Emaciated horses have a very low body condition score with extensive loss of muscle and fat.

Horses with a history of neglect and starvation are at risk of serious health issues, including negative effects on their heart and digestive tract.

These severely underweight horses need to be carefully managed with veterinary care and precise nutrition strategies during their recovery.

Reintroducing feed must be done slowly to allow your horse’s body to adjust. Otherwise, rapid metabolic changes can cause life-threatening complications.

If you have rescued a skinny horse, start by feeding small meals of high protein forages, such as alfalfa or high quality grass hay. Avoid feeding grains at the beginning of refeeding programs to prevent Refeeding Syndrome.

Caring for Emaciated Horses

When a horse’s energy requirements are not met, she initially uses body fat and carbohydrate (sugar) stores to support necessary bodily processes. After fat and carbohydrate stores are depleted, she will begin breaking down body protein to meet her energy needs. [1]

When we think of body protein stores, we think of muscles. Indeed, horses who don’t get enough energy will break down muscle tissue and lose muscle mass.

However, during times of extreme energy restriction such as starvation, other body stores of protein including heart and gastrointestinal tissue may also be broken down.

The deterioration of cardiac and digestive tissues is accompanied by changes in metabolism that can lead to complications and health issues, which should be addressed by a professional.

For this reason, every refeeding program should begin with veterinary care and close monitoring.

Refeeding Syndrome

Refeeding Syndrome occurs when emaciated horses are reintroduced to proper nutrition too quickly. In healthy horses, consuming a meal increases blood glucose concentrations, stimulating insulin release.

The same is true of emaciated horses, but alterations in insulin-stimulated mineral and electrolyte metabolism in these horses can cause life-threatening complications such as edema, diarrhea, neurological issues, and heart failure. [2]

Refeeding syndrome is not triggered by a single meal but develops over a few days to a week. Refeeding emaciated horses for weight gain must be done carefully, under close veterinary supervision, to limit factors that can precipitate health complications.

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Veterinary Consultation

Regular, frequent vet assessment is critical, especially at the beginning of refeeding programs for skinny horses.

Below are several common health issues that your vet will likely check for and monitor:

Dental Issues

Poor dentition can be both a cause of starvation and an effect of neglect. Neglected horses often receive inadequate dental care, which can lead to dental issues that limit their intake of forages.

Poor dental health can also contribute to weight loss and impact refeeding strategies. If your vet determines that your horse has dental issues, you can soak feeds such as forage pellets to make meals easy to consume.

Parasitic Infections

Return to a normal deworming schedule can alleviate parasitic infections and promote weight gain. [3]

However, if your horse is extremely thin at the beginning of refeeding, it may be beneficial to wait to implement a worming program until their health is stable. [2][ 4]

Consult closely with