Wow! That is a very important question! How important is your horse’s gut health? What do you believe as a horse owner? For some owners and horses, the connection is real, such as in the case of ulcers, recurrent colic, or irritable bowel type of conditions, but for others, it may not be so obvious. The gut and digestive tract in the horse is an immense organ system that, believe it or not, is closely tied in with proper health and function in the entire body! So, whether if you have current digestive or gut issues in your horse or not, this organ system could be the root of many of your horse worries!
As a practicing veterinarian for over 2 decades, gut health per se, was not always on my mind. Sure, as a veterinarian, I and many of my colleagues managed and treated hundreds of cases of colic and diarrhea cases, including enteritis and colitis, but did that equate to ‘gut health’ concerns? To be honest, back then and even now for many veterinarians, it does not. Many tend to view that colic as just gas, or a weird situation in which the colon became displaced, or that horse ‘contracted’ Salmonella or Clostridial diarrhea. Ten year ago, I thought that way, but my logic was wrong. Likely, this is why many of those cases responded, then continued to have problems or many just simply failed to respond. I, or we, as veterinarians were taking the wrong approach and many still are to be honest.
As we move through time, we begin to evolve and understand things differently, sometimes seeing them from a new perspective. In more recent times and over the past few decades, human research has evolved and closely links many health conditions in people, from allergies to cancer and even arthritis, to gut health and the microbiome. Then, human research goes further and comes to conclusions that things like our diet and even emotions are directly linked to this gut health phenomenon. To go one step further, in some studies, through dietary intervention and usage of specific herbs, the gut health and microbiome can be re-balanced, resulting in improvements in those health conditions without the need for medications! Pretty incredible if you ask me, considering the biased view of western medicine that only medications are the answer.
So, how does this translate to the horse and their health or soundness??
The Equine Digestive Tract, Microbiome, and Health
I’ve discussed the equine digestive tract and microbiome in more detail in two other articles, so given space and time, I will allow you to refresh and review. Those two articles can be found here and here. The bottom line is that the gastrointestinal tract in the horse is more than just a vat of fermentation for food digestion. This is a complex organ system, composed of billions of different types of bacteria which not only assist with digestion, but produce various chemicals that either promote health and well-being, or create the opposite along with inflammation. If you create a state where the normal balance of those bacteria is off-kilter, then a state of disease or even lameness can quickly follow.
Let’s take a case of colic as an example. So, here you have a horse that colics, maybe severe gas colic with a displacement of the large colon. This excess gas production doesn’t ‘just happen’, it is a result of an imbalance in the microbiome population, leading to excess gas production and improper fermentation. In many cases, this is due to an improper diet being fed or other ‘stress’ contributor that is creating the shift in bacteria.
Now, let’s move forward with the case. Your horse is medically managed on the farm, but has another severe episode of pain and now your veterinarian is referring you to a medical facility where he can be monitored closely and administered fluids with medications for pain. Over the course of the next 24 hours, your horse gets worse, almost to the point of requiring surgery, but begins to show signs of recovery. However, in the next 48 hours, things take a turn, not so much colic pain, but more loss of appetite, dehydration, and loose stools. Now, your veterinarian is suspecting Salmonella diarrhea, which can be really serious and possibly fatal due to endotoxemia.
So, did your horse contract this Salmonella bacteria in the veterinary facility? Likely not in all honesty. Is the bacteria present in the stalls in that hospital? More often than not, yes, but that doesn’t mean he contracted it there. More likely, this case of Salmonella diarrhea is a direct result of the shift in the microbiome that was originally present in your horse. Salmonella is often normally present in all horses, but on a very low, almost undetectable level. However, when the conditions are right and the population begins to shift due to many factors, the environment in the gut changes and ‘bad’ bacteria like Salmonella are allowed to increase in numbers. This is most often what creates these conditions. In reality, your horse is compromised to begin with and now you are seeing the aftermath. This can be further complicated by use of medications, including antibiotics, during hospitalization, which are necessary in some cases, but in others, they can dramatically alter the digestive microbiome.
Now, I’ve seen and treated many cases of diarrhea in the horse, including Salmonellosis, and they are neither fun nor inexpensive to manage. Most, luckily, have done well and recovered, while others progress to a point of no return. My point in using Salmonella as an example is to point out the extreme that is possible. The goal here is to create recognition of what could happen, but also to recognize that the path is being created in a high percentage of horses currently whether if they are clinically sick or not.
This same shift in the digestive microbiome or dysbiosis, is occurring in the average laminitic patient, the average metabolic and Cushing’s patient, the average horse with allergies and uveitis, in many tendon and joint situations, and even the average competition horse. It is happening, but just on a lower level. Almost like a pot that is boiling, waiting to spill over into something more serious. The question is whether if you recognize it NOW or LATER?
Fecal Cultures and What they Indicate in the Horse
Up until 10 or so years ago, I perceived things like a typical equine veterinarian. If I had a case of colic, I treated it and moved on, maybe giving the owner some ‘preventative’ advice. If I had a case of diarrhea, what ever the cause, I treated it, using medications and antibiotics, and hoped for the best in that horse. The point is that I perceived each of those situations as being isolated incidents, when really they were not. What I was seeing was the culmination of events that had been festering for months if not years, finally coming to a ‘head’ or boiling point.
I began to see the light as I did more research. About 5 years ago, I stumbled across a research article on laminitis in the horse with metabolic disease. In that article, it noted that most of these horses demonstrated an overgrowth of Streptococcus Group D and Lactobacillus bacteria in their feces. Interesting, I thought. Is that cause or effect? It was then that I began to do our own fecal cultures, developing our current technique to detect these two groups and determining a ‘normal’ range of detection. After completing close to 400 cultures, over 4 years, you begin to see patterns emerging.
Out of every 10 horses that are cultured in our laboratory, 7 of them demonstrate higher than normal levels of these bacteria types on fecal culture. That is 70% of all horses cultured! That’s a big WOW! The next thing to note is that not all of these horses are reported as having clinical problems per their owners, but yet, if you dig deep enough into their current history, you will find problems. They just aren’t problems that the owner reports or is concerned with. These include behavioral issues, foot health issues, allergy issues, metabolic or weight issues, recurrent tendon injuries, or even episodes of intermittent loose stools or gas. This is often noted when an owner is concerned about one of their horses, but submits specimens from the other 4 horses they own. The one of concern often demonstrates problems, but 2-3 out of the other 4 do as well, despite having no obvious concerns noted by the owner.
Pretty interesting, right? Is this a cause for concern?
Gut Health in the Horse: It Depends on How You Look at It
To me, as a veterinarian and researcher, it is very important and something to be noted. Once you see the connection between gut health in the horse and other health or soundness issues, the problem becomes self evident. Go to any horse event, especially if lasting for several days or longer. Take a close look at the horses. Watch their behaviors, their body conditions, and if possible, what comes out of their rear ends. Also, closely note the high use of ulcer medications and even the frequency that vets are on the property managing colic cases. Then, look even closer at foot health and incidence of poor wall growth, cracks and dry hoof conditions, not to mention thrush or white-line disease. In many instances, these are the high-dollar performance horses in various disciplines.
Also, take a close look and observe the number of cases of EPM, Lyme, allergies, uveitis, or other immune related conditions in the horse. How many owners do you know or hear about on social media contending with these equine health ailments? Now, if you know some, take a close look at the horse and their history. Most of them are easy-keeper types, bigger builds, and many have a history of gut issues if you dig deep enough. This is not coincidence. Most horse owners feel as if these conditions happened to them or their horses, when in reality, they created the circumstances for the condition to develop. There is no sense in complaining about a situation in which you played a major role in creating on some level.
The digestive microbiome is out of kilter, out of balance, in most of these horses, especially if problems are noted as listed above. These are tell tale signs that things are not right in the average horse. Take it to the next level and you then create the metabolic horse with ongoing laminitis, or the horse with EPM, Lyme, or even poor hoof health and soundness. Same scenario, just taken to a higher degree. So, yes, as a veterinarian, I am concerned about what is going on. Even more concerned when I see misleading advertising regarding certain feeds, ulcer medications, and some supplements claiming to ‘fix’ these problems. More so, at the least, they are covering up the problem, while on the other end of the spectrum, the could be making matters worse for the horse and the owner.
The problem exists but most owners fail to recognize it clinically or admit that the problem is present. They may be dealing with ongoing foot issues, including thrush, white-line disease or poor growth, could be contending with laminitis and metabolic issues, or even a failure to recover fully from a tendon condition, but they fail to make a connection with the gut and the microbiome. For other owners, they may be dealing with obnoxious behavior in a horse, ongoing ulcers, or even irritable bowel type conditions, but again fail to see what is truly happening and more so just seeing the current problem as an isolated event.
If you can see the problem for what it is, it then opens the door to make changes. Not necessarily medications or even supplements, but just real changes in the diet, stress, housing, and environment. Making the proper changes in that area can shift the digestive microbiome towards balance in a matter of days. This can be further enhanced through other dietary and herb provisions, such as proper pre-biotic usage or herbs that can impact the microbiome positively. When these change are made, recovery comes quicker and is more complete.
In many competitive horses, due to ongoing stress of competition, training and travel, some contributing factors cannot be addressed completely. While this is not ideal for anyone, in most it can be worked around with a proper regimen and approach. It may not produce ideal results, but in most it will improve the horse and keep problems from flaring while under stress.
So…Is Gut Health Important in the Horse?
Absolutely, on more levels than you can imagine. The reality is that this developing problem is often easily remedied but there are many contributors. However, in many cases, once the condition has been recognized, the patient has progressed a good distance away from a state of health. Thus, recovery is possible, but may require more effort, time, and patience. From my perspective, the approaches taken are often very complex and expensive, when they don’t need to be. All you need to do is step back, see the gut for what it is and realize what ‘irritates’ it and what the gut thrives on for health and balance. Put those together and reduce the contributors to the best of your ability and soon your horse will be on the road to recovery!
Have questions regarding your own horse and recovery? Consultations are available!
Author: Tom Schell, D.V.M, CVCH, CHN