Anxiety is very common in the horse, especially noted in the lighter weight and leaner breeds, such as the Thoroughbred. The anxiety is often self-evident in the horse by seeing vices such as cribbing, pawing, weaving, or just overall restlessness. The anxiety, when uncontrolled, will also lead to a high incidence of gastric or stomach ulcers, weight loss, and a difficult horse to handle or train. Management options currently utilized in traditional veterinary medicine are often palliative at best, rarely getting to the root of the problem. In addition, some of these therapies can lead to negative side effects and be quite costly to the owner. An alternative approach exists, which can immensely impact and benefit these horses, but it requires a different line of logic.
A 6-year-old Thoroughbred mare was presented for evaluation. She had a brief history of being on the track as a two-year-old, but was retired early due to unknown reasons. She has been with her current owner for over a year and in training for eventing purposes. The main complaint or concern being offered by the owner is regarding behavioral problems. She can be very difficult to handle at times and aggressive on pastures with fence line running and pawing when alone. The mare does seem more focused when under saddle, but is easily distracted. These behavior problems appear to have worsened over the past year per the owner.
Her history is that she came from a farm where she was on 24/7 turnout with a herd consisting of six other horses. Once purchased, she was moved to a training facility, being allowed turnout in a paddock by herself for about 6 hours per day. She always had line of site with other pasture mates and even able to touch noses across fence lines and interact.
The mare’s current diet consists of orchard grass hay at 2% of bodyweight per day along with a fortified grain and vitamin-mineral supplement. Her weight can fluctuate so the owner does modify the amount of forage and grain provided. She has a history of gastric ulcers, which are being managed with daily omeprazole and sucralfate. In addition, the owner has been given a medication called reserpine to manage her anxiety and behavior problems. Despite the medications, the mare’s stomach ulcers continue as does her behavioral problems. The owner is frustrated due to lack of progress in keeping her focused in her training. One final thing to note is that the mare’s feces are solid at times, but more times than not, they are very loose and cow-patty in consistency, splattering the walls of her stalls.
Anxious Thoroughbred Mare and Management
Upon examination, the mare is very alert and distracted, having a hard time standing still and was constantly moving. Her eyes were very wide and suspicious of all activity and she defecated with loose fecal material. Her heart sounds were normal, but pulse rate was increased. Body weight is normal and adequate. Digestive sounds were increased in all quadrants. An oral examination indicated red mucous membranes and a somewhat dry tongue with little saliva to offer. The mare is current on all vaccines, coggins testing and is routinely dewormed. A fecal evaluation done by the primary veterinarian was negative for parasites.
Given that the main physical examination was normal with no major clinical problems noted, her behavioral problems were the main area of focus. The recommendations made to the owner were as follows.
- Recommended increased pasture turnout along with co-mingling of herd mates to allow for physical interaction.
- Forage was recommended to be improved by moving to alfalfa for increased nutrient provision and to allow for benefits of phytochemical present in the legume to benefit digestion and mental health.
- All grains were to be eliminated and the mare was put on 1 pound of alfalfa pellets twice daily to act as a ‘grain’ and a medium for supplement administration.
- All supplements, including vitamin-mineral blend, were to be discontinued.
- The owner was advised to start Cur-OST EQ Adapt & Calm once daily per label doses to impact behavior and monitor.
- Medications were to be continued for the first week, and then discontinued if things were improving clinically.
The owner contacted me via text within 72 hours and noted that the behavior patterns were worse. She was extremely difficult to handle at times and quite anxious. It was recommended that she switch to the Cur-OST EQ Stomach blend for 7 days, administering twice daily, and then move to once daily administration. The owner was then instructed to reimplement the EQ Adapt & Calm blend at half dose (1 scoop) along with the EQ Stomach.
Upon re-evaluation at 30 days, the mare was markedly better. She was less restless, willing to stand still for examination, and more easily handled. Her eyes were alert and responsive, but she was less distracted by other things and willing to be led freely. The owner was continuing the supplement regimen as directed and all medications had been discontinued. Overall, the mare was markedly improve and the owner was happy with her level of training progress.
Anxious Thoroughbred Mare, Herbs, and Discussion
Anxiety is the polar opposite of depression. One is a lack of energy or stagnant energy and the other is too much energy, being uncontrolled. In Ayurvedic medicine, anxiety is viewed as being a condition of excess vata, being excessively dry and cold at times. In Traditional Chinese Medicine, anxiety is viewed as being connected with the heart pathway, excess heat, and lack of cooling moisture in the body or Yin deficiency. Given this, anxiety can often be worse seasonally, having heightened periods in the cooler times of the year which also tend to be drier in nature. This can exacerbate the internal problem or imbalance in the horse. Likewise, sometimes the anxiety can be worse in the summer, due to an external heat adding to the excessive internal heat, which then stirs the mind and neurological system.
It is in my experience that in many cases, there is a lack of internal moisture in the body of a horse with overt anxiety and an accumulation of heat. This heat can be made worse by external temperatures and is definitely made worse by grains, some forages, and even some medications which can have a drying and heating effect upon the body. The heat will literally dry up moisture, which is already deficient, and reduce body fat stores which results in a fluctuating body weight, often being thin.
Essentially, in the typical Thoroughbred with anxiety, there is a lack of moisture and an excess of heat. This lack of moisture can impact the entire body, creating short circuits if you will in the neurological system and brain, but can also lead to a drying effect upon the stomach which leads to ulcers. The lack of moisture or Yin component leads to a relative excess of Yang and increased heat in the body. Think of moisture as keeping a fire under control and when it is not present, the fire can rage. This heat can be stirred up and create emotional problems and also literally burn the stomach, hence the ulcers.
Common anti-ulcer medications address the ulcer, not the clinical problem. In some cases, they are effective in management of gastric ulcers, but rarely do they solve the underlying problem so many horses continue to deal with anxiety and behavior issues. In addition, some ulcer medications can impact digestion negatively and impair some nutrients from being absorbed, mainly magnesium which is interestingly connected to emotions and neurological function. Ideally, we address the underlying problem for best results, not mask it with medications.
Going along those lines, stress is a huge culprit as it can heighten neurological function or depress it. When a horse is in this situation, with dryness and heat, stress become more evident as they are over-reactive to situations. Stress needs to be managed and controlled, thus the recommendations to alter the lifestyle and turnout. In addition, the main formula chosen, EQ Adapt & Calm, helps to modify the stress response as this herb is an adaptogen, helping to stabilize those pathways in the body. The only problem with this specific herb is that it tends to be a bit warming to the body, which can add to the heat already present. There are other ‘cooling’ adaptogens which could be used, but I was more curious to see how this mare responded, as each can be different. It is interesting to note that the anxiety and altered neurological function is what is likely to blame for the loose stools in the mare. When the mare is stressed, intestinal movement is increased, and thus, transit time is reduced and therefore there is less time for fluid reabsorption. This is what creates the loose stools.
Grains are also very heating and can be very drying to the body, which is why it was recommended that they be removed. This is difficult for many owners as they are taught that grains are needed for various reasons, especially for energy and stamina. It is in my opinion that grains are rarely needed and their heavy usage in the TB industry is likely closely linked to the high incidence of gastric ulcers, tendon problems, and poor foot health in that breed.
The whole goal was to reduce stress and alter the diet to ‘cool’ down the body. The problem that arose in this case was that the EQ Adapt & Calm added heat, which irritated the mare. Given her response, it was recommended to switch to the EQ Stomach blend, which offers a cooling and moisturizing effect upon the body, also soothing irritated tissues such as stomach ulcers. This blend benefits digestion additionally by cooling the stomach down and helping to stabilize the bacterial populations due to naturally occurring lignans and fiber. The owner used this blend solely for one week to re-establish moisture and cool the body down, which it proved to be very successful in doing.
After the moisture was re-established, the owner restarted the EQ Adapt & Calm blend along with the EQ Stomach to further support and stabilize stress pathways. In this case, the mare responded beautifully and was back in work with no medications. Her feces returned to normal and the owner reported a marked reduction in loose stools. In other cases, the EQ Adapt is still too heating and we have to rely on other ‘cooling’ adaptogens such as Bacopa extract.
Other options for cooling benefits in these types of cases include the use of Amalaki herb extract or the EQ Cool Down formula. Both can cool down the internal heat which is present, settle the nervous system, and benefit gastric ulcers. They are especially beneficial when added alongside of an adaptogen such as the Ashwaganda in the EQ Adapt & Calm.
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Author: Tom Schell, D.V.M, CVCH, CHN