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Ep. 057: How to Prevent and Manage Laminitis

Co-hosts Dr. Tania Cubitt and Katy Starr discuss laminitis in horses, including what is laminitis, what is the difference between laminitis and founder, causes of laminitis, how to feed a horse with laminitis and so much more!

Episode Notes

On this episode, co-hosts Dr. Tania Cubitt and Katy Starr discuss laminitis in horses, including what is laminitis, what is the difference between laminitis and founder, causes of laminitis, how to feed a horse with laminitis and so much more!


We’re excited also to welcome two listeners of our Beyond the Barn podcast and members of our Standlee Facebook group community, “The Life We Live, Ride, and Love” to join us for some listener Q & A. A huge shoutout to Donna and Amy for joining us on this episode!


You may think this episode is just for anyone who is currently feeding a laminitic horse or pony, but anyone who owns or cares for a horse will find value in this discussion. We also dive into strategies about horse feeding and management to help prevent laminitis, because an ounce of prevention is certainly worth a pound of cure!


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  • *Views and opinions expressed by guests are their own and do not necessarily reflect the view of Standlee Premium Products, LLC.*

Katy Starr (00:01):

Hi, I'm Katy.


Dr. Tania Cubitt (00:02):

And I'm Dr. Cubitt. We're going Beyond the Barn. Come join us on this journey as we bust equine and livestock nutrition myths and interview some of the most intriguing experts in the country.


Katy Starr (00:15):

We'll go behind the scenes of how premium Western Quality Forage is grown and brought to your favorite farm and ranch retail store. We're so glad you're here.


Katy Starr (00:26):

Mark your calendars. Wednesday, April 19th, 2023, Dr. Cubitt and I will be hosting a horse nutrition Facebook Live Q and A event. We'll be answering your questions about getting your pastures and horses ready for spring grazing. How could I minimize the risk of colic in my horse transitioning from hay to spring grass? What is the best time to let my metabolic horse graze? And so many more questions. And we will have some Standlee free product coupons to giveaway. So don't miss this event. See our show notes for more details. 


Welcome back to another episode of Beyond the Barn, Dr. Cubitt, it's great to have you with us today.


Dr. Tania Cubitt (01:13):

I am excited to be back.


Katy Starr (01:14):

Today we're going to be talking about Laminitis, which I think is a really good one to discuss this time of year just because it has some more relevance I guess with pasture and grazing and things like that. But before we get started, any of the topics that we cover on the Beyond the Barn Podcast are more generalized and not specific to any individual horse or any specific situation. So be sure to always work with your veterinarian and your nutritionist before making any drastic changes to your horse’s feed program. Or you can reach out to us and talk directly with Dr. Cubitt or Dr. Duren on any specifics that you'd like to know. And Dr. Cubitt, another cool thing that we're trying today is we are actually going to be having a couple of our Beyond the Barn podcast listeners join us as guests for some q and a on today's episode.


Dr. Tania Cubitt (02:10):

I'm excited about that. I think it's great to have some of our listeners with us.


Katy Starr (02:14):

Yes. So as we get started on this topic, can you actually break down what is Laminitis in horses?


Dr. Tania Cubitt (02:22):

The definition or kind of the very broad term, it's just inflammation. So any -itis, whether it be tonsillitis or tendonitis, -itis is inflammation. And the tissue that is inflamed is the laminae, which are these finger-like structures that hold the hoof wall to the underlying structure, the coffin bone. And so it's inflammation of that laminae, that tissue between the hoof and the coffin bone. That is in its most simplistic form what Laminitis is.


Katy Starr (02:54):

Okay. And this I've heard a little bit, but what is the difference between, I'm hearing the terms Laminitis and founder. What are the differences between those?


Dr. Tania Cubitt (03:04):

I am actually going through this at the moment because I'm helping to write a book chapter and in our book chapter we have pasture associated disorders and laminitis is obviously one of those. And there's this kind of ongoing conversation between the authors of this exact question, what is Laminitis versus founder? And you can read some texts and they will say interchangeably, they're exactly the same thing. founder is kind of an old lay term and laminitis is the more correct term. And then others will say that laminitis is simply just the inflammation of that tissue. But when that tissue breaks down and we actually have a separation of the hoof wall from that coffin bone, that that is what we call Founder, the progression of Laminitis to the kind of next stage of the disease. So it's really hard. There's not really a right or wrong answer cause it depends on what you're reading or who you're talking to. Sometimes it's literally an interchangeable term and sometimes it means the kind of progression of laminitis.


Katy Starr (04:08):

Okay, that makes sense. I mean, and when I was, you know, doing my research for this episode, what you just said is exactly what I discovered. And so I find that to be pretty interesting. I guess when we talk about it or veterinarians talk about it with their clients or anything like that, we just need to be a little bit more descriptive in how we, how we talk about it.


Dr. Tania Cubitt (04:28):

Yeah. And I think for most people that have gone through a case of laminitis with their horse, it doesn't really matter what we're calling it. We understand, kind of, veterinarians are very good about telling us at what point of the disease we're at and they'll do an x-ray and they'll talk about degrees of rotation. And so when they're talking about that degree of rotation, their amount of separation from the hoof wall, that pedal bone is kind of rotating or coffin bone is rotating downward. So a lot of people that are in the midst of this aren't really even concerned about laminitis versus founder. It's like, well how bad is this that I'm dealing with?


Katy Starr (05:11):

Right. Well and speaking of that, so the progression of this disease is that when veterinarians are working with their clients who have like a laminitic horse or pony, is that how they kind of base the stages of laminitis? Is that rotation how far that rotation occurs? 


Dr. Tania Cubitt (05:29):

Correct. Again, I'm not a veterinarian so I can't speak to veterinarians, but yes, stuff gets real when we start talking about degree of rotation. Because there is a certain point where there is a point of no return. It's very difficult to kind of come back.


Katy Starr (05:43):

Yeah. Okay. That makes a lot of sense. So what is laminitis actually caused by? What are some of the things that can cause it?


Dr. Tania Cubitt (05:50):

I see that question on our list here and I'm thinking, oh my gosh, there's a whole episode just in all of the causes of laminitis. So if we think about those laminae that I was talking about, these little finger-like structures that kind of interlock on either side and hold the hoof wall and the coffin bone in place, those laminae are full of microscopic blood vessels. So anything that affects the blood will in turn affect those tiny little blood vessels. So it could be the horse ate too much grain, the horse ate too much spring grass, potentially the horse had a retained placenta, say a mare had a retained placenta and it got toxic. Well, all that toxicity is gonna go through the bloodstream. Horse ate a weed, that toxicity goes through the bloodstream. Anything that travels through the bloodstream really can cause this inflammation in the hooves.


Dr. Tania Cubitt (06:48):

And then we've also got mechanical. So they would be more nutritional or internal causes. And then we have, in my mind, I think about it more as a mechanical laminitis. So years ago there was a horse, a Kentucky Derby winner Barbaro who broke one leg and then was putting all of his weight on the other leg. And so that leg that was carrying all the weight for all that time while he was trying to recover the broken leg, it developed laminitis. A lot of horses that are carriage horses or buggy horses that are pounding down the road, we even call it road founder because it's just that constant concussion in their feet causing inflammation.


Katy Starr (07:30):

That is so interesting. So really like laminitis can be one of those things where, yes, sometimes with poor management it can occur, but sometimes you could get kind of like the short straw and just have an unlucky situation that comes up that maybe is a little bit more out of your control. And then how common is laminitis in our horses?


Dr. Tania Cubitt (07:54):

Well, if you're a veterinarian working in a practice that has a lot of ponies in your demographic, you might say it's very prevalent. And then if you're working in an area where there's not a lot of, you know, horses and not a lot of spring grass and you might not say it's that prevalent at all. A little research paper that I looked at, it's literally called the Frequency of Equine Laminitis, a systemic review with quality appraisal of published evidence. And this was from back in 2011, said that equine laminitis ranges the frequency of equine laminitis ranges from one and a half to 34% of cases.


Katy Starr (08:36):

Okay. And then are there certain breeds or ages or, I mean you kind of mentioned lifestyle in the sense of horses that are constantly pounding their feet but that are more prone to actually getting laminitis.


Dr. Tania Cubitt (08:52):

Certainly the breeds that are easier keepers, we call those, those the thrifty genotype, they tend to develop a cresty neck very easily, carry extra body weight easily. Those horses, ponies, saddlebreds, you know mustangs, they're all much more at risk of developing laminitis.


Katy Starr (09:10):

Could you also then see this happening with like donkeys or mules?


Dr. Tania Cubitt (09:15):

Absolutely. Donkeys and mules are very easy keepers and they are at much higher risk of developing laminitis than some other horses.


Katy Starr (09:23):

Okay. What are some of maybe some of the first initial signs or symptoms that we might see with laminitis? And then as it progresses, if there are additional symptoms that come up, can we see with that?


Dr. Tania Cubitt (09:36):

Well certainly it becomes painful. I mean when you have inflammation it is painful. So one of the things that I always encourage people to do, you know when we've talked about other vital signs in horses, whether it be respiration rate or heart rate, that you want to know what your horse's normal resting heart rate is, and then also what is their normal exercising heart rate when you've just done some pretty basic exercise or what is their normal temperature. It's what we call the digital pulse. So there's an artery that runs down the horse's lower limb and you want to take a pulse there. And if it's what we call a bounding or strong digital pulse, like it's really sometimes when you have a migraine or a bad headache and you feel your temples and you can just feel your head pounding. If you feel that bounding strong pulse under your fingers, that's a symptom.


Dr. Tania Cubitt (10:32):

Heat, inflammation causes heat. So heat in the hooves can be a symptom when they have that classic rock back and they're leaning back and trying to take weight off their front feet. I'm sure we've all kind of can imagine in our minds that horse, we've all seen pictures of a horse like that. Horses that have had laminitis in the past may have a distorted hoof shape or unusual, we actually call them founder rings when there's a bump in that starts up at the coronet band and grows down the horse's foot. Now that can typically be from Laminitis, but it can also be from any other insult or stress that's gone on. You know, maybe your horse had a bad bout of colic or a sickness, they'll get one of those rings that's kind of like your fingernails. If you go through some kind of insult or stress, high stress or sickness, you'll get a ridge in your fingernails.


Dr. Tania Cubitt (11:23):

Increased heart rate is another one. And then that stretching worst case, sometimes you'll see a kind of blood coming out, bleeding in the laminae. And if the rotation is bad enough, then that coffin bone is going to protrude out the bottom of the horse's hoof. Most people will know that something's going on way before they ever see that, but that's kind of the worst case. Maybe you're riding your horse and they just start to have a shorter choppier stride in the front and you just don't know why. Maybe get your farrier to kind of evaluate the hooves. And then veterinarians will also do glucose and insulin challenges and increase insulin levels because insulin resistance usually couples laminitis in kind of ingested or nutritionally-related or hormone-related laminitis. And so that's when we can't clear the insulin. The insulin can't do its job so it won't clear out of the blood. So we might have high glucose or high insulin in the blood. The other thing would be always be cautious if your horse goes through some kind of infection or diarrhea, other inflammatory disorder, you always, always be looking for it to come out in the feet.


Katy Starr (12:37):

Oh, interesting. Okay. 


Dr. Tania Cubitt (12:40):

Obesity, I would say is not a symptom, but it's usually a precursor as well.


Katy Starr (12:43):

Okay, that's good to know. Then you know, we start talking about feeding some of these horses. What would you say is the best type of hay to feed a horse that has laminitis?


Dr. Tania Cubitt (12:54):

You know, if it's a mechanical laminitis, like literally I've smashed one foot and I'm taking all the weight on the other, or I'm pounding down the road and I've just got this mechanical inflammation, anything that's going to decrease inflammation, cold hosing, that's not necessarily what to feed a horse. But when it's more of a, a nutritional laminitis, horse is overweight or has eaten too much spring grass or this is a hormonal issue, then the types of hay, it's not necessarily the type of hay, it's the carbohydrate content or the sugar and starch content of that hay. We want it to be 10% or less.


Katy Starr (13:34):

And then are there any, well, okay, I guess that kind of addresses that a little bit. I was going to say are if there are any hay types that we should avoid.


Dr. Tania Cubitt (13:43):

Yeah, and again, I would say typically your warm season grasses like bermuda or teff are going to sit in that low non-structural carbohydrate range and things like your orchard grass or timothy are and fescue are going to be your cool seasoned grasses and they're always going to sit a little higher. But with that being said, make sure you're always testing your hay before you feed it because you might have an anomaly. And then when it comes to feeds, anything that is high in sugars, your cereal grains, we know are going to be high in starch. Molasses is high in sugar. So anything that contains either one of those, your wheat bran high in sugar and starch, and really it's just that the total diet hay and concentrate combined is 10% or less.


Katy Starr (14:36):

Right, and we've talked about this before, sometimes people are always thinking so singularly about each specific ingredient in the diet. When really they need to be looking at the whole diet. But you know, if you're looking at how much of a horse's diet is generally made up of hay, that does take a good chunk of it.


Dr. Tania Cubitt (14:56):

Yes. So small deviations in hay make big differences in the diet. But if you're feeding a supplement for example, and it has a small amount of sugar in it, if the supplement is being fed at one to two ounces a day, it's really not going to matter if it's got 25% sugar in it because 25% of one ounce is negligible.


Katy Starr (15:17):

Okay. And that was my other one was wondering about some of these other feed types that you know, outside of hay, how that impacts the horse and what we should be looking for. So that was good. Can we allow laminitic horses or ponies to graze?


Dr. Tania Cubitt (15:35):

My immediate gut reaction and general blanket statement because we're not working one-on-one with our listeners. Would be no, they cannot graze. Especially in the spring and the fall. Now does that mean that those horses will never be able to graze? Sometimes that's exactly what it does mean, but sometimes we can get it under control and at certain times of the year with a muzzle we can allow these horses to graze. But really once your horse has developed laminitis and has had it, it really shifts their hormonal normal. So unfortunately, a lot of horses that develop laminitis due to a nutritional or hormone or obesity kind of related incident, they can't ever graze again. Graze pasture.


Katy Starr (16:23):

Yea and I know we've mentioned this occasionally on previous episodes, but can you briefly explain why spring and fall we need to avoid that in particular?


Dr. Tania Cubitt (16:33):

It's those cool season grasses that a lot of us have in our fields. They grow in the cooler weather. So we get out of the winter when nothing's growing cause it's too cold and we have a little bit more moisture in the soil and in the spring and fall those grasses have rapid growth. We see that lush spring grass come on and it is full of sugar.


Katy Starr (16:53):

Right. And it can even change somewhat significantly throughout the day as well. Right?


Dr. Tania Cubitt (17:00):

Yes. That was some research that we did. We replicated some research that was done in Wales but looking at daily variation in sugars and starches in the grasses and early, early in the morning, say 5:00 to 10:00 AM the sugars are the lowest. That's if we haven't had a frost the night before. And then by 4:30, 5:30 in the afternoon we have the peak sugar accumulation because the sun has shone on that grass all day long and caused photosynthesis, which is the accumulation of energy in these grasses. 


Katy Starr (17:37):

Right. And some of these other questions that I have come up I've heard other horse owners talking about and one of them is, should you walk a horse with laminitis?


Dr. Tania Cubitt (17:46):

Absolutely not. No. It's severe pain, severe inflammation. If you want to do something outside of nutritional management, it's cold hosing to get the inflammation to go away. There are ice boots that they can wear, bedding the stall, nice and soft so we take away some of that pain. But no, you should not be walking a horse with laminitis.


Katy Starr (18:10):

And I'm assuming that also goes to say that a horse with laminitis should also not have shoes on?


Dr. Tania Cubitt (18:16):

Well no, it doesn't mean that they shouldn't have shoes because a lot of times we have to use corrective farriering to change the weight distribution on the feet, maybe take some weight off the heel or the toe. Again, I'm not a farrier either. But yes, they do often wear shoes, especially if we've had a complete breakdown of that hoof wall. So they will wear shoes, but you certainly shouldn't be riding them. I mean it's like


Katy Starr (18:42):

That extra weight. Mm-hmm


Dr. Tania Cubitt (18:42):

If we have a severe injury, should we be resting it and recovering or should we be fighting through that, we should be resting and recovering. 


Katy Starr (18:51):

Right. And once a horse is actually diagnosed with laminitis, and I don't know if this depends on the stage that it's diagnosed at, but can it fully heal at any point or is it something that they're going to have to live with the rest of their life?


Dr. Tania Cubitt (19:04):

You answered that in the beginning. It just depends on how severe the laminitis, how severe the rotation and a horse is not going to live within a state of laminitis of inflammation for the rest of its life. If we can intervene, we can decrease the inflammation. There's certain drugs that people will use to take that inflammation and that swelling and pain away. It means the horses always at higher risk of being triggered into a laminitic episode. But some horses heal fully and they do just fine. I mean, one of my very good friends did all of this research in grad school, has a hunter horse who developed laminitis and had a couple of years off rehabilitating him and he just won a class, a hunt class in Wellington. So you know, horses can heal, they can be managed and they can go back to a very productive life.


Katy Starr (20:01):

Right. And it probably just really has to do with how aware you are with your horse and their well-being and and everything. So, and you've mentioned this before, we've talked about this, obviously you're not a veterinarian, but what are some of the best treatments for a horse that would have laminitis?


Dr. Tania Cubitt (20:20):

It's having a great vet on your team that's going to help you with the treatment protocols, but I know that basic things are cold hosing, ice boots just to get the swelling to go down. And then obviously we can talk more about the nutritional management of that horse.


Katy Starr (20:37):

Right. So then what do you see when it comes to feeding and management? What tips do you have to help, first of all, prevent laminitis in the first place, but then if, if there are any differences for a horse that actually currently has laminitis.


Dr. Tania Cubitt (20:51):

And when we talk about laminitis and preventing laminitis, we are really talking about the prevention of nutritionally-related laminitis, obesity-related laminitis, not the mare got a retained placenta and she got toxic or ate a weed and got toxic. That's sometimes just bad luck. But as far as that nutritionally related, don't let your horse get fat. Obesity is, you know, starts the ripple effect of all the other cascade of events that occur in the horse that then leads to laminitis. So don't let your horse be overweight, develop insulin resistance. And especially those horses that have a tendency to carry more of a crest. The crest, which is that fat kind of on the top of the horse's neck is more of an indicator of these metabolic issues, that laminitis falls into, than overall body fatness. The original work that was done developing the cresty neck scoring system was again another graduate student and I helped her do the work.


Dr. Tania Cubitt (21:52):

And there are two groups of ponies on a farm that all were heavy, you know, really round type ponies. Some had a crest, some were genetically predisposed to have that cresty neck and others weren't. The other kind of line or phenotype when you're looking at them did not. And the ones that had the cresty neck, much, much higher incidence of laminitis compared to the horses that didn't carry a crest. So crest is really an indicator of their risk factor for metabolic disorders, including laminitis. But yeah, they're kind of my risk factors on how to prevent it. Feeding management, if you know that you have a easy keeper and we are trying not to let them get too fat, exercise is excellent. Unless your horse is doing exercises at speed, they don't really need high carbohydrate diet. So low carb diet. A lot of horses, I just say, okay, it's a pony, it's got a little bit of a cresty neck. Even if we don't have a problem, I will always be a little wary of allowing them to eat spring or fall grass when it's really peaking and growing. So you know, just really being proactive about avoiding certain things.


Katy Starr (23:10):

Excellent. And now I would like to move into the second segment of this episode. Dr. Cubitt and I have decided to have a couple of our podcast listeners jump on and join us for some Q and A. And Donna is joining us today, she's actually also a part of our Standlee Facebook group, The Life We Live, Ride, and Love. Donna, thanks for joining us and being here today.


Donna (23:37):

Thank you for inviting me. It's great to be here.


Katy Starr (23:38):

So as we kind of get started, we'd love for you to just introduce yourself and tell us what state you're from.


Donna (23:46):

This is Donna. I live in Minnesota, where even in the middle of March we get snow and cold weather. It's great part of the year, part of the year it's not. I have two horses. My issue has been with my 20 year old Arab Saddlebred mare, great horse, but she's had some health issues. And then I have a young one who is an Arab Quarter Morgan. Big challenge. And horses are a big part of my life and I just want to do my best to keep them healthy and happy. And as everyone knows, that can be a challenge.


Katy Starr (24:18):

Yes. Well just by being here, we sure appreciate you Donna, and being involved, engaged. Obviously it shows just how much you care about your horses. And so I will let you go ahead and get into your questions for Dr. Cubitt.


Donna (24:33):

Thank you Katy. So it's the 20 year old mare who has had laminitis and when she got, it was a couple years ago, she's still actually recovering, but she had a lot of stress at the time. So as well as physical issues, she had a lot of stress, a lot of emotional issues. And I'm just wondering, is there some way to assist a horse, deal with all that stress that they're having when you know they can't get up and run and play. And she was laying down for most of three months, so she was pretty sad and I just felt terrible that I couldn't do more for her. So is there anything we can do to help the emotional side of this horse so they're not so depressed?


Dr. Tania Cubitt (25:16):

Donna, this is an excellent question and I'm glad that you've brought it up because a lot of times really in ourselves and in our animals, we look for outward symptoms that we could, physical things that we can see. So she had laminitis, we could see that she had something wrong with her feet and the veterinarian will treat that. Ahorse has colic, you know, the symptoms take her to the hospital and you can get that fixed. But it's this emotional or mental stress that you can't necessarily see it. You can see that she was depressed, maybe she was missing a buddy or just missing the life that she had before. That is a real symptom and it's why it's so important that you have a good grounding on what is normal for your horse. So we always talk about knowing what your horse's resting heart rate is, their respiration rate, but just what is a normal demeanor for your horse?


Dr. Tania Cubitt (26:10):

Are they, you know, I have a dog, he always looks depressed, but he's not. That's just his normal thing. But if you have a horse or an animal that's usually pretty hyper and then all of a sudden they're not, something is going on. And we certainly are seeing more and more research now looking at stress and looking at these mental health issues. I know that this is kind of separate, but I think it, it kind of hones in on this point a little bit. Feeding times, for example, horses are very routine animals and they, they like to be fed at the exact same time every day. And there was some research that looked at if seven o'clock is the time that you feed the horses every day and you come at eight, it significantly increased their stress. They were pawing, they were knocking on the stall.


Dr. Tania Cubitt (26:57):

You know, people would laugh and say, oh they're, they're ready for their food. But when you can actually measure cortisol, which is a measure of stress, a hormone that they secrete when they're stressed, the cortisol went way high. So I would go out on a limb and say that your horse, while she was depressed from being stuck in a stall, and I think you had sent in that her pasture mate had died. So there was a lot of things that changed in her life. I guarantee her cortisol level had gone up and that then actually has cortisol when it goes up, it has actual physical things that it does to the body. Things like increased permeability in the gut. So in the hind gut there are cells that line the intestine and when we increase stress, whether it be mental stress or physical stress from putting them in a trailer or exercising them, then it breaks down the kind of bonds between these cells and we can develop what we call leaky gut.


Dr. Tania Cubitt (27:59):

So if your horse potentially developed maybe some loose manure or diarrhea, then I would say that was a hundred percent attributed to her depression. Her mental health also suffered because of the physical things that she was going through. So you know, you seem a little tentative to say I know she had some mental health issues, but it's really not something we talk about in our animals, but we should talk about it more just like we should be talking about it more inourselves. You certainly saw real symptoms and if we were to go back in time, I would say a gut health supplement would be 100% what I would feed at that time. Because you're also potentially, so a lot of horses that develop laminitis are a little bit overweight. Sometimes they're a lot overweight. And so we're trying to combat that as well. So maybe we're restricting diet that also plays into decreased gut health. So based on what you were noticing, I would've definitely recommended a gut health supplement because stress we know decreases gut health. 


Katy Starr (29:05):

Did that answer your question? Okay, Donna, does that make sense?


Donna (29:07):

Yes, it did. And it kind of leads into the next question if you're ready. I'll go ahead with that. 


Katy Starr (29:14):

Go for it. Yeah. 


Donna (29:16)

Okay. So when the vet was out, he pretty much just said watch her diet and avoid all sugars. Fine, I get that. But he didn't say anything for the pain, well he said bute for the pain and she hates bute. So that was not a good way to go. So I'm just wondering, you know, there's hundreds of different supplements out there and are there other things we should be giving these horses so they can feel better and recover faster?


Dr. Tania Cubitt (29:45):

Oh my gosh. So yes, there are so many supplements out there, but when it comes to, you know, first thing your veterinarian was right recommending the bute. If your horse doesn't like bute, then there are other non-steroidal anti-inflammatories or anti-inflammatory drugs that are going to decrease the inflammation that is caused by the laminitis and relieve some of the pain, because we all know pain is really the thing that's driving this discomfort and the stress when we've got laminitis. So he's trying to decrease the pain, which then would decrease the stress on the horse. So some kind of anti-inflammatory is good. When it comes to, is there a supplement that's going to reverse laminitis? No, there's no supplement. It's time and patience and management. It's the low sugar starch diet. Now if the horse was overweight and then so we had obesity and potentially who had insulin resistance cascading or triggering the laminitic event in the first place.


Dr. Tania Cubitt (30:47):

Then there are certain ingredients that I look for in supplements. One of them is a new type of chromium. It's chromium propionate. It is the only FDA approved form of chromium, it's called chem trace chromium. And it actually can up-regulate those insulin receptors and allow them to clear that insulin glucose out of the blood. So that can certainly help. But when their pain is gone and the veterinarian hasgiven the all clear to start moving the horse, then we need to start doing a little bit of exercise. Maybe, you know, if the world was perfect and we all had a million bucks, then we would might do water therapy so that a horse doesn't have a lot of stress on the feet but they're still able to get that exercise. You know, whether it's just hand walking, not even hand grazing cause the grass is probably really high in sugar.


Dr. Tania Cubitt (31:40):

But just doing a little walking with the owner and getting them out of the box stall. Just taking away some of those things that were stressing them and giving them back a little bit more quality of life. Now when I say giving them back a little bit of quality of life, again it comes back to the individual horse and what were they used to before? Some horses, we have some racehorses, and they get depressed because they're not exercising and they're not galloping. Other horses like yours, maybe it was just, I was a pasture pet and I was allowed to graze and kind of do my own thing and now I'm stuck in a stall, and I hate this so it might be just walking with my owner. So it's like I feel like the owner knows best what is going to bring their horse quality of life. And if we can bring a few of those things safely back into their life, and I'm starting to sound like Dr. Phil, but I would try and do those things. I think, you know what I mean.


Donna (32:35):

And we started very slowly with a little more exercise and walking down the road and just getting her out. She wasn't ever in a stall. Yeah, she has a lean-to she goes into, but she was still outside. She could look around, she could see people and I think that helped. But since her pasture mate had died, she was alone. And I was like, well I'm not going to bring home a new horse until I think you're ready.


Dr. Tania Cubitt (33:01):



Donna (33:02):

I spent a lot of time with her.


Dr. Tania Cubitt (33:04):

Mm-hmm . I worked with some show jumpers once and they traveled all around the world. I was in grad school and it was my way to pay for my extracurricular activities. And I looked after all these horses, and I kid you not, these show jumpers had a goat as a pet and another one had a miniature donkey and they , they were their emotional support animals.


Katy Starr (33:29):

Yeah. Animals need emotional support animals.


Dr. Tania Cubitt (33:32):

But you were doing the right thing, Donna. You're, you know, trying to get back some of that quality of life. The other thing is sometimes when horses have been on a really restrictive diet and they feel like they're not getting fed at all, using things like teff or really low carbohydrate hays or hay pellets or chaff or cubes, is a really nice way to allow them to eat more. Feel like I'm a normal horse again without getting all of the things that they don't need. That can help with mental health as well.


Katy Starr (34:02):

Excellent. Well I hope Dr. Cubitt was able to help you with your questions, Donna.


Donna (34:08):

Yeah. She was like, say the big thing was she was so sad. It's like, I'm sorry, I would sit with her for hours and hours if you could and it's Minnesota and it was cold. You know.


Dr. Tania Cubitt (34:20):



Katy Starr (34:21):

Makes a lot of sense.


Dr. Tania Cubitt (34:22):

We always want to do more. I think you were doing all the right things and its patience and it's just kind of riding through the lows with her.


Katy Starr (34:30):

Well Donna, thank you so much for joining us on the Beyond the Barn podcast today. Dr. Cubitt and I, were so glad to have you on here with us.


Dr. Tania Cubitt (34:38):

I know. And Donna's a pro. We can have back. I know.


Donna (34:41):

I would love to be back. Thank you. I hope you both have a great afternoon.


Katy Starr (34:45):

Thank you.


Dr. Tania Cubitt (34:46):

You too.


Katy Starr (34:47):

And our next podcast listener guest that we have joining us today is Amy. Amy, thanks for being on the Beyond the Barn podcast with Dr. Cubitt and I today.


Amy (34:56):

Thank you for having me.


Katy Starr (34:58):

So Amy, just to kind of start us off here, can you introduce yourself a little bit and why don't you tell us what state you're from?


Amy (35:06):

So I'm from Idaho, originally, actually from Massachusetts. I've been out here for almost two years.


Katy Starr (35:14):

Excellent. So you're right in our Standlee neck of the woods.


Amy (35:17):

Exactly. I drive by all kinds of alfalfa fields to my travels.


Katy Starr (35:22):

So Amy gets to see the legit stuff before it gets to the farm and ranch retail stores .


Amy (35:28):

Yeah, it was pretty eye-opening actually to, you know, to see all of the acreage that Standlee has under cultivation.


Katy Starr (35:36):



Dr. Tania Cubitt (35:37):

Well certainly not be something you see often in Massachusetts.


Amy (35:40):

That is a fact.


Dr. Tania Cubitt (35:41):


Katy Starr (35:42):

A world difference. Huh. That's awesome. Well Amy, I know one of your, kind of your initial questions, we kind of got started, we had talked about earlier in the episode, but I'm going to go ahead and let you just get into your questions to ask Dr. Cubitt and we're just going to roll with it.


Amy (35:57):

Okay. So I have a lot of questions, but I'll start with the basic one and that is, what specific forge types would you recommend, Dr. Cubitt, for horses that are prone to laminitis?


Dr. Tania Cubitt (36:11):

This is a great question Amy, and it's really for me more about testing the forage that you have available to you. And I mean doing a chemical analysis at a lab so that we know what sugars and starches we are dealing with in that forage. Blanket answer to that question if we weren't testing is I'm going to lean more on your warm season grasses like teff or bermuda grass, they're typically going to have lower sugars and starches than your cool season grasses like orchard or timothy. Alfalfa also as a legume is self-limiting and doesn't store a lot of sugar and starch. So if you have a thinner horse that is prone to laminitis, then we oh, could use alfalfa as well. But it's really more about the actual sugar and starch content. I've seen in your old stomping grounds, new England, a lot of local grass hays that are very low in sugars and starches but grow that same type of grass species in Idaho under much more optimal conditions and we may see much higher sugar and starch content. So general recommendation, warm season grasses like teff or bermuda, but really get your hay tested.


Amy (37:31):

Excellent. So I am personally all about testing and I've been testing probably for about the last five years now. Five years ago I started to get into this because my horses didn't have laminitis, thank God. But I started looking at too much sugar exactly as you said.


Dr. Tania Cubitt (37:53):

Yeah. And being more proactive so that they didn't develop laminitis.


Amy (37:57):

Being proactive would be a better plan. So based on that, how do you feel about just, you know, starting as a base about testing horses for insulin resistance so that way you have a baseline on that particular horse as far as their proclivity to being susceptible to laminitis?


Dr. Tania Cubitt (38:20):

Absolutely. If the world was perfect and we all had all the money in the world, then I would say yes, everybody should have baseline bloods done on their horse. Everybody should know what baseline respiration rate, heart rate, temperature, hoof temperature, digital pulse, like the pulse in the leg. We should know what their normal reference ranges are. Cause I always, I sometimes I say do it in the summer, in the winter or do it pre and post exercise so you know what is normal for your horse. And just like in people when you go for your annual physical and your doctor might ask for a blood test and just look at what your normal ranges are, then yeah, it'd be lovely if everybody could have that on their horse so we know what is normal. So that then when your horse might start to show symptoms you can then take another blood test and say, oh wow, they're, you know, these numbers are slightly higher. And the reason why I say that getting a baseline is a good idea. Some horses normally are lower or higher in glucose and insulin or other blood parameters that we're going to measure, but that's normal for them. So if they normally are a little higher and then you did a blood test because we've got a couple of other symptoms and it was just sitting exactly where it was, then somebody might, it might give you a false positive if you know what I'm saying. So no, having a good baseline is an excellent idea.


Amy (39:51):

I do. Yeah, I agree with you. Because every horse, just like every person is an individual and numbers aren't going to be, you know, exactly the same across the board. Okay.


Dr. Tania Cubitt (40:00):



Amy (40:01):

So what other influences on the horse's diet and lifestyle would you evaluate when coming up for a treatment plan for a horse that did have a bout of laminitis.


Dr. Tania Cubitt (40:13):

And you know, as a nutritionist I want to say, oh, nutrition is going to, you know, we fix the nutrition and everything is golden. But really it's the whole management of the horse and it's decreasing stress overall, increasing exercise. As far as nutritionally, I'm looking for a low carbohydrate diet that is less than 10% non-structural carbohydrates combined. And that's taking into account your hay, any concentrate you're feeding, all combined would be less than 10%. But then it's also, you know, we do that but we also want to make sure the horse is getting exercise. If there's the ability to do exercise, we're getting exercise. Even something like forced exercise. If they're going out into a field that we put the water in one corner, the gate in another corner, the hay goes in another corner and the salt is in another corner. So they're forcing themselves to continually exercise cause there's nothing better for insulin sensitization than or stimulation than exercise.


Dr. Tania Cubitt (41:12):

Exercise is excellent. So it's really a holistic approach looking at all parts of the horse's life, decreasing stress cause stress increases cortisol, increasing cortisol triggers a whole cascade of other negative effects in the horse. Our previous caller, we were talking about the emotional stress that her horse went through when her horse had laminitis and it had to be stalled and then a pasture mate died. And you know, she certainly could tell that her horse was depressed. It's not something we think about. And I said if I did a blood test on the horse, I guarantee cortisol would've been high. And that actually is negatively impacting other parts of the horse's life. So take looking at everything in the horse's management.


Katy Starr (41:54):

Well thank you Amy. We really appreciate you being on here today and offering up some questions about laminitis and everything. And I hope you found this to be valuable.


Amy (42:05):

I did, and well the value to me is educating as many people as possible so that we can improve the lives of our equine partners going forward.


Katy Starr (42:17):

Most definitely.


Dr. Tania Cubitt (42:18):

Yes. And I think we're all in the same boat with that one and I just appreciate you getting on because as our earlier guest said, you know, I think our listeners really like to hear from, you know, real world scenarios. It just connects us a little bit closer to the end user when we can have you on. So thank you so much for getting on.


Amy (42:40):

Well thank you again for having me. And you know, as I said, it's very refreshing. I think you have a really phenomenally good grasp of this subject and can help a lot of horses.


Dr. Tania Cubitt (42:52):

Appreciate it.


Katy Starr (42:51):

Awesome. Thanks Amy!


Amy (42:53):

Thank you.


Katy Starr (42:55):

Dr. Cubitt, I think today's episode has been really great. It was awesome to have some of our actual listeners on the episode today, but what are some of your key takeaways that you would like to leave our listeners with on the topic of laminitis.


Dr. Tania Cubitt (43:10):

Prevention is so much better than any cure that we could find. So when it comes to laminitis, we did mention that it comes from so many different causes, but if you think about the most common causes being, metabolic syndrome and obesity, these new kind of nutrition-related laminitis, then let's be proactive, not allow our horses to get too overweight. Really watch for that cresty neck exercise is key. Keeping these horses exercised, making sure in the spring we are limiting access to green pasture. And in the fall, utilizing a low carbohydrate diet, utilizing low carbohydrate hays that are available like a teff or warm season grass like bermuda. These are all keys, but I think just kind of getting ahead of it because anybody that's had a horse with laminitis will tell you it's devastating. It can be very financially unpredictable, it can cost a lot of money.


Dr. Tania Cubitt (44:16):

So we really want to avoid it as best we can. Once you're in it though, you know, putting a team in place that you trust a nutritionist, a veterinarian, a farrier, and we are here to be on that team with you and advise you as to the nutrition for your horse. But again, it's low-carb feeds, but if your horse was overweight and we're trying to decrease body weight, we've also got to be careful that we don't just trade one problem for another. We're not decreasing calories and intake to decrease body weight, but then creating gastric ulcers or stereotypic behaviors. So that's why having someone on your team is really valuable.


Katy Starr (44:52):

And as we start to wrap this episode up, I actually have another review that I would like to share with you, Dr. Cubitt.


Dr. Tania Cubitt (44:59):

I love these reviews. Makes me feel good about myself. Hit me with it.


Katy Starr (45:03):

When people leave these reviews, they have their little kind of username that they can tag with it. So I don't know if I'm saying this correctly, but I'm looking at it and I see vancemc . So anyway, they say “Great information!!! Great in-depth information on each subject. They discuss very well organized and easy to listen to. Even for a newbie like me, quote unquote, don't forget to turn off the water. Makes me chuckle every time. Classic.” If you haven't forgotten to turn off the water before, are you even a horse owner . So anyway, it was such a great review. We appreciate you listening. We appreciate you sharing your reviews. Please send more our way. Let other potential listeners know what this show is about, what you like about it, and please share with us your topic ideas as well at So again, Dr. Cubitt, thank you so much for your time today and we'll catch you next time.


Dr. Tania Cubitt (46:08):

Thank you, Katy.


Katy Starr (46:10):

Thanks for listening to the Beyond the Barn podcast by Standlee Forage. We'd love for you to share our podcast with your favorite people and subscribe on Apple, Spotify, or your favorite listening platform. Until next time, keep your cinch tight and don't forget to turn off the water.


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