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11/03/2020

Why Digital Pulse?
What is the Digital Pulse?

Digital in this instance denotes the digit or foot and pulse refers to the pumping of blood through an artery or vein entering or exiting the foot. To be more precise, the digital pulse is taken or referenced at what is called the V.A.N. apparatus. V.A.N. stands for Vein, Artery, and Nerve. V.A.N. describes the physical conformation of the vascular structures located in a specific location on the pastern of the horse.
If you were to place your fingers on the front of the pastern, mid way between the coronary band and the fetlock (ankle), and slowly slide them towards the inside of the pastern, your fingers would slip into a slight hollow, that feels fleshy. This is the location where you would take the digital pulse. See accompanying photographs.
The digital pulse is a reliable indicator of what is occurring within the vasculature of internal foot, including whether inflammation may be present within the confines of the hoof capsule.
In the normal horse at rest, locating a pulse at the V.A.N apparatus can often be difficult, as it is very faint, this because systolic pressure (arterial blood pressure created by the pumping of the heart) is relatively low in this location. With increased exercise and the accompanying increase in blood pressure, the pulse is more easily felt. This is why you should check digital pulse (DP) before exercise. You are not attempting to identify pulse "rate" but rather "pressure."

The vasculature of the equine foot is unique in a couple of ways:
Firstly, the veins within the foot do not have valves in them. Valves within veins prevent back flow of blood through the vein.
Secondly, there are no A.V.A.'s (Arterial Vascular Anatomsis), described as bypasses that allow for blood to be shunted from an artery directly to a vein, bypassing the delicate capillaries.
Lacking these features, the vasculature of the foot, lying between the internal foot and the hoof capsule is readily influenced by changes in circulation.
Changes in circulation can be the result of an increase in blood flow, or by a restriction of flow within the vascular of the foot, caused by inflammation. It is very important that you determine which of the two may be occurring.
Both cause an increase in pulse at the V.A.N. apparatus. Increased blood flow in most cases is a good thing, whereas inflammation resulting in the inability of the blood to enter the foot correctly, is a bad thing. Restriction due to inflammation can result in blood being shunted by A.V.A.'s that are present in the vascular at the coronary band and above. With blood being shunted from the arteries to the veins before it enters the foot, pressure felt at the V.A.N. is increased.
It is safe to say that lameness usually accompanies inflammation in the foot. Also, heat will often be felt when you rest your hand on the outer hoof wall. If you have an increase in pressure, but there is no heat, or lameness, it is likely that the increase in pressure is related to an increase in blood flow. You should be aware that there is a fine line between increased circulation and inflammation. The cause of vascular dilation and increased circulation can also result in inflammation.

My advice is that you learn how to take your horse's Digital Pulse and take the time to observe the pulse each morning, before you exercise your horse. Do this for at least a week. I rate DP on a scale of 0/3 with 0 being normal. If I have difficulty finding the pulse it rates a 0. If it is faint it is rated 1, if it is easily felt it rates a 2, and if it is bounding I rate it a 3. You should be checking the pulse when your horse is sound to establish a baseline. If after a week you have found it normal for your horse to have a faint pulse, then faint pulse for your horse would rate 0. This will allow for early detection of changes in the foot's circulation of "your" horse.
Here is how you use your baseline.

0 Normal, no concerns

1 Monitor daily for change, no real change in daily routine.

2 Horse should not be exercised, and veterinarian should be consulted.

3 Treat as an emergency; horse should be seen by your attending veterinarian at the earliest possible time.

I do not always treat immediately for inflammation when I have a 2 or even 3. I first want to determine whether there might be an abscess brewing. If an acute abscess is brewing, in all likelihood the horse will also exhibit severe lameness. Treating for inflammation can hinder the abscess process. Abscesses often have to run their course and reducing inflammation can slow the process, leading to complications down the road. If you are not sure, it is always best to consult your veterinarian.

About the Author:
Keith "KC" La Pierre APF, RJF, CF, MIAEP has been a farrier for more than 35 years. KC is the co-founder of the Institute of Applied Equine Podiatry. KC teaches and lectures on Applied Equine Podiatry through out the world. KC has developed and introduced dozens of innovative theories, methods, and products that continue to improve the quality of life of the horse.

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09/10/2020

Be Cautious With Iron
by Dr. Kellon
Iron is essential for all forms of life; a mineral element that has no substitute and powers key life-sustaining reactions in your horse's body. Iron also has an insidious dark side.

From pregnancy to performance, nothing happens without iron

The most well know role of iron is in red blood cells, where iron forms the active center of hemoglobin, the pigment which carries oxygen in the red cells. It performs a similar function in the muscle pigment myoglobin, which gives muscle its red color. Iron is needed for thyroid hormone production. Iron containing enzymes are also used inside the cell's nuclear powerhouses, the mitochondria.

Iron has many functions because chemically it is extremely reactive - almost too reactive. Unfettered iron is like molecules in a nuclear reactor. It can do a tremendous amount of damage to the tissues. In a normal horse, there is virtually no free iron. It is all securely bound to carrier and storage proteins until well controlled and sequestered reactions free it up for use.

Because of the important jobs iron performs, and the fact deficiency is common in humans, iron finds its way into equine vitamin and mineral supplements and fortified feeds. Iron is a common ingredient in "blood builders" and widely recommended for any horse that is anemic.

However, more is not better for iron and the truth is that equine diets contain more than enough (sometimes much more) iron than the horse needs. There has never been a documented case of iron deficiency anemia in an adult horse - ever. Still, since it's so important it can't hurt to supplement anyway, just in case - right? Actually, no.

Because free iron is so dangerous to the body, there is an intricate system to keep it under control. Iron can be absorbed through the gaps between intestinal cells, a process that is increased in the presence of products of fermentation of hay/forage. Otherwise, iron is absorbed into intestinal lining cells in the small intestine. From there, its release into the body is controlled by hormones/regulators that can block movement out of the cell and control the electrical charge of the iron, which in turn determines if it can be picked up by its carrier protein, transferrin.

Once iron is in the body, it is basically there to stay. Unlike other minerals, the body has no avenue for getting rid of iron other than tiny amounts in sweat. This iron accumulates over time. A high enough dose all at once can kill a horse (foals are especially susceptible) but toxicity is more likely to build up over time.

In 2019, Theelen et al published a paper documenting iron overload and liver damage in horses consuming natural water sources with iron contents of 0.72 to 75.2 ppm at the time of testing. https://pubmed.ncbi.nlm.nih.gov/30269378/ . Kellon and Gustafson 2020 described abnormal iron indices in two populations of horses with high insulin levels https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971364/ - an association that is well established in people, multiple other species of animals and even birds. Less dire consequences may include anemia, muscle pain, copper and zinc deficiency, poor performance and poor coats from the oxidative stress.

Even unsupplemented diets often contain considerably more iron than the horse needs and levels in the body will rise over time. It makes no sense to add to the burden with the horse's supplements. Look for the words iron and ferrous in both the analysis and the ingredients list.

Eleanor Kellon, VMD

Hyperinsulinemia associated with equine metabolic syndrome and pituitary pars intermedia dysfunction is a risk factor for laminitis. Research in other species has shown elevated body iron levels as both a predictor and consequence of insulin resistance. ...

08/12/2020

Understanding Amino Acids
by Dr. Kellon
Amino acids are the basic unit of proteins. The cellular ribosomes are protein assembly factories where amino acids are strung together to build proteins according to the formulas contained in the horse's DNA. https://www.genome.gov/genetics-glossary/Ribosome. If an amino acid in the formula is not available, assembly of the protein stops.

The formula for the amino acid sequence in proteins is locked in the horse's DNA.

Amino acids consist of a carbon containing carbohydrate backbone and a nitrogen containing amino group.

A limiting amino acid is one that is most likely to disrupt protein production because it is deficient. Lysine is the most important limiting amino acid for growth. It is also a common deficiency in adult equine diets. The adult requirement has been estimated to be 0.47% of the diet - so 47 grams per day for a horse consuming 10 kg (22 lbs) of food. Deficiencies of 7 to 10 grams are common in unsupplemented diets.

Amino acids can also be classified as essential or nonessential. There are 20 amino acids, about equally divided between essential and nonessential. An essential amino acid is one that must be in the diet in correct amounts because the horse cannot manufacture it. Nonessential amino acids can be produced by the horse by transferring the amino group from one amino acid onto a different skeleton. There is no net increase in amino acids when this happens because the amino acid that donated its amino group to form another is no longer an amino acid and will be metabolized/burned. All limiting amino acids are also essential amino acids.

Amino acids are needed to make much more than muscle. Enzymes, antibodies, hemoglobin, cellular receptors, cytokines and many hormones are all synthesized from amino acids. Next to water, protein is the most abundant substance in all body tissues from brain to hoof.

For as important as amino acids are, you would think we have detailed knowledge of the requirements. Unfortunately, except for lysine that is not the case. A very limited number of studies have suggested threonine may be the second most important limiting amino acid, at least for growth.

Methionine is growing in importance as a limiting essential amino acid. This is a sulfur containing amino acid. As the soil levels of sulfur drop because of pollution control, so do the sulfur amino acid levels in plants. https://wp.me/p2WBdh-RZ . Methionine deficiency will show up as poor hoof quality, poor coat, reduced muscle mass and impaired performance.

Requirements for methionine are estimated to be approximately 1/3 of lysine but as food levels drop it could overtake lysine as the most important limiting amino acid. As a % of their protein, peas, beet pulp and soy, in that order, are the best lysine sources. Grains and seeds are the best sources of methionine. You can also economically supplement your horse without excess calories using the three most likely deficient amino acids in Tri-Amino https://uckele.com/tri-amino-2lb.html .

Eleanor Kellon, VMD

Tri Amino helps maintain strong muscles, healthy weight, and supports a healthy topline with the three most essential amino acids. Lysine aids in bone health and immune function. Methionine plays a role in the synthesis of structural proteins, especially hooves and connective tissues, and hair and m...

02/22/2020

Anemia in Horses
by Dr. Kellon
Let's get one thing out of the way right up front. Insufficient iron is not the cause of your horse's anemia, and feeding more iron is not going to fix it. In fact, it might make things worse. Even if your horse has a source of blood loss, like bleeding ulcers, he has more than enough iron stored in his body to replace that.

Anemia is an abnormally low number of circulating red blood cells

Except for foals raised without access to soil or with heavy parasite burdens, iron deficiency does not exist in horses. Too much iron causes oxidative stress which makes red cells more fragile. It can also cause secondary deficiencies of other minerals critical for red cell production, like copper. If you can't get iron out of your head, prove it's not iron deficiency with a serum iron or a full iron panel from KSU's Comparative Hematology laboratory.

Iron deficiency also causes a characteristic type of anemia called microcytic hypochromic. This means that the red cell size, measured by MCV on the lab report, will be low and hemoglobin concentration, MCHC, is also low. If you don't see this, it isn't iron deficiency.

Full blown anemia is rare in performance horses but they may develop drops in their red cell counts, which normally run on the high end of normal. The cause here is usually oxidative stress from exercise which makes the red cells more fragile and easily damaged. The solution is to avoid excess pro-oxidants like iron supplements (especially intravenous) and institute supplementation with antioxidant nutrients commonly deficient such as vitamin E, selenium, copper and zinc. Because of the stress they are under and potential compromise of the gut microbiome, B vitamin supplementation may also help.

The most common cause of anemia is horses of all ages is anemia of chronic disease. When the body is under attack from organisms (e.g. Lyme, internal abscess, Strangles), bowel or other organ disease, cancer, severe wounds or burns, iron is made less available because it fuels inflammatory processes and growth of organisms. This type of anemia will resolve when the underlying condition is corrected.

Older horses with or without PPID (pituitary pars intermedia dysfunction, aka Cushing's disease) very commonly have a mild anemia with red cells counts and hematocrit/PCV hovering at or just below the lower limits of the laboratory ranges. The combination of less exercise and an age-related drop in metabolic rate decreases the oxygen requirement of senior horses so some drop in red cell numbers is physiological. There can also be an element of anemia of chronic disease in many older horses. In any case, the anemia is almost always not the primary problem.

Finally, there are infections that attack the red cells directly, like the Equine Infectious Anemia (EIA) virus, Babesia/Piroplasmosis, Leptospira and Ehrlichia. These horses are usually obviously ill, have fever and sudden drops in red count. The horse's overall condition will alert the veterinarian to look for these disorders.

Sound nutrition is important for creation and maintenance of good red blood cell parameters. In addition to adequate protein and calories, pay attention to:

vitamin E for antioxidant defenses (do not rely on the E in multiingredient mixtures; add it separately)
B complex vitamins (especially in older, stressed and compromised horses)
generous levels of the usually deficient selenium, zinc and copper, with low to no added iron to compete for absorption
On the herbal front, Echinacea has been documented to support healthy red blood cell production in horses.

Eleanor Kellon, VMD

11/17/2019

Is the ointment you're using on that cut helping or hurting? Remember these tips when treating horse wounds.

11/07/2019

Researchers found zero-finger tightness equaled 10 times the tightness of a human limb tourniquet.

10/08/2019

The blood vascular system of the hoof... I just can’t get over how intricate it is ♥️

10/07/2019

Insulin Problems – Forget about NSC
by Dr. Kellon
Hay or pasture is a major component of any horse's diet, and is likely to be virtually the complete diet in animals that are obese. Since insulin resistance is often part of the reason why a horse or pony becomes obese, it's important to know how to determine if their diet contains a safe amount of carbohydrate but not all carbohydrates are created equal.

Carbohydrates in forage plants include soluble and insoluble fiber (cellulose, hemicellulose, pectins, galactans, beta-glucan), starch, simple and complex sugars and fructans. NSC = Non-Structural Carbohydrates. These are plant cell carbohydrates that are free in the cell and not part of the cell wall. NSC includes starch plus water soluble carbohydrates - simple sugars, plant sugars and fructans.
So far it sounds like looking at NSC would be smart if you have a horse with high insulin. The problem is, NSC also includes things that do not influence insulin, most notably fructans. https://wp.me/p2WBdh-gn. By including fructans in the evaluation of a forage's safety/suitability, many perfectly appropriate hays are being rejected and owners are spending a lot more time, analysis fees and energy than they need to be.
The answer is to look at the tests that are most relevant to insulin rising - starch and ESC. ESC = Ethanol Soluble Carbohydrates. It is the best measure of the simple sugars that can trigger an insulin response when they are digested and absorbed.
Does it make that much difference?
Evaluation of 221 grass hay samples from Oregon (K. Gustavson, personal communication) showed if using 10% NSC as a cutoff for hays that would need to be soaked or not used, 87% would be called a problem. If the threshold is raised to 12% NSC, 70% were identified as problematic. When 10% ESC + starch was used as the guideline, only 4% were an issue. Hays passing the 10% or less ESC + starch test were subsequently fed to horses diagnosed as having Equine Metabolic Syndrome without issues.
An argument is sometimes made that NSC should be used because the other carbohydrates contribute calories and most of these horses need to lose weight or have their calorie intake controlled. However, a lot more than fructan goes into determining the DE [Digestible Energy = calories] of a forage and the hay analysis also actually provides a DE number. That is what should be used to determine caloric content and how much to feed, not NSC.
The take-home message here is that the scientific studies on Equine Metabolic Syndrome and laminitis are all now clearly showing that insulin is the issue. When evaluating possible hays for these horses, the focus needs to be on elements that can cause an insulin rise - ESC + starch. It's time to stop talking about NSC.
Eleanor Kellon, VMD

Despite the fact there is absolutely no proof that the level of grass fructan (levan) found in horse pastures and hays has ever caused laminitis, fructan continues to be touted as the cause of past…