General guidance from Dr Josh Slater BVM&S PhD MRCVS from Peer Reviewed Article U.K. VET 3,6, 1998

1. Low protein:

     avoid most cereals (barley, wheat and oats)
     avoid early-cut hay
     avoid clover or alfalfa hay
     feed oat hay ad lib or (less satisfactory) feed meadow hay ad lib

2.   High carbohydrate

     feed molassed sugar beet pulp plus maize (2:1 RATIO) little and often to appetite at a rate of up to 2kg/100kg body weight

3.   Supplement vitamins A, D, E and B(12)

Dietary Support published by Dodson & Horrell  EQUITALK edition 3

Dietary Support

Nutrition needs to be considered as part of the care of horses with liver damage

Fibre

Should be highly digestible, low to medium protein and the horse encouraged to maintain his intake.

Damp hay with diluted molasses to improve consumption, empty nets before refilling with fresh hay and feed small amounts regularly rather than presenting the horse with a huge net.

Protein

Dietary protein should be moderately restricted, but you need to feed enough to stop the body reserves being broken down and to maintain a positive protein balance.

Small amounts of high quality protein (which produce less waste, ie less ammonia) is better than using more of a lower quality protein, straw should therefore be avoided.

The branched chain amino acids, which are good energy and protein for the brain and muscle, need to be increased (Gulick et al, 1980)

Sugar Beet and Dodson & Horrell micronised maize are good sources of branched chain amino acids.

Carbohydrates

A mix of simple sugars and some highly digestible complex carbohydrates should be fed in small meals frequently. Enough energy needs to be fed to stop breakdown of glycogen and to smooth out the glucose/insulin peaks and troughs.

Molassed sugar beet provides both simple glucose and structural carbohydrate; oat starch is more easily digested compared to some other cereals. If you find that your horse is not interested in eating, at this stage it is betterto tempt them with anything rather than sticking to rigid rules.

Vitamins and Minerals

B vits appear to help in appetite stimulation and are used as co-enzymes by the liver. Your vet may inject your horse on a regular basis and ask you to feed B vits daily or weekly, folic acid and B(1) are usually recommended (Mair, 2000) eg B-sure

Vit E  a deficiency may exaggerate the damage to the liver because of production of peroxides and free radicals. Vit E is a natural antioxidant and together with selenium may help mop up the free radicals.  Vits A, K and D should not be over supplemented as A is stored in the liver and could become toxic, D can lead to renal failure and K can cause haemolytic anaemia.

Copper is stored in the liver and feed with high levels of copper should be avoided as extra copper further damages the liver cells.

Zinc Extra zinc may help inhibit collagen accumulation in the liver.  It may also inhibit the absorption of copper from the gut by inducing metallothionein which mops up copper.

Vinegar

May be effective at decreasing blood ammonia, feed about 240ml to a 450kg horse (Mair, 2000).  eg. Dodson & Horrell Cider Vinegar.

Probiotics and Yeast

Because metabolism has been disrupted this is likely to effect the bacterial flora of both the front and hind gut.  20g of Yea-Sacc should be fed daily to help maintain hind gut stability, courses of probiotics will also help the front part of the gut maintain its defence against disease.

Dietary support prescribed by Curonw and Verhulst Equine Vets

Add 20 ml of EQUISTRO Haemolytan 400 to feed once per day for 12hh pony with GGT of 120

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