The Emergency Diet

Most cases of laminitis are associated with abnormally high insulin. Unless there is another clear cause, such as a feed-room break-in, retained placenta, severe systemic illness or supporting-limb injury, the safest initial approach is to manage the horse as though high insulin may be involved while the cause is investigated.

The Emergency Diet is a temporary short-term diet, generally used for around two weeks while you arrange hay testing, diagnosis and a properly balanced long-term feeding plan. Its purpose is to reduce hydrolysable carbohydrates, ESC plus starch, as quickly as possible while still providing enough forage and essential nutritional support.

Emergency Diet: Quick Guide

For a 500 kg horse, adjusted proportionally for body weight:

  1. Remove all access to pasture, including short or apparently eaten-out grass.
  2. Stop apples, carrots, treats, grain, sweet feeds and most bagged feeds.
  3. Feed grass hay at 2% of ideal body weight or 1.5% of current body weight, whichever gives the larger amount.
  4. Weigh hay dry, before soaking.
  5. Until the hay has been tested, soak it for 30 minutes in hot water or 60 minutes in cold water, then drain thoroughly.
  6. Use only a small amount of a suitable low-HC carrier feed, just enough to carry the supplements.

  7. Feed the hay allowance across the day, using slow feeders where appropriate.

  8. Test the hay as soon as possible. If ESC plus starch is 10% or less, soaking is generally no longer required, and the long-term diet can be balanced to the hay analysis.
  9. Add daily:
  • 5 g elemental magnesium
  • approximately 60 g ground linseed/flaxseed or chia
  • 2,000 IU vitamin E
  • 1–2 tablespoons iodised salt in the carrier feed
  • Provide additional plain or iodised salt free choice

The Emergency Diet in more detail

 

Remove the horse from pasture

The horse must have no access to grass during the acute stage. This includes short grass, frosted grass, stressed grass and areas that appear to have been grazed bare.

A sand yard, arena, round yard, stable or another secure grass-free area can be used. The surface should be comfortable and non-edible. Avoid straw bedding, as some horses will eat it.

The concern is not simply whether the pasture looks lush. The important issue is how much hydrolysable carbohydrate it supplies and how strongly the individual horse’s insulin responds.

Stop other feeds and treats

Immediately stop:

  • Grain and grain-based feeds
  • Sweet feeds
  • Molasses
  • Apples and carrots
  • Sugary treats
  • Unnecessary bagged feeds
  • Any feed that cannot confirm an appropriate carbohydrate level
The ECIR target for metabolic horses is less than 10% HC, calculated as ESC plus starch. For bagged feeds, starch should preferably be below 4% and fat below 4%.

Prescription medication should not be stopped without discussing it with the prescribing veterinarian.

Work out the hay allowance

Feed:
  • 2% of the horse’s ideal body weight or 1.5% of its current body weight, whichever amount is greater.

For example, a horse currently weighing 600 kg with an ideal weight of 500 kg would receive:

  • 1.5% of 600 kg = 9 kg
  • 2% of 500 kg = 10 kg
The horse would therefore receive 10 kg of hay per day, weighed dry before soaking.

Do not simply reduce an overweight horse to a very small quantity of poor-quality hay.

Starvation diets can worsen insulin resistance and increase the risk of hyperlipaemia, particularly in ponies, miniature horses and donkeys.

Soak untested hay

You cannot reliably tell whether hay is suitable by looking at its colour, texture, smell or species.

Until testing confirms that the hay contains 10% HC or less, soak it to reduce soluble sugars:

  • 30 minutes in hot water, or
  • 60 minutes in cold water
Drain the hay well and dispose of the soaking water where the horse cannot drink it. It will contain some of the carbohydrates removed from the hay.

Soaking does not remove a predictable amount from every hay, which is why testing remains important. Once testing shows that ESC plus starch is 10% or less, routine soaking is usually unnecessary.

Divide the daily allowance across the day and use a suitable slow feeder if the horse consumes it too quickly. The priority is providing the correct total amount of appropriate hay, not unlimited access to unsuitable hay. 

Use only a small carrier feed

The carrier feed is not intended to provide a large meal. It is simply used to deliver salt, magnesium, vitamin E, linseed and any medication.

Plain unmolassed beet pulp that has been rinsed, soaked and rinsed again is the ECIR-preferred carrier. Soy hull pellets may also be suitable. Any commercial carrier should guarantee:

  • HC below 10%
  • Starch preferably below 4%
  • Fat preferably below 4%.
Use only enough to ensure the horse eats the supplements.

Magnesium

Provide 5 g of elemental magnesium daily for a 500 kg horse, adjusted for body weight.

This is the amount of actual magnesium, not 5 g of magnesium oxide powder. Magnesium products contain different percentages of elemental magnesium, so check the product analysis and calculate the quantity required.

For example, if a magnesium oxide product contains 50% elemental magnesium, approximately 10 g of that product would supply 5 g of elemental magnesium.

This is a temporary Emergency Diet amount. Once the hay is tested, magnesium should be included as part of the full mineral balance rather than automatically continued at a standard dose.

Linseed, flaxseed or chia

Feed approximately 60 g of freshly ground or stabilised linseed/flaxseed or chia daily for a 500 kg horse.

This provides essential fatty acids that may be low when the horse has no access to fresh pasture.

Whole linseeds should be freshly ground so the horse can digest them properly. A small coffee grinder works well. Stabilised ground linseed is another practical option.

Vitamin E

Provide 2,000 IU of vitamin E daily for a 500 kg horse.

Vitamin E requires contact with fat for effective absorption, so it can be fed in the same meal as the ground linseed or chia.

Salt

Add 1–2 tablespoons of iodised salt per day to the carrier feed for a horse of approximately 450–500 kg, adjusted for body size.

Also provide additional plain or iodised salt free choice.

Introduce salt gradually if the horse is not accustomed to it, particularly if appetite is poor.


What about a vitamin and mineral supplement?

The official ECIR Emergency Diet uses temporary amounts of magnesium, essential fatty acids, vitamin E and iodised salt. It is not expected to create a completely balanced long-term diet.

A suitable low-HC mineral supplement may be used where its nutrient levels are known and appropriate, but no premixed product can be assumed to perfectly balance every hay.

The long-term goal is to test the hay and supplement the nutrients that are deficient while accounting for excesses and mineral interactions. However in some cases we understand that this is not possible 

If you are on Agistment or only able to buy small quantities of hay at a time, the best option is to choose a Mineral Mix that is designed to balance the average pasture and hay, something like Missy's Bucket is ideal.