Podcast: The Hoof Gut Connection: The Link Between Digestive & Hoof Health

Dr. Ethan Romas-Hill, Poseidon Animal Health's Veterinarian, recently appeared on the Humble Hoof podcast.

The Humble Hoof Podcast is part of the Horse Radio Network and has thousands of listeners and over 100 episodes published. The podcast is hosted by  Alicia Harlov who is a full time hoofcare provider on the North Shore of Massachusetts, and a member of Progressive Hoofcare Practitioners. 

Episode 110: Gut Health and Hoof Health

Transcript:

Alicia Harlov

Welcome to the Humble Hook podcast. My name is Alicia Harlov. This is a podcast for both horse owners and hoof care professionals, offering discussions into various philosophies on the health of the hoof and soundness of your horse. Please check us out on Facebook or at thehumblehoof.com.

 

Alicia Harlov

I've seen his videos on TikTok, and I see that he has a lot of sound comfortable barefoot horses. And I wanted to see if he saw a connection between the gut and hooves, and he agreed to chat with me about it. So usually the first question I with for everyone is, well, I mean, obviously for veterinarians, is if you would be willing to tell us a little bit about how you became interested or your journey into veterinary medicine and also your interest in hoof care, if you're willing to chat about that.

 

Dr. Ethan Romas-Hill

Yeah, absolutely. I've been on to grow up on the back of a horse, like a lot of us. I've, I guess, started with hoof carers at a fairly young age I've always, in some capacity, trimmed and shod my own horses and horses of my friends. Then, both through dressage through my teenage years and decided that I wanted to do a bit more with horses and make my life built around horses. So be a vet, it was. I went off to vet school. I wasn't sure if I wanted to really continue with horses. Had the conversation in my head a lot, the Do I do small animals? Do I do large animals? Because that's how our system is over here. And really had horses throughout that time myself and had friends' horses that suffered in two areas. I could see through competition riding that there were two big areas above all else that were the main reasons why someone maybe couldn't take their horse to a competition, or they had to have time off, or where were they spending their money? Where was the big pain points for horse owners. That wasn't an opportunity to say, Hey, that's where I'm going to send a business and make money there.

 

Dr. Ethan Romas-Hill

But for me as a horse owner and a horse lover, and really an educator in a lot of ways, I needed to find the big areas where we could improve. I think everyone would agree that top of that list is usually nutrition. And second of that list is, I guess, hoof health in every aspect. While I have done some time as a small animal a bit and more in the orthopedic surgery area, that led me back into sporting dogs and found my way back into sporting horses. Throughout that time, I guess, how did I get into gut health? I actually had a horse several years ago now. He was an imported horse that I bought after he had been imported to Australia from the Netherlands. He had all these weird signs that we understand so much better these days. But to summarize it, he should have been a superstar and was throwing people off into the wall, breaking their spines. I picked him He was very, very cheap. He still looked good, but you could tell there was something not quite right. I had him for a week and he tried to throw me off into a wall.

 

Dr. Ethan Romas-Hill

I scoped him and found the most, still to date, the most severe I've ever seen in a horse full stop. At this stage, really, we'd have the conversation, but it's not the same conversation we're having today. I feel every horse owner really understands horses quite well, no matter where you are in the world. There's some places that understand better than others, but it's about sharing that education around. But at this point in time, that was still fairly new in these sportier horses. That's where the spark for me came through gut health. Later down the track, I've had horses, but I've got one horse currently competing at advanced dressage level, training Proust and George now should start in our spring at Proust and George. He was one that I was basically told This is probably navicular. Retire him. He's never going to come good from this. You'll have to keep him shone, blah, blah, blah. At this point, I was working with it quite a bit, and this was getting a second opinion because I didn't trust myself at that stage, especially when it's your own horse. To cut a very long story short, that horse is obviously now competing advanced priest George level or about to go priest George, and he doesn't wear shoes and has Probably the best feet and the soundest feet of any horse that I put hands on.

 

Dr. Ethan Romas-Hill

I look back to my own educated thoughts around both gut health and hoof health, and I felt trapped in a corner where I couldn't do anything. I don't like that feeling. I don't want anyone else to have to feel that way. That's where I've found my life's purpose and directed my life towards, is learning as much about these two areas as well as general horse management and dressage principles, training of horses. I've directed my life towards finding out as much as I can and sharing that information. It's a bit of a long-winded way, but I think when you understand the why behind doing something, the how becomes easy. And I really try and align strongly with that purpose.

 

Alicia Harlov

Yeah. And a few things that you said really hit home for me. And I feel like there are two hills that I die on. One is that there And one is that there has to be a connection between nutrition and the hoof. And also the second thing that you mentioned, which I am so incredibly passionate about, is that a lot of horses that are diagnosed with hoof issues, like navicular, might not actually have pain stemming from their feet or from the navicular region. It could be their feet hurt, but it doesn't necessarily mean that it's just this degenerative disease. And we have to look at what else might be going on in the body or their management or their diet or their gut or things like that to make sure that we're not missing the mark. I'm super excited to be talking to you about that because there's things that I'm super passionate about. And can you remind me where your practice is based out of?

 

Dr. Ethan Romas-Hill

I'm based out of a surrounding Melbourne and surrounding Sydney, I work between the two in Australia.

 

Alicia Harlov

Awesome. Yeah. So it's quite the time difference. Thanks for putting up with that when we're figuring out a time to chat.

 

Dr. Ethan Romas-Hill

No, that's okay. It's a fairly reasonable time here right now.

 

Alicia Harlov

Yeah. Okay, good. Yeah. And so something that I wanted to focus on today in our conversation is gut health. And I've been wanting to do a podcast episode about this for a very long time, but I feel like I know so little about it that it makes it hard to have an educated conversation. So I might have to have you help me with that in terms of the direction of some of these questions and things like that. But I guess to start off, what are some of the most common issues that you see in horses in regards to their gut? Obviously, you mentioned ulcers before. Is that pretty widespread across the board?

 

Dr. Ethan Romas-Hill

I think it depends where you are, what we'll focus on, really. And the conversation you have regionally, it depends on the level of education and the level of intervention that's already been made. So in some spaces, we'll talk more about ulcers, but then you've got other spaces, especially where there's a lot of competition where people will control this, and I'm going to put this in asterix, really well with drugs like a meprazole, which I don't know what your brand names over there are. It'll be something ulcer guard, ulcer shield, things like that. That will pretty reliably keep ulcers at bay. That's obviously a big issue for us. Those drugs control that quite well. Other drugs like mizacrosyl and sucralophate will help there. But I think it's so important to realize that you're talking about an organ that has maybe 15 liter capacity in an average horse. Then behind that, there's another 75 liters of capacity and surface area where there's so much functionality and so much life in the horse. We're talking about this one little bit at the start. More specifically, we're actually often only talking about a band around the stomach that is about three centimeters max wide where they're likely to get ulcers.

 

Dr. Ethan Romas-Hill

So when you put it into perspective like that, the ulcer conversation feels really small. Can it produce massive issues? Absolutely, it can. But if we're only controlling that one area of the gut with these specific drugs, I'll admit, stucrofate does coat all the way through. It is quite a good drug. But when we talk about a meprazole, we're talking about just protecting this one little tiny region and thinking that that means that our horse's entire gut is healthy, and it's just not what we know anymore. So this is what I mean when we talk about things a bit different depending on the region. I Australia, I can speak of more so, is quite ahead in understanding of gut health, which is fantastic. We think a lot about the high in gut now. I guess the dietary changes, the why behind a meprazole. I don't know how familiar you are with the dosing schedule for it, but usually, most preparations will be about 360 milligrams per millil here. From what I understand in the States, it's quite easy to access. It's not very easy to access. Over here, I think it's a lower concentration over there.

 

Dr. Ethan Romas-Hill

But usually it'll be about 2-4 milligrams per kilogram for 28 days. That's a pretty standard protocol. What you see frequently is horse owners that will do the 28 days and maybe taper off or stop, make no other changes in that time, and then they're back on the medication again in a month down the track. The horses Those often look quite good. But when you go and look at the longer term more complex structures like feet, you'll say, oh, but his coats fine, why is his feet so brutal? Why do his feet not grow? But we've had this effective system now of masking this in such a way that we are neglecting the true gut health of things. So as a general comment on this, that if anyone listening takes away absolutely nothing else from this, it's that Omeprazole was never designed to be a long-term treatment. Really, it's not a disease to me. I guess it is because it's functional, but I treat it like an injury. If you think of the horse's body as a continuous tube and their gut continues with their skin, you think of it as this one big protective immune organ that separates the outside environment from the inside environment.

 

Dr. Ethan Romas-Hill

If If you had a cut on your skin or an ulcer on your skin, you're not going to think of it as a disease necessarily, especially if it's related to people who get psoriasis from milk. If it's a reaction to something you're eating and you get an ulcer on your skin, you are not going to call it a disease. You're not going to eat that thing anymore. That skin is continuous with the gut. An ulcer is an injury. You don't treat an injury with a long term course of chemotherapy, which is what a meprazole is. It controls the dysfunction of over acid production in that time, that 28 day period. So you've got time to make the changes that you need to be able to have that horse go on and thrive with a healthy gut. Does that make sense? Yeah.

 

Alicia Harlov

So you're basically saying it's treating the symptom at that point, but it's not addressing the cause of what led you there.

 

Dr. Ethan Romas-Hill

Absolutely. But the question that then comes is, what the hell do we do?

 

Alicia Harlov

Yeah. So I guess another question because, obviously, we're talking about a meprazole, and this is just maybe off topic. But I know in people, a meprazol can cause other issues. I know that it can affect B12 absorption or other nutrient absorption. Is that true in horses, too, or is that strictly a human issue?

 

Dr. Ethan Romas-Hill

So in humans, I think they refer to it as the divorce maker because, one, it can produce quite a bit of gassiness. I think anecdotally, there's behavioral changes in horses with the use of meprazol. It's not something that I would consider It's extremely significant, but it's in my mind. The really big thing that I consider with a meprazole is it's quite potent at chelating calcium or binding calcium. Calcium needs to exist in a certain form to be able to be absorbed. So while that's maybe... Unless you're giving it long term to an adult horse, I'm more concerned there with your young growing horses. So I see plenty of maybe futurity horses that people are thinking they're doing the right thing with because they want take them to competitions and protect them during travel. And yes, you will protect the stomach during travel. You won't necessarily protect the whole gut. But also you've got this calcium binding in an animal that's actively growing and trying very hard to bind calcium together in such a way that they can build bones. And this starts to come into feet a bit. If we look at quarter horses are probably overrepresented.

 

Dr. Ethan Romas-Hill

In navicular, this is... Feel free to disagree with me there, but that's just my understanding from what we have in Australia. You've got small, upright feet and big bodies. Especially if they start to go negative, You got to see more navicular signs, of course. Yeah, absolutely. But then I think these horses often go out and are on a lot of meprazole early. It's not just quarter horses across the board, but horses are on meprazole really, really early. Then we have problems with a specific bone in their foot having calcification problems. That's a link that I've made, not based off on any research, but it starts to make you think a bit more. Where are we pulling calcium from? Where is it needed? You'll start to see an increase in things like pathological fractures, these tiny repeat injury fractures in racehorses. The racehorse industry in Australia is very big. We see lots of two-year-old, three-year-old horses with a lot of pressure on their bones that aren't completely calcified. They are fed really, really high cereal-grained diets. And the only way that they can be controlled from getting four gut ulcers, stomach ulcers, is with lots of Omeprazole constantly.

 

Dr. Ethan Romas-Hill

The soundness rate of retired racehorses with anything from subchondral bone disease like your osteocondrosus, your OCD lesions is well and truly overrepresented in these adult horses. Is it genetic? Is it from early trauma on these bones? Is it from calcium homeostasis issues? I don't know. But to me, having something that's going to bind such an essential macrominimumeral that is used in pretty much every muscle function in the body. It's the reason that your nerves can relax, I guess, can reduce their excitability. It's the main electrolyte that's used to allow your heart to pump, and we're binding it for the smallest percentage of the horse's gut. I'm not saying don't use a meprazole, but there is a cost to everything that we do with drugs, and they're usually to achieve a fast result. I know horses that have passed away from ulcers, and they needed, probably at the right time, a meprazole to really help them. I'm definitely not saying don't use it. I'm an advocate of it in a lot of spaces, but I'm not an advocate for the use of any long term chemotherapy. Let's We cannot forget, we're using chemicals to change a horse's body function.

 

Dr. Ethan Romas-Hill

This is chemotherapy, long term chemotherapy to manage something that is not truly a disease. It is a side effect of less than perfect, I'll say, less than perfect management. And really, I strongly believe that the true cure, for lack of a better word, is education on how to better manage our horses and having better understanding of stress in horses.

 

Alicia Harlov

Yeah, absolutely. I want to ask you about that, the causes and what you see leading to these gut issues. But I wanted to also mention that you were talking about hoof issues and navicular and things like that. Something that made me latch on to the idea of gut health is that there's little pockets of groups that are starting to talk about gut health and its link to laminitis and and hoof sensitivity and lamina connection. I mean, I think we've always... I mean, I've always assumed that if the gut isn't healthy, they're not going to be absorbing their vitamins, minerals, nutrients well, possibly. And I could see why that would affect the eat. But something that really intrigued me were people who still now are swearing up and down that if the gut is not healthy, then these horses, especially horses that are predisposed to metabolic issues, are more likely to have laminate episodes. And so that's something where I've really wanted to see if there's... I mean, maybe we don't have any research on this. Maybe there isn't a true correlation, but I don't think it can hurt to have a healthy gut, either way.

 

Dr. Ethan Romas-Hill

I think I'd love to be able to start some research I don't know, specifically, but there certainly is research that links this. And I don't think it's a bad thing to use case studies and anecdotal research here, well, anecdotal evidence here, because there are so many There's so many horses that get laminitis, and there's so many horses with various gut issues that you can see really strong correlations, even with anecdotal evidence. It's really, really hard to do, especially longitudinal studies. But any study you do in horses, I can tell you from experience, is very, very hard to control. Sometimes anecdotal evidence, and a lot of it, is really, really valuable. The reason it's really hard to do research in horses is unless you own, say, 50 horses, and you feed them all yourself, or you have one research system feeding them all yourself, compliance is really, really hard. If you're trying to take bloods from horses, their stress levels throw out all of your data. So sometimes seeing environmental factors, if you don't own them, they're in different places and you're not seeing them every day. It's really, really hard to control. I've done some research into metabolism in horses.

 

Dr. Ethan Romas-Hill

But by the end, when you're trying to come up with these horses with needles, they get this instantaneous spike in glucose, which is obviously going to result in a slightly delayed insulin boost. When we're measuring insulin, just because they're stressed because they don't want to be poked with a needle, it's really, really, really hard. So that's just a bit of a preamble there. But the other thing that we can pretty consistently see is horses that are thriving. If you looked at a horse and said, That horse is thriving, with a certain degree of accuracy, you're going be able to predict how likely that horse is to have any disease, let alone hoof disease. I think that the link that you're looking for here is what are the things that help a hoof stay together. So with any tissue in the body, you've got the structure. So we've got proteins, really what's making up us because we don't have a cell wall. We We have these proteins and we need something to hold them together with, and that's energy. So that applies to every single tissue in the body. And then we have things that will strengthen those connections and weaken them.

 

Dr. Ethan Romas-Hill

That's something that I'll come back to in a minute. And this bit sounds a little bit touchy feely, but we've got three reliable ways that we can get energy into the body of a horse. They can take the energy from the ground, which we care about as hoof care professionals. Sounds very silly, but when a horse moves, that ground reaction force is actually taking the Earth's potential kinetic energy that it has in it, and they then use that to move. The only connection with the horse to the ground is through their feet, obviously. That's a big energy source. That's why we care so much about feet. We've got the sun. I can't control much of the sun, so I won't talk about that. But then we have the digestive tract. You're starting to get this link straight away with the gut and the feet. They're so intimately linked. They are two of the huge avenues of energy into the body. If we don't have a gut that can effectively absorb these proteins, like you said, we don't have what we need to build the hoof. We talk about proteins like methionine all the time, lysine, these really important known amino acids in producing hoof tissue.

 

Dr. Ethan Romas-Hill

We can research this on cadavers. We can use histological slides looking for these amino acids effectively. I'm no pathologist. I don't know how they find that, but they can isolate these specific proteins. The horses that are having a less high likelihood of disease, well, I guess, that don't have clinically apparent disease, have higher proportions of certain things than those that do. That's an oversimplification, but that's how we understand it. If you've got an ineffective gut that can't take in proteins properly, you Your ingredients list is already tainted. Then I've said now we've had two of the three energy routes into the body explained, then we've got the gut. If the gut can't effectively produce energy and can't effectively absorb energy, how are we meant to put through any energy and protein into building feet? And that's the metabolic digestive function of the gut. But like I was saying before, the gut is one massive immune organ. It's up to 70 % of the immune system can be in the horse's gut. So when you think of the immune system, a lot of people think, oh, that protects me from getting sick. The immune system encompasses all of the body's protective mechanisms.

 

Dr. Ethan Romas-Hill

And a lot of that is built up from white blood cells, which are our inflammatory cells that include our inflammatory mediators. So when you say that If we phrase it differently, that the capacity to produce inflammation, 70% of the body's ability to do that is found in the gut. We're talking about laminitis being an inflammatory condition. Do I know for a fact that that's linked? I would like to think I do, but I can't put that down on a piece of paper very clearly. But if we've got this massive vessel of inflammation, it just makes sense that we start to have this, what I call the glass almost full model versus the glass half full model. Whereas a horse with moderate levels of gut inflammation needs quite a bit to push it over the edge in all of its other cells because all of these inflammatory cells are cycling through the entire body. Then you get these horses that have high levels of basal inflammation because one of the biggest organs in their body, their gut, if not the biggest, is inflamed. So they only need this tiny little shift to throw off all of the immune system in their body towards inflammation.

 

Dr. Ethan Romas-Hill

And because it's communicating through the blood, if you've got inflammation in one spot, it all goes to the heart and gets recycled. It's going everywhere. I could talk about that on and on and on, but I hope that that's just a little bit of a taste to start with of why it's so important, why it's linked to so many things, and why it feels like the root of all evil is poor gut health in horses. I truly believe that it is the place that we need to start. It really doesn't matter what the condition is. If your gut is compromised, you need to start there if you can. And it's not a true emergency. But long term health in horses is is dependent on their gut health. That's a phrase I'm happy to be quoted on. That is how strongly I believe that.

 

Alicia Harlov

Yeah, absolutely. And honestly, I think it's a missing link in some cases that I'm working on. Having a hoof rehab facility, one main focus of ours is forage. I want the horses here to have safe, tested forage available 24/7 without the risk of becoming obese. I've spent years looking for the ideal slow feeder for us, and we have found it with Hay Boss feeders. When I tell you that my Hay Boss XL Feeder has cut my feeding time by 90%, I mean it, and it might even be an understatement. The covered feeders with integrated slow feed nets allow for all my horses here to have access to hay all the time, which is healthy for their guts and minds. They're also not able to completely binge all at once because the nets keep them in check. They're available all over North America right now. But side note, if you're in New England, I got mine from Mountain Lane Farm who delivered it right to me and showed us how to set it up and use it. We can't imagine our lives without it here. And so I guess, back to that question from a little bit ago, what do you see as some causes for gut issues?

 

Alicia Harlov

If ulcers or things like that are a symptom, what is leading up to that insult or injury?

 

Dr. Ethan Romas-Hill

I think that there's an undeniable genetic link for some of these horses, and that's pretty much all I'll say. Some of them They have more of the potential to produce more acid, need more help with their gut. They don't cope as well with what we feed them. That's because, I said, I wouldn't say it more, but really, we've halted evolution in horses. We're talking about a really old species that we have had for maybe 5% of their existence, if that, in domestication. Then we've made them completely adapt to our systems without letting them evolve. The way we've them to adapt is by selectively breeding horses that don't show us their stress in a clinical way. We have learned that if a horse is stressed, they need to be anxious. That is the biggest problem, whether you're a trainer, whether you're a vet, whether you're a hoof care professional, whether you're stable. And that is the biggest problem you will ever face as a horse person is misunderstanding understanding stress in horses. I promise you, if you truly understand stress in horses, you will have competition success, you will have healthy feet, you will have healthy coat, you'll have a horse that colics less, you'll have a horse that gets less laminitis.

 

Dr. Ethan Romas-Hill

These are all stresses. I want to stress that that is stress-or, S-T-R-E-S-S-O-R. These are stress-or, it's not stressors. That's important. These things that influence their stress levels. By the time we can see stress in a horse, A horse, it's too late. That's not to say you can't do anything, but it means that a horse's capacity to cope with stress is finite. If you think about the levels of stress that a horse will have to reach before we can see it, that generally tells you how much physical capacity. This could be their own ability to produce buffers, their own pain tolerance, their own ability to produce B vitamins. That is their coping mechanisms for stress. There's a term called allostasis. You're probably familiar with homeostasis, which is trying to maintain a stable internal environment despite changes in the external environment. Allostasis is closely related, where we want to make changes so that we can maintain homeostasis. That might be the extra environment is changing and the PH in the stomach is dropping. The body allostatically will then want to produce more acid buffer to keep the PH the same within homeostatic levels. So that's the horse's capacity to cope with stress.

 

Dr. Ethan Romas-Hill

Anything that changes I think you'll agree with me, any change in a horse's life can be stressful. This can be something as simple as you've got a different truck of hay that's come and it looks exactly the same, but the horse's gut is stressed by it because it's slightly different. Every thing can stress the horse, but they have a capacity to cope with it. When we push them beyond that, that's when the overarching diseases of the gut, diseases of the feet, to some description, metabolic diseases, endotoxic diseases, they then start to show their head because the horse can't cope with them anymore. When we come back to things like your B vitamins, you've also got most of the horse's serotonin in the gut. So that's when we start to see B vitamins and serotonin. Potentially, the serotonin model is not extensively researched, but it's a nice idea to think of because we see horses with gut problems that show us more signs of behavioral stress, anxiety. But If you take it back and you fix all their gut problems, you don't see it as much. That's an undeniable link for me. So when you start to understand stress, we don't have this magic, Oh, you need to feed your horse more of this.

 

Dr. Ethan Romas-Hill

You need to feed your horse more of this. We need to do everything we can to, one, reduce the stress on the horse, and two, bolster their ability to cope. So that's where your real diet and management practices come in and change your How neat. Change your whole way of thinking about things. Any competition rider knows that you can have a horse that can go around and do a perfect test at home and take them out to a competition, and they do terribly. Why? Why? How does travel affect them? How does change on feed affect them? How does change in the chlorination of the water that they're drinking at the competition? How does being in a stable when they're used to being in a pasture affect them? These things. The overarching term for all of those changes is stress. And that stress is physical with us and with the horse. So it's a really cool way of thinking about it. I guess I've ganced around your question a bit of what causes these. Because when you understand stress, you can see that it doesn't really matter what the direct cause is. The causes probably come from some stressor.

 

Dr. Ethan Romas-Hill

So we'll jump to ulcers now. The horse's gut is constantly producing acid. That's normal. That's what the horse's gut should do. They need acid to be able to effectively break down things that we can't. And because of the way that a horse digests, that they ferment after their true stomach, opposed to a cow who uses their true stomach After their fermentation, horses need to absorb and digest a lot of protein in the early gut. And now I'm going to a rabbit hole. A cow will ferment, produce microbial protein through that fermentation process. Basically, they're growing these microbes, and then they digest them. They're pulling these microbes apart, taking their protein and taking the energy source and taking the postbiotics that they produce. A horse, on the other hand, needs really high quality protein that they can digest effectively with enzymes and acid, because by the time it's gone to the gut, the home gut, where the microbes are doing the digestion, those microbes don't get absorbed. They go out the other side, we're more worried about the postbiotics that they're producing. So when you see these horses that may be protein deficient, you'll see them be coprophagic.

 

Dr. Ethan Romas-Hill

They will be eating their poop. That's the reason that they do it a lot of the time. It's not a mineral imbalance. A lot of it is just looking for protein because their fecal matter is so high in microbial protein. So it sounds like I'm digressing again, but I will come to a point with this. So if we have this excessive acid production and we're feeding horses in a human or anthropomorphic way, where we feed them maybe once or twice a day in a very concentrated meal, they then have a lot of time where they're not actively digesting complex structures. So this acid actually doesn't get utilized and just sits there. So this horse's stomach is designed to have food in it all the time as a grazing species. And we are then pouring more and more acid in with nothing to do. Of course, we're going to get burns. When the bottom two-thirds of stomach are coded with a protective layer, but the top third is not. We empty the stomach. And then what do we do? We ride them. A wild horse will walk, and then walk, walk, walk. They will run, sorry, can't for long distances.

 

Dr. Ethan Romas-Hill

But generally, they walk and they graze and they've always got full stomachs. We'll put them on a float with no food for 2 hours, get to a competition and get on their back. They've had this massive acid production. They had nothing making a mat over the top of this acid layer and stopping it from flashing on the walls. It just makes sense. It's a management thing. But I'll come back to the level of stress that this walking horse gets in the wild. That is quite low. Everything we add on top of that is a stressor. Instead of painting this picture that everything we change in the house, they're not really that good at coping with, especially if we are then not protecting their gut with what it would basically need, which is a food source that suits their way of digesting. So what do we do instead of feeding them more correctly, forage-based diets, constant access to good quality pasture, or that's not suitable for a lot horses, but good quality forage, low GI, low starch forage is ideal. We instead put medications in them to make them suit us and what we want to do and fill them full of omeprazole.

 

Dr. Ethan Romas-Hill

If we're treating ulcers, that's fine. But I'll come back to what we said before about the horses being quite poor at pulling any low-quality protein out because of the way they digest. If we suppress this acid production, we're actually suppressing the horse's ability to digest feed. If you do that, recently, I saw a horse that had this for seven years, seven years of a Mevrazol treatment. His diet was being reduced and reduced. It was just an unhappy, unhealthy horse with this fantastic owner who's scratching their head because this is what we've been conditioned to do is fill them full of meprazole because it makes us feel safe. I can say that this horse will be released I'm just going to put a bit of data on this, in seven years, never scoped negative for ulcers until we made the 28-day shift in management, gave it a bit more protection and control that stress with a temporary fortification of its ability to cope with stress, which was we're giving them supplementation, that's not going to have a long term effect. He scoped for the first time in seven years negative of ameprazole. I'm not anti-ameprazole, but I just want people to think and be really judicious with the use of these these chemotherapeutics.

 

Dr. Ethan Romas-Hill

So again, I've rambled on there a bit, but it's a really simple but complicated idea. If you take it back to stress all the time, that is the keep it simple, stupid version. Is this stressful for my horse? Is this a stressor? Is this a change? How can I help them to best cope with this so they can continue to function as naturally as possible.

 

Alicia Harlov

Yeah. And that's something that we, I mean, I try to focus on a lot here is we have a forage available 24/7. We have tested hay available all the time. The horses are, well, here we have horses out 24/7. They can choose if they want to be inside. They can choose if they want to be outside. My big thing is, how can I allow these animals to feel safe and feel like they have all that they need and all the resources they need? And obviously, we're saying that People often have to do these management changes in order to get to that spot where the horse is having less stress in their life. And what are some other things? Because I get horses in that come from show barns. They have zero turnout from where they're coming from. So it's honestly a stresser when they move here because all of a sudden they're outside and they're not in an environment they're used to. And as they're adapting, what are some other things that... I know you You mentioned supplementation, and honestly, I'm super interested in that, mostly because I have horses that come in from all different backgrounds, and I want to help them through that transition without just tossing meds at them because they're not my horses.

 

Alicia Harlov

So what are some things that you see as helpful to help their gut adjust to those changes in their lifestyle and environment?

 

Dr. Ethan Romas-Hill

I think that you've hit a good point there that no matter how much we try, horses that did not They're not really ever designed to live in our environment. So they always have a degree of stress. And that's going to vary depending on how much we handle them and whatnot. And also we can't control everything. If we get a thunderstorm, if they do have to move barns and stuff, how do we help them? I guess that's what you're asking. This is my point that I come to with supplementation is in an ideal world, we wouldn't have to supplement horses with anything, truly. They're very good at producing a lot of the things that they need. But I actually had this conversation with a colleague yesterday and said that some people will get dry skin and some people won't. You can use nutrition to improve the quality of the skin that's being produced and get a result long term. You can use medications to help this. But sometimes you'll just go and put a bit of It's not going to be extraised on it. That seems like a very rudimentary thing, but you're supplementing the skin's ability to do its job.

 

Dr. Ethan Romas-Hill

When we feed things to horses for specific purpose, whether that's protection, whether that's trying to feed microbes or not, we are just helping them do something that they're already doing. If it's a good supplement and a functional supplement, that's what it should be aiming to do. I think when we talk about functional supplements versus maybe a nutritional supplement, there's a There's a difference there. I'm more talking about functional supplements right now. Again, come back to stress. What is the stressor? What is that stressor doing? Let's do the opposite of that. Let's make that temporary. So at the risk of, I don't want this to become a product promotion or anything like that, but I can give you an example. Recently, I worked with this horse that was on a mechresol for seven years. We did a 28-day period in which we shifted its diet across and we tracked its fecal PH across this process, which I actually really like fecal PH because it doesn't tell you specifics, but it tells you a lot about what changes are going on. We know that a fecal PH below about 6.4, the horse will be digesting its own gut wall.

 

Dr. Ethan Romas-Hill

We wanted to see, I think the magic number is about 6.85, but anywhere between there and 7.5, I'm pretty comfortable with. So this horse had been a leprosol for a very long time. And if you look at how a meprazole works, it's very slow to reach its peak concentration. It's very slow to come down. So tapering off doesn't work with this drug. You actually have to go cold turkey. And you don't see signs for up to five days later of an issue because that's when And their acid is very much... The drug is gone and we've got a drug that's long term suppressed acid. So all of a sudden we get this massive burst of rebound acidosis. So this is a really good example. So there's a product from I'm animal health called Stress Pace that I use. And again, I don't want this to be a promotion, but there really isn't anything to replace it. So what we did with this horse is we had a dosing schedule of Stress Pace working off the fármico-kinetics of a necrosol I made a dosing schedule that allowed for the peak control of acid rebound. Because I've recently been discussing with a specialist from one of the major hospitals, an internist, that they get this really, really bad acid rebound.

 

Dr. Ethan Romas-Hill

How Why do we stop this? And they just don't have an answer. And that's why I have to talk about Stress Pace here, because I don't know what another answer is. Stress Pace is basically a product that's been designed to bolster the horse's ability to cope with stress because that's a finite resource, remember. I can go through ingredients and whatnot, but that's how I want to hear it. But really, it's better to understand what it offers in this situation. So we're going to use it in this case because it can have the capacity to help strengthen the horse's gut wall, feed the microbiome, support the microbiome, and prevent acid shifts. So we've got an amazing graph where we see the stopping of a mepresol, a slight drop in the fecal PH. Over a seven-day period, I want to add that it never dropped below a PH of seven. And this horse, while Omeprazole started with a PH of 6.6. So we see this tiny little dip. And then as we get to about four days, five days, it takes. But it never goes below PH of seven and then comes back up and plateaus and stays almost perfectly around the 7.2, 7.3 mark.

 

Dr. Ethan Romas-Hill

And this horse then went to a competition. We put it on a stress-based protocol for that competition where we strategically use it so it doesn't become an expense, doesn't become a stressor for the horse, doesn't affect them nutritionally long term. It's just an adjunctive treatment, I guess, to give them a bit more. So this horse then went on a float. He's not a good floater, and that's likely due to a long term discomfort that he had. And now it's a learned behavior. And On the side, horse's situational memory is probably the best of any species. That's why they stimulus generalize. If they bend somewhere that stressed them out, everywhere that looks like that place will then stress them out. This is why plastic bags are scary to horses because they can look Something like that, something else. I'm digressing. The horse then had a bad floating accident. The float actually had to be dismantled around the horse. This is what we consider a conventionally anxious horse. We tracked the vehicle pH through this whole process conveniently, and he came straight home. And we continued to track it for several days. Afterwards, there was almost no decrease in gut PH, which Which is amazing, really.

 

Dr. Ethan Romas-Hill

You can have horses that go into a stable and will get ulcans because their acid drops so much from... Sorry, the acid, the PH drops so much just from that stressor We're talking about a horse that's already scared of the float, that's been on the float for 2 hours, and is stuck and doesn't know whether he's going to get out or not. And his body is under that much stress and still We were able to help him resist the change and protect his gut. Moreover, like I said, that horse had never scoped negative in seven years. The week later, he went to be scoped. This beautiful trainer, they rode him there because they're so governed by the fear of poor gut health in this horse because it ruins everything for them and damages their relationship where she can't enjoy him anymore. She rode him to be scoped. The horse scoped negative for the first time, and it was off of meprazole and had just had this severe floating accident. I can tell you that there are ways that we can increase the horse's ability to cope with stress, which is pretty cool. I don't want this to be a product advertising.

 

Dr. Ethan Romas-Hill

This is the things that I know to use and that I trust and that I can put my name as a vet behind. What we did with this horse is we increased his forage from low GI forage sources. We basically reduced him back to feeding him like we would feed a lamanid horse. I feed all horses that way. I don't think that they need any more. I'll touch on that in a minute. We put a product called Digestive HP into his diet. That's your daily version, your daily buffering capacity, your daily amino acids that they need to build the gut wall, your daily postbiotics, which are basically, if When I think about probiotics, probiotics are the bacteria that are the good guys that live in the gut. Prebiotics are like the fertilizer for them, and postbiotics are what they produce. A lot of products have probiotics in them that are on the shelf. I'll It's all that you decide, but we've got a live organism that's going to survive the production process, has to survive shipment, has to survive the shelf, has to survive your storage, has to survive through a low PH environment of the gut, the foregut, then has to go through the entire digestive process and get to the hindgut, which is a very alkaline environment, and then function there.

 

Dr. Ethan Romas-Hill

There are some, one I can think of that has been shown to have some activity. Most probiotics, in my opinion, and from what I've discern from the research, most probiotics can't survive that process to function. So digestive HP uses postbiotics. So I always liken this to insulin. When we give people insulin, it's actually insulin that's been specifically created by bacteria designed to produce insulin. That's a postbiotic. When we put postbiotics in, we are putting the products that we want these good bacteria to be producing in to support them and give them time to return to normal function. The other concern you have about probiotics is there's now very new and emerging research that if you can get probiotics in and they survive through encapsulation or other methods, there may be a strong link to anti-microambial resistance because they transfer DNA within each other. So my position at the moment, based on the most current science, and my opinion could change with better science, is that postbiotics are probably our best way to do this at the moment. So postbiotics and prebiotics are our friend. So that's your daily postbiotic and prebiotics to help with the gut function.

 

Dr. Ethan Romas-Hill

And you've got digestive enzymes. Like I said, the horse is very... They need to do a lot of their enzymatic digestion in the foregut because afterwards it's basically just carbohydrate digestion. We've got these horses that we want on grain-free diets. If you look at a lot of the products that are available in the States at the moment, a lot of them use the benefits of beta-glucans. This could be an entire lecture on itself. Beta-glucans help modulate the immune system and help prepare repair and support the gut wall. Beta-glucans are in the cell wall of yeasts, grains. They're one of three carbohydrates that make up cell walls. Instead of supplementing those, my position is we make the horse able to pull those out of the cell wall more effectively. So we are just enhancing their digestive process rather than putting stuff in there to have an effect. We don't need to put beta-glucans in. We can just make them able to effectively use beta-glucans. Beta-glucanase, that's something that's in this. When you put ingredients in that are designed to do something and have a purpose, you start to see the benefits when they're science-based. There's none of this, let's just throw a bit of this, throw a bit of that, which happens all over the world with humans, with horses, with dogs, with cats.

 

Dr. Ethan Romas-Hill

There's a lot of it. But I feel really comfortable using something that's based on science. So we've got that daily support that's going to help them resist those weird changes to the day that we can't control and help them to cope with the stressors that we inflict on them. And then in periods of acute stress, like diet changes, travel, even scoping them. I've had horses that when you scope a horse, you will usually keep them off food for 6 to 12 hours before, which within 4 hours, the horse's gut starts digesting itself. So the night before, we'll often give these horses a dose of stress paste, which is basically like a tube, a syringe of paste. And we've looked at the ulcers the next day and had to spray the pectons in the stress paste off of these ulcers because they've protected them so well, even that far down the track, which is pretty remarkable. I say, four hours till they start digesting and we're going to keep them off food for 6-12 hours. A lot of horses will have low-grade ulcers on a scope. Most horses will. How many of those are because we kept them off food for 6 to 12 hours before?

 

Dr. Ethan Romas-Hill

I don't know the answer to that, but that's another place where you've got, what else do you use? I don't have another answer. I use stress paste. You've got some clay-based pasts like your bentonite Stress-based pastes, which can be really helpful if you need to bind something. But the problem that I have with those is they bind everything indiscriminately. If there's something in that, you can't really suspend anything in bentanites or whatnot that are It's really beneficial because it holds onto them. It is really hard to find something that you can use in these situations. That's why I think that stress pace has been so popular. It's in a lot of vet hospitals. It is everywhere. You come to a competition in Australia, and honestly, it is everywhere because there isn't really something that does the same thing. It's going to bolster your B vitamins. What we're talking about before. B vitamins are heavily linked to behavior. And I will talk about B vitamins a bit later in this because they're very highly linked to hoops. But we've got these two ingredients that we can use now that we can give them daily, I guess, metronomic support.

 

Dr. Ethan Romas-Hill

Morning and night, they get this, morning and night, they get this. This is going to support them. You put things like microtoxin binders in there. Microtoxins, we'll have to do another podcast on this because microtoxins are a massive area of concern, massive area of concern. But these are all the things that contribute to the horse's health. And a microtoxin could be a stress before a horse coming back again and rambling. But stress, stress, stress, stress, stress. So on periods of stress, changes in diet, changes in hay, medications, sedation, getting their feet done if they're a stressy horse, overhandling, high work, hot days. Interestingly, when you see a horse that's tucked up or hounding in their appearance, they've done a lot of work or it's a hot day. That's because horses will divert the water from their gastrointestinal cells to their skin to help them cool down. So they are cooling, and especially when they're not eating, they don't need those cells to be turgid and full of water. So they get this sucked up appearance. Then when we rehydrate them and cool them down, they come back out again. Oh, they've gained weight again. No, they've pulled all the water away.

 

Dr. Ethan Romas-Hill

And water is obviously really important. So betaine is an ingredient that's in Stress Pace, and it's probably the strongest osmolyte in the body of a horse. Its job is to hold water within cells. So you can take two horses. In my experience, I could have taken two horses on the same horse and taken it to a competition without Stress Pace and taken a photo and taking to a competition with Stress Pace and taking a photo. And I can almost guarantee you that the flank fill is better in the horse, in my horse with Stress Pace. I've got to be careful not to make a claim there, but that's what I've noticed as a vet and a competition writer and someone who's finally attuned to horses. So all these little effects of stress, can you see how it's not about making the horse quiet, but the summative effect of controlling all of these stressors It's then going to have the horse feeling better and able to perform. And I don't have another answer for you for how we can rapidly help them in acute times of stress. And that's why stress paced has been so, so, so popular.

 

Dr. Ethan Romas-Hill

We've changed the way that people are thinking about stress with it. Daily support with digestive HP and times of acute stress with stress paced. I know I want to bet my bottom dollar that you will see significant improvements in a horse's ability to cope with stress and the signs you see, which then improves every aspect of their life with those. I've been working with these products as a vet for what we've been probably seven years Working through this process and helping with the design of these products. I've got a massive sample size in my head to make these comments off, but I really believe it. Then we come back to making your diet management changes. If you do those and supplement the horse's ability to cope with stress, you are in the top 0.01% of the world in horse management straight away. I believe that. You can tell I believe it because I'm rambling on about it because I'm so extremely passionate about it because I've seen horses die of what I would call the major diagnosis. They're stressed. Colic, unless it's a physical, an epipelioic entrapment or a nephrosplantic entrapment, even an intersepception, which is more about not feeding the horse.

 

Dr. Ethan Romas-Hill

But the physiological colics that we see horses die of are generally directly related to a poor capacity to cope with the stress that they're facing. You know how you'll see? I don't want to put any blame on any owners that have experienced colic. It's a terrible thing, and some horses will experience it no matter what we do. But I cannot help to make the correlation that people who have a very strong focus on limiting stress in their horse, making sure their diet is perfect and supplementing the horses, not necessarily the products I mentioned, but supplementing them in some way to help to support their gut, have a lower incidence of not only fatal colics, but colics in general. I believe that. I really believe that.

 

Alicia Harlov

Yeah. And honestly, a lot of what you were saying, especially about the ingredients I've heard because I will say that a lot of my nutrition information has come from Dr. Kellyn because the hoof care organization that I'm certified with and that I'm a mentor for, we have to take courses and one of those options for courses is with Dr. Kelen. And she's talked about betaine and throughout summer months in hydration, she's talked about beta-glucans. She's talked about... Actually, I'm going to misquote this, so I probably shouldn't even say this is exactly what she said. But I know that she's talked about probiotics and not using them all the time. So this is information that backs up everything that I I've heard. And it's really interesting and awesome that there are products that are taking that path in, obviously, science-based approach. So that's really, really cool. And I don't really have any... I guess I'm trying to think of where I was going with that, but just agreeing with you.

 

Dr. Ethan Romas-Hill

I accidentally turned this into a bit of a lecture rather than a conversation. But what you're saying there is, I think what I started with, it's really complicated. It's not really simple. The people that are… I think about this 24/7, and Dr. Telen probably is the same. When you're thinking about all the time, the people that are looking at these variables constantly, we all independently seem to come to the same key conclusions, no matter what it is. That's because when we come back, it's really hard to study horses. It's really hard to do clinical trials or anything like that in supplements. Almost no one does it. But I want to tell you about the power of... When we talk about supplements, let's come to, how do I choose a supplement for my horse? I'm not just going to say it because I have an animal health products. But social proof is really great. That's coming from a vet. When you say social proof, when you see lots and lots of testimonials, and I'll make a note on that in a minute, and people are having success, I think that is actually just a compilation of case studies, uncontrolled case studies.

 

Dr. Ethan Romas-Hill

It's longitudinal research that's uncontrolled. But if no one is incentivizing people to give those testimonials and it's off their own accord, I would always consider testimonials as good evidence to support a product if there is no incentive to those people then doing it. First and foremost, I'm a horse person. I don't want to spend money where I don't have to. I want one supplement that will do the job of them all. That's my ideal. Faisan was really actually extremely lucky. Extremely lucky. About eight years ago, they produced the product called Digestive EQ in Australia, which was the early iteration of Digestive HP. It is the reason I believe that Australia is so good on gut health because it changed the conversation. There were lots of bets that went, There's no way. There's no way this works. You're making too many promises here. But testimonials kept flowing in. There was a professor, Professor Andrew Dart at Sydney University, one of the most prestigious universities in the world. For those that don't know, when we refer to anyone as a professor, at least in the system that I'm used to, an associate professor is a national expert A professor is the title professor, not the occupation, the title being given a professor, it means you're a world expert.

 

Dr. Ethan Romas-Hill

This guy, this professor, I should be a bit more respectful there. They're using my Australianisms, is a world expert in horses. And he went, I'm not just going to sit here and be skeptical about this. I'm going to do my own study. So he did his own independent trials with it. And I'll have to send this through to you, Alicia. They'll blow you away. The horses that were receiving the product, they more or less were tracking weight. So they fed this particular group of horses a certain way. I missed, I haven't read it quite well. Fed these horses a particular way and then fed them exactly the same. Changed nothing else but out of indigestive EQ, which is the early equivalent of the digestate HP that's available in the States. And the results were not only clinically significant, they were statistically significant as far as I understand, which It's pretty cool just to say that that is actually there has been independent research done. Because usually that's only in drugs because people want to invest in drugs because they'll make them lots and lots of money if we can prove that they work. Proving that drugs don't work, no one will ever fund that.

 

Dr. Ethan Romas-Hill

No one will ever fund me on a study to say that we shouldn't be giving them that result all the time. I don't think that they will unless I can get research grants and whatnot, but no true funding in the way that drug companies get funding for their medications. I don't want to discredit research, but keep in mind this is coming from a vet who's worked in the research space Using all of these sources of primary evidence and whatnot to make judicious decisions with everything we do in horses, but including supplements, is really, really important. I see it all the time, not just with presiding supplements, but all supplements. People come into the comments and say, Where's the peer-reviewed research? Where's this blah, blah, blah, blah, blah? I really appreciate people doing that. They are being judicious and they are being skeptical, but it's not the only valuable piece of information that you can have. There is research behind these products. It's not just, Oh, there's no research behind these. But still buy them. No, we've got it. There's a lot of people that don't. But there are a lot of products that don't have research that I use in my animals, and I know that they work.

 

Dr. Ethan Romas-Hill

And that's sometimes enough. So I guess putting your thinking hard on as a horse and trusting your gut, maybe that can be the title of the episode, and making decisions based on outcomes and other people's successes. So I don't know if you saw, I made a comment on one of the forums the other day on Facebook about how I use information as a vet, and I use the three-legged stool model. Did you see me talking about that?

 

Alicia Harlov

I don't think so.

 

Dr. Ethan Romas-Hill

Okay, you'll love this, hopefully. Sorry, that's probably an Australian reason to tell some of that love them, but I'm quintessentially Australian. I'm very casual about everything, even being a medical professional, but that's how I exist. The three-legged stool model for me is one leg is research and what we can read in books. It's important. If you lose that leg, the stool falls. Then you've got another leg that is your own experience. Every horse that I shoe, every horse that I scrape, every diet that I make. I'm very, very, very fortunate to be working on some of the top performance horses in the world that are going on planes. That is a large portion of my job. They're going on planes very regularly and managing the stress in these horses. So every time I work with one of these horses, I get a little bit better at it. And that's not to say I'm not good at it to start with. That's not how we exist in the world. You're always learning, right? But we always get a little bit better, and that leg gets a bit stronger. It's less likely to fall. And then the third leg is probably the most important, really, is other people's experiences.

 

Dr. Ethan Romas-Hill

That's anecdotal evidence. So if I see that Alicia has put a shoe on a horse and she's put on, I don't know, a hospital plate with nothing underneath it on a horse that's got signs of navicular and the horse got worse, I'm less likely to then do that in the future. Or I'll go and ask her, Hey, what do you think about this? What did you learn? What were your What did you see? That's extremely valuable, extremely valuable. That forms our pattern recognition. We've got these three legs of the stool that if we sit on top of that and use all of them and sometimes shift the weight towards one side and shift towards the other, in any situation, we can come up with a logical answer. I encourage everyone listening to use that model. Don't be too against non-peer-reviewed research in something that's not really developed in a lab. So I guess I'm getting on my soapbox there a bit, and I'm probably more exposed to cable stories on Facebook that want to take everything away from people trying to do the right thing is just trust yourself, trust other people's experience, and trust what information is out there.

 

Dr. Ethan Romas-Hill

There's a lot of good information out there. And the way you can sift through it is... I trained for six years at university, more or less, to filter through research. That's what vets get, primarily. We can't know everything about every animal. But if they can teach us to filter through the truth and what's false, then we can come across anything and find information on it, especially in this world of access to information that we have. So if everyone takes a bit of that in their stride and says, How can I find the right information here? Every single time you do it, you get a little bit better. It's really, really cool. And that's because you're developing your own personal experience and seeing other personal experiences to be more judicious in which textbook data, the other leg that you use. It's a bit cyclic here, but can you see what I'm getting at? This whole everything I've really said today is actually really, really simple principles. You just go slow down, use a bit of pattern recognition, use what you know. We're horse people, we know horses. We, like hoof care professionals, you spend a lot of time underneath horses.

 

Dr. Ethan Romas-Hill

You know them. Why should a paper tell you what you can and can't use? And that's from someone who writes papers. They're one leg, they're one leg of the stool. And if I could do an entire I should just on that. I've digressed a bit here, haven't I?

 

Alicia Harlov

And honestly, I feel like we could talk about this forever. And I didn't know if you had some last minute advice to owners who might be dealing with this topic of wanting to improve their horse's gut. Or I mean, really any of the listeners, if there's any tips or advice you want to send home with them.

 

Dr. Ethan Romas-Hill

So I'll give you some from... I'll try and look it back into hoops because that's what we all hear for, primarily, is that if you understand the horse's ability to produce energy, it's from the production and slow production of volatile fatty acids in the hindup. The bacteria produce those, and that makes up 80% of the energy that the horse has. If you have a horse that gives you a lot or is spooky to start with, is hot to start with, is norny to start with, and you have to lums them down. But once you do that, you have no energy. The that can't finish the cross country course. It's because we're relying on this high GI, quick burst energy rather than this lovely slow release energy that the horse has been designed specifically to be able to do. Slowly break down fibers and give you this slow source of really great energy. That's volatile fatty acid production. When you get starchy sources or sugar's molasses, molasses has a place in horses. It's very slim. It's basically if they won't eat, that's when molasses comes in. That's about the only place I ever use molasses. It's quite a big stresser.

 

Dr. Ethan Romas-Hill

But if we're feeding these high-grain, high-cerial-grain diets, that are super starchy, unprocessed corn is the big one, they're really, really easy, especially after a bit of enzymatic digestion, for horses to use those simple sugars and make volatile acids really, really, really fast. And when we talk about volatile fatty acids, the key word there is acids. We get this massive acid production in the hindgut with bacteria and funghi and viruses and all of these massive microbiota that are allowing this horse to function. They're controlling its brain. They're producing hormones that communicate with the brain. It's this mind control aspect of the gut microbiome. People who have depression generally have a less healthy microbiome. This is how strong the link is. They want to live in an environment that's around that PH8-9 alkalinity and we take it down to six really rapidly or five, five, seven, anything lower. They all die, and we're going to shift towards acidophiles, bacteria and yeast and viruses that love acid. And the whole postbiotic production system, what they're producing changes. Why is this important? Because we expect horses to perform. That's one. Because we control it, because we are influencing this directly with what they eat.

 

Dr. Ethan Romas-Hill

When bacteria can't break down what we're putting in there because it's not educated to break down that stuff, that's your rapid changes of diet. It either won't be digested or it'll be digested in the incorrect way and throw everything out. So a key takeaway, any change you make to the horse's diet, make it slowly and systematically and planned over about two weeks. But frequent changes to the horse's diet that are small and are relative to what they're exposed to are excellent. If your horse works a bit harder, you can give it a little bit more hay. If it's a cold day, give it a little bit more hay. If they're having a week off, drop it back a little. You can make these little changes. You don't need to be giving them so much all the time because that's when we see horses that go, Oh, he rears, he bops, he does this. It's because you're giving them more than they need, because people are too scared to change, they go the other way. So you can make changes to their diet. Feel confident making small changes to their diet. You can do that every single day.

 

Dr. Ethan Romas-Hill

Don't change the ingredients, don't change things by, say, more than a random figure might be 5 or 10 %. But those small changes are really great. So focus in the diet on forage-based diets that are low in sugar, low in starch, And pasta brings in another component, which is your fructions, which is your grass sugars. But we won't talk about those because we're just talking about what we can feed. So sugar beet pulp, un molasses. In In my opinion, the single best things you can feed a horse for 99% of conditions, they are suitable. Beet pulp is a byproduct of the sugar industry. It's not sugar beet pop because it's got a lot of sugar. It had sugar in it, but they stripped it out. If you know anything about big companies, they don't want to lose any of the valuable resource, and sugar is a valuable resource, which is good for us because you can trust that no sugar beet pop is going to be quite low in in sugar, very, very low. Let me dig safe. It can be quite high in iron. I think that becomes a very nitty-gritty conversation. A lot of our soils are already too high in iron.

 

Dr. Ethan Romas-Hill

I think the benefits outweigh any risks with beet pulp, and I would confidently put, unless they have an allergy, maybe, but confidently put every... I should put a disclaimer in here. Don't put out every horse in this, but really, because my horse, no matter what horse I bought, no matter where I was, I would feel confident putting sugar beet pulp into their diet. Unmelassised, micronized is the best. We have different forms over here. I have nothing to do with this company, but we use a product called Speedy Beat over here.

 

Alicia Harlov

Yeah, we have it here, too.

 

Dr. Ethan Romas-Hill

I know that one. There's probably others over there, but that's one that I can confidently recommend. I fed it for more than a decade. And touch wood, I've had dozens and dozens and dozens of my own horses, and I shouldn't say this out loud. It's cursing yourself. I've never, ever had a horse truly colic. Mild colic science at best from travel, but never had a horse colic. And I've pretty much always fed beetpop. It is probably the most effective prebiot for horses microbiome, which means they can use it really well to make those volatile fatty acids. And it fertilizes them. It makes them really good at doing their job. We know this is the stuff. So that's something that I would include. It can be cost-prehibitive, but honestly, if you put half a cup into your horse's diet, you will have benefits to their microbiome. I think we'll have to have another catch up for this for sure.

 

Alicia Harlov

Yeah, I would love to.

 

Dr. Ethan Romas-Hill

These horses, I'll say pop the hay in a bag with small holes. There's been some concerns about horses damaging their teeth from slow-fitted nets that's been recently not disproven because we never seek to prove things with scientific research. We just support things. The Finding that horses will damage their teeth from long-term use of slow-fitted hay nets is lacking in support given recent research. It used to be a supported theory, but the research actually doesn't support that. So I have no problem with horses having their feed from slow feed hay nets. And there's also research around the intake. The intake per day actually doesn't change with slow feed hay nets. Just the rate So which can get quite confusing. But say you give a horse one biscuit of alfalfa hay and they eat it in 15 minutes, that is not ideal, but that's how fast they can eat. Whereas we can give them maybe 10 biscuits of alfalfa hay that's been soaked in the slow feed of hay net, and they will always have the same capacity to eat hay throughout the day. They can only take so many bites in the day. So It's really interesting.

 

Dr. Ethan Romas-Hill

They can be eating all the time. And even if we say, gave them five biscuits on the ground, I don't recommend feeding them off the ground, but five biscuits or five flakes off the ground, they'll eat them quite fast. And we might think, Oh, but she doesn't have food all day. She's not eating much. She doesn't get a lot of food. But then we'll see a horse that gets the exact same amount with a slow fit and then says, Oh, he's eating all the time. He must be so fat. The total intake doesn't change. The rate changes and a slow, constant feed of energy to the higher is good for a horse's metabolism. Bursts, peaks, and troughs, ups in glucose means peaks in insulin. We don't want any of that. So I guess, what am I saying here? Beat, pulp is good to include. Slow consumption of constant access to feed is ideal. I think, Alicia, we might have to talk about in another episode, I'd love to talk about feeding horses for or weight loss and refeeding horses that have been starved because the metabolism behind that is extremely interesting, and I love to talk about it.

 

Dr. Ethan Romas-Hill

But it's important that you don't starve horses ever for any reason, even if they are fat or even if they have If they have a metabolic caused lamanitis. We can't starve them because they're designed to have food going through them all the time. It takes four days for them to digest or up to. If we have a big gap in there that's full of gas, That's when you start to get twists and colics and whatnot, constant access to feed. They need to have a level blood sugar. So that's the big advice there. I haven't even got to feed, but thinking about the gut as an immune organ and thinking about it as a place that is a factory of production of everything that the horse needs, apart from there are some essential things like ALA, which is an omega-3, but that's just an example. These essential things that they need to get from grass, usually. But most things they can produce themselves. I'm going to finish with a little bit of a pearl of wisdom here that will make you think about gut health in between our next conversation about feet. Where this now, I feel like I've laid the foundations for talking about feet a bit here, is that horses don't make a lot of biotin in their diet.

 

Dr. Ethan Romas-Hill

We know that biotin is a key player in the Krebs cycle, the strategic acid cycle. It's involved in energy production. It's involved in the strength of connective tissue, full stop. It's really important. I don't think that anyone's going to disagree Any hoof care professional in the world will disagree that biotin is important in the production of healthy hoops. Why do we see horses with horrible hoops when they have hindgut problems? Here's this wonderful answer I have for is the horse's microbiome produces almost all of its B vitamins. Vitamin B7 is also known as biotin. The horse, maybe a 600 kilo horse might need seven and a half grams biotin a day. To function and do all the things that we need them to do. Then you imagine a horse with briddle feet and look at and think, That horse has briddle feet. Biotin is just one ingredient there, but is their hindgut working properly? Because they should have the ingredients that they need to build healthy feet with no supplementation. Horses do not need biotin supplementation. You look at what I feed my horses, I feed the biotin. Why? It's cheap, safe, it's a fail safe, and it seems to work.

 

Dr. Ethan Romas-Hill

The more you give to a certain degree, your benefits increase. But if I have anything happen to my horses, their feet are so important to me that if they have a big stress event and they can't produce their own biotin anymore, I I want them to be covered. The other thing is it can take up to 12 months from when you start a perfect diet and perfect management for the horse's gut to heal and recover to a level that they have a truly functional microbiome. With horses that have a poor hoof condition and that is associated with seemingly poor gut health, I'll generally recommend including biotin in the diet for at least 12 months until we can confidently say that the kind gut is working well enough to produce the biotin that they need to create healthy tissue. So my horses, it's all the connective tissue. It's part of the citric acid cycle. That's how we make energy. So everything that's stuck together in the body involves biotin. So does this make the risk of tendon injury? Does it make their risk of eye injury, skin injury? I don't know. But it makes sense to me that we support the hindgut to produce these key ingredients audience to make healthy tissues all the time, even if the answer is just in case because the research isn't there yet.

 

Dr. Ethan Romas-Hill

Horses with healthy hindguts are shiny. They don't get sick. They have great beautiful coats. They grow beautiful tails. They're are happy, bright horses. B vitamins. People think, Oh, yeah, but they're B vitamins. They're just vitamins, right? Oh, but so and so's... Sorry, that may be an Australianism. This person's Baby has spina bifida because mom didn't have high enough folate intake while they were in pregnancy. Folate is a B vitamin. Niacin is a B vitamin. Thiamine is a B vitamin. If a cow is deficient in thiamine, they get polioencephalomalacia. They go nuts. These are B vitamins, and we don't need to put them in. We don't need to put them in because the horse can make them. But we feed them so anthropomorphically or so human-centric that we stop their ability to do that. We are doing it. When you have horses that have an unhealthy hindback and have brutal feet, we've actually done that. Horses… Okay, I should probably finish this conversation, but I'm truly finishing it. Horses give us so much. We expect so much from horses. I know personally, they not only give me my career, but my whole life is built around horses.

 

Dr. Ethan Romas-Hill

My passion is riding horses. My passion is being around horses. When I'm around horses, I'm happy. When my friends are around horses, I'm happy. I've made these connections in my life. Look, the connection that you and I have. I've made friends overseas. Through horses, they've given me so much in my life. And we need to keep up and learn more about them so that we don't take away from theirs to have them in ours. It's not fair. And they've given us so much, and we owe them so much. And a lot of the things we see, 80 % of the things that I've seen horses for are for husbandry that's not quite as good as it could be yet. But I want to look at that in a positive sense and say that it's not quite as good as it could be yet. I can't do that, or I can't feed like that, or I don't feed like that, or I can't manage him that way. Change thinking, too. Up until now, I couldn't do that. Every time we listen to a podcast, I'm hoping that some people have learned some things from today. Up until now, I didn't know that horses, high nuts, produce biotin.

 

Dr. Ethan Romas-Hill

I'm going to think about that. This whole up until now model, that's how we learn with horses. Partner, commission, research, our experience, other people's experience, put the clinical picture together and always just be aiming to do better. To do better because we owe it to the horses because we love them and they're amazing creatures, and they give us so much. It's time we start giving back.

 

Alicia Harlov

Absolutely. Yeah, thank you so much. And I think this is such a great conversation. Obviously, there's so much more to even discuss, so I would love to pick a time to maybe expand on it. But I think this is a good amount to digest, and I really appreciate you being willing to chat with me about this.

 

Dr. Ethan Romas-Hill

It's absolutely my pleasure. As I said, it's my biggest passion, and I love to share. I've worked hard to try and discern myself what good information is and what bad information is. And I feel I'm a quick to do so. I still, here and there, struggle with bits of information, and I consider myself a little bit of an expert in this space, so I can only imagine what the rest of the community feels like that maybe hasn't had the luxury of the education that I've been really privileged to have and the mentors in my life that I've had that have helped me to learn this. If I can share that in any way, I feel very privileged to be able to do so and a privilege to to be here. I'm privileged that everyone has taken the time who is listening to listen to what I have to say and feel the passion that it comes from. The genuine intent that I have here in helping, I'm not only the horse that's in front of me as a vet. I love doing that. I love to see the change. But I know that the capacity that knowledge and education has to improve the lives of animals is immense.

 

Dr. Ethan Romas-Hill

I'm hoping that this conversation that we've had today is It could have changed lives with thousands of horses. Who knows? But that's why I get up every day. That's why I've shown up today. I really think that we have a power to make difference through critical thinking and sharing our own knowledge and experiences and looking at what's available to help our horses if we can't do things perfectly.

 

Alicia Harlov

Yeah, absolutely. Awesome.

 

Dr. Ethan Romas-Hill

Wonderful to meet you. All right.

 

Alicia Harlov

Have a good rest of your day. I guess it's day there. Yeah.

 

Dr. Ethan Romas-Hill

Yeah.

 

Alicia Harlov

I've got to get a bite now. Bye. I always say that I'm slightly more hoof obsessed than the average person. And chances are, if you're listening to a hoof care podcast, you are too. So we should probably be friends. Feel free to find me on Facebook or email me at thehumblehoof@gmail.com.