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Discuss EPSM / PSSM diet at the Horse Health forum - Horse Forums.

Some of you may have seen my other thread about my mare tying up and ...
  1. #1
    Senior Member+ Callie's Mom's Avatar
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    EPSM / PSSM diet

    Some of you may have seen my other thread about my mare tying up and being diagnosed with PSSM type 1 (P/N)
    I have been doing a lot of research about what to feed, how to exercise. etc - lots of info out there... too much, its overwhelming!

    I started her out on a simple low carb, high fat diet with added supplements... I had her on meadow grass hay, grass hay pellets, corn oil, vitamin E, and a product called Tie-by which has other important ingredients like Selenium, magnesium, DMG, etc. My vet only said I only needed to feed her the hay, grass or alfalfa pellets and corn oil (he has 2 PSSM horses and rides endurance).

    Well this diet didn't seem to do anything for her - she was sluggish, grumpy and overall just not her normal happy self.
    So, I talked to a friend who knows a good deal about horses tying up but not necessarily about feeding a PSSM horse... so I took the parts of his suggested diet that made sense for my mare and did further research.

    What I feel has made the most dramatic improvement in my horse is decreasing the oil (and changing it to Flax instead of corn oil) and adding in Acetyl-L-Carnitine. The very first day I gave her the Acetyl-L-Carnitine (ALCar) she was more herself, had more energy, looked bright and alert! She has been on the new diet with the ALCar for about a week and a half now and she seems to be doing really well.

    Has anyone else here used ALCar with their horse? What results did or didn't you see?

    I have been walking her for about 10 minutes per day this week (after I saw her feeling more normal) and have started walking her over ground poles now as well. We went for a little 10 minute ride yesterday and even did a couple minutes of gaiting. I plan to take her on our first trail ride (maybe 20 minutes long depending on how the ride starts) tomorrow - will be the first trail ride in over 2 months!

    Yesterday:


    Here is a blurb from one of the many articles I have read on ALCar: (from: http://austhorse.com/epsm-alternative-approach/)

    Dr Eleanor Kellon VMD, an equine nutrition specialist recommends a different approach ďIíve lost track of how many horses suspected to have PSSM/EPSM and put on high fat diets end up with me because they get insulin resistance and laminitic. We donít know the safe dose of fat for an insulin resistant horse, but we sure donít want to be feeding as much fat as is already known to induce insulin resistance in a normal horse!Ē

    Her approach is to limit carbohydrates and supplement with L-carnitine to assist in getting fat from body stores into the mitochondria, in conjunction with regular exercise and a mineral balanced diet. L-carnitine is a type of amino acid, necessary for moving long chain fatty acids into the mitochondria to be burned. Studies have shown that availability of free carnitine in the muscle cell influences the relative rate of burning of fat or carbohydrate. Even normal horses in training benefit from L-carnitine supplementation, showing higher metabolic efficiency during exercise. With L-carnitine supplementation, itís been possible to greatly reduce or eliminate high fat feeding, with better results. Inside the body, L-carnitine exists either in the free, L-carnitine, form or as acetyl-L-carnitine. More recently, Dr. Kellon has been using the acetyl-L-carnitine form because a laboratory study has found acetyl-L-carnitine can turn on a pivotal enzyme which directs glucose into the mitochondria to be burned rather than into pathways that produce glycogen.
    Dr. Kellon says, ďUntil we know more details of the biochemistry of EPSM/PSSM, itís important to treat each case as an individual. How a horse responds to treatment depends both on the disorder and other underlying features of their metabolism. Some horses respond quite well to the high fat diet, others relapse or have a partial response. Some have complications. The L-carnitine and acetyl-l-carnitine has helped many horses improve further.Ē
    2008 RMHA Mare - "Polly"/ 2004 TWH Gelding - "Java"

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    I would start over - go back to low sugar/starch. Do that for 1-2 weeks. Do a "reset" so to speak.

    If you decide to add oil, I would not at all use corn oil - very high in pro-inflammatory Omega 6. Use flax oil if you can.

    However, I might even not do the oil for now - use another fat source. I'd probably try rice bran, up to 2lb.

    I have not read up carnatine in relation to EPSM, so can't help there.
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    For the EPSM horse low starch and sugar is KEY . You also have to consider that a 900 - 1000 lb horse needs 10 to 12 000 calories per day. This increases with heavy work. The horse also needs to obtain 20 to 25% of its diet from a soluble fat source.

    Thing to remember:
    -EPSM horses usually require a higher amount of protein to rebuild the lost muscle mass during work (Alfalfa or alfalfa pellets recommended for this)
    -ALWAYS have a salt block available to the horse - inside and outside.
    -Selenium . Vit E - test your hay and make sure horse is meeting the required 1000 units of Vit E / 1 mg selenium per day.

    Horse I trained was put on this:

    -2.5 lbs alfalfa pellets
    -1 lb Agribrands Request / Nutrient Complete (Depended on the stock really)
    -Canola Oil (This is much healthier then corn oil) (About 1 cup -which is about 2000 calories)
    -Vita Plus Supplement
    - Buckeyes ultimate finish 100% fat (1 cup)

    Twice a day,.
    Horse got about 3 feedings of about 4.2 lbs timothy hay per day. So about 13 lbs grass hay / day.

    He was 16hh, in moderate work daily. Never had any episodes on this diet, owner was so shocked that the horse could be ridden like it used to be and NOT tie up afterward!

    You can also put the horse on a ration balancer , then add canola oil OR something like buckeyes ultimate finish to increase calorie/fat intake. While feeding 70/30 - alfalfa / timothy hay.

    And maybe your vet mentioned this or not, but they need a much longer warm up/cool down and a regular (almost strictly regular) working routine which increases or decreases are taken VERY slowly to keep them healthy. The horse I worked with had to be worked daily to keep without issues as well.
    Every horse has a dream and a passion within. It's not about the trainer, it's about the training to bring that passion out.

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    The general recommendations for Se intake is 3ppm of the whole diet. But in the end, you must must must test the horse's blood to see what his levels are. It doesn't matter if the hay/feed appears to have enough - if the horse has problems with Se uptake, then you need to add more.

    The same thing applies to the Vit E - much safer to test the horse, as it doesn't matter how much is in the hay - if he has a problem with its uptake, and being EPSM he may well have an issue, then he needs supplemental. If you test, and see that both E and Se are low, the thing to do first is increase the E, as that often will pull the Se up with it (Se needs adequate E to be used).
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    JB, I started with low starch/carb then added each piece in along the way. Well to be exact, I started on low carb plus vitamin E and Se. Then after not seeing too much improvement and the actual diagnosis of PSSM, I started her on the oil very slowly... My friend who came over to talk with me about her diet mentioned feeding her Dynamite TNT - I tried to PM you about it but your box was full for a few days I haven't started her on TNT because she seems to be doing well with her current diet but what do you think about TNT as an RB for PSSM horses?

    Drafthorse, I did forget to mention that one of the recent diet changes was giving her some alfalfa in the AM. She gets Alfalfa + Grass in the AM, then grass hay and her supplements at Lunch, then grass only at night.

    I do plan to have her levels retested after she is on the current diet a little longer...
    2008 RMHA Mare - "Polly"/ 2004 TWH Gelding - "Java"

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    I fixed my box, sorry!

    I love TNT - have fed quite a lot of it in the past. I think IF the horse can tolerate the soy, it's a very nice ration balancer-like sort of supplement. It has the fat, the v/m, the added magnesium, and more. Really nice product.

    One thing on the typical EPSM diet - it's not at all uncommon for horses to get worse before they get better. Seeing no change isn't necessarily a good thing, it may mean that while the diet isn't hurting, it isn't helping. IIRC the worsening of issues comes from the body starting to re-do how it sees nutrients for energy, and I've heard of it taking a couple of months to switch over and settle down.
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    I have one issue with that. Dietary fat does not cause IR. Being fat can cause IR.

    Having said that, from the one photo (which isn't much to go on admittedly), your mare appears quite overweight. So the approach to her diet might need to be a bit different than your 'typical' EPSM diet. However for EPSM horses, sometimes getting them on a disease appropriate diet (which will be higher in fat and perhaps higher in calories than their previous diet) can actually facilitate weight loss.

    I do have one question just for clarification. Are you feeding her flax or flax oil? How much?

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    Dawn, I have read up on the higher fat / calorie diet sometimes being good for horses that are already over weight despite what one would think. She was very over weight when I got her:


    She easily slimmed down with regular riding (got her in Aug this is end of Sept I believe):


    She hasn't been "worked" in over 2 months as we have been sorting out what the issue was and her diet...
    I had her tested for IR and it was negative but I think she could easily be pushed that way and am being cautious of what I feed her.

    To answer your question, I am feeding her flax oil. Since I just started it about 10 days ago, I think, I only have her on 3 ounces (about 3/8 cup).
    2008 RMHA Mare - "Polly"/ 2004 TWH Gelding - "Java"

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    Mmmmmm, I think there is SOME evidence that points to a long-term high fat diet predisposing a horse to IR issues. I'll have to dig deep to find the reference.
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    Quote Originally Posted by JBandRio View Post
    Mmmmmm, I think there is SOME evidence that points to a long-term high fat diet predisposing a horse to IR issues. I'll have to dig deep to find the reference.

    Granted it's been at least 2-3 years since I've read it, but I've seen studies going both ways. And the one that was pointing to a high fat diet leading to IR made no point of including the horse's body condition into the mix. So really (imo) wasn't all that useful. I'd love to see newer research if anyone can dig some up!

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