Heart of Phoenix’s Re Feeding protocol for Starved Horses
Horses that arrive at a Body Score of 1-3 (or so) are in danger of developing re-feeding syndrome, but they can also already be in organ failure. It is important to understand if the organs are failing, a refeeding protocol is not going to save them.
They are also in some degree of danger of colic, though this hasn’t been something we’ve battled during the refeeding process.
Re-feeding Syndrome is a serious, potentially fatal, complication of nutritional restoration. A major cause can include low phosphorus blood levels following intake of foods high in calories or glucose. Phosphorus depletion causes abnormalities in the cardio-respiratory system. Symptoms also develop in response to changes in potassium and magnesium levels. Rapid changes in nutritional intake can place excessive strain on the impaired heart which is then unable to maintain adequate circulation. The liver and the central nervous system are almost always affected, also. We have seen mis-fed horses initially show muscle tremors and rear end weakness before they collapse.
Not only is there a risk of this serious metabolic issue that can lead to death, but we believe the risks of losing the horse due to severe starvation (thus creating organ failure) increase when re-feeding is done at too slow a rate, because the rescuer is afraid of overfeeding.
This is a fine line.
Some people frequently cite a study that stated a horse at the lowest level of starvation, a body score of 1, the lowest the scale will rate, has a very small change of survival.
However, here at HOP, we have never lost a horse to refeeding syndrome. We have euthanized several horses who had compromised organs due to starvation.
MANY of our cases have been body scores of 1.
Our feeding process is different than the recommendations found in some articles, a sizable number of emaciated horses rehabbed successfully prove that, for hundreds of horses, it works for HOP.
We feel time is short to stabilize a horse coming in at a body score of 1 when you start to “re-feed.” You cannot make mistakes.
The MOST important aspect, for us: We make sure they have a loose quality mineral and salt from the moment they arrive (a block of salt AND a block of mineral will work if that is all you can offer). If these are not there from the beginning, the horse seem to have a lower rate of survival if they are a body score of 1. We have also used CMPK labeled for cattle in critical cases of a collapsed animal or one near collapse, which is a calcium, phosphorus, magnesium and potassium supplement in the proper absorbable ratios made for cattle with “milk fever”. We find this stabilizes downed horses. Good gel electrolytes can be used, too.
Without quick access to minerals and salt, especially before unlimited water, you can run into problems as the horse who is already very deficient starts to consume more water.
We think this lack of understanding is likely the main reason people lose the starving horse. Calcium, Magnesium, Phosphorus, Potassium and Sodium are so important. Get these into the horse fast as they start to eat. We find they usually prefer minerals to water during the first day. They will use the loose minerals frequently for weeks. We highly recommend doing HUMAN re-feeding studies to better understand this, as there is more research on human refeeding.
Do not add the salt and minerals to the feed. We leave it separate and free choice.
Obviously, clean water. You wouldn’t believe how denied these horses can be of this basic need which is why they are apt to drink copious amounts of water. Minerals at same time as WATER.
Then we offer free choice, good quality, grass hay. We will offer alfalfa AM/lunch/Pm. We personally do not limit grass hay here at all. We do not do limit grass hay. Others suggest this, but it has never been how we rehab. Access to some grass in our region has proven very safe, as well, even from the start of rehab, as well.
We start almost all of our horses out within the first few days of intake with a dental float, unless critical. No matter the weight of the horse, the teeth are done right away, unless they are unstable. We do a fecal, and by 10-14 days, we have begun a safe de-worming process (usually safeguard). It is a slower process than you would take with a healthier animal.
We uses to use probios paste or the probiotic powder sometimes.
We find treating for gastric ulcers from the moment of intake yields a happier, healthier horse quicker, as most emaciation cases have ulcers when scoped.
Depending on condition, overall brightness and vet check, we will begin to introduce a no molasses / no corn type of low starch feed, something low grain in base, high in forage, a handful twice a day, in 14 days or so.
We do not usually use weight gain products. We almost never see any need. No need to rush the gain with supplements behind solid nutrition.
The best thing for a horse to achieve optimal weight, after teeth are addressed, is free choice forage/hay (seniors or those with dental issues or other health conditions are exceptions). We want a slower, steady weight gain.
Forage is the foundation of rehab and equine nutrition as time goes on. We use free choice, good quality grass hay offered from intake. We pair that with chopped alfalfa in 3 feedings (used because of the great calcium / mineral ratios).
We offer grain 2-6 weeks into re-feeding, and our
| Feed Form | Pelleted |
| Type of Horse | Idle or Low/Moderate Work |
| Crude Protein | 14.00% |
| Crude Fat | 10.00% |
| Crude Fiber | 20.00% |
For feeds, we generally like pellets without high molasses content.
Generally, think of grain or concentrate as a small part of the diet of the rehabbing horse.