Electrolyte imbalance - help!

[spacefaer]

Has anyone any experience of a horse suffering from a electrolyte imbalance that is getting slowly worse, or could suggest any reason for it?
Google isn't helping much!

He's on adlib good quality hay, regular turnout, an Equerry mash with a general balancer.
He drinks his normal amount, is peeing and pooing normally. Good appetite. Nothing has changed in his routine or environment recently.

Was diagnosed with a magnesium deficiency, which has now escalated to a calcium/ phosphorus imbalance (obviously due to my magnesium supplementation ) and has just today shown signs of his potassium levels being off.

He's also demonstrating a decent (!) Level of exercise intolerance.

Any thoughts or suggestions? My vets are stumped.
I'm planning on getting a blood test done next, just to see how out of whack he is, but am utterly at a loss as to the cause.

 

[Tiddlypom]

What tests have been run on him so far?

Exercise intolerance does bring some sort of PSSM to mind.

 

[Sossigpoker]

How was he diagnosed with magnesium deficiency and how do you know the potassium is out of whack?
The grass is very green at the moment so that will push the potassium up. You should feed salt as well as magnesium to counter act this.

How does the exercise intolerance show?
PSSM is actually pretty rare , most horses actually have a musculoskeletal problems. And even if your horse has the gene ,.there's no evidence to show that it's the gene that causes problems.

I'd be inclined to have a blood test to check for vitamin and mineral levels. And add 1-2 table spoons of table salt to his feed per day , as well as the potassium.

I thought my cob was showing "PSSM symptoms " but he turned out to have hock arthritis and SI pain. So I'd get a good lameness work up done too.

 

[SEL]

Potassium high or low? High potassium can be a sign of some sort of blood sugar problems so I'd want to check for EMS and type 1 PSSM depending on breed.

Blood tests aren't hugely reliable for magnesium or potassium I've always been told so might also be worth a chat with the lab

 

[expanding_horizon]

Has anyone any experience of a horse suffering from a electrolyte imbalance that is getting slowly worse, or could suggest any reason for it?
Google isn't helping much!

He's on adlib good quality hay, regular turnout, an Equerry mash with a general balancer.
He drinks his normal amount, is peeing and pooing normally. Good appetite. Nothing has changed in his routine or environment recently.

Was diagnosed with a magnesium deficiency, which has now escalated to a calcium/ phosphorus imbalance (obviously due to my magnesium supplementation ) and has just today shown signs of his potassium levels being off.

He's also demonstrating a decent (!) Level of exercise intolerance.

Any thoughts or suggestions? My vets are stumped.
I'm planning on getting a blood test done next, just to see how out of whack he is, but am utterly at a loss as to the cause.

How are you diagnosing these imbalances? I didn’t think blood testing was that reliable? And it f doesn’t sound like you are running multiple blood tests?

I feed magnesium with the balancer I use. Most U.K. forage will be low magnesium to start with. All forage provides excess potassium to needs. (Unless a racehorse / high level endurance horse).

I add calcium to balance the high phosphorus in the oats, copra and linseed I feed.

I feed 50ml table salt to provide sodium all year round.

I top up with flavoured electrolytes if extreme sweating occurs.

 

[PurBee]

I’d be motivated to get kidney tests done, as usually the electrolytes, when there’s plenty of them in the diet, get either stored for future use, or excreted, enabling the blood to maintain its ideal levels of each. Its a self-regulating system when all is working as it should.
If there’s higher than normal levels of any of them, the excretion route isnt working for whatever reason.

Some electrolyte balance is controlled by adrenal/pituitary/endocrine routes (sodium/aldosterone), so if there’s excess of any electrolyte showing consistency in bloodwork, either endocrine gland signalling issue, or issue with the actual organs that should filter them out: kidneys.

Deficiencies are more easily understood and managed. Excesses require deeper investigation.

 

[spacefaer]

Ok so long story short (unless you want the lengthy version) he started having seizures. Losing proprioception, nystagmus, the whole thing. My vets wanted to scope him or MRI him once we felt he was safe to travel, as they were thinking tumour or blood clot.
After a lot of research, I found he was ticking a lot of the boxes (12/15) for magnesium deficiency, so I gave him a tub of NAF magic (not all at once ) and all of his symptoms disappeared. Including the seizures, despite the external triggers that had caused them still being present.
The vets tested his blood for the Mag levels, but of course they showed as within the normal range as it's stored in the bones and released in to the blood when required.
He's been good - feeling great in fact - in low level hacking and a bit of larking round the field.

The last few days however, he has been absolutely shattered after the slightest exertion and on Saturday, he tied up on the way home from a short hack ambling round the block. The only cause I could establish for the tying up is an imbalance in the calcium phosphorus ratio, which my vet agreed today is most likely to be caused by the extra magnesium.

Apologies for the essay!

 

[spacefaer]

Oh and he's a 16 yr old Irish draught. Never had anything wrong with him before, barring accidents.

 

[ycbm]

I know a lot of barefooters feed ridiculous amounts of magnesium after a book recommended massive doses. I've never heard of that causing tying up issues, so I would go with suggestions that you should get his kidney function tested.
.

 

[SEL]

Has he had more grass than normal or any other change in feed? I'd also be running bloods to see if there's something else going on.

 

[PurBee]

The tying-up has a few suspected causes, with electrolyte imbalance being one.

How much sodium is he getting? If low amounts during summer especially tying-up type symptoms can be seen:

Salt Deficiency​

Horses are most likely to develop signs of salt (NaCl) deficiency when worked hard in hot weather or fed salt-deficient rations. Horses deprived of salt tire easily, stop sweating, and exhibit muscle spasms if exercised strenuously

Nutritional Diseases of Horses and Other Equids - Nutritional Diseases of Horses and Other Equids - Merck Veterinary Manual

Learn about the veterinary topic of Nutritional Diseases of Horses and Other Equids. Find specific details on this topic and related topics from the Merck Vet Manual.

www.merckvetmanual.com

From other posts youve made…IF im remembering correctly, your naf magic dose of mag wasnt huge - as that product has a few other ingredients added too. Naf themselves dont tell us on their page what dose of mag. is in each dose, annoyingly! (It may say on the actual tub, it doesnt on their website)
(iIRC you were asking recently about switching to just plain mag ox, and worried the switch due to the magic’s other ingredients might bring other symptoms back)
So considering the relatively low dose of magic, i wouldnt suspect the mag to have caused a complete wobble of all other electrolytes.

Yet considering this time of year - ireland and uk have recently had a relative surge of warm weather, and grass growth is is generally mad from accounts of others on here, there is the possibility of high potassium spikes in the grass, (which you’d want to dose a bit more magnesium to counteract) - as that tenses up muscles, muscles spasms, very stiff gait.
( FYI the cow farming community are constantly warned by agri extension departments of grazing spring grass potassium spikes affecting their herd and causing muscle spasms and seizures (tetany), and to have magnesium on hand to quickly counteract it)

OR there’s excess sodium loss through it being warm, he’s in light work too (hacking?), and the sodium loss via the combination of being hotter, and being lightly worked, with low salt added to diet, has caused an ‘in-body’ calcium spike - which also contracts muscles, inability to relax , stiff gait.

The above is based on considering the other ingredients in naf magic, and the dose of mag in naf likely being around 10-15grams per maintenance dose, as a rough guess. (Due to that being the RDA level once horse is out of deficiency)
(They dont even say how much the other major ingredients are per dose either so i cant reverse calculate the mag. amount left!)

I recal youd settled on the lower maintenance dose of magic, so personally i dont suspect the magnesium to have caused such a dire swing of electrolytes and really think additions of more grass = potassium increase, maybe combined with lacking also sodium due to sudden warmth = tight muscles and fatigue. Treatment for that due to those causes would be increase of feeding magnesium and sodium.

Very excessive magnesium doses fed, that the body cant excrete fast enough usually causes sloppy poops. So you can asses from the journey of him being on naf magic, if his poops ever got softer? If not, i’d not suspect too much magnesium as causative of electrolyte imbalance.

 

[spacefaer]

I know a lot of barefooters feed ridiculous amounts of magnesium after a book recommended massive doses. I've never heard of that causing tying up issues, so I would go with suggestions that you should get his kidney function tested.
.

According to my research, tying to can be caused by a calcium phosphorus imbalance. And that can be caused by an imbalance in magnesium
I'm right at the edge of my technical knowledge here!

 

[spacefaer]

Has he had more grass than normal or any other change in feed? I'd also be running bloods to see if there's something else going on.

Nope, nothing has changed

 

[expanding_horizon]

According to my research, tying to can be caused by a calcium phosphorus imbalance. And that can be caused by an imbalance in magnesium
I'm right at the edge of my technical knowledge here!

Doesn’t sound like your vet is helping you much!

 

[spacefaer]

@PurBee thank you so much for your post.
He's been on 3 scoops twice a day of the Magic. I tried the Mag Ox but he started losing weight quite quickly and I read that it can be used for weight loss in laminitics and EMS horses, so I put him back on the Magic to be honest.
He's only turned out maybe a couple of hours a day, on well grazed grass so I don't think he's getting a significant change in that?
When i say he tied up, he went very wobbly behind, no stiffness as such or muscle tremors, but he felt very weak and reluctant to move forward. I let him stand and pick at the grass verge, then it seemed to ease enough to walk home 1/2 mile slowly. The last section, he just felt utterly weary. And he stood and slept the most of the next day. Today he went out, charged around full of energy and Joie de vivre for about 15 mins, then subsided rapidly and plodded around the field with his head low and with raised veins. Not normal behaviour for him.

 

[Sossigpoker]

@PurBee thank you so much for your post.
He's been on 3 scoops twice a day of the Magic. I tried the Mag Ox but he started losing weight quite quickly and I read that it can be used for weight loss in laminitics and EMS horses, so I put him back on the Magic to be honest.
He's only turned out maybe a couple of hours a day, on well grazed grass so I don't think he's getting a significant change in that?
When i say he tied up, he went very wobbly behind, no stiffness as such or muscle tremors, but he felt very weak and reluctant to move forward. I let him stand and pick at the grass verge, then it seemed to ease enough to walk home 1/2 mile slowly. The last section, he just felt utterly weary. And he stood and slept the most of the next day. Today he went out, charged around full of energy and Joie de vivre for about 15 mins, then subsided rapidly and plodded around the field with his head low and with raised veins. Not normal behaviour for him.

Are you giving him salt ?

 

[PurBee]

@PurBee thank you so much for your post.
He's been on 3 scoops twice a day of the Magic. I tried the Mag Ox but he started losing weight quite quickly and I read that it can be used for weight loss in laminitics and EMS horses, so I put him back on the Magic to be honest.
He's only turned out maybe a couple of hours a day, on well grazed grass so I don't think he's getting a significant change in that?
When i say he tied up, he went very wobbly behind, no stiffness as such or muscle tremors, but he felt very weak and reluctant to move forward. I let him stand and pick at the grass verge, then it seemed to ease enough to walk home 1/2 mile slowly. The last section, he just felt utterly weary. And he stood and slept the most of the next day. Today he went out, charged around full of energy and Joie de vivre for about 15 mins, then subsided rapidly and plodded around the field with his head low and with raised veins. Not normal behaviour for him.

Sorry, i thought i had remembered you had reduced down to minimal dose with the magic (memory a bit rusty!)
It would be helpful to know how much mag in the magic he’s getting if he’s on 3 scoops x 2 daily = 6 scoops.
Naf say the loading rate for 7-10 days is 2-3 scoops (despite not saying how much mag is in that dose! )

If youre giving 6 scoops daily, and hes been on that dose a while, there is the possibility that he is experiencing high magnesium symptoms, which can decrease/block calcium and phosphorus uptake (no matter how much calcium/phos is fed). Yet usually this is with excessive high doses, which is a possibility with 6 scoops.
Its so difficult to say if youve been giving excessive level that to him, as naf dont tell us dose rates.
If you have a look on the tub it will hopefully say how many grams per kilo, or grams per scoop is magnesium oxide.

As you describe a muscle weakening, rather than stiffening/tremors, and lack of energy - that could be hypermagnesia as calcium gives muscles the ability to contract - if there’s less than ideal muscle contraction able, there will be no natural power to their usual gait, and appear weakened.

10grams per day mag for a 500kg horse is the recommended maintenance dose for a horse to just plod around a field eating, just being a horse. Any work on top, stressful conditions increases that dose. Around 80/90 grams is the very upper limit for a horse in medium level work.

Everything is about dose when supplementing raw concentrated minerals, so if the 6 scoop dose could be worked out accurately, it would be very useful.

 

[GSD Woman]

Does anyone still put a salt block out in the pasture or a smaller one in the stable? You used to be able to get them with added vitamins and/or minerals to help balance what was lacking in your grass.

 

[Tiddlypom]

It does sound like there is something really rather wrong, the electrolyte imbalance could be a red herring. PSSM suddenly causing symptoms in a 16yo is highly unlikely

Hope that you soon get to the bottom of this.

Cardiac issues? If your vets are scratching their heads, can he be referred on?

 

[AmyMay]

Are you feeding electrolytes?

 

[spacefaer]

It does sound like there is something really rather wrong, the electrolyte imbalance could be a red herring. PSSM suddenly causing symptoms in a 16yo is highly unlikely

Hope that you soon get to the bottom of this.

Cardiac issues? If your vets are scratching their heads, can he be referred on?

His heart is apparently impressively strong and slow in its beat - he's been a performance horse all his working life so has achieved a good level of fitness

Does anyone still put a salt block out in the pasture or a smaller one in the stable? You used to be able to get them with added vitamins and/or minerals to help balance what was lacking in your grass.

He had a Himalayan salt block in his stable which he studiously ignored. he's now got a D&H Uniblock (general vit/min supplementat) which he's not overly interested in.

@Amymay I got him some electrolytes over the weekend - he had some in his breakfast this morning......

 

[spacefaer]

@PurBee
NAF say
Where low Magnesium is indicated we recommend the Magic Powder, powder over liquid as the powder contains Magnesium Oxide, providing 147,000 mg Magnesium per kg. When feed at 25 - 50 g/day (Maintenance rate) this will provide 3675 mg to 7350 mg Magnesium.

 

[expanding_horizon]

His heart is apparently impressively strong and slow in its beat - he's been a performance horse all his working life so has achieved a good level of fitness


He had a Himalayan salt block in his stable which he studiously ignored. he's now got a D&H Uniblock (general vit/min supplementat) which he's not overly interested in.

@Amymay I got him some electrolytes over the weekend - he had some in his breakfast this morning......

Most electrolytes dont meet the RDA amounts for plain sodium.

 

[expanding_horizon]

10grams per day mag for a 500kg horse is the recommended maintenance dose for a horse to just plod around a field eating, just being a horse. Any work on top, stressful conditions increases that dose. Around 80/90 grams is the very upper limit for a horse in medium level work.

Everything is about dose when supplementing raw concentrated minerals, so if the 6 scoop dose could be worked out accurately, it would be very useful.

that is 10 grams of elemental magnesium. The weight of base dose in Magnesium Oxide is a fair bit more.

 

[Sossigpoker]

His heart is apparently impressively strong and slow in its beat - he's been a performance horse all his working life so has achieved a good level of fitness


He had a Himalayan salt block in his stable which he studiously ignored. he's now got a D&H Uniblock (general vit/min supplementat) which he's not overly interested in.

@Amymay I got him some electrolytes over the weekend - he had some in his breakfast this morning......

Horses need salt much more than any electrolyte mix , which probably doesn't contain enough salt
A salt lick isn't sufficient. A 500 kg horse should have about 2 table spoons of table salt pet day.

 

[PurBee]

that is 10 grams of elemental magnesium. The weight of base dose in Magnesium Oxide is a fair bit more.

Yes exactly - to get 10g elemental from mag oxide form of magnesium, we need to feed double - 20grams of mag ox to get 10g pure magnesium out of it as 50% of mag ox is pure mag.

 

[PurBee]

@PurBee
NAF say
Where low Magnesium is indicated we recommend the Magic Powder, powder over liquid as the powder contains Magnesium Oxide, providing 147,000 mg Magnesium per kg. When feed at 25 - 50 g/day (Maintenance rate) this will provide 3675 mg to 7350 mg Magnesium.

Thank you!
so if youre feeding 6 x 25g scoops = 22g of (elemental pure) magnesium.
(They likely mean elemental magnesium in their values as they say “providing 147g magnesium per kg” rather than ‘containing 147g mag oxide per kg’)


So in light of that dose value - IF sodium/calcium/potassium/phos are lowish, the magnesium could be dominant and causing muscular lassitude/weakness, than cramping/tight muscles.
As he’s not keen on the licks, its best to get the sodium in a bowl feed.
Depending on work load, if 3/4 hourly hacks per week, 4 scoops would give 14.7 g pure mag - which would be about right. 3 scoops would give horse unworked maintenance rate @11g
(thats based on 1 scoop=25g)

Can you recall how much mag ox grams you gave when you switched to try it, that caused weight loss?

 

[SEL]

Does anyone still put a salt block out in the pasture or a smaller one in the stable? You used to be able to get them with added vitamins and/or minerals to help balance what was lacking in your grass.

OP - I'd get bloods done as a priority. When my mare was diagnosed with a myopathy I read everything there was to read on tying up and never came across magnesium as an overdose issue. Selenium, iodine and B12 can all cause problems if deficient but then so can the usual suspects - feeding too much starch / lack of exercise preparation.

I hope you get to the bottom of it

 

[Bonnie Allie]

Had one of these years ago. Blood test after blood test, nutrition assessed over and over, really poor recovery post exercise as well and I eventually had to force vet to send us to horse hospital at the Uni for further tests and research.

Specialist did a gut absorption test and then got it peer reviewed by Kentucky in US. Horse had massively inflammed gut lining which was preventing from absorbing the nutrients he was being fed. Was medicated and changed overnight. It was resolved very easily but we had spent thousands over 8 months to get to that spot. Wish I had insisted on horse hospital earlier. They also continued to use our horse until his latter years as a research horse on gut health.

Then recently had a horse that had mechanical laminitis post septic pedal bone ostietis and box rest. Phosphorous/calcium ratio got out of whack due to emergency diet and gut inflammation due to pain meds, then she had a seizure.

Horse hospital addressed first and foremost by fixing gut inflammation and then addressed nutrition, changed pain meds and got her moving. never had another seizure and healed well.

Maybe head to your nearest horse hospital, preferably one with a research bent.

 

[Red-1]

Does anyone still put a salt block out in the pasture or a smaller one in the stable? You used to be able to get them with added vitamins and/or minerals to help balance what was lacking in your grass.

Yes, I use a Simple Systems salt tub, with magnesium added. I got it because Rigsby used to test as EMS and is always on a diet to keep him slim. I di add salt to the feed when at grass as well, but like the self-serve of the sat/magnesium salt block/tub.

Salt Lick Tub - Robust Field/Stable Salt Lick

A salt lick in a tub for all horses and ponies.</p><p>Salt is perhaps the most important electrolyte for all horses and ponies and can be made available ad lib in the field or stable.</p><p>The Simple System Ltd Salt Lick Tub contains sodium and a top up of magnesium in salt form.<br>

www.simplesystemhorsefeeds.co.uk

He also gets a little mag ox and a lot of salt in his feed (token) at this time of year.