The Five Freedoms
When the Five Freedoms are not met, a horses’s situation needs improvement.
1. Freedom from hunger & thirst
by ready access to fresh water and diet to maintain health & vigor.
2. Freedom from discomfort
by providing an appropriate environment including shelter and a comfortable resting area.
3. Freedom from pain, injury or disease
by prevention or rapid diagnosis and treatment.
4. Freedom to express normal behavior
by providing sufficient space, proper facilities and company of the animal’s own kind.
5. Freedom from fear and distress
by ensuring conditions and treatment which avoid mental suffering.
Starvation
During starvation, a horse’s body initially uses its reserves of fat and carbohydrates for energy. When those reserves are gone, his body must cannibalize its own proteins as a source of nutrition, resulting in muscle wasting and further weight loss. As his body scavenges protein to survive, damage to heart muscle and other internal organs occurs, which can result in permanent dysfunction.
Diagram of a horse for anotomy & body fat assesment.
Refeeding Syndrome
Refeeding syndrome is a life-threat-ening metabolic complication that occurs when a starving horse eats too much food too soon. It is not obvious from the outside of the horse when it starts to occur; it is an internal problem. There are many intertwined metabolic abnormalities that occur during refeeding syndrome, so the physiology of all of all of the changes unknow to this day.
Refeeding syndrome begins with spikes of soluble carbohydrates (sugars) ingested in the horse’s newfound nutrition. His body responds to the sugar by releasing insulin, which carries sugar inside cells so that it can be used for energy. In the case of refeeding syndrome, the body hasn’t had access to carbohydrates for so long, it over responds and releases too much insulin. This results in low blood sugar. The animal cannot maintain normal body functions, and although this response is mild at first, it can spiral out of control until the horse develops life-threat-ening respiratory, heart, and kidney failure.
The thinner the horse is, the higher the risk for metabolic derangements. Complete food deprivation will result in worse metabolic derangements and more intensive, complicated medical care. Horses that have had access to limited amounts of food recover better. When a rescue horse has a BCS of 1 to 3, your veterinarian should be involved in formulating the plan to re-feed him. Signs of refeeding syndrome occur three to five days after being fed, but can be two weeks after the first meal. When the horse has access to large meals too early, his risk is increased.
Safely Feeding the Starved Horse
Small, frequent meals of alfalfa alone are the safest way to feed a starved horse. To determine this, The University of California, Davis has worked with rescue groups to conduct clinical trials using horses with a BCS of 1 or 2. When compared to a diet of grains and grasses, the horses’s body has a lower peak glucose and insulin response with a diet of alfalfa, reducing the chances of developing refeeding syndrome.
For reference, a normal horse should eat 1.5 to 2 percent of his body weight per day in feed (15 to 20 pounds for a 1,000-pound horse). The basis of any horse’s diet should be forage or hay.
Forage Selection
Ironically, many of the notable food-processing abnormalities observed with refeeding a starved horse are similar to metabolic problems observed with uncontrolled Type Il diabetes in humans, which is more or less manifested as insulin resistance (IR) in obese horses. IR horses are sensitive to sugar and starches, and have driven forage research and understanding. This knowledge can be extrapolated to helping starved, metabolically deranged rescue horses.
Forage Facts
In the nutrition world, sugars and starches, along with their molecular cousins, fructans, are referred to as non-structural carbohydrates (NSC). Determining the NSC and nutrition content by simply looking at hay is impossible; it must be tested. There are a few generalities that will allow you to make an educated guess when evaluating hay.
Grains or sweet feeds have the highest NSC content, followed by cool-season grass hays. Cool-season grasses include timothy, orchard, and fescue. NSC is lowest in alfalfa (a legume) and coastal Bermuda (a warm-season grass hay). Other factors that affect the NSC levels in hay or forage include plant type and maturity, harvest conditions, and local farming practices, which are influenced by geography and weather.
For most horses, a high-quality, easily digestible, nutrient-dense hay is needed. If a plant is overly mature when it is baled into hay, horses won’t eat it because excessive indestible fiber makes it unplayable (for example course straw).
Alfalfa is the forage of choice for refeeding a starved horse: its caloric content is high because of its high protein content, but the sugar content is low. Additionally, it has high levels of electrolytes such as calcium, magnesium, and phosphorus, which can help ameliorate some of themetabolic derangements seen in refeeding syndrome.
If a horse can not chew hay or forage, another form of roughage must be provided. Alfalfa is available in pelleted and cubed forms, as are some grasses. It si best to feed these soaked or wet because if pellets are swallowed too quickly, choke may occur.
Feeding Program
Feed quantities are by weight, so you will need a reliable scale. Also, these numbers are for the average-age-sized horse who we expect to have an ideal weight of about 1,000 pounds. Feed amounts should be adjusted according to the horse’s expected final weight based on his frame.
Starved horses are re-fed, beginning with one pound of alfalfa six times daily. It is tempting to feed grain to a starved horse, but this increases the chances of refeeding syndrome and death. Alfalfa is high in protein, which helps to level the blood sugar and insulin spikes that are the problem during refeeding syndrome.
Conventional horse-person wisdom maintains that grass hay is the safest forage, and free-choice access is the best. Research and clinical cases have proven this to be false in the instance of starved horses. While it is hard to resist conventional wisdom, I assure you it is more difficult to watcha starved horse with new access to food lie down and die despite all efforts to save him. I assure you it is more difficult to watch a starved horse with new access to food lie down and die despite all efforts to save him.
If a horse has not had alfalfa before, there can be some gastrointestinal side effects, such as soft stool or gas production. However, in a truly starved horse who has had little or no access to forage, any feed can result in gastrointestinal side effects. There is a subset of horse owners that ascribe to an “Alfalfa Is Bad” myth. You must abandon this belief in order to properly care for your starved horse.
The purpose of following the feeding plan outlined here is to first reset the horse’s metabolic function and mitigate the development of refeeding syndrome. After that has been accomplished, weight gain can occur.
Days One through Three:
Feed 1 pound of high-quality alfalfa every four hours for the first three days. The total the horse will eat during this period is 6 pounds per day.
Your horse should be allowed free access to water as well as a salt block duringthis time. If he is dehydrated as well as emaciated, your veterinarian will make a plan for rehydration.
Day Four to Two Weeks:
Gradually increase the amount of alfalfa by about a half pound per day total and begin to decrease the frequency of feeding. Work toward a total of 12 pounds per day divided into three feedings. The three feedings should be eight hours apart.
During the first two weeks, don’t expect any weight gain. What you are doing with this feeding program is resetting your horse’s metabolic system back to normal so that he can survive and gain weight. It can feel frustrating to not yet be feeding him grain or allowing him free-choice access to his forage, but this is the safest way to ensure that the thinnest horse survives.
Two Weeks to Two Months:
Continue to add a half pound of alfalfa per day to your horse’s diet. Gradually increase the amount until you are feeding as much alfalfa as the horse will eat. A horse can eat up to 2 percent of his ideal body weight per day. For the average-sized horse, this is about 20 pounds. During this time, you may work to decrease the frequency of feeding to twice daily. Once he is eating all the alfalfa he can, it is safe to gradually add other feed material such as grain or grass hay to the horse’s diet.
Long-Term Plan:
Once your horse is approaching a healthy weight—again, this can take from six months to a year—you will be able to adjust to a long-term plan for him based on his ongoing needs and exercise intensity.