Insulin resistance and laminitis

What is insulin resistance?

Insulin resistance is a metabolic disorder. The hormone insulin, produced by the pancreas, is important for sugar metabolism and ensures constant glucose levels in the blood and proper distribution of nutrients in the body. When a healthy horse eats, nutrients are delivered through the intestinal wall into the bloodstream. Insulin levels in the blood then rise. Insulin causes sugar to be absorbed from the blood by muscle and fat cells. In addition, insulin inhibits sugar production by the liver. Through these processes, insulin lowers the blood sugar concentration after ingestion of food. In horses with insulin resistance, fat and muscle cells respond to insulin only when the concentration in the blood is unnaturally high. The insulin receptors of the cells have become less sensitive, requiring much glucose to be processed differently. The excess glucose in the blood is converted by the liver into fats that are distributed to the fatty tissue in the body.

Horses with insulin resistance often have fat deposits around the mane crest and tail end, are often overweight and have skin problems. Due to a reduced ability to release glucose from cells, these horses often suffer from lethargy and muscle fatigue. Horses with insulin resistance have a very increased risk of laminitis.

Osteoarthritis

In laminitis, the white line between the hoof wall and the hoof bone is inflamed. The white line is the tissue that connects the hoof bone and the hoof wall. The white line consists of lamellae and these contain very many blood vessels and nerves. In laminitis, the blood vessels near the lamellae become affected, disrupting the blood supply to the lamellae. This reduces the supply of oxygen and nutrients to "the white line," resulting in an inflammatory reaction in the lamellae. This is also known as laminitis. Because of the inflammation, substances are produced that damage the lamellae and can even break them off. As a result, the hoof wall becomes detached from the hoof bone, causing the hoof bone to fall down and press on the sole of the hoof. This is also known as horseshoe tilt. In severe cases, the hoof bone protrudes through the hoof wall.

Osteoarthritis can arise from multiple causes and can be broadly divided into three groups: nutrition, other conditions such as insulin resistance or overuse of the foot.

Nutrition

The wrong feeding regime can increase the risk of insulin resistance and laminitis.

Too much sugar and starch

Fresh spring grass is a notorious cause of laminitis, due to its high content of fructan (a form of sugar). Too much grain-rich concentrate can also be a trigger. This is because grains are rich in starch, which are fast carbohydrates (sugars) and cause a high sugar spike.
A high intake of sugar creates a very high insulin peak. Insulin, in addition to lowering blood sugar levels, also causes the contraction of small blood vessels, especially in the laminae. Obstruction of blood supply thus leads to a lack of oxygen and nutrients resulting in inflammation.

In addition, a carbohydrate-rich diet can cause intestinal overload. Carbohydrates (sugars and starches), are broken down in the small intestine. Only a limited amount can be digested in the small intestine, and excess flows through to the large intestine. Here, carbohydrates are fermented by the bacteria in the intestine, producing lactic acid. The acidity in the colon drops, causing the "good bacteria" to die. This releases toxins, endotoxins. Acidification can damage the defenses of the intestinal wall and endotoxins enter the bloodstream. Endotoxins are harmful and are also associated with laminitis.

Feed changes

A horse's intestinal flora is specific to what food is eaten. The gut flora cannot withstand a sudden feed change and the bacteria can die off en masse, resulting in endotoxin poisoning. It also creates an imbalance in the intestinal flora that can also negatively affect health

Magnesium deficiency

Magnesium deficiency can make cells more insensitive to insulin. This can cause blood sugar levels to fluctuate widely, resulting in a higher risk of laminitis.

Underlying conditions

Certain diseases in horses can increase the risk of laminitis. Equine Metabolic Syndrome is described as a collection of risk factors for the development of laminitis involving hormones and metabolism. A disturbance in insulin regulation is at the root of the problem.

An adapted ration

Proper rations can prevent insulin resistance and laminitis. At all times, excess weight should be prevented. If there is excess weight, the horse will need to lose weight. Horses that have been laminated once are prone to recurrence.

When the horse has hoof pain, NO concentrate should be given and grazing should be avoided. The horse should be fed only coarse-stemmed hay, which is low in sugar. For better recovery, additional vitamin and mineral supplements are recommended. Especially vitamins A, E, C, Biotin, Zinc and Selenium. Vitamin C, E and selenium act as antioxidants and help eliminate toxins from the body. Vitamin A is important for bone and tissue repair. Zinc and Biotin are needed for hoof repair. In addition, zinc provides healing and defense against infections.

Limit easily absorbed carbohydrates

The base of the ration should consist of coarse-stemmed roughage, low in sugar and of good quality. Limit easily absorbed carbohydrates. Carbohydrates are broken down into glucose. So low in concentrate and a low sugar/starch concentrate or a grain-free vitamin/mineral balancer. If the horse needs to perform a lot, energy in the form of fats/oil can be given or choose a grain free granola.

Keeps gut flora healthy

It is also important to keep gut flora healthy through a high-fiber ration. Soybean hulls are a good supplement for easily digestible fiber and support gut flora. Avoid large/sudden changes in the ration. This is because the horse's gut flora is specific to what food the horse eats. It may take 2-3 weeks for the intestinal flora to adjust to a new ration. If too much change is made, unwanted bacteria may increase. Slowly build up the current ration and the new ration (7-10 days). You can support the intestinal flora with yeast or a vitamin B complex.

Avoid grass in spring and fall, limit grazing

Vers voorjaars gras is erg gevaarlijk voor paarden, door de wisselende en hoge gehaltes aan fructaan. Weidegang moet langzaam opgebouwd worden, niet alleen voor het fructaan, maar voor de darmflora van je paard. Chronisch hoef bevangen paarden kun je beter niet in de weide zetten op een zonnige dag na een koude nacht. Door een te lage temperatuur <12 graden, kan het gras niet goed groeien. Wanneer er wel voldoende zon, water en voedingsstoffen voor het gras aanwezig zijn wordt er gewoon fructaan geproduceerd door het gras. Echter kan dit niet gebruikt worden om te groeien en wordt het fructaan dus in het gras opgeslagen. Het Fructaan gehalte in het gras is dan het hoogst. De combinatie van een zonnige dag en koude nachten in het voorjaar en najaar zorgt voor een extra hoog fructaan gehalte in het gras.

Support with supplements

Magnesium

Horses with insulin resistance and those prone to laminitis may benefit from extra Magnesium. Magnesium deficiency is thought to make the body's cells more insensitive to insulin. This has not yet been scientifically proven, but in horses the administration of magnesium appears to have an effect on insulin resistance. What is important is the form of the magnesium. Inorganically bound magnesium (phosphate, sulfate, oxide, citrate) must compete for absorption with other minerals (mainly calcium). Almost all horse feeds use magnesium oxide. Organic magnesium bound to an amino acid (protein) does not have to compete and is therefore much better absorbed.

Fenugreek

Fenugreek is also a supplement that helps balance blood sugar levels and contributes to normal glucose and insulin metabolism. In addition, fenugreek helps support and balance fat metabolism.

Spirulina

Research has shown that Spirulina helps lower insulin levels in the blood and thus has a positive effect on horses with insulin resistance. In addition, the research shows that Spirulina can contribute to weight management. Spirulina contains a high level of vitamin B1 (Thiamine). Thiamine is important for carbohydrate metabolism, helping the horse release energy from carbohydrates including sugars.