Our three-month-old foal was diagnosed with physitis in both hind fetlocks. We first noticed swelling about one month ago. At that time, we prohibited the foal from further accessing his dam's grain, as he was eating quite a bit of it. We started him on balancer pellets but then took him off those as well because of the high protein content. I have limited his turnout to a small paddock. He shows no sign of lameness, and there’s no sign of heat or pain on palpation, even when pressure is applied. He is growing fast and is well-developed. His dam has no problem staying in optimal weight.
Physitis is not one of the more severe orthopedic problems diagnosed in foals and rarely has permanent effects on the long-term soundness of the horse. However, it can be painful for young growing horses, and compensating for the pain might strain other parts of the body, including other immature joints. Therefore, a proactive approach to treating foals is wise.
Restricting activity of the foal is recommended because it can help keep the foal from getting too sore on the stressed joints. This is particularly important if the foal shows any signs of soreness or lameness.
Excluding the foal from its mother’s feed tub is an excellent idea, because it is so difficult to measure how much of the meal the foal is eating. Some mares allow their foals to eat the majority of the feed. The foals you don't have to worry about are those that are kept away from the feed tub by mares that are more strict or protective of their feed.
If the foal was over four months of age, weaning would be recommended, but at three months it is still a little young to take that step. If the physitis was causing noticeable lameness, then it may be a consideration, but it does not sound like that is the case with this foal.
Reducing caloric intake is recommended to slow growth. Growth may slow but it will not stop; therefore, we need to supply the foal with the vital nutrients for healthy growth. Cutting the foal back to balancer pellet was the best step, but cutting all fortification is not ideal. Without fortification (such as what the balancer pellets provide), the foal will not get the supplemental protein, vitamins, and minerals necessary for proper bone and tissue development.
Contrary to popular belief, overconsumption of protein is not responsible for orthopedic problems and is vitally important for healthy bone and tissue growth. Nutrition-related bone problems are usually caused by excessive calories from carbohydrates and fats. Your concern about the protein content of the balancer pellets stems from a misunderstanding. The amount of protein in a balancer product needs to be high because the intake is so low. For example, if you feed 1 kg of a 10% concentrate feed, it supplies 100 g of protein. A balancer pellet is trying to supply that amount of protein in only 400 g of feed. This is why most balancers need to be at least 25% protein (400 g x 0.25 = 100 g protein).
In short, I would keep the foal on reduced exercise until the swelling reduces and maintain him on the balancer (about 400 g per day). Kentucky Equine Research (KER) makes a bone supplement called DuraPlex for horses on restricted turnout. It is designed to keep horses from losing bone density.
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