Avon Ridge Equine Veterinary Services

🌟 Less Than 25% of Gastroscopies This Year Have Required Ulcer Treatment

Despite still performing large numbers of gastroscopies, less than 25% of horses we have scoped in 2026 required treatment with ulcer meds - a significant improvement compared with previous years.

This is an incredibly encouraging shift and represents a dramatic improvement in the way our patients are being managed. It suggests that our clients - arguably some of the most educated, proactive and management-focused horse owners around, are taking on board the latest evidence-based advice and making meaningful long-term management changes that are improving the gastric health of their horses.

What makes this even more impressive is that many of these horses are in intensive work, travelling regularly and actively competing.

🪄 There’s no magic formula. It’s about giving our owners a customised management (and diet) plan to suit the horse’s workload while addressing their individual risk factors.

✅ Good gastric health is absolutely achievable in performance horses when tailored veterinary advice is given to owners and management is optimised.

Gone are the days of automatically reaching for long and likely unnecessary courses of ulcer meds. Our clients also recognise that treating “because it could be ulcers” is a flawed approach that often ends up costing more in the long run. Gastroscopy is the only way to know for certain.

With our mobile, at home gastroscopy service, the process is more convenient and arguably less stressful for the horse, while also allowing us the time to investigate the real underlying cause of clinical signs when ulcers are not identified.

🙌 Well done to our clients who are putting in the work behind the scenes. Your horses are benefiting from it.

🤓 As always, I’ll continue to share the latest research and recommendations with you on our exclusive client email portal.

🚙 Learn more about our mobile gastroscopy service: https://avonridgeequine.com.au/mobile-gastroscopy-service/

🩺 Contact us on 0427 072 095 or book an appointment online: https://avonridgeequine.com.au/book-an-appointment/

Draft horses are gentle giants, but when emergencies happen, they can present very differently to lighter horse breeds.

One of the biggest challenges with draft horses is colic. Research and clinical experience show that these horses may display surprisingly subtle signs, even with severe and potentially life-threatening intestinal disease. Instead of violent rolling or dramatic pain behaviours, some draft horses may simply appear quieter than normal, mildly uncomfortable, or “not quite right.”

Their large body size also creates unique risks. Draft breeds appear predisposed to certain gastrointestinal problems including large colon displacement and volvulus. Stallions may also be at increased risk of inguinal or scrotal hernias. Unfortunately, draft horses undergoing colic surgery tend to have higher complication rates and lower survival rates compared with lighter breeds.

Even routine examination can be more challenging. Re**al palpation may be difficult due to their size, and veterinarians often need to be particularly careful with medication dosing because draft horses can be more sensitive to sedatives and anaesthetic agents.

For draft horse owners, recognising subtle warning signs is incredibly important:
• reduced appetite
• standing quietly away from companions
• pawing or shifting weight
• mild flank watching
• reduced manure output
• increased heart or respiratory rate

The take-home message? Never underestimate mild signs in a draft horse. Their calm temperament can sometimes mask the severity of disease.

Early veterinary assessment can make a major difference to outcomes.

📞 If your horse is showing signs of colic, CALL 0427 072 095 immediately.

🥕 BREAKING: Horses Have Strong Opinions About Carrots 🐴

A little light reading compared to the usual research updates I post 🤓

Scientists offered horses a carrot tasting menu:

🔸raw
🔸grated
🔸boiled
🔸dried
🔸carrot juice

(Yes, somewhere a researcher boiled, grated and blended carrots for horses - all in the name of science!)

Here’s what they learned:

🥕 Raw carrots = rockstars. Instantly inhaled. Zero hesitation.

🥕 Grated carrots = acceptable. Like pre-chewed snacks for lazy chewers.

🥕 Dried carrots = meh, but ok …still carrots. Fine.

🥕 Boiled carrots = NO THANK YOU. The equine equivalent of soggy Weet-Bix. But seriously, are how many people out there boiling carrots for their horses?!

🥕 Carrot juice = confusion 🧐… then curiosity… then okay fine.

(Usual reminder: treats = treats, not dinner 😉)

🔸 And no, you’re not going to tip your EMS horse into a laminitic episode by feeding it a carrot occasionally. As someone far smarter than me said way back in the 16th century: “The dose makes the poison”

📚 Reference:
Preliminary assessment of leisure horses’ preferences for different forms of carrot (Daucus carota subsp. sativus). Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12691516/

No better way to start the day than a morning hike with the dogs 🥾 🐾

A clinically important finding from a recent cabergoline PPID study was not simply ACTH suppression, but the consistent reduction in appetite following treatment.

Horses receiving intramuscular cabergoline demonstrated a transient but measurable reduction in appetite, most notably within the first 24–72 hours following administration. This reduction is appetite has also been commonly reported with pergolide therapy. While cabergoline effectively reduced plasma ACTH concentrations from a mean of 153.35 pg/mL to 24.1 pg/mL and maintained values within seasonally appropriate reference ranges, appetite suppression remained the most consistent adverse effect identified. Importantly, despite lower appetite scores, there was no statistically significant difference in bodyweight loss compared with controls, suggesting that the reduction in intake was generally short-term rather than associated with clinically significant weight loss.

This finding is highly relevant in clinical practice because appetite suppression in PPID horses should not be regarded as a minor or incidental side effect.

We reported similar findings in our study (Sundra et al, 2024) evaluating cabergoline use in horses with PPID, where transient inappetence was also the most commonly observed adverse effect. This consistency across studies reinforces that appetite suppression is one of the most important practical considerations when selecting and managing cabergoline therapy.

This becomes particularly important when considering concurrent administration of drugs like ertugliflozin (SGLT2 inhibitors).

From a clinical management perspective, initiating cabergoline and an SGLT2 inhibitor simultaneously is difficult to justify.

In reality, for anyone with even the most basic understanding of how these drugs work, it should be obvious that starting both ertugliflozin and cabergoline (or pergolide) at the same time should be avoided.

❗️This is not new information.

It has been widely discussed in the public domain for several years since ertugliflozin first began being used in horses.

Ertugliflozin requires consistent caloric intake, stable nutritional management, and careful monitoring of appetite and triglyceride status to minimise the risk of adverse effects, particularly hypertriglyceridaemia and excessive weight loss.

Furthermore, even starting cabergoline (or pergolide) in a horse receiving ertugliflozin, when transient appetite suppression is expected, creates an entirely predictable management problem.

Reduced intake during SGLT2 inhibitor initiation increases the risk of preventable complications, increases veterinary costs for owners, and most importantly, significantly compromises horse welfare.

👉 These are, more often than not, completely avoidable complications.

Careful case selection, timing of therapy introduction, correct dosing and close monitoring should part of routine endocrine management rather than being considered secondary concerns.
🤷‍♀️ Horse owners: you should be closely monitoring feed intake in your horses receiving these drugs. Report any changes in appetite to your veterinarian immediately.

✅ In many horses, appetite suppression associated with cabergoline or pergolide can likely be mitigated when managed by an experienced veterinarian who understands how to introduce these drugs safely.

Cabergoline is an unregistered medication in horses but may be a valuable alternative to pergolide in selected PPID cases. However, appetite suppression must be recognised as a clinically significant management factor rather than a trivial adverse effect.

🩺 Contact us on 0427 072 095 or book an appointment online: https://avonridgeequine.com.au/book-an-appointment/

Bracken, A., Tyra, H., Vetter, M., Kiger, K., Rao, S. & Bass, L. (2026) ACTH suppression and adverse effects of cabergoline in horses with pituitary pars intermedia dysfunction. Equine Veterinary Education

New research out of the USA has added to the growing body of evidence supporting the use of SGLT2 inhibitors in horses with equine metabolic syndrome (EMS) and insulin dysregulation.

In this placebo controlled study, researchers evaluated the SGLT2 inhibitor bexagliflozin (a drug currently available in the United States) in horses with naturally occurring hyperinsulinaemia. Horses treated with bexagliflozin showed significantly lower insulin responses following oral sugar testing compared to those receiving placebo.

Why is this important?

High insulin levels are one of the key drivers of laminitis in horses with EMS and therapies that reduce these insulin spikes play an important role in both treatment and prevention strategies. We are now seeing consistent findings across multiple studies and different drugs within this class.

The medication was generally well tolerated over the short study period, although some horses showed increases in triglycerides. This reinforces an important point that these medications require careful veterinary oversight, including baseline testing and ongoing monitoring.

As always, medications are just one piece of the puzzle. Diet, weight management, and individualised care plans remain absolutely critical in managing EMS and reducing laminitis risk.

The takeaway?

We are continuing to see strong, emerging evidence that SGLT2 inhibitors can be a powerful tool in the right cases, but they need to be used thoughtfully with the right monitoring and alongside a well structured management plan.

🩺 Contact us on 0427 072 095 or book an appointment online: https://avonridgeequine.com.au/book-an-appointment/

Lowndes CR, Luethy D, Skelton G, Kulp J, Stefanovski D, van Eps AW. Bexagliflozin controls hyperinsulinemia in horses with naturally occurring insulin dysregulation: a placebo-controlled crossover trial. J Am Vet Med Assoc. 2026 May 8:1-10. doi: 10.2460/javma.26.02.0098. Epub ahead of print. PMID: 42102868.

Part 3: Supplementation, dosing, and what actually works

When a horse is deficient in vitamin E, supplementation is recommended regardless of whether clinical signs are present.

However, not all vitamin E supplements are equal, and this is where things often go wrong.

There are two main forms of vitamin E used in equine supplements.

Synthetic vitamin E, often listed as all-rac-alpha-tocopherol, is less bioavailable and not as effectively utilised by the horse.

Natural vitamin E, listed as d-alpha-tocopherol or RRR-alpha-tocopherol, is significantly more bioavailable and is the preferred form for supplementation.

Within natural forms, there are also differences in formulation.

Powder or pellet forms are typically esterified, which improves shelf life but requires additional processing in the horse’s digestive system before absorption.

Liquid formulations are water-dispersible and generally result in a more rapid increase in blood vitamin E concentrations, often within 24 hours. These are particularly useful when actively correcting a deficiency.

Current NRC daily recommendations for vitamin E in horses are 1 -2 IU/kg body weight. This means maintenance levels can be anywhere between 250-1000IU per day depending on the size of the horse or pony.

In clinical cases of deficiency where signs are present, doses around 5,000 IU per day for a 500 kg horse are commonly used, although requirements can vary depending on baseline levels, underlying disease, and individual response.

Follow-up blood testing is important to ensure that supplementation is achieving the desired increase in vitamin E concentrations.

❓ A common question is whether horses can receive too much vitamin E.

In humans, very high doses can interfere with vitamin K metabolism and affect blood clotting. It is not yet clear whether the same effect occurs in horses, and this is still being investigated. However, it reinforces an important point.

More is not always better.

This is another reason why supplementation should be targeted and guided by testing, rather than adding products in without a clear plan.

It is also important to recognise that some horses may have impaired absorption of fat-soluble vitamins, which can result in an inadequate response to supplementation. In these cases, further investigation is warranted.

Long-term, the most effective way to maintain adequate vitamin E status is regular access to fresh pasture. However, for many horses, particularly EMS horses, this is not possible.

This means supplementation and monitoring become essential parts of managing both metabolic health and muscle function.

If your horse is on restricted pasture, on a hay-based diet, or struggling with muscle development, vitamin E status is something that should be considered as part of a broader clinical assessment.

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🩺 Contact us on 0427 072 095 or book an appointment online:
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Part 2: Vitamin E & The EMS Horse

If you have an EMS horse or pony, you are often doing exactly the right thing by restricting pasture access to reduce non-structural carbohydrate intake and minimise laminitis risk.

But there is an important consequence that is often overlooked.

Pasture restriction also removes the horse’s primary source of vitamin E.

This creates a very common scenario where horses are managed correctly for insulin dysregulation, but inadvertently become deficient in vitamin E.

Many of these horses are maintained on hay-based diets, sometimes with soaked hay, further reducing nutrient content. While this is appropriate for metabolic control, it significantly increases the risk of inadequate vitamin E intake.

In practice, I see this frequently in horses that are:

- On long-term pasture restriction
- Maintained on hay only diets
- Not receiving targeted vitamin supplementation
- Struggling to build or maintain topline

Vitamin E deficiency in these cases can contribute to muscle weakness, reduced performance, and difficulty developing or maintaining muscle mass, even when energy intake appears adequate.

It can also complicate the clinical picture in ridden horses. Horses may be assumed to have training or fitness issues, when in reality there is an underlying nutritional deficiency affecting muscle function.

The only reliable way to assess vitamin E status is through blood testing.

We can measure serum or plasma vitamin E concentrations. The sample must be handled and prepared carefully to obtain an accurate result as Vitamin E levels can be affected by several external factors. Interpretation should always be made in the context of the individual horse, their diet, and clinical signs.

👉 Get in touch with us using the booking link below if you’d like to get your horse’s Vitamin E levels checked.

Stay tuned for tomorrow’s post about supplementation - what works and what doesn’t.

🩺 Contact us on 0427 072 095 or book an appointment online:
https://avonridgeequine.com.au/book-an-appointment/

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🌟 Don’t let the cute face fool you… Shorty is convinced he’s a wild stallion, destined to roam free, not stand here dealing with the injustice of veterinary visits! 🤣

Part 1: Why vitamin E matters more than you think**

**This is the first of a 3-part educational series on vitamin E in horses.**

Vitamin E deficiency is one of the most overlooked problems in horses.

In almost all mammals, Vitamin E is essential for the integrity and optimum function of several systems in the body, including nervous, immune, reproductive, muscular and circulatory systems.

Vitamin E is not just another vitamin. It is a potent antioxidant that protects cell membranes from oxidative damage. Importantly, vitamin E levels are associated with the maintenance of normal muscle and nerve cell function.

Horses rely almost entirely on fresh green pasture for vitamin E intake.

Once forage is cut and dried into hay, vitamin E levels decline rapidly. By the time hay is fed, the vitamin E content is often negligible. To make matters more challenging, the vitamin E added to many feeds is synthetic and has significantly lower bioavailability compared to natural forms.

This means many horses on hay-based diets are likely not meeting their requirements, even when their diet appears otherwise balanced.

Importantly, vitamin E is not stored efficiently in the body. Horses require consistent daily intake to maintain adequate circulating levels.

Deficiency does not always present with obvious clinical signs early on. Instead, it often shows up as subtle issues such as:
▪️poor topline
▪️reduced muscle development or muscle wasting
▪️underperformance
▪️weakness

By the time more significant signs develop, deficiency may have been present for some time.

Stay tuned for tomorrow’s post, specifically tailored for horses with EMS.

🩺 Contact us on 0427 072 095 or book an appointment online:
https://avonridgeequine.com.au/book-an-appointment/

📬 If you found this helpful, subscribe for more veterinary led, trusted advice here:
https://avonridgeequine.aweb.page/exclusive-veterinary-insights