Relationship of Dysbiosis to Insulin Resistance & Laminitis

Restricting a horse’s diet has many negative effects, as described in the following article from KAM Animal Services.  Could the diet adopted out of necessity (if not outright desperation) by owners of insulin resistant horses and easy keepers, actually be contributing to their predisposition to laminitis? 

Read the whole article here:

Here are pertinent excerpts from the lengthy article:

By: Kate McBride Puckett
November 27, 2006

Dysbiosis, also known as “Leaky Gut Syndrome” is defined as a perforated hind gut, an excessively permeable intestine or a condition of erosion and ulceration of the gastrointestinal tract.

Symbiosis is defined as the relationship between organisms in which one organism is in an intimate association with another. A pertinent example of a symbiotic relationship is the intestinal flora of a healthy species lives in harmony with its host. As such the bacteria of the intestine is often referred to as “friendly” and helps to maintain homeostasis and many “health promoting” activities including detoxification, vitamin production, and protection against pathogens.

If this relationship is out of balance, the mere overgrowth of so-called “friendly” bacteria, dys-symbiosis or dysbiosis results and inevitably leads to holes in the gut. Dysbiosis, and subsequent increased permeability of the intestinal mucosa, in general can be caused by a myriad of causes including protozoan parasites, bacteria,  yeast, excessive antibiotic or NSAID use, parasite infestation, maldigestion, stress, and an imbalanced and restricted intake diet. The most critical point to consider with dysbiosis is the extreme damage it causes the equid by permitting bacteria, pathogens, etc. to escape the intestinal lining and enter the bloodstream. With this more permeable intestinal mucosa, essentially the filtration system of the intestines is defunct/deficient and provokes three detrimental responses to “foreigners” or pathogens leaking into the blood stream:

1.)   an Immune Function System response

 2.)  a Systemic Inflammatory System response, and

 3.)  an Insulin Resistance response (which can be measured by endocrine systems tests).

Another consequence of dysbiosis is a resistance to insulin, a recently recognized syndrome labeled “Syndrome X” or Insulin Resistance syndrome. Essentially this is a metabolic syndrome characterized by an inability to transport glucose into the cell.

This resonates in the horse because an increased risk of several digestive and metabolic disorders has been associated with feeding (high carbohydrate and sugar) meals of grain and molasses.  Post eating, the pancreas produces insulin to lower blood sugar levels, however with the consequent flooding of sugar into the blood due to dysbiosis, this results in reactive “rushes” of insulin that either cause decreased future insulin levels leading to high blood sugar (diabetes), erratic insulin levels leading to low blood sugar (hypoglycemia), or Syndrome X, whereby insulin receptors in the liver, muscle and fat cells become damaged and cannot transport glucose effectively. These blood sugar conditions also cause the adrenal glands to produce increased cortisol levels catabolizing proteins and weakening and inflaming connective tissue and lamellar structures within the feet.  The cells become resistant to insulin and the glucose from the feed can no longer penetrate the cells. In turn, the horse suffers from inflammation, laminitis, and/or founder.   This metabolic syndrome also causes a general build up of lactic acid (due to stress and poor oxygenation) that interferes with muscle function, endurance,
metabolism, immunity, and hoof health, exacerbating laminitis.

Essentially the equine digestive system is a complicated system designed to process frequent small amounts of food.  By confining horses, the amount, frequency and type of feed available for them to consume is now determined by humans. Before what was a continual input from grazing, has become a once a day feeding of unvaried, unbalanced large quantities of feed. 

The causes of dysbiosis include: high starch meals, infrequent feedings and confinement during feeding times (Equine stomachs constantly produce hydrochloric acid which eats away at the mucosal lining if empty), response to chronic pain, heavy exercise (Horses contract their abdominal muscles under stress forcing the stomach’s hydrochloric acid into the upper stomach), NSAIDS and Steroidal drugs (These drugs prevent prostaglandin production, key components of the protective mucosal lining of the GI tract), and parasites.

The clinical signs of dysbiosis are varied.  Typically the horse eats grain, but will not eat hay, has a rough coat, suffers weight loss and has dificulty gaining weight, is often anxious, stressed, nervous, and objects to working or to the saddle itslef, is often sore to the touch to the bladder 21 acupunture point and is reactive to palaption along the gut sagittal line.

Once dysbiosis occurs in the equid, this essentially opens the door to many equine diseases. In addition to the aforementioned diseases founder, laminitis, inflammatory diseases i.e. arthritis, and metabolic disorders i.e. insulin resistance; dysbiosis also contributes to Cushing’s disease, endotoxemia, Diabetes mellitus, azoturia, colitis, inflammatory bowel disease, irritable bowel syndrome, infectious enterocolitis, celiac disease, bacteremia, Chronic Obstructive Pulmonary Disease (Heaves), liver disease, and colic. Most often these conditions manifest in the horse as colic, which is often recurrent and unrelated to management. Chronic weight loss and chronic diarrhea may also result from leaky gut syndrome.

Further it has a devastating effect on the liver as it is recruited to filter all “contaminated” blood from the intestine. Signs of liver dysfunction, which include tight, sore muscles, weak, easily injured tendons and ligaments, poor hoof quality, eye disorders and irritability will appear before the liver has time to increase liver detoxification enzyme production (detectable via blood tests) and thus excess free radicals are left to circulate in the blood exacerbating chronic disease i.e. laminitis.

Treatment and Prevention of dysbiosis is fairly straight forward and a simple way to avoid such grave consequences. First off, return your horse’s life to him. Permit your horse to be a horse as close to its natural state as possible. Relocate your horse “out” with ample running room, grazing, and companionship. Offer plenty of high quality grass hay and frequent small low starch meals. It is always best to prophylactically prepare/protect your horse’s gut prior to any stressful situations: deworming, vaccinations, shipping, shows etc. Maintain a well-balanced feed for your horse with appropriate Calcium/phosphorus ratios as close to 1:1 as possible. Have horses teeth checked and floated regularly and try to keep the horse’s daily regime predictable and prompt as possible. “The more boring your horses daily life, the better”.

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  1. I had no idea horses could develope insulin resistance. Looks like I need to do some research about that. Thanks for the info. I’ve added your link to my site, I think you have a lot to offer my readers.

  2. Hi MiKael and thanks for the response and kind words.

    Here is another article posted earlier on this blog which talks about Insulin Resistance

    The Dysbiosis article does not mention the ‘cresty neck’ look in horses which is another sign of possible insulin resistance, but this first one does.

    Not a whole lot seems to be known by the veterinary community about insulin resistance in horses, rather, owners seem to be leading the way in that regard. Feed companies are starting to formulate feeds that meet the demands of owners who are looking for low starch ‘grains’ to feed their horses.

    It sounds like the predisposition to laminitis seen in such horses is one of the end results of the vicious cycle of domestication, confining horses, and restricting their diets because their lifestyles allow them to gain weight so easily. Since it seems to be at least partially caused by ‘toxins’ invading the bloodstream through the perforated hindgut, it would seem that the apparent reactivity to high sugar foods is from undigested sugars entering the bloodstream resulting in inflammation, rather than any particular inability of the horse to digest sugar, or an over-sensitivity to it.

    As always the take home message is prevention, and return to as natural a lifestyle as possible (which includes lots of exercise!)

  3. If Laminitis is related to the liver and its “normal” condition why isn’t Borrelia burgdorferi (Bb) concidered a triggering mechanism of Laminitis??

    Please advise,

  4. Hello,
    I’m not sure how laminitis is related to the liver; did you obtain that information from this article? I also don’t know what BB is and how it would be a triggering mechanism of laminitis? Perhaps it would be more helpful to direct your question to the author of the article, Kate McBride Puckett. Sorry I couldn’t be of more help.

  5. laminitis is nasty stuff!!!!!!!

  6. I carry low sugar horse treats that are safe for Insulin resistant horses.


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  8. Bb is a bacterial spiorchete that feeds on the host electroylytes and proteoglycans. These fluids make up the gel between cells and the cell surface membrane responsible for cell to cell communication and receptors allowing substances to bond with the cell.
    Without cell-cell communication the bodies defense mechansim attacks and destroys the malfunctioning cells. Much like cancers. Once the events are set in motion the Immune system takes over and can result in Laminitis.

  9. wm – I have NO idea what you are talking about.

  10. here’s a link to some amazing articles about the diabetes link to laminitis… its not a disease of the hoof as we’ve been told all these years… its a metabolic disease that then affects the foot as it progresses into what is now being referred to as EMS, Equine Metabolic Syndrone…. which makes sense with the article on this page… if the horses gut is imbalanced and not able to maintain the health gut bacteria… soon the immune system is compromised and the ph balance is also becoming more acidic and soon the lamina are affected by the toxins to the hoof- it becomes a vicious cycle if the root cause is not addressed… you can through probiotics at it all day, be very careful about testing your hay, allow grazing only at the right times when the NSC are the lowest…, but why not treat the root cause of the imbalance???

    the link between laminitis to the liver has to do with the toxic overload that the liver has to process among other things… when the lamina deal with the overload of fructans and other toxins… when in an accute laminitic attack… the floodgate release of an enzyme called Matrix Metalloproteinases occurs (normally its only temporary to allow the hoof wall to grow down).. Thats when thte laminae that attach to the inner hoof wall and the coffin bone separate leading to rotation and founder… ” the floodgate” gets stuck open when the fructans in grass are fermented by the bacteria in the hind gut of the horse… a high intake of fructans dramatically changes teh bacterial population in the hind gut causing a massive overgrowth of Streptococcus bovi.. this damages the lining of the colon which releases toxins into the blood stream.. when these toxins reach the hoof they cause an unrestricted release of MMPs and start the laminitis process…. (this is somewhat paraphrased from that website that describes a herbal product that is called MMPstop- used at the first sign it stops the process… I know- I’ve used it!

    this is a great article by a MIT research scientist and chinese herbalist… who has been treating laminitic horses VERY successfully for many, many years now…using chinese herbal medicine…

  11. I found your blog looking for information on reactive hypoglycemia. This is the first I’ve read about insulin resistance in horses. Thanks for such an informative article! Steph

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