Nutrition is the cornerstone of health,” said Clair Thunes, PhD, an independent equine nutrition consultant and owner of Summit Equine Nutrition in Sacramento, California.
Nutrition is a significant part of the foundation on which an animal’s health and well-being are built. Proper nutrition is critically important to achieve and maintain optimal health and ensure optimal performance in every horse. However, it is often a subject in which veterinarians receive little formal training beyond the handful of compulsory courses in vet school or undergraduate studies.
Once veterinarians are hired for their first positions or start their own practices, they find little attention devoted to nutrition. “In my experience working in a veterinary practice, nutrition was not something that was focused on unless there was a specific clinical indication,” said Katherine Williamson, DVM, manager of Veterinary Services at Purina Animal Nutrition.
“I see practices advertise they are specialists in dentistry or internal medicine, but never have I seen a veterinarian advertise they are a nutritionist,” Thunes said.
Routine farm calls, lameness exams and emergencies consume a veterinarian’s daily schedule, leaving little time for nutritional evaluation and consultation.
“Due to our training, we veterinarians tend to focus on basic aspects of preventative care such as vaccinations, dental care and fecal exams, often overlooking the nutritional components of wellness,” Williamson said. “Expanding the practice’s services to include nutritional assessments is as much about changing a mindset and creating new habits as it is about familiarizing oneself with each of the different diets and their pros and cons.”
Long ago, small animal practices figured out the benefits of discussing nutrition and diets with their clients. “It’s something our small animal counterparts do a bit better than we do,” Williamson admitted.
Walk into any small animal clinic and you’ll see shelves lined with prescription food and multiple supplements from which to choose. “It’s unrealistic for an equine vet to carry and sell feed out of the back of their truck, but I don’t see vets with supplements, either,” Thunes added.
Adding nutritional services to your practice’s standard service offering will not only lead to healthier animals, but serves as a way to differentiate your practice from others in the area. Incorporating nutritional services doesn’t necessarily mean you have to go back to school.
What’s in Your Wellness Exam?
“During a wellness exam, you can do a thorough dietary history for each horse, including details about any concentrate feeds, hay and supplements the horse is receiving,” Williamson suggested. “It’s also good to ask what kind of pasture the horse is on and for how long.”
An accurate nutritional assessment all of the horse’s rations includes weighing a horse’s hay and grain ration. The horse’s age, weight and activity level should also be documented. For a complete understanding of the horse’s nutritional intake, a full hay analysis should also be done, which should be sent out to a lab for analysis.
The tag from the feed bag will also reveal a good deal about the feed’s nutritional balance and how much the horse needs to benefit from that balance. “If a feed bag says you need to be feeding X amount of feed a day, but the owner is actually feeding Y (often less than the recommended amount), the horse may not be getting the nutrients it actually needs. Or it may be getting too many nutrients,” Thunes said.
At the same time you document the horse’s intake, assess the horse’s body condition score and note it in the animal’s chart. “If you notice the animal is a 7 (body condition) or more, it’s a good time to discuss obesity or metabolic syndrome in the horse,” said Williamson.
A comprehensive wellness exam is an in-depth examination of the horse’s caloric intake as well as a determination of whether the horse is receiving a balanced and adequate mineral intake.
“I see a lot of vets offer a wellness package that includes a discount on shots and a nutritional assessment,” Thunes said. “Unfortunately it’s not a thorough assessment of the horse’s entire nutritional intake.”
A veterinarian who is not equipped or staffed to offer an all-inclusive nutritional assessment can establish a relationship with a nutrition specialist, such as an independent nutrition consultant or a nutritionist at a feed company. Forming a partnership with an independent nutritional consultant can be particularly helpful, especially in difficult medical cases.
“Using an independent nutritional consultant may depend on geography and the horse owner’s budget, but if the vet has gathered sufficient information on the horse’s diet and body condition, then the consultant can use computer software to determine if the horse’s nutritional needs are being met,” Williamson said.
Ultimately, a wellness exam that includes a nutritional assessment is a conversation starter. “Assessing a horse’s condition only takes a few minutes, but it opens the channels of communication and can open avenues of revenue through diagnostic testing for issues in which nutrition may play a role, such as PPID and equine metabolic syndrome,” Williamson said. For example, when a veterinarian sees a horse carrying more weight or abnormal fat deposits, he or she might suggest testing to determine insulin/glucose and/or ACTH levels.
Once a client orders diagnostic tests, you have to be prepared to answer questions or direct them to someone who can. “I tend to see diagnostic tests done, then the vet tells the client, ‘Your horse is insulin resistant and needs a diet low in starch and low in sugar,’ ” Thunes said. “It’s a tailspin for owners. They are bombarded with stuff on the Internet pushing products and making claims.”
Be prepared to provide a detailed dietary regiment for the horse. “An independent nutritional consultant or a feed company nutritionist can provide specific recommendations based on a horse’s specific needs,” Williamson said.
Fee for Service or Value-Added
The big question any veterinarian has when considering new services is whether to assess a fee for the service or to include that service as a value-added bonus to the client. In the case of wellness exams that have been expanded to include nutritional assessments, Williamson recommended that veterinarians “estimate the amount of time a thorough body condition/nutritional assessment will take, then assess a fee based on the fee structure you use for something like a pre-purchase exam, which is calculated based on the length of time it will take to complete. However, if your clients are looking for additional value-added services, you may consider adding a more abbreviated assessment with the option for more in-depth assessments for a fee.”
Based on the findings of a wellness exam and a horse owner’s budget, fees can be charged for additional consultations, especially when hiring an outside consultant.
Expand Your Knowledge
Veterinarians interested in increasing their knowledge of equine nutrition can find information available from numerous resources. “The National Research Council (NRC) Nutrient Requirements of Horses is an easy-to-use guide,” Williamson said. There is also an online component produced by the NRC available at http://nrc88.nas.edu/nrh/ that allows users to compute a horse’s nutritional needs through the use of an online calculator that takes into account the animal’s weight, gender and level of activity.
“Veterinary medical reference books such as Equine Applied and Clinical Nutrition: Health, Welfare and Performance edited by Raymond J. Goer, Patricia A. Harris and Manfred Coenen are particularly helpful,” said Williamson.
Major feed companies provide detailed information on their websites about the recommended feed quantities for horses based on their ages and activity levels. The websites also include detailed analyses of the minerals and/or vitamins available in the feed.
In addition to the self-education tools, veterinarians can learn more about nutrition at seminars and symposiums. “Purina holds an equine veterinary conference every year and speakers cover a variety of topics related to nutrition,” Williamson said. “The Equine Science Society Symposium is not an event vets necessarily consider attending; however, if you want a crash course in nutrition, especially in recent research, it’s a good one. It also provides excellent contacts through networking.”
Workshops that focus on PPID and equine metabolic syndrome also offer a lot of nutrition information within the broader topic of those conditions. Each year, the American College of Veterinary Internal Medicine (ACVIM) in conjunction with the American Academy of Veterinary Nutrition (AAVN) offers a one-day symposium on veterinary nutrition during its forum. “They are somewhat heavy in small animal, but do cover some horse nutrition,” Williamson said. “It may be worthwhile to purchase the proceedings if not attending in person. Additionally, the American College of Veterinary Nutrition holds sessions focused on clinical nutrition topics during the annual ACVIM Forum.”
Nutrition: the Foundation of Wellness
Sometimes it is obvious that a horse is not receiving the appropriate nutrients. His coat is rough or dull and his hooves are weak or brittle. Other times a horse can look great on the outside, but actually be deficient in certain minerals.
“Correct nutritional management is as important as veterinary medical care. Equine nutrition is at the core of every horse’s wellness program, affecting how they look, feel and perform. A complete and balanced equine nutrition program can even save money in the long run with improved immunity and a coat that glows with good health,” Thunes concluded.