Raised liver enzymes and vitamin E

[daydreamer]

hi all, I'm just looking for ideas/opinions.

My horse was not quite right around Christmas time. He'd started being reluctant to go into trot (he's young so initially put it down to a training issue) and then became very grumpy to touch and be around and was eating less hay. I had the vet out who took bloods and agreed it might be ulcers. The bloods came back with 2 liver enzyme levels very slightly raised - the vet didn't say which ones and I forgot to ask. The vet didn't seem overly concerned about the liver enzymes but did say to try milk thistle and possible a liver supplement. He was scoped and that came back negative. He's been on the Feedmark Ultimate Ease since in case it was a hindgut issue (wouldnt touch yeast). He also had about a month to 6 weeks of milk thistle until that ran out. He's also been having Feedmark LiverAid (but maybe at about a half or 3/4 dose as he was on the milk thistle and he feed seems to be nothing but powder!).

I'm hoping to move yards so had to have a strangles blood test so decided to recheck bloods. Apparently the 2 raised liver enzymes are still at about the same levels as they were previously (I didn't have a pen with me so didn't write the figures down, I think she said one was 71). She said bile acids and bilirubin were fine indicating that the function was ok.

She recommended I used the vets own liver supplement for a month and vitamin E. I do wonder what is in their liver supplement and how much it would differ from commercial ones. I've been looking into vitamin E and with the liver supplement I have been giving him and his balancer he is getting around 2000iu a day anyway but I don't know how much is needed to help with a liver issue.

My horse seems well in himself, very good weight (), out during the day but obviously not much grass at this time of year, ad lib hay. He had the osteo twice who said it seemed like he was stuck in right bend. She did say she didn't detect it on an initial feel of his back/muscles and that it felt "quite deep/internal". After the first treatment (plus starting all the supplements and having a field change) he seemed to be happier and his appetite improved. I've been doing lots of in-hand work and long reining and a tiny bit of riding (20 min W twice a week, just started some T) and his straightness has improved and he seems to be going better. He's only 5 and a 1/2 and I just want to do what is best for him.

Any ideas appreciated! Thanks

 

[ycbm]

Is the vitamin E you are using natural or synthetic? Synthetic is only half able to be used by the horse, which would be only 1000iu a day which is pretty low, especially for coming to the end of winter.
.

 

[daydreamer]

@ycbm Good point, I've just double checked and both the balancer and the liver supplement are the synthetic versions so a low dose. Slightly frustrating that an expensive liver supplement has a fairly low pose of vitamin E and a synthetic one at that. Some previous threads on here about vitamin E have been really interesting and useful. I've been looking at the nano-E and the Forage plus supplements and debating which to use.

 

[ycbm]

ForagePlus is fine IF your horse can metabolise it, and some can't. Most can, ime.

 

[SEL]

I've just done a course of Trinity's L94 with my pony who came back with elevated AST and she's really perked up. She's also been on forage plus natural vitamin E and once the L94 finished straight milk thistle.

 

[paddy555]

@ycbm Good point, I've just double checked and both the balancer and the liver supplement are the synthetic versions so a low dose. Slightly frustrating that an expensive liver supplement has a fairly low pose of vitamin E and a synthetic one at that. Some previous threads on here about vitamin E have been really interesting and useful. I've been looking at the nano-E and the Forage plus supplements and debating which to use.

I think that if you leave out specialist vit e supplements designed purely for that purpose and just look at vit E added to feeds, balancers, general supplements and even ones such as your liver one you will find that low grade vit e is used. High quality vit E is expensive. They can get away with putting vit e on the label but that doesn't mean there is a lot of it nor that it is very good.
I believe when I last checked (but happy to be corrected) that FP's supplements used synthetic vit e and I'm sure Equimins advanced complete does.

So that makes me wonder about expensive liver and anything else supplements when they are bought for specific problems.(I'm probably just cynical)

I always get a copy of blood tests from the vet. That way I can see exactly how low or high a problem area is.

You can blood test for vit E levels.

It is unclear if you have been supplementing vit e in the past to any degree but I believe a shortage can manifest itself once a young horse starts to work. I found that in one of mine.

re your liver enzymes there was someone on here who did have liver problems and so did other horses at her yard. I think it may have been Hormonalfilly. She may have some input on testing and resolving it. It just rings a bell.

Your horse getting to be not quite right around Christmas could tie in with vit e deficiency. There is little in hay/grass from Oct onwards. So by Christmas a horse who has a requirement could be starting to struggle.

 

[criso]

I too had issues with multiple horses on the yard with raised liver enzymes. We did a lot of investigation and a biopsy but while ruling things out, were not able to find the cause. Best guess was something they were eating.

I supplemented vit e used both natural and synthetic, no difference in result but i did adjust dosage depending on the form; milk thistle, the concentrated stuff from equicure as horse is fussy; and mycosorb once we suspected it was food related. The mycosorb was the only thing that seemed to make a difference.

No long term harm and the biopsy showed a healthy liver and no clinical signs. Have since moved yards and liver enzymes came down to normal though haven't tested recently.

 

[daydreamer]

I believe when I last checked (but happy to be corrected) that FP's supplements used synthetic vit e and I'm sure Equimins advanced complete does.


It is unclear if you have been supplementing vit e in the past to any degree but I believe a shortage can manifest itself once a young horse starts to work. I found that in one of mine.


Your horse getting to be not quite right around Christmas could tie in with vit e deficiency. There is little in hay/grass from Oct onwards. So by Christmas a horse who has a requirement could be starting to struggle.

The Equimins advanced complete is synthetic vit E as that is what I give him and checked. I haven't been specifically supplementing vit E, it's just because the vet recommended it this time as the liver enzymes are still high. She did say that I could buy it from the vets and it would probably be a higher quality than what you could buy commercially - I imagine that means it is pure rather than synthetic but part of me wonder how much is the vets just upselling and how much information would they have given me about dosing rates etc. Interesting that you say young horses can struggle once they start more work, hopefully if I start supplementing vit E it will help.

 

[daydreamer]

I too had issues with multiple horses on the yard with raised liver enzymes. We did a lot of investigation and a biopsy but while ruling things out, were not able to find the cause. Best guess was something they were eating.

I supplemented vit e used both natural and synthetic, no difference in result but i did adjust dosage depending on the form; milk thistle, the concentrated stuff from equicure as horse is fussy; and mycosorb once we suspected it was food related. The mycosorb was the only thing that seemed to make a difference.

No long term harm and the biopsy showed a healthy liver and no clinical signs. Have since moved yards and liver enzymes came down to normal though haven't tested recently.

Thanks, that's useful to know. It's interesting that the yard he grew up on (there until Feb '23) and that he was at for again for a month (Aug '23) has had reports of horses with high liver enzymes. I wonder a) if any issues are current and if not how long ago they might be from and b) how many horses would come back with slightly raised liver enzymes if tested in winter. if the vit E does play a role in maintaining a healthy liver.

We've been at our current yard for about 6 months and are moving again in a couple of weeks so that might help. The vet did mention biopsy if things didn't improve but I would like to avoid that if possible. I think it is interesting (and worrying?) that if I hadn't have had bloods done I would have no idea that there was an issue.

 

[shortstuff99]

It is also worth looking into iron levels and liver issues. Excess iron can cause liver problems in horses and stop the uptake of zinc and copper. Also believed high iron leads to laminitis and cushings in horses.

 

[criso]

The Equimins advanced complete is synthetic vit E as that is what I give him and checked. I haven't been specifically supplementing vit E, it's just because the vet recommended it this time as the liver enzymes are still high. She did say that I could buy it from the vets and it would probably be a higher quality than what you could buy commercially - I imagine that means it is pure rather than synthetic but part of me wonder how much is the vets just upselling and how much information would they have given me about dosing rates etc. Interesting that you say young horses can struggle once they start more work, hopefully if I start supplementing vit E it will help.

There is a wide variety of vitamin e supplements and ones that contain vitamin e so while i can see a vet not wanting to commit, i wouldn't assume theirs is higher quality.

I did use the vet liver tonic at first but it was a gloopy liquid and fussy horse wasn't keen so sourced my own ingredients.

My horse was already being supplemented vitamin e at a maintenence level when he had problems, the other horses on the yard with raised enzymes weren't. His levels were in the middle of those tested. It was first discovered in spring but continued into winter so didn't seem seasonal.

He was also being supplemented copper and zinc based on an analysis of grazing.

. It's interesting that the yard he grew up on (there until Feb '23) and that he was at for again for a month (Aug '23) has had reports of horses with high liver enzymes

It's possible that this is where it came from and they haven't come back down to normal yet. Mine did take a long time. Vit e and milk thistle will help.
.

 

[daydreamer]

It is also worth looking into iron levels and liver issues. Excess iron can cause liver problems in horses and stop the uptake of zinc and copper. Also believed high iron leads to laminitis and cushings in horses.

Interesting, thanks.

My horse developed vitiligo around his eyes in Jan '23 which some people think is related to mineral imbalance. In humans there is some thought that vitiligo and liver issues may be related. It did improve and pigment came back over the following 6 months or so. But the vitiligo recurred in around October/November or so last year and is still fairly bad. Is it just a coincidence that it was after we had been at the liver problem yard? It also coincided with a yard move and more stress though so could be completely unrelated! I wish there was more research on everything and that we could all run diagnostic tests and analyses for free so we knew what was going on instead of trying to guess!

 

[Charrose77]

Interesting, thanks.

My horse developed vitiligo around his eyes in Jan '23 which some people think is related to mineral imbalance. In humans there is some thought that vitiligo and liver issues may be related. It did improve and pigment came back over the following 6 months or so. But the vitiligo recurred in around October/November or so last year and is still fairly bad. Is it just a coincidence that it was after we had been at the liver problem yard? It also coincided with a yard move and more stress though so could be completely unrelated! I wish there was more research on everything and that we could all run diagnostic tests and analyses for free so we knew what was going on instead of trying to guess!

How is your horse now and did you ever get to the bottom of it all? My mare had blood tests due to a colic incident that came from nowhere……..her results were awful, the GGT level was 441 (should be <49) and now, three weeks later even higher 641. Bile acids weren’t originally affected but are now. Grass is being tested, they finally got the kit yesterday and sent it off, we don’t think it’s the hay as I took her straight off of what they had and put her on bagged haylage……could be a virus? But she is so quiet, really not herself at all. Am going out of my mind, a few others horses on the yard have come back with raised enzymes also, one as bad as her but he is absolutely fine, one mildly raised, also fine……the others haven’t tested and no other horse showing signs.