Developing a Re-feeding Program In general, a slow and steady approach should be taken when re-feeding the debilitated and malnourished horse in order to avoid overwhelming a digestive and metabolic system that has been greatly impaired by starvation. Long periods of nutrient deprivation causes atrophy of the intestinal mucosa, which can lead to impaired digestion and absorption along with an increased risk of sepsis due to bacterial translocation across the gut wall (Geor, 2000). The development of a nutritional program should follow a full physical examination by a veterinarian. If an underlying condition or disease is suspected, a complete blood count with differential and an assessment of liver, kidney, and gastrointestinal function will be helpful to identify proper medical treatment. Initial bodyweight should be recorded, and photographs of the horse should be taken to document current condition. The severely debilitated horse which is 40% below optimal bodyweight may no longer be able to support itself (Lewis 1995). If the horse is more than 50% below ideal bodyweight, then the prognosis for survival is extremely poor. The severely debilitated horse that has been recumbent for 12–18 hours may not be able to stand, even with assistance. In such cases, the use of a sling may be warranted (for a more in-depth information on the use of a slings in horses it is best to refer to Bowman (1995) & Madigan (1993)). Since many severely neglected horses may also be dehydrated, treatment should begin, if appropriate, with rehydration. If the horse is severely dehydrated but willing and able to drink, Kronfeld (1993) has suggested offering 2–4 L of dilute salt water (0.5–1%) every 30 minutes until thirst has been abated will prevent hypernatremia, a condition that would discourage further voluntary drinking. Once the horse has satisfied its thirst, free-choice water can safely be offered. If the horse will not drink voluntarily, parenteral or enteral administration of fluids may be necessary in the most severe cases. Initially, intravenous fluids should not contain added dextrose or potassium, and an enteral solution should contain an oral electrolyte mixture (Kronfeld 1993; Lewis 1995; Rainger & Dart 2006). For the acutely and chronically starved horse, the goal should be to slowly reintroduce feed containing the targeted amount of Digestible Energy over a period of 7–14 days (Beckvarova & Thatcher 2009). During this period of time, the best approach for initial re-feeding consists of multiple small meals of good quality Lucerne hay with no additional calorie or grain supplements. This recommendation is based on a series of experiments designed to measure the metabolic response to re-feeding in chronically starved horses over a 10-day period (Stull et al. 2003; Witham and Stull 1998). The authors of these studies concluded re-feeding with Lucerne hay alone for the first 10 days is the preferred method, due to its lower glycaemic index and high dietary phosphorus & magnesium which helps to prevent re-feeding syndrome.
Posted on: Wed, 02 Oct 2013 02:34:44 +0000
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