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Carolyn Stull, PhD - University of California at Davis


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When re-feeding a starving horse some important points to remember include:


* Re-feeding syndrome usually occurs within the first 3 to 7 days.

* The recommended diet is high-fat and low carbohydrate.  Phosphate, magnesium and potassium levels must be adequate.

* Alfalfa hay is recommended. 

* The best approach is frequent small meals of high-quality alfalfa.  The frequency should be decreased gradually and the amount fed increased gradually over a 10 day period.

* After 10 days to 2 weeks the horse can be fed as much as it will eat.  Researchers feel that this time period is critical for the successful transition of the gut from a starved state to a fed state.

* The energy level of the horse will increase in about 2 weeks.  Animation of the ears, eyes and head will be the first noticeable movements.

* Three to five months is the expected time frame to restore and rehabilitate the horse back to its normal weight.

* Careful monitoring of the horse is essential during the re-feeding process.  Serum electrolyte levels should be checked at least every 24 hours for the first 5 – 7 days.


Starved animals have impaired immune systems so they should be separated from other animals.  Physical symptoms to monitor for re-feeding complications include:  muscle weakness, neurological dysfunction {including weakness, seizures, coma}, and cardiac dysfunction.  Hypomagnesaemia can produce irritability or aggression in the horse and hypophosphatemia can cause hemolytic anemia. 

Electrolyte imbalances may need to be corrected with fluid therapy if any of these symptoms are noted. Because starvation impacts the renal and cardiac function, complications may also include excess fluid levels in the body.  This condition can be further complicated by the increased insulin levels which, in turn, cause a reduction in sodium and water excretion.

Another possible re-feeding obstacle concerns thiamine.  Thiamine is involved in carbohydrate metabolism so, the resulting deficiency caused by starvation may be aggravated by carbohydrate re-feeding.  If this occurs the horse may suffer from ‘Wernicke’s’ syndrome which may cause ocular disturbance, ataxia or coma.  Thiamine supplementation should be provided.  Because oral absorption may be compromised, thiamine supplementation should be administered by injection.  Other than parenteral thiamine, no other supplementation is indicated during re-feeding. 


According to Dr. Stull, the re-feeding recommendations are as follows:



Days 1-3

Feed one pound (@ 1/6 of a flake) of leafy alfalfa every four hours for a total of six pounds per day divided into six feedings.  Contact a vet to evaluate the medical status of the horse.

Days 4-10

Slowly increase the amount of alfalfa and decrease the number of feedings so that by day six, you are feeding just over four pounds of hay every eight hours (total of 13 pounds per day in 3 feedings)

Days 10 – several months

Feed as much alfalfa as the horse will eat and decrease feeding to twice a day. Provide access to a salt block. Do not feed grain or supplemental materials until the horse is well along in his recovery; early feeding of grain and supplemental material complicates the return of normal metabolic function and can result in death.

*Provide clean, fresh water at all times.

*De-worming and correction of dental problems are very beneficial to the horse’s recovery.


                                                   TAKE HOME POINTS


Prevention is best defense for starvation: 

-  Always provide high quality forage equal to at least 1.5% of the horses body weight.  Adjust the amount fed according to the horses BCS.  A BCS between 5-7 is the ideal.

-  Analyze the forage fed and provide the appropriate nutrient supplementation for the horse’s age, job and, activity level.

-  De-worm the horse based on fecal egg counts and veterinary recommendations.

-  Provide appropriate and regular dental and veterinary care.

In The Event of Starvation or Malnutrition:

-   Consult with a veterinarian and a nutritionist.

-   Re-feeding syndrome usually occurs within 3 – 5 days.

-  The best approach is frequent small meals of high quality alfalfa.  Gradually increase the amount fed and decrease the frequency fed over a 10 day period.

-   Feed according to the guidelines set forth above.

-   Closely monitor the horse for any complications that may develop during the recovery process.



Stull, Carolyn, PhD, July 2003,  The Horse Report, UC Davis, Volume 21, Number 3,  pp456-457  ‘Nutrition for Rehabilitating the Starved Horse’, UC Davis Medical Center.

Witham, Christine L.  DVM, MPVMStull, Carolyn L.  MS, PhD, (1997)  Refeeding the Starved Horse: Metabolic Responses to Three Isoenergetic  Diets, Authors’ address: Veterinary Medicine Extension,School of Veterinary Medicine, University of California at Davis, Davis, CA 95616.AAEP.



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