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  Discussion on Treatment for Bran disease
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Member:
zelda

Posted on Monday, Jan 18, 2010 - 7:21 pm:

6 months ago I bought a 16H3 4yo Warmblood. When I assumed ownership I asked the previous owner for his feeding regime and it included 1 lb of Oat bran, orchard grass and 2 lbs of commercial 14% protein pellets daily. Unaware that this was a terribly imbalanced Ca:P I continued to feed him this way for the next month (he was also on pasture 8 hrs a day) until I noticed a change in his facial skeleton (swelling) which I recalled had a nutritional cause. He was also crouching rather than pushing off his limbs when he moved. As soon as I diagnosed the imbalance I stopped riding him, stopped feeding oat bran, added alfalfa to his diet and supplemented with 6 g of calcium citrate in his pellet with some beet pulp. I set the CA:P ratio to 3.5 to 1 for 3 months. My question is how long does it take for this condition to reverse? This is a talented dressage horse and none of the local vets have any experience with this. His nose has returned to normal and he is moving better...I ride him very cautiously but he sweats easily and doesn't gain weight well. Would it be sufficient to return to a 2:1 ratio now with alfalfa at about 30% of his hay mass and discontinue the Calcium carbonate?
Moderator:
DrO

Posted on Tuesday, Jan 19, 2010 - 6:26 pm:

Hello lucie,
Though the symptoms sound about right the history you give us is really not consistent with such a problem, particularly in an adult equine. 1 lb of bran in an adults diet of balanced concentrate and grass forage, hay and/or pasture, should not be enough to throw the Cal/Phos ratio into the realm of causing Bran's Disease. The problem is the dilution of the imbalanced bran with approximately 25 lbs of balanced feed should return the mineral ratio to a acceptable, though barely so, ratio.

I do think balancing the Cal/phos ratio of the bran with alfalfa or beet pulp is a sensible move but I think you need to explore other possibilities for the changes you are seeing just to be sure you are not missing something.

If we assume this is the problem I don't know how long it will take to return to normal, I was hoping to research that today but a emergency or two got me behind today, I will try and research this question for you tomorrow.
DrO
Member:
zelda

Posted on Wednesday, Jan 20, 2010 - 7:39 pm:

Thanks Dr O. I think the problem was Orchard grass hay because its' ratio of Ca:P is about 0.9:1 compared to other grass hay which tends to be higher in Ca. It did nothing to offset the high P in the bran. As well, when he arrived he was stressed by the change and seemed to have difficulty chewing and showed minimal interest in his hay. He would take a few bites of hay and walk around. So I inadvertently gave him more and more beet pulp and bran because he was losing weight. I'm guessing his teeth were soft and sore so he preferred the soft nature of the beet pulp mix. Within a week of changing his feed to a balanced ration he started eating better. He especially likes Alfalfa (like most horses) and his weight improved. This continued for the next few months but just recently he went off his feed again (after I stopped the Calcium supplementation). We are currently investigating ulcers now. I think there is a good likely-hood he has or has had ulcers compounding everything. I hope you are successful in your research on treatment for the CA;P imbalance as I really wonder how much bone remodeling he has to do to recover fully and how long to supplement.
Thanks so much...
Moderator:
DrO

Posted on Thursday, Jan 21, 2010 - 9:51 am:

Hello lucie,
Overt symptoms of Bran's Disease (also goes by Bighead and Nutritional Secondary Hyperparathyroidism (NSHP)) does not usually occur until the cal / phos ration DrOp to 1 / 3 and you are no where near that number. Using your figures for the orchard grass I don't see how you get anywhere close to this. There can be complicating factors like oxalate consumption but even with this I have trouble getting close to a number that might cause NSHP.

To get back to one of your original questions I did some research and the typical recovery time is 9 to 12 months. I would love to have an image of your horses head this disease has become so rare I have not seen one in 25 years of practice.
DrO
Member:
zelda

Posted on Monday, Jan 25, 2010 - 11:39 pm:

Thank you for the information Dr O...Wow that is a long time for recovery. Do you think it is Ok to continue riding? He is progressing well but I keep the sessions short and he is on a 2 'on' 1 'off' schedule. I also need to report that he is responding positively to the Omeprezol treatment for ulcers so we have solved a second issue for him.
As for pictures of his head when he had bran disease, my local vet described it as 'definitely moose like'. I really wish I had had the foresight to take a picture but what I can say is the swelling increased the diameter of his nose by at least one inch and took about 2 months to return to normal. He also has a 'swelling' about 3in X 2in on the inside of his left front leg, near the growth plate above the fetlock. It has reduced by half but is still visible 6 months later.
So why did this happen at all? I still think he had had an imbalance of Ca:P for at least a year and the situation was exasperated by him not eating much hay and my increasing the bran because he was losing weight. If only a person could set the clock back...
Moderator:
DrO

Posted on Wednesday, Jan 27, 2010 - 11:49 am:

Hello lucie,
I am not sure what happened to your horse but it is difficult to understand that it would be NSHP from this history.

I would not ride a horse recovering from NSHP, after all a horse with healthy bones can fracture a leg and I would suspect the joints of such a horse more prone to developing arthritis.
DrO
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