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How to Minimize Gastrointestinal Disease Associated with Carbohydrate Nutrition in Horses

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How to Minimize Gastrointestinal Disease Associated with Carbohydrate Nutrition in Horses IN-DEPTH: PRACTICAL NUTRITION—“HOW-TO” How to Minimize Gastrointestinal Disease Associated With Carbohydrate Nutrition in Horses Ray J. Geor, BVSc, MVSc, PhD, Diplomate ACVIM; and Pat A. Harris, MA, PhD, VetMB, Diplomate ECVCN The feeding of high cereal grain rations and tendency to suppress natural foraging behavior are at odds with healthy function of the horse’s gastrointestinal tract and may increase risk of colic and gastric ulcer disease. Recommended feeding practices targeting reduced risk for development of diet-associated gastrointestinal problems included the provision of adequate forage (1.5% of body weight per day), limiting the size of high starch meals (Ͻ2.0 kg for a 500-kg horse), and increasing use of non-starch sources of energy (e.g., vegetable oils and fiber sources such as beet pulp and soya hulls). Authors’ addresses: Middleburg Agricultural Research and Extension Center, Virginia Tech, 5527 Sullivans Mill Road, Middleburg, VA (Geor); and Equine Studies Group, WALTHAM Centre for Pet Nutrition, Melton Mowbray, Leicestershire LE14 4RT, United Kingdom (Harris); e-mail: [email protected]. © 2007 AAEP. 1. Introduction which in turn often results in decreased provision Carbohydrates are the primary source of energy in of forage compared with the non-working state. the diet of horses. Horses, as non-ruminant herbi- Survey studies have indicated that racehorses vores, evolved to use forages high in structural car- weighing 450–550 kg typically receive 3–6 kg of bohydrates through bacterial fermentation and the concentrate per day, with some horses receiving 1–3 production of volatile fatty acids (VFAs) in a highly Ͼ8 kg/day. Such high grain intakes by horses developed large intestine. However, the daily di- (and/or a low forage-to-concentrate ratio, e.g., 30: gestible energy (DE) needs of racehorses, endurance 70) have been implicated in the development of horses, and 3-day eventers are about double the gastrointestinal problems, particularly gastric ul- requirements of horses not in training and typi- cer disease and colic associated with disturbances cally forage (relatively low energy density and to hindgut function. bulky) alone will not satisfy the energy demands The objectives of this paper are to (1) review in- of their athletic training and competition. To formation concerning links between diet, feeding meet this increased energy requirement, horses practices, and disturbances in gastrointestinal func- are commonly fed more energy dense feedstuffs, tion (e.g., gastric ulcers, colic), especially in relation especially concentrates rich in starch and sugar to carbohydrate nutrition, and (2) provide recom- (non-structural carbohydrates, e.g., cereal grains), mendations for feeding management that may help NOTES 178 2007 ր Vol. 53 ր AAEP PROCEEDINGS IN-DEPTH: PRACTICAL NUTRITION—“HOW-TO” to reduce the risk for development of gastrointesti- The ingestion of high concentrate and low forage nal disease. diets has also been implicated in the development of gastric ulcers, which in turn may result in signs of 2. Feeding Management and Colic colic. Colic is caused by many conditions, each of which These observations raise several questions con- may be related to specific risk factors such as cerning the effects of diet composition and dietary changes in diet, feeding practices, exercise patterns, change on gastrointestinal function, including the and housing, or inappropriate parasite control pro- capacity of the equine digestive tract for grain grams. An association between feeding practices (starch) digestion, possible reasons for increased and disturbances in gastrointestinal function has colic risk with high levels of grain feeding, and the long been hypothesized,4,5 but the mechanisms link- effect of a sudden change in diet (grain or forage) on ing diet with the development of intestinal dysfunc- gastrointestinal function. tion are poorly understood. Indeed, the exact relationship between diet and colic is difficult to 3. Carbohydrate Digestion and Hindgut Function determine because of the variety of feeds and feed- ing practices used throughout the world, as well as Limited Capacity for Starch Hydrolysis in the Small differences in study populations. Furthermore, it Intestine is often difficult to separate the effects of diet and From a digestive viewpoint, carbohydrates in horse feeding schedule from other management practices, feedstuffs can be divided into three main fractions: which often will depend on the horse’s breed and (1) hydrolyzable carbohydrates (CHO-H), which can use. Nonetheless, the results of recent epidemio- be digested in the small intestine by mammalian logical studies have provided support for the propo- enzymes (or if they escape digestion in the small sition that diet composition and recent changes in intestine and reach the hindgut, can be rapidly fer- diet are important risk factors for development of mented in the hindgut); (2) rapidly fermented car- 6–10 9 colic. Tinker et al. prospectively examined the bohydrates (CHO-FR), which cannot be broken down risk for colic on 31 horse farms over a 1-year period. by mammalian digestive enzymes but are readily Both a change in concentrate feeding (odds ratio available for microbial fermentation; and (3) slowly ϭ [OR] 3.6 relative to no colic) and the feeding of fermentable carbohydrates (CHO-FS). The hydro- high levels of concentrate (Ͼ2.5 kg/day dry matter, lyzable fraction included hexoses, disaccharides, OR ϭ 4.8 and Ͼ5 kg/day dry matter, OR ϭ 6.3, some oligosaccharides, and the non-resistant relative to feeding no concentrate) were identified as starches. Although some fermentation of these risk factors for colic. In addition, colic risk in- compounds may occur in the stomach, the primary creased when processed feeds such as pellets were products of digestion of these compounds are fed. Hudson et al.8 reported that a recent (within 2 monosaccharides that can be absorbed in the small wk) change in type of grain or concentrate fed (OR ϭ intestine, with a relatively high energy yield. The 2.6), the feeding of Ͼ2.7 kg of oats/day (OR ϭ 5.9), rapidly fermentable fraction included pectin, fruc- and a change in the batch of hay fed (OR ϭ 4.9) were tan, and some oligosaccharides not digested in the significant risk factors for an episode of colic. In small intestine. Resistant starch and neutral de- another prospective, case control study, neither the tergent hemicellulose could also be included in the amount nor type of concentrate fed was associated rapidly fermented fraction. The slowly fermented with colic risk, although the researchers did con- carbohydrate fraction includes cellulose, hemicellu- clude that horses at pasture may have a decreased lose, and ligno-cellulose that result primarily in the risk of colic.10 On the other hand, a recent (within production of acetate in the large intestine. 2 wk) change in diet, in particular the type of hay fed In non-ruminant species, there are three primary (including hay from a different source or cutting of steps in the hydrolysis of starch: (1) hydrolysis of the same type of hay), was a significant risk factor ␣-1,4 glycosidic bonds by pancreatic ␣-amylase and for colic.10 In this study, feeding hay other than intestinal glucoamylase, yielding primarily maltose coastal/Bermuda or alfalfa significantly increased and maltotriose (which is further hydrolyzed to mal- the colic risk, but this may have reflected hay qual- tose and D-glucose); (2) hydrolysis of maltose by the ity and digestibility rather than type of hay per se. brush-border membrane disaccharidase maltase, Changing to a poorer-quality, less-digestible hay or yielding D-glucose; and (3) transport of D-glucose across feeding wheat straw or cornstalks may predispose the enterocyte brush-border membrane by the Naϩ/ horses to large colon impaction.10 In a practitioner- glucose co-transport protein, SGLT1. There is some based colic study in the United Kingdom, a recent evidence that horses have a limited capacity for com- change in management was associated with at least plete digestion of starch in the small intestine (i.e., 43% of the cases of spasmodic or mild undiagnosed pre-cecal starch digestion). At low levels of starch colic. The most common management change was intake (130–140 g/100 kg body weight [BW] from oats, turnout onto lush pasture in the spring.11 In re- barley or corn as a single meal), ϳ80% of the starch viewing the results of available epidemiologic stud- was digested in the small intestine.13 When starch ies, Cohen12 estimated that approximately one third feeding was doubled (250–270 g/100 kg BW), pre-cecal of colic cases had history of a recent change in diet. starch digestibility decreased to 50–55%. Grain type AAEP PROCEEDINGS ր Vol. 53 ր 2007 179 IN-DEPTH: PRACTICAL NUTRITION—“HOW-TO” and processing affect the efficiency of starch hydrolysis tate, propionate, and butyrate, which are an impor- in the small intestine, and thus, the amount of starch tant source of energy. In addition, the VFAs that can be tolerated (see Recommendations for Mini- (particularly butyrate) regulate the expression of mizing Digestive Disturbances). Based on the results genes controlling proliferation, apoptosis, and differ- of their studies, Potter et al.13 recommended that the entiation of gut epithelial cells.18 maximum amount of starch that should be fed at one The rate of fermentation and the microbial and meal is 3.5–4.0 g/kg BW. Feeding Ͻ300 g starch per biochemical contents of the large intestine are af- 100 kg BW was recommended by another author,14 fected by diet composition and feeding pattern (i.e., and recently, it has been suggested that, even at this continuous “grazing” or small, frequent meals vs. level, there may be concerns depending on the nature large meals administered twice daily). An abrupt of the feed.15 This recent work suggested that, change from forage only to a forage/concentrate diet whereas at 300 g starch per 100 kg BW, all the oat will result in an increased rate of fermentation and starch was digested in the small intestine, 20% of the marked changes in the microbial population, lumi- barley starch and 34% of the corn starch escaped the nal pH, and the contents of VFA and lactate.
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