The Golden Years
How many of you out there have horses over 18 years? 20 years? 25 years? 30 years? I still work on a 34 year old horse his name is Great Gusto and he lives up to his name wholeheartedly! I also have a 25 year old at home that I’ve owned since the day he was born and he has been a major part of my life. What a wonderful tribute isn’t it; being able to stay a part of our horse’s lives for such an extended period.
So what exactly is considered an “aged” horse? I will say aged instead of old because it sounds a bit more politically correct, don’t you think so? Horses are generally considered aged at 18-20 years of age, and if you compare that to a human, you would consider him 60-65 human years. It is at this time we see some of the clinical signs we are going to discuss in this article. However, several functional horses are used well into their 20’s and when they hit a specific numerical age it should not be the “cut off” for specific exercise, showing, etc… Each horse ages differently and each instance will have to be taken into consideration.
Geriatric care for the equine has developed into a hot topic as of late. More research is being done day by day on how we can best care for our equine into their golden years. What we’ll try to do with this article is to create a sort of checklist to help you keep an eye on important aspects of your older horse’s life to keep him as healthy, happy and comfortable as possible into his later years. Likewise, we will continue to monitor your aged horses with our annual physical examinations and bloodwork screenings pointing out anything you need to change or be aware of with their condition.
Dietary Needs/Absorption: It is estimated that aged horses may suffer about a 20% reduction in the ability to digest and absorb certain nutrients. Most of this loss of function seems to occur in the large intestine. This percentage used to be much higher and we can thank our better deworming protocols for giving us aged horses with healthier gut walls that are better able to absorb nutrients. Research has well established that there are three main nutrients that a horse does not digest well as it becomes aged: fiber, protein and phosphorus. An easy way to provide a lot of these dietary changes is by switching to a commercial grain that is designed specifically for “senior” horses. A lot of these diets are geared towards aged horses with slightly higher protein, phosphorous and easier digestibility. Likewise, most of these diets are pelleted, formulated with softer texture that is easier to chew and are processed which allows easier digestion and in turn absorption of nutrients.
As a result of this absorption reduction, you may have to provide an aged horse with more feed and higher levels of nutrients, JUST to help him maintain his condition. When evaluating their diets, look for a diet with at least 10% fat, 0.35-0.45% phosphorus and 12-14% protein. Likewise you should consider supplements. Since horses usually get all the B vitamins they need from the beneficial fiber-digesting bacteria that live in their guts, aged horses with compromised digestive function may not have “properly B vitamin producing bugs” in their guts. Likewise, Vit C to help with immune response (i.e. response to vaccinations and sickness) and Vit E as an antioxidant have both been advocated as well. Dosages include 2-4 ounces of yeast culture a day (Vit B), 1000 IUs of Vit E a day and 10 grams of Vit C (ascorbic acid) twice a day per 1000 pound horse.
Also you should try not to feed more than 4 pounds at one feeding. If we have switched your aged horse to a complete feed, you should try to not feed him large amounts at once. Increasing the frequency of feedings with smaller meals can help with digestibility, e.g. feeding 3-4 or more times a day. If you feed too large of a meal, it can overwhelm the small intestine and crowd the stomach, which can push the food through the digestive tract too quickly. Other tricks such as adding oil to the feedings (corn oil or flaxseed oil) can be a rather inexpensive fat supplement as well.
Finally, you should always remember that even though your horse may have been dominant once, he may have lost his pecking order out in the pasture. It is important to make sure that your aged horse is able to receive all his required rations and not be scared away from his feed by younger pasture mates (which likewise leads to FAT pasture mates). Please make every effort possible to feed your aged horses separate from others, giving him ample time to eat his feed and forages.
Dental Needs: At some point most aged horses will likely have dentition problems. As we have discussed in previous newsletters, horse’s teeth are considered hypsodont, which mean they continually erupt throughout the horse’s lifetime. Eventually, however, the horse’s teeth will actually run out because there is a limit to the length of the horse’s teeth. These exhausted teeth that fall out will create abnormal wear patterns to the entire grinding surface, which can greatly decrease the horse’s ability to grasp and grind feed effectively. Or the teeth will remain in his gums but become so smooth (like ivory on piano keys) that they don’t grind anything anymore. This can result in a decrease of diet digestion and poor delivery of nutrients to the body overall.
Not every aged horse has dentition problems, my 25 year old at home has wonderful teeth thank goodness. Is it in his genetic cards to have good teeth? Is it the fact that he’s had very regular dental care throughout his lifetime? Is it the fact that he has perfect alignment to his teeth and wears them very evenly? All of those probably contribute to his great teeth, but I continue to check them regularly to be on the safe side. If your older horse still has good dentition and seems to be maintaining his weight well, then diet changes may not need to take place. If you see evidence of quidding (dropping balls of hay when they eat), weight loss, taking a long time to eat, etc.., then we will likely need to do a dental evaluation, fix what we can and make some dietary changes (see dietary needs).
Eyesight: It is relatively common for aged horses to develop cataracts, but these rarely cause complete blindness unless there is another pathologic eye problem occurring. Cataracts usually develop slowly due to old age and thus the horse becomes accustomed to them as they form. Cataracts create a cloudiness in the lens and aged horses deal well with the slight impairment of vision (so they can’t read the newspaper in the morning, they’re not complaining too much). However, I do recommend keeping a close eye on aged horses when there is a major change in their life. Factors such as new pasture mates, a new pasture or barn, different fencing, etc… can sometimes cause a horse to take a double take even with perfect eyesight, so work slowly with new things. I also recommend everyone to make it a habit to talk around your aged horse so they always know where you are. It’s a good habit for horses of any age, but especially ones that may have slightly impaired eyesight.
Exercise/Arthritis: If the nutritional requirement of an aged horse is not met, then it may begin to lose lean body mass (muscle) to be broken down into protein. You can try to help prevent this muscle loss by feeding a yeast culture, increasing the crude protein in the total diet, (providing his kidney function is normal) and verifying the phosphorus is adequate (see dietary needs). However, even with the best diet imaginable, as a horse ages it will begin to lose some muscle mass and the tendons and ligaments will lose some of their elasticity. Speed will be the first to go, which is then followed by agility, strength, and finally endurance. Regular exercise is the best thing for those which are sound enough to do so. The best option is a program of regular light exercise that helps maintain body condition and muscle tone, and allows the horse to be used for trail riding or similar tasks. Daily turnout is another way to ensure that the horse receives regular exercise. Constant movement helps keep joints lubricated, muscle toned and is certainly important for maintaining good spirits.
If your aged horse has already lost a significant amount of muscle mass and your goal is to get him toned and into better shape you need to start out slowly. An aged horse that has lost significant condition is at increased risk of injury and preserving soundness is very important. We don’t want to do more harm by trying to help him. If your horse has a problem with chronic lameness, it will obviously limit the amount of work that can be undertaken. Start out slow and err on the side of caution. As a rule of thumb, carefully warm up and cool down an aged horse and do not increase the weekly training distance by more than 5%. Three 10-15 minute sessions per week on the longe line or under saddle may be an appropriate place to begin. Also keep in mind that aged horses tend to be less tolerant of the heat, partly because of the decline in cardiovascular function. This means to be very careful when exercising in hot conditions.
Likewise if you are going to start working an aged horse or are currently riding an aged horse you need to verify that his tack is still fitting appropriately. A common place for an aged horse to lose body condition is on the top line, especially around the withers. A saddle on a horse with thin, tall withers will not fit properly and will put undue pressure on the withers and on the caudal back with no weight distribution in between. For most of my aged horses, I recommend finding an orthopedic pad that will conform around your horse’s shape to be used under your regular saddle pad.
Many aged horses have arthritic problems not only due to work they have performed throughout their lifetime but also simply due to natural, cumulative wear and tear on their joints with time. It is important in these instances to get horses out and moving. The more an aged horse stands still without motion, the more stiff and uncomfortable he will become. There are also several joint supplements out on the market that can markedly improve a horse’s quality of life. The medications I have had good results with include Cosequin®, Adequan® and Legend®. I have had good results on maintenance levels with these products and owners have definitely notice a difference in their horses. These products will help increase the joint fluid if needed, increase the thickness of the joint fluid (viscosity) and will help protect the remaining cartilage in the joints. We can also inject joints directly with protective medicines if a specific joint is more problematic and then follow up with systemic joint supplements.
Another common problem in an aged horse can be discomfort in the hocks. Pain in the hocks may make it difficult for your aged horse to push himself to his feet after lying down. In these cases, they may start not lying down as much to sleep and they will sleep standing up with the occasional episode of suddenly starting to fall. Many people may think that their horse is “fainting” or is developing “narcolepsy” (sudden sleep episodes). Often times, however, it is the aged horse’s body getting overly tired from not laying down to sleep, their body’s stay apparatus (the areas that lock into place to allow a horse to sleep standing up) doesn’t work well anymore and they are starting to collapse as they sleep standing up. So even if you don’t utilize your horse by riding him, it is still important to keep his joints as healthy as possible just for his overall health.
Tumors/Lipomas: It is safe to assume that some sort of tumor is present in the majority of aged horses. I’m not saying that all aged horses are riddled with cancer, tumor simply means a growth or swelling. If you have a gray horse it may very likely have melanomas (common places under the tail head, around the sheath or udder). Other types of cancerous tumors such as squamous cell carcinomas or lymphosarcomas are also increased in aged horses, but still pretty rare. A very common tumor is an abdominal fat lipoma, which grows from the fat that surrounds the intestines. Lipomas are not malignant but can cause problems because they tend to grow on long stalks that can wrap around portions of the intestine and obstruct the flow of blood and abdominal contents. It is the most common cause of a surgical colic in aged horses. The reason for the predisposition of aged horses to lipomas probably relates to the number of years required to form a lipoma with a sufficient length of stalk to strangulate intestine. Aged geldings have a 2X increase than mares or stallions and ponies have almost a 4X increase as they have a greater likelihood to store body fat.
Cushing’s Disease: Another common tumor found in aged horses is a tumor of the pituitary gland within the brain. Research has indicated that more than 70% of horses living beyond the age of 20 will develop Cushing’s Disease. Although the tumors themselves are considered benign and slow-growing, they alter the secretion of certain hormones that can have profound effects on a horse’s health. They can cause glucose intolerance and decreased sensitivity to insulin (the hormone that regulates sugar levels in the bloodstream), causing levels of cortisol, insulin and glucose to become high within the body. These elevations can cause several clinical signs in a horse including: long, shaggy hair, pot bellied appearance, fat deposits around the eyes, low energy levels, increased appetite with no apparent weight gain, muscle wasting, increased drinking, increased urination, decreased immune function with increased susceptibility to infections, gum disease, chronic laminitis, recurrent hoof abscesses, etc.. Horses with Cushing’s Disease do not necessarily have each clinical sign and sometimes diagnosis is not solely based on clinical signs but on subsequent bloodwork to detect these elevations of cortisol, insulin or glucose.
Although there are medications for Cushing’s Disease, they can only help prevent and reverse some clinical signs. None of the medications cure and eventually the condition will worsen despite therapy. Besides the medications there are other preventative, husbandry measures that can be followed. Keep your horse at a good body condition (body scores of 5 or 6). Fat aged horses (body scores of 7, 8 or 9) can lead to a higher risk of laminitis, glucose intolerance, problems associated with Cushing’s disease and add stress to joints and limbs. Also, avoid molasses and high-carbohydrate diets and try increasing fat and protein. Feeding a high fat, high fiber diet can improve glucose and insulin metabolism in Cushing’s horses and reduce the risk of founder.
There is another disease that can mimic Cushing’s Disease in many ways, Equine Metabolic Disease (EMD). They used to call this disease “pre-Cushing’s” because they thought it was a precursor to developing Cushing’s Disease. They have now realized it is a separate entity and have given it a separate name. This disease often results in insulin resistance and obesity. Unfortunately, it’s often our fault. Domesticated horses tend to be fed rations that are excessive with respect to their requirements and provide calories in a highly concentrated form. This results in horses that are loaded with fat tissue, ie FAT.
Originally, these fat cells were thought to be nothing more than storage areas for energy, now they realize that they may represent a major source of endocrine hormones. Many of these signals deriving from the fat cells directly hinder the action of insulin and cause insulin resistance. Fasting blood work indicating excess insulin in the blood with no increase in cortisol gives a strong chance that the horse is suffering from EMD.
The main goal in treating EMD is centered on weight loss, increased physical activity, and limitation of soluble carbohydrate in the diet. The problem is that many of these horses are dealing with chronic laminitis and it’s very difficult to increase the physical activity of a sore footed horse. We have also had some luck treating some of our EMD horses with Chromium, a trace mineral that helps with insulin uptake which is used in homeopathic human medicine. Overall, you should try to feed EMD horses with only hay (Hays fed to insulin resistant horses should contain no more than 10% sugar and starch combined. Analyzing your hay is the only way to know for sure), no grain and fruit treats of any kind should be fed, beet pulp can be an addition to the diet if needed, and free-choice access to lush grass should be avoided to cut down on the possibility of ingesting too much sugar and exacerbating any laminitis complications.
Living Wills/Difficult Decisions: Even with the best care possible, there will inevitably be a time when our aged horse’s life (as does every living thing) comes to an end. This end may come in the form of a sudden problem such as a surgical colic. Pedunculated lipoma colics have resulted in several lengthy discussions and hard decisions having to be made on short notice. It is better if you have a plan of action if you are faced with this problem. These colics require surgery for survival, a procedure that will take place at a referral facility such as Purdue. Surgical considerations such as transportation to the facility and costs of $3000-$5000 with an approximate 50% chance of return to previous function need to be considered. It is also important to know that the post surgical survival of aged horses was not significantly different from younger horses. In other words, the prognosis is based on the cause of the colic and not on the age of the horse. In most instances, the financial considerations and financial “worth” (not emotional worth) of the horse precludes many owners from electing for surgery for their aged horse. It is imperative, however, that you have made this decision already and that others know your wishes if you are not available for consultation. We have an emergency consent form that can be filled out by owners, especially if owners are to leave their horses in the care of others while out of town. It covers many important topics and can allow a caregiver to make informed decisions if the owner is not present. I highly recommend all my clients to fill one out for their horses of any age. You can request one or download one from my website.
Likewise, a dwindling appetite, chronic pain, lack of desire to move, or self imposed isolation from the herd or humans can all tell you that your horse’s systems are shutting down. Your aged horse’s quality of life should be your most important factor for his overall health. Difficult decisions need to be made in certain instances, but as we’ve allowed our aged horses longer lives, we’ve also increased the need to verify that life is of good quality. No one knows your horse better than you do.
In conclusion: I hope this article gives you more insight to caring for our beloved “aged” horses. Keep in mind that the way a horse ages in comparison to a human, an annual physical examination is like a human getting one every 3.5 4 years. A good, annual physical examination is very important for your aged horses. Routine bloodwork checking out body systems, red cell counts, screenings for Cushing’s or EMD, etc… are also important aspects of preventative care. After writing this article I decided to see just how many of my horses in the computer are “classified” as aged i.e. 18 years or older. I was very surprised to see over 10% of my patients falling into this category. I’m pleased to be a part of such wonderful care extending our horses lives. Keep up the good work.
Did You Know?
There may be a simpler, less expensive diagnostic test in the near future to detect gastric ulcers than a gastroscope examination (sticking an endoscope down the esophagus and into the stomach). Sucrose levels in urine have long been used to diagnose gastric ulcers in people and dogs, and research indicates that the same applies to horses. A urine sample is obtained, a meal and a liquid sucrose solution is given, and then two more urine samples are obtained 2 hours and 4 hours later. The hard part may be to catch the urine, but overall it is something that can be done on farm.
The "Poop Challenge"
If you read our last newsletter “The Scoop On Poop” you know that current parasite control methods include fecal flotations to check up on your individual programs. If all is going well it should be easy for you to forego your spring dewormer in lieu of a fecal flotation. Hold off on your spring dewormer until your spring vaccinations are done. We will check a fecal flotation then verify whether you in fact need to deworm your horse that go around, if there is evidence of parasite resistance by high numbers of a specific parasite or if you need to use a specific product for your deworming needs. So go ahead and take the “Poop Challenge” with us this year.
Spring Is in the Air
Spring is in the air and we’re getting geared up for our quality, preventative care programs for your horses. With vaccinations and dental work filling our days, please keep in mind that you may need to call in advance if you have a specific day in mind for your spring work. Many clients have already started scheduling appointments in March and April so call early if you are needing specific day requirements and don’t wait until the last minute unless time is NOT of the essence to you. Look into our Wellness Packages for a convenient way to provide your horse with a year’s worth of preventative health care. Due to absentee owners in boarding barn facilities, there is a new policy requiring payment the day the work is scheduled. For more information check us out on line or contact the office. Thanks for your continued support. We look forward to another healthy year full of quality care for your horses.
Some of you are reading this because a friend or relative gave it to you. You may be sitting here thinking that you are OK and don’t really need any help. It is not easy to admit that you are a horse-aholic and it is even harder to bring yourself to a HA meeting for help. HA is here to assist you. I have some questions to ask. If you answer YES to more than three of the following, you have come to the right place.
If you answered YES to one of the above, there is still hope. If you answered YES to two, you are in serious trouble. Our advice to all of you with three or more YES’s is to sit back and smile. Turn to the smiling person next to you and know that your life will always be filled with good friends and good horses, and it will never be boring. (I answered YES to 10 of them, I guess I need a lot of help. Dr. Danah)