Can you ride a horse with liver disease?

There was surprise among our team of horse insurance experts here at SEIB when we recently discovered that liver disease in horses is relatively common. We were however, reassured to find that early detection and treatment of liver disease often leads to a positive prognosis.

With the help of Lily Fraser BVMSci MRCVS from the fabulous team over at Paton and Lee Equine Vets, we decided to find out more about the workings of an equine liver.

Lily Graduated from Surrey Vet School in 2021 and completed an internship in Kent before coming to work for Paton and Lee where she has been a team member for the last 3 years. Lily has a keen interest in the medical side of equine vet work and enjoys driving around the Essex countryside with her faithful vet dog, Bramble the chocolate Lab!

What is the liver?

The liver is the largest organ in a horse’s body, weighing up to 7kgs. The horse’s liver has many important functions, including aiding the digestion of nutrients, it produces bile to digest fat and detoxifies and eliminates waste products. The liver also helps store vital vitamins and minerals, including iron, copper and vitamins A, D, E, K and B12.

Lily said: “The liver collects and processes the blood returning from the gastrointestinal system via the portal vein, where its role in detoxification is most important. The liver breaks down and eliminates harmful by-products from normal digestion, such as ammonia and large fats, which can become a large issue if not effectively removed. The liver also contributes to the metabolism by moderating the storage and release of glucose in response so systemic insulin levels etc.”

Common causes of equine liver disease

Toxic causes of liver disease – These include Mycotoxins, which are toxins produced by fungi or mould, they can contaminate feed and forage. Poisonous plants, especially Ragwort is a well-known and common cause of liver disease in horses. Too much Iron can also be toxic for horses and lead to liver disease.

Infectious causes of liver disease – Although less common in this country, there are infectious causes of liver disease, such as viral and bacterial hepatitis, but most of the time liver disease is caused by environmental toxins.

Other causes of liver disease – On rare occasions, horses can contract liver tumours and small ponies on very restrictive diets can be prone to fatty liver.

What are the symptoms of liver disease in horses?

Symptoms of liver disease in horses can include weight loss, lethargy, skin disease such as photosensitization and jaundice – a yellow discolouration generally found around the gums and mucous membranes.  

“The liver is able to regenerate over roughly a 6 week period if the inciting cause has been removed. Hence, there has to be quite significant damage (around 70%) before there are changes seen on blood results and obvious external clinical signs. A blood test analyses the enzymes and products related to the liver, and if the levels are raised this is a specific indicator for liver disease and is often enough to begin treatment.

“If the horse doesn’t respond to treatment or if we need more information on the most appropriate treatment then a liver ultrasound and biopsy can also be performed under standing sedation. The liver samples are then analysed at a cellular level by histology at an external laboratory before we decide on an appropriate treatment plan with the results.”

Should I ride my horse if he has been diagnosed with liver disease?

“If your horse has been diagnosed with mild liver damage, then they may be fine to be ridden; however, any extra strain on the body could further aggravate the liver. Therefore, individual veterinary advice for each horse is the most appropriate course of action.

“Horses in later/end stage liver failure can often become ataxic (unsteady) on their feet in which case it is not advisable to ride them.”

How to treat liver disease in horses?

Treatments for liver disease are often ongoing and can need to be in place for several months. Treatments can include Supplements often containing milk thistle, Changing the horses forage can also be an effective way to treat liver disease if the horse’s hay or pasture is a suspected cause of the disease. If the horse has liver disease caused by a bacterial infection then antibiotics can be effective as can treatments for liver fluke. Sometimes steroids are used to help treat inflammation caused by liver disease.

Lily said: “Depending on the type and severity of liver disease, then any combination of the above treatments may be used. There are also veterinary-grade Liver Tonics available, which contain high levels of antioxidants and multivitamins. High-grade vitamin E is also a potent antioxidant. Steroids are the strongest anti-inflammatory for treating liver fibrosis; however, these are not suitable for all horses, especially those prone to laminitis.”

Helping keep your horse in top health

SEIB Insurance Brokers are specialists in insurance for Horses, Horsebox Insurance, and Horse Trailer Insurance. We are able to provide flexible policies to suit individual client needs and boast over 60 years of expertise and knowledge. 

With thanks to Lily Fraser BVMSci MRCVS of Paton and Lee Vets.