I have a 26 year old TWH that has chronic diarrhea. He had vet work done last year, when it first started, with his blood work coming back normal, fecal exam okay and teeth are okay. No feed or hay change. Actually, his stool will be somewhat normal, not firm apples but has some substance to them, for most of the time then about once or twice a month it gets loose to the point of liquid. I had him on ProBalance during some of this time period but it did not seem to affect his stool. He is now on Stomach Smoother but still having the same results as with ProBalance. His coat is shiny, he eats all his grain and most of his coastal hay (his preferred hay for 23 years) and is still very active. His weight is pretty much staying the same the last year. – GB
Dear GB,
Diarrhea is one of those conditions that differs from horse to horse. Because what works for one doesn’t always work for another, you just have to start somewhere, keep a good journal, and try different treatments until something works.
You’ve started in the right place: with your veterinarian. That is, ruling out some of the more common causes through a complete physical examination, blood work and fecal exam. Some uncommon causes of chronic diarrhea require particular tests of blood, feces and even GI tissues; you may have to specifically ask your vet to run these additional tests.
When experimenting with treatments, I recommend keeping a record of everything you try and sharing this “diarrhea diary” with your vet. Before you try anything though, I strongly encourage you to deworm your horse (no matter the result of the fecal) with Panacur PowerPac or Quest (if he’s not debilitated). Then give a product with ivermectin and praziquantel to ensure complete coverage of all internal worm species.
Next either try adding products to his diet or changing his diet, but not both at the same time, because then you won’t know which treatment worked! Since your horse has been eating coastal hay, you could switch him to another kind of grass hay or to alfalfa hay. You could also try changing his grain or replacing it altogether with a multi-vitamin/mineral supplement or ration balancer. Remember to make any diet changes slowly, over a two-week period, so your horse doesn’t develop additional problems like colic or laminitis.
Here is a list of products to try to see if they help. Give them one at a time, with your vet’s advice, and for at least 30 days:
Probiotics, prebiotics and yeast – to reinoculate and feed the “good bugs”
Kaopectate and Pepto-Bismol – coat, soothe, relieve!
Psyllium – in case the diarrhea is caused by inflammation from sand
Daily dewormer – to prevent gut wall damage from parasites
Digestive enzymes – such as amylase, lipase, cellulase and protease
Hindgut buffer – encapsulated or protected sodium bicarbonate
Digestive support – products with L-glutamine, Licorice, Oat fiber and oil
Plant extracts – adaptogens to help normalize the body’s systems
If none of these over-the-counter treatments work, you may have to go back to your vet and start trying prescription products. Here are a few that have worked for some horses:
Steroids – prescription immune suppressants
Antihistamines – prescription products that may work best with steroids
Antibiotics – prescription only since some antibiotics can worsen the situation!
Rheaform – a prescription product that reduces motility in the colon
Lomotil – prescription anti-diarrhea medication
Imodium – over-the-counter anti-diarrhea medication
Opiates – prescription narcotics related to morphine
Unfortunately, it’s not uncommon for a treatment to work for a few weeks or months then the horse’s stool gets sloppy again. And some horses never improve, struggling with chronic diarrhea the rest of their lives. Just be patient and thorough and hope for the best!
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Lydia F. Gray, DVM MA, currently serves as the Medical Director/Staff Veterinarian for SmartPak Equine. Prior to joining SmartPak, Dr. Gray served as the first-ever Director of Owner Education for the American Association of Equine Practitioners. She has authored numerous articles in publications such as The Horse, Horse Illustrated, Western Horseman and a variety of veterinary journals and magazines. Dr. Gray is also a frequent speaker at horse expos, veterinary conventions and other locations. After graduating with honors from the University of Illinois College of Veterinary Medicine and receiving her Master's Degree in Interpersonal and Organizational Communication, she practiced at the Tremont Veterinary Clinic for several years. Dr Gray is active in the American Veterinary Medical Association and Illinois State Veterinary Medical Association and enjoys training and showing her trakehner Newman in her spare time. Find Dr. Gray on Google+: Find Dr. Gray on Google+
did GB ever find out what was wrong with her TB?
my horse has the same exact symptons.
My horse had chronic diarrhea for a few years, and we must have tried what seemed like every type of supplement or treatment program, with absolutely no results. What ended up completely curing the diarrhea was switching him from timothy/alfalfa hay to hay cubes for a few months, and then switching him to orchard grass. Turns out, the long stem timothy hay is very upsetting for his stomach. Who knew!
We are very happy to hear that you figured it out Ellen, great investigatory work!
My horse has been on the regular version of SmartDigest for about 2 years now, and it has completely eliminated his diarrhea, which he used to get every summer and sometimes when we switched hay (vet said it was idiopathic – we couldn’t pinpoint a cause). No problems at all for the last year & a half!
What fantastic news Caitlin! We are so happy to hear that SmartDigest has helped make your horse more comfortable and eliminated the chronic diarrhea. Thank you for sharing your story!
I’m confused on the deworming advice. Panacur (fenbendazole) OR Quest (Moxidectin) plus immediately give Ivermectin AND Praziquantel (Zimecterin Gold, for example, is combo product)? The Panacur Power Pac is 6X the price of Quest – what determines which to use? I’ve always thought that giving too much dewormer at once may stress the horse’s system – should all these chemicals be administered at the same time?
Hi Sarah – Great question! The Panacur PowerPack and Quest both control encysted small strongyles, which can be a difficult-to-diagnose cause of loose stool in horses. Your veterinarian can advise you on which product might be best for this purpose in your horse. Your product choice will then determine when to give the next dewormer, either four weeks if Panacur or twelve weeks if Quest. This is because of their different egg reappearance periods, or, how long it takesl worms develop into adults and start laying eggs again.
A 10 day course of Metronidazole worked for us after 6 years of struggling with chronic diarrhea.
Try adding alfalfa cubes to his diet. This simple suggestion from a friend cured my first elderly horse, and has worked for others I have since known, including a Morgan who had liquid diarrhea for 2 years and for whom nothing else worked. It can be as little as one “coffee can” a day; soaking the cubes also works for horses whose teeth are very poor.
I agree with the write up and if no health reason can be found another thing to consider in an aged horse is the fiber length of the forage. I would monitor the stool to see if the fiber in the feces is larger than normal. An older horse is not able to chew and crush the forage as is necessary for digestion. Digestion starts in the mouth and steps take place all the way to the colon. It is the job of the colon to absorb the fluid. Fiber length can affect the proper function of the colon. We are lucky to have so many quality senior diets. I have a 33 (estimated age, grade horse) year old gelding that has 3 molars left. These teeth are fine, but face it he only has 3. I recommend an equine dentist (the DVM type) the best senior diet you can get and chopped hay so that digestion is most likely to proceed with less work from chewing, and balance the diet to meet his work load (more calories and buckets of supplements are a waste of energy, time, and money if your horse can’t use them) Your DVM can help with this or a nutritionist at any Veterinary School. Your DVM should be able to help direct you to good resources. Good luck and I pray you have many more years of happy trails with your older horse.