Alasdair Botting

Grass Sickness

Clinical signs are attributable mainly to stasis of the entire alimentary tract, and include depression, inability to swallow, lack of appetite, gastrointestinal distension and impaction, abdominal pain, sweating, elevated heart rate, muscular tremors, weight loss and drooping eyelids. There is no specific treatment for the disease. The majority of affected horses are euthanised on humane grounds, but some horses with mild chronic grass sickness may survive with intensive nursing care.

Acute Grass Sickness

This is the most serious. It is of rapid onset, the horse is severely distressed, has an elevated heart rate, and patchy sweating, may be dull and depressed. Moderate quantities of green fluid may be produced from the nostrils (this should always be considered a serious signs in a horse). There is lack of gut movements, and usually no faeces will be produced. There are often muscle twitches involving the muscle of both fore legs. Horses with acute grass sickness are often confused with colic, but rarely roll or go down. Veterinary attention is required urgently. Often when a stomach tube is passed a vast quantity of grass fluid will flow back. Destruction on humane grounds is the only option.

Subacute Grass Sickness

Affected animals rarely have gastric reflux (green discharge) but will show most of the signs displayed by the acute cases. An inability to swallow is a prominent sign along with drooping of the upper eyelid. Subacute cases are always fatal; the course of the disease is 2 – 7 days.

Chronic grass sickness. These cases are less severely affected than subacute cases and may be able to eat small amounts of food. Some of these horses may survive for considerable periods of time and may respond to treatment.

However many are left permanently damaged, and unfortunately euthanasia is the common outcome. Currently there is no way of treating this disease.

Risk factors include:

  1. Recently introduced to new pasture.
  2. Previous history of grass sickness on pasture.
  3. No hay or conserved feed being fed.
  4. Aged 2 to 7 years.
  5. Highest incidence April – July (but can occur all year

It must be stated however that all horses can be affected by grass sickness. Grass sickness is caused by widespread severe damage to the neurons (nerves) in the autonomic nervous system (this is the part of the nervous system that helps control the intestines).

Patchy sweating is common in all forms of grass sickness.

It is not possible to protect your horse 100% from grass sickness. The following advice may help:

  1. Always feed some conserved forage (hay) even when horses are turned out 24 hours a day.
  2. Don’t put horses in the at risk age group (2-7 years) out onto pasture where there has been previous cases.
  3. Make sure your horse is healthy with regular worming or fecal egg count monitoring.

The cause of grass sickness has remained a mystery for the last ninety years. Research workers have recently made some interesting advances, but there is still much left to find out about
grass sickness. We need to raise awareness and we need more funding for research.

Equine Metabolic Syndrome – Feeding

What should I feed my horse with Equine Metabolic Syndrome

The goals of treatment are:

  • Induce weight loss in obese horses
  • Improve insulin sensitivity through weight loss, diet and exercise
  • Avoid dietary triggers for laminitis

Help your horse lose weight

Main methods of weight loss are:

  1. Calorie control/ reduction
  2. Reduce dietary glucose
  3. Increase exercise if possible

A weight loss of 500-700g a day and a loss of 1-2 Body Condition Score points over 12 weeks can be expected with a reasonable weight loss program.

Firstly, eliminate or greatly reduce pasture access. Turning out horses during early morning, on cloudy days, shady paddocks or using a grazing muzzle can help reduce their carbohydrate intake.  However, access to pasture is risky for metabolic horses so it may be safer to remove all grazing while on a weight loss program.

Without any access to grazing, metabolic horses should be fed no less than 1.2% of their bodyweight of a moderate quality grass hay divided into multiple meals.

Soaking grass hay for 30 minutes in hot water or 60 minutes in cold water can reduce the soluble carbohydrate levels further. However it should be noted that this can also remove other nutrients from the hay which should be replaced with a supplement or small amount of low starch hard feed.

Even without soaking their hay, a mineral supplement or low starch ration balancer may still be of benefit while on a reduced feed ration to ensure all your horses’ nutritional requirements are met. Our Multi Vitamin Supplement was designed with this scenario in mind.

You should monitor their weight loss closely using Body Condition Scoring (BCS) and a weigh tape so you can adjust the diet accordingly. (See BCS post)

For metabolic horses you should aim for a final BCS between 4-5, with the more chronically laminitic horses being maintained closer to 4. Some ponies may never reach a 5 or less making 6 acceptable.

Once this target is reached the forage portion of their diet can increased to 1.5-2 percent of their bodyweight to maintain their weight and prevent any gains or further loses.

Once a metabolic horse has been stabilised they may tolerate some grazing, providing they are monitored closely for signs of EMS.

Gaining Weight

If your metabolic horse needs to gain weight, the extra calories should come from an increase in dietary fibre and fat. This can be done by increasing their hay ration or adding in a low starch hard feed.  The addition of oil (such as canola/corn oil) can be a great way to increase the calories from fat within your horses’ diet, starting with a quarter cup and slowly increasing it to around one cup a day.

If you have any questions regarding your horse and metabolic disease or any other topics please call us today.



Gastric Ulcers

Gastric Ulcers

Equine Gastric Ulcer Syndrome (EGUS) is an incredibly common disease of horses, particularly for those in training.  There are two main classifications, squamous ulcers caused by excess acid exposure and glandular ulcers which are less well understood.

Risk factors for EGUS

  • Transportation
  • Stress
  • Intermittent feeding
  • Racing/ competition
  • Intense training
  • Large amounts of concentrate feed
  • Illness
  • Stable confinement

Symptoms of gastric ulcers

There a large number of possible symptoms of gastric ulcers, these are a few of the more common ones:

  • Poor coat
  • Colic- particularly immediately after eating
  • Poor body condition
  • Poor appetite
  • Poor performance
  • Change in behaviour
  • Girthing pain
  • Chronic diarrhoea


The most accurate and useful method of diagnosis is gastroscopy. Gastroscopy provides a visual assessment of the ulcers, allowing a suitable treatment plan to be designed and for progress to be monitored.

We have a portable gastroscope that we can bring to your horse, saving the stress of transporting them to a clinic.


Omeprazole is currently the only licensed medication for the treatment of ulcers in the UK. Luckily it is usually very effective if a reliable formulation is used.  There are a few other adjunctive treatments available which are discussed in the gastric ulcer blog post on our website.


Recurrence of ulcers is very common, particularly in horses in intensive training or competition. Low doses of omeprazole have shown to help prevent the recurrence of ulcers in these horses.

Proper management can reduce recurrence, constant access to forage, regular turnout, giving a small forage feed 30 minutes prior to exercise and allowing your horse to express normal behaviours have all been shown to help prevent ulcers.

If you have any questions about gastric ulcers or your horses’ health please call us.

Equine Metabolic Syndrome

What is Equine Metabolic Syndrome

Equine metabolic syndrome can be defined as a collection of risk factors that are associated with an increased susceptibility to laminitis. Characteristically these are obesity, patchy accumulation of fat, laminitis and insulin resistance.

Diagnosis of Insulin resistance is difficult because insulin levels are affected by a huge number of factors including diet, exercise, pain, stress, illness or Cushings. The gold standard method is not practical for regular use but there are a number of other methods available.  The most commonly used for practical reasons is a single blood sample taken after an overnight fast to test for high resting insulin (Resting hyperinsulinaemia).

However, a normal or low resting insulin does not necessarily rule out insulin resistance.  If a horse is displaying a number of other signs of EMS a glucose challenge test can be performed. A measured amount of glucose is fed following a 12 hour fast and a blood sample is taken 2 hours later.  Horses with IR are likely to have an excessively high insulin level and/or a delayed return to normal blood glucose levels.

If EMS is identified in your horse it is very manageable with dietry changes with or without the addition of medicines such as levothyroxine sodium or metformin to increase insulin sensitivity.

The goals of treatment and management are:

  • Induce weight loss in obese horses
  • Improve insulin sensitivity through weight loss, diet and exercise
  • Avoid dietary triggers for laminitis

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