About the Author
Dr. Julie Vargas dvm
It is well known that most performance horses in training or competition suffer from discomfort caused by gastric ulceration. While stomach ulcers are readily identified via gastroscopy, hindgut conditions have been overlooked in part due to the difficulty of obtaining a definitive diagnosis. Recent research suggests that equine hindgut pathology is significant and potentially as common as stomach ulceration.
A presumptive diagnosis of hindgut ulcers can be made on history, clinical signs, changes in blood work, abdominal ultrasound and more recently by the testing for occult blood in manure samples. The presence of blood in the manure can be helpful as an ancillary diagnostic test in horses to help identify a problem in the foregut, hindgut or both.
One commercially available fecal occult blood test, Succeed Equine Fecal Blood Test from Freedom Health LLC, combines a test for fecal hemoglobin with one for albumin. Detection of abnormal concentrations of fecal albumin and hemoglobin does provide some guidance as to the existence of hindgut pathology as bleeding within the gastrointestinal tract, specifically gastric ulceration or colonic ulceration, are the most common sources of bleeding.
The principle goals of treatment for hindgut ulceration include avoidance of NSAIDS, more frequent low bulk feedings, reducing inflammation, and managing stress levels. Omega-3 fatty acids have been utilized with good success as a natural anti-inflammatory. In addition, the added fat calories from the oil allow for decrease sugar and starch content in the diet. ProElite oil is a camelina plant-based product providing excellent bio-availiabity of omega-3 fatty acid supplementation.
To investigate the difference in fecal occult blood testing pre and post 30-day ProElite oil trial.
6 adult horses
Horses were selected based on a positive fecal blood test (Succeed Equine Fecal Blood Test) with a concurrent negative fecal egg count. In addition to the positive blood fecal, horses had at least one addition clinical sign consistent with gastrointestinal ulceration prior to the start of the study. Succeed fecal occult blood test and baseline blood work including CBC and chemistry was performed at Day 0. A written survey (survey #1) was completed by a veterinarian indicating clinical signs and history of the horse.
ProElite oil was supplemented in the feed at 4 ounces daily for 30 days starting at Day 1-Day 30. Logs detailing administration and acceptability of the oil, and the horse’s feeding and training regime were maintained by the trainer/owner of each horse. Repeat fecal occult blood test, blood work (CBC and chemistry), and clinical response survey was performed at the conclusion of the 30-day ProElite oil trial.
According to the trainer/owner logs, all 6 horses completing the survey were amenable to eating the 4 ounces of ProElite oil fed directly over and mixed in the feed. Of the 6 horses, 5 were fed the total amount of oil split into 2 ounces fed twice a day and 1 horse was fed the 4 ounces all at one feeding.
The Succeed Equine Fecal Blood Test indicates bleeding in the GI tract by measuring fecal hemoglobin and albumin. Detection of abnormal concentrations of fecal albumin and hemoglobin does provide some guidance as to the existence of GI pathology in different ways. Albumin is a protein that is free-floating in blood plasma. While it is present any time there is a bleeding injury, it may also be released through smaller injuries that only seep plasma. This manner is consistent with hindgut “leaky gut” syndrome. Additionally, albumin is digested by bile and proteolytic enzymes in the small intestine. As a result, albumin present in a horse’s feces is thought to primarily originate from the hindgut.
A separate parameter noted in the fecal blood test measures hemoglobin. Hemoglobin is always present any time there is an injury that produces whole blood. While hemoglobin may be somewhat degraded in the digestive process, it is at a much lower rate than albumin. When bleeding occurs in a horse’s gut, some of the blood is degraded, leaving the rest to move through the digestive tract until it is expelled in the horse’s feces. Therefore, hemoglobin in a horse’s feces could have originated from anywhere within the GI tract.
In this study, the intent was to choose horses with high fecal albumin as noted by a strong or a faint positive line on the Succeed Equine Fecal Blood Test. All horses were also required to have a negative fecal egg count as parasites in the digestive tract may alter the test results.
Although a definitive diagnosis can not be made entirely based on a positive fecal albumin, with the addition of clinical signs related to GI pain, there is a high likelihood of hindgut pathology. Results of this study showed a positive correlation and improvement in both fecal albumin and clinical signs related to each horse’s presenting complaints. Blood work on each horse was pulled prior to the start and at the end of the trial. No significant results could be ascertained from the blood work alone.
5/6 horses went from positive fecal blood tests (albumin specifically) to negative fecal blood tests. All surveys noted improvement in clinical signs. Supplementation with ProElite oil at a dosage of 4 ounces daily was correlated with improved fecal blood test results and resolution of clinical signs associated with GI upset.
Dr. Julie Vargas dvm