Nutritional support for the dysphagic adult horse

When changing the hay makes a difference: A series of case reports

Dry hay (composed of grass, legumes, or a mixture of the two) provides the primary source of alimentary fiber in stabled horses with limited access to fresh pasture. However, hay can also give rise to health problems in the horse, depending on the quality and quantity of its components. Pathologies may be rooted in biological problems, such as inadequate digestion disturbances, or reflect mechanical difficulties - for example, due to the presence of sharp plant parts that irritate the oral mucosa, or due to physical intake problems that inhibit consumption. Unwanted plants in the hay may cause stomatitis and affect the oral mucosa, resulting in inappetence, hemorrhagic drooling, gingival hyperemia, edema, and ulcerative lesions, as reported in case 1 of the present study. Horse dysphagia, defined as a difficult in ingesting feed through the mouth and esophagus, is another important cause of malnutrition in the horse, and identifying the site of its origin is important in order to provide practical advice for nutritional management, as reported in case 2. Free fecal water syndrome (FFWS) is a condition where the horse exhibits two-phase feces expulsion, with an initial solid phase followed by a liquid phase. Although the etiology of FFWS is still unknown, hay quality seems to play a key role, as the outcome of case 3 suggests. This case series highlights the importance of hay quality and of providing an appropriate and adequate fiber intake. Moreover, good hay management becomes crucial when horses are affected by contextual pathologies, such as stomatitis, dysphagia, or FFWS.

Equine Dysautonomia

Equine dysautonomia (ED; also known as equine grass sickness) is a neurological disease of unknown cause, which primarily affects grazing adult horses. The clinical signs reflect degeneration of specific neuronal populations, predominantly within the autonomic and enteric nervous systems, with disease severity and prognosis determined by the extent of neuronal loss. This review is primarily focused on the major clinical decision-making processes in relation to ED, namely, (1) clinical diagnosis, (2) selection of appropriate ancillary diagnostic tests, (3) obtaining diagnostic confirmation, (4) selection of treatment candidates, and (5) identifying appropriate criteria for euthanasia.