Re: Re-addressing fructan level #Fructans


In addition to Sherry's excellent and accurate response, a reminder to go full circle with "diagnosis."

First and foremost, what is the cause of the laminitis? We often forget that laminitis is a secondary outcome. Treating laminitis is like trying to get the cows back in the barn - how did they get out in the first place?

If the horse has or had documented high insulin and that is the known cause of the laminitis, the question should be, "Did the diet change result in a reduction of insulin?" If yes, then the diet is effective and the source of the current symptoms need to be investigated. Other things to consider - does the horse have unmanaged PPID? Does the horse have abscesses brewing from post-laminitic damage? Is the trim/hoof support adequate? Is there an underlying infection?

If fructan is an issue related to laminitis, then the mechanism is through endotoxemia or "sepsis-induced laminitis." In that case (which, BTW, has never been documented on pasture and certainly not hay), then there would be symptoms accompanying or preceding the laminitis, like a gut upset. 

In the experiments where researchers triggered sepsis-induced laminitis using rapid induction of inulin fructan, they needed a minimum of 5 lbs to trigger laminitis in 30% of animals and 8 lbs in 100%. That's pure fructan, delivered to the gut all at once. If this horse is eating hay (slowly) with 4.64% estimated fructan, fed at 2% bodyweight per day, that's about 1 lb of fructan, and a different form of fructan than that derived from artichokes, delivered over the course of the day. I would be more than happy - thrilled actually - if someone could explain to me how that would trigger sepsis-induced laminitis. Even the unproven theory that there is a release of fructose/glucose molecules as the fructan is being fermented and that somehow results in hyperinsulinemia is squishy in this case because even if you use NSC (WSC+starch), it's barely above 10%. So... where's the logic?

Sorry - don't mean to shoot the messenger and you were absolutely correct to ask. It's just that, after over 10 years of illogical argument with no data to support it, it gets annoying. Take this quote for example,

"Although laminitis has yet to be induced experimentally by feeding fructan-rich pasture or a fructan-rich extract, there are anecdotal reports of clinical laminitis occurring when diets are below 10% ESC+starch but high in NSC." Again... what is the cause of the laminitis? Notice that it doesn't say, "there are reports of hyperinsulinemia..." again (and again) pointing to the outcome, not the cause. The paragraph concludes with, "Until specific research data are available, horse and pony owners would be well advised to avoid feeding high-NSC pasture and hays,... to soak... to use grazing muzzles."

As a scientist and advisor to this group, I find this completely illogical. It basically says, "There is no proof, but let's put the burden on the horse owner." Not only is there no proof, there's no physiologic basis for the rationale. Fructans are pre-biotic and are likely more beneficial than not. They certainly don't have a role in glucose or insulin production unless the horse is a species unlike all other mammals. 

Argh... sorry - it's not you - it's this topic!

Kathleen (KFG in KCMO)

Director and Research Advisor, ECIR Group Inc.

Missouri, USA, 2005 


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