risk. Older horses may be predisposed to laminitis from past occurrences or from repeated concussion trauma or road founder over the years.”

The likelihood and severity of a laminitic event increases when a horse’s hooves have other health problems.

“Poor hoof quality increases the chance that laminitis will pro­gress into a rotation and founder,” Gravlee says. “Stabled horses with a lack of exercise are more susceptible. Close observation should be given to a horse that is overloading one foot due to lameness or pain in another foot.”

Jessica Normand, senior director of product research and development for SmartPak, the Plymouth, Mass., equine nutrition company, provided this list of laminitic symptoms.

  • Shifting of weight from foot to foot (Obel lameness Grade 1).
  • Slight stiffness of gait (Obel Grade 2).
  • Reluctance to move (Obel Grade 3).
  • Classic founder stance (all four feet forward, so hind feet carry more weight) (Obel Grade 4).
  • Horse lies down and doesn’t want to get up.
  • Warm feet, bounding digital pulse rates.
  • Sweating.
  • High heart and respiratory rates.

SmartPak recommends that horse owners call in a veterinarian for a proper diagnosis as well as for treatment and ongoing management, which may include prescription medication. The veterinarian can also test for Cushing’s disease and/or equine metabolic syndrome.

Williamson believes that, as with arthritis, farriers are in a good position to spot signs of laminitis.

“Farriers are going to notice things like sensitivity to pressure on that hoof capsule, to pounding or during clinching,” she says. “Reactions to any of these might be signs that the horse is currently in a laminitic episode or has had one in the recent past.”


The health of the feet is often the best indicator of the overall sufficiency of the diet …


She says the familiarity with the hoof capsule makes farriers more aware of signs such as damage to coronary bands, abnormal growth lines or a change in hoof-wear patterns toward more heel wear.

“A farrier may well be the first one to see the signs, especially in milder laminitic episodes,” Williamson says. “They are more likely to notice a sole is dropping near the toe, which could be evidence of (distal phalanx) rotation.”

While laminitis is obviously a very serious problem, Williamson says it’s not unusual to find horse owners that will be reluctant to listen to a farrier’s suggestion — even insistence — that a vet be called in. She says it’s not always just a matter of the cost of treatment.

“I’ve found horse owners who are almost resistant to opening that can of worms,” she says. “They understand on a fairly basic level what laminitis is, but they think it’s almost a death sentence for their horses. Mentally, they just don’t want to go there if the horse is not hobbling around in agony.”

But even if it appears that a horse has recovered from a relatively mild laminitic episode, Williamson believes a veterinarian should be called in.

“A horse that’s foundered once is likely to founder again,” she says. “Unless you can pinpoint one specific cause — such as a horse getting into a grain — let’s try to figure out what the inciting cause might have been so we can prevent that from happening in the future.”

Kellon notes that laminitis actually can often be a symptom of other medical issues. Horses that have endocrine disease, Cushing’s disease (pituitary pars intermedia dysfunction, or PPID) and high blood insulin levels are at risk for laminitis.

“Advanced PPID is easy to recognize from an abnormally long, often wavy, coat that fails to shed and increased drinking and urination,” she says. “However, laminitis can be the very first sign of the disease, long before those changes, and will often be accompanied by signs of insulin resistance such as fat pockets in the fossae (shallow depression) above the eyes and fatty deposits along the crest.

“Subtle indicators of hoof pain may be present before the full-blown episode, such as reluctance to make sharp turns, avoidance of hard surfaces or toe-first landing to avoid full weight bearing.”

Insulin resistant horses are not always overweight, but Kellon says fat deposits above the eyes, the crest of the neck and at the withers and thighs will persist in horses of otherwise normal weight or even those with severe weight loss.

As a farrier, if you see the shaggy coat, fat deposits, cresty neck or other signs of Cushing’s or insulin resistance, it’s a good idea to suggest the owners bring it to a vet’s attention.

The typical insulin resistant horse or pony is overweight with a prominent fatty neck crest.  Photos: Elanor Kellon

The Nutritional Approach

Diet can play an important role in combating these conditions in senior horses, but experts caution that there is no dietary silver bullet when it comes to dealing with arthritis or laminitis in senior horses. Rather, they stressed the importance of a balanced, nutritious diet throughout the life of a horse to head off these problems before they occur.

“We’ve not found that diet plays a significant role in the development in any of these diseases,” Williamson says. “But what diet can impact is the manifestation of these diseases.”

Cushing’s disease is due to a tumor that occurs on the pituitary gland. Williamson says there is some evidence that obesity may contribute to the development of this tumor as horses age, but so far that definitive link hasn’t been proven. But while there aren’t specific nutritional interventions for these conditions, a horse that is kept in a good body condition will put less stress on its joints.

“It’s more about maintaining a horse in a good and healthy body condition throughout its life,” says Williamson. “That’s the biggest and best impact that nutrition can have.”

“Prevention is far better than a cure and horse owners should think about consulting with a nutritionist every now and then to check that the diets are suitable and properly balanced,” says Melyni Worth, president of Foxden Equine, of Stuarts Draft, Va. “Vets are for dealing with problems after they have arisen and nutritionists are for preventing them.”

Worth, who holds a doctorate in agricultural biochemistry and a master’s degree in equine nutrition, says there are no specific nutritional deficiencies that lead to arthritis. Rather, it’s “too much of a good thing” in terms of grass or calories that leads to a horse being overweight, which contributes to joint problems, as well as the development of equine metabolic syndrome and a predisposition to laminitis. A good diet can help to prevent this.

“The diet should always be regarded overall, taking everything into account; hay, grazing and supplements, if needed,” she says. “People tend to forget that and just keep adding supplements, when an overall balancing of the diet would work better.”

Worth says magnesium supplements have proven successful in helping to restore hoof circulation and prevent laminitis, but she adds that once the condition “gets going,” a veterinarian must be called in.

LEARN MORE

Learn how nutrition affects hoof health at
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Gravlee also believes diet plays an important role in preventing both arthritis and laminitis.

“Insufficient or excessive levels of any of a number of nutrients can predispose horses to arthritis or be detrimental to hoof health. For example, excess selenium and/or copper deficiency can lead to weak hoof walls with horizontal concentric rings,” he says. “Other indicators of possible nutritional issues would be hair-like projections emerging from the hoof walls, crumbling and cracking of the hoof walls, outer wall flaking, altered pigmentation of the hoof wall, softness of the hoof wall, brittle hoof wall or a dull hair coat.”

Gravlee points out that poor-quality protein and diets that are high in nitrogen can lead to higher levels of nitrogen compounds in tissues. Nitrogen compounds are known to have inflammatory properties. He says there is also a strong relationship between the amino acid tyrosine, iodine, hoof problems and obesity.

“Blood testing for minerals and other nutrients will often indicate dietary deficiencies or excesses by not only evaluating the level of the nutrient in the blood, but more importantly the ration between nutrients,” he says. “Just as there is a ratio of calcium to phosphorus in the diet and blood, other nutrients also need to be within correct ratios.”

Kellon says iron overload may ac­company insulin resistance and has been known to make the condition worse in some species. She says the most common diet deficiencies involved in insulin production and signaling antioxident/anti-inflamatory defense systems are copper, zinc and selenium.

If diet deficiencies are suspected, Kellon says the most effective approach is an analysis of actual hay or pasture.

“This tells the owner not only what is deficient, but also how much supplementation is needed,” she says.

While supplements are usually not developed specifically for senior horses, Gravlee says they still can be helpful.

“A quality hoof supplement can not only provide protection from the effects of laminitis and laminitis recovery, but also strengthens the ligaments that support the joints,” he says. “Joint supplements or a combination of hoof and joint supplements containing adequate proline can benefit the older horse. Proline is an amino acid that gives ligaments strength and elasticity.”

First Line Of Defense

All of the experts consulted for this article stressed the vital role that hoof-care professionals play in sounding the early warning of problems in
senior horses.

“The horse owner or caretaker that sees a horse on a daily basis may not be aware of a developing problem due to the gradual nature of some evolving conditions,” says Frank Gravlee, veteri­narian and founder of Life Data Labs.

“The farrier is in the unique position of seeing the horse periodically in a time frame sufficient to detect the cumulative effect of the small daily changes. The alert farrier is the gatekeeper of the horse’s health.”

Teeth And Body Condition As Red Flags

The next time you’re examining a senior horse, you might want to take a little time to look in its mouth and overall frame, as well as its feet.

Katherine Williamson, senior veterinarian, equine technical solutions for Purina Animal Nutrition, says a senior horse’s teeth have a major impact on its overall health.

Dental condition plays a huge role in senior horse nutrition, body condition and overall wellness,” she says. “Deteriorating dental condition is the No. 1 problem for senior horses. It makes them less efficient chewers and chewing is the first step in the digestive process.”

If horses can’t chew properly, they’re not breaking down fibers and grains so that they can be digested farther along in the digestive tract.

That problem is further complicated, Williamson points out, because senior horses also often experience changes in the bacteria populations in the hindgut.

“Those bacterial populations are responsible, for example, for most of the production of the horse’s B vitamins,” she explains. “If you’re seeing an older horse that, over 6 months has a deterioration of hoof quality, it may not be producing biotin like it once did. In that kind of situation, it might be a good candidate for a biotin supplement.”

Older horses may also develop problems with poorer quality forages.

“Forages that have more fiber or stems typical of third- or fourth-cutting hay are less digestible,” says Williamson. “We often find that an older horse won’t be able to maintain body condition on a hay they did just fine with the previous 10 years.”

Monitoring a horse’s body condition can provide farriers with useful information, as well as providing warning signs of trouble.

“Body condition can let you know about metabolic problems like Cushing’s disease,” Williamson says. “A horse can be skinny as a rail, but still have those fat deposits or cresty necks.”

Williamson says any major change in body condition should be a red flag. A farrier who understands how to access body condition can pass that information on to a horse owner and veterinarian in a language the vet will understand.

She says veterinarians most often use the Henneke Scoring System, a 0 to 9 system in which 0 is emaciated and 9 is utterly obese.

“Once you learn to do this, it doesn’t take long,” she says. “You watch the horse walk up to you and run your hands over it. It’s one thing if a body condition goes from a 5 to a 6, but if I hear about a horse going from 5 to 7, that’s going to indicate a need to decrease calories or increase exercise.”

The ultimate goal in monitoring changes in senior horses’ dental health and body condition is to keep them in good health and head off problems.

“The hardest time we have with senior horses is when we get behind the 8-ball on them,” Williamson says.

“Then they lose body condition, develop joint pain, arthritis or laminitis. Then we’re chasing. You’re much better off looking for ways to prevent those problems up front.”

 

September/October 2017 Issue Contents