Choosing the Best Insurance for your Horse

Its estimated that in the UK the horse population is almost one million. Due to the greater value of horse compared to dogs, cat or other common pets and the fact that vet fees are greater too has made the UK equine insurance market is very competitive. Most horse owners will have some form of horse medical cover as a way to cover the high horse treatment fees.

Companies that offer Insurance for Horses

PetPlan is one such company that offers Equine Insurance in the UK, horses are often referred to as the elite animals of the world and a thoroughbred is one of the most finely tuned animals in the world, but all horses can be susceptible to injury and strains. There are many factors to consider with regards to equine insurance which include:

Equine Insurance policy options

* Cheap Horse Insurance – The cheapest equine insurance policies will give you the basic of protection for your horse, with a fixed limit on both the length and cost of any treatment. Due to this any long term illness will mean the owner will have to pay the bill and as a result will not be able to take out any new horse insurance to cover existing ailments. With the high cost of the horses and the treatments involved horse owners tend to look to the more higher value insurance for their horses.

* Mid Range Horse Insurance – This is the next step up from the cheaper horse insurance, the basic differences are the longer length and cost of treatment their not much other differences. Again, long term illness would be uncovered after the initial timescale has been exceeded and it would be near impossible to obtain insurance for that treatment elsewhere.

* Lifetime Equine Insurance – When you consider the cost of buying and owning a horse, most people feel safer with lifetime horse health insurance. This takes away much of the pressure with regard to vet fees and while there is a maximum funding amount per year, this will begin again when the policy is renewed, even for existing ailments. Lifetime also mean the full term with no small print excluding horses after a certain age.

Equine Vet Costs

No new horse owner should be without Equine insurance as the costs involved compared to other animals. Horses cost a substantial amount to house and feed and their regular vet costs can be substantial to say the least. As with all pet insurance cover it is essential that you compare horse insurance quotes. Online horse insurance quotes are available ready though the interest and you can find most of the prominent horse insurers online.

Equine Quarantine Costs

While the overall cost to quarantine a horse can be large, it will depend on if the horse travels overseas or may come into contact with a condition which requires the isolation. Horse quarantine fees can be substantial to say the least and many people not in a position to cover them at short notice. This is where the best equine insurance policies will come into play and offer much needed assistance.

Lost Horse / Horse Theft

Horse theft and the number of lost horses are very substantial and while many are returned unharmed and fairly quickly it can be hard work find and retrieving them. Many of the better equine insurance policies will offer assistance towards the cost of advertising for the return of a lost horse as well as a reward for their safe return. Therefore it is essential that you check out what horse cover you have with your policy.

Horse Treatment Costs

Equine insurance UK is a substantial market which has shown signs of further growth over the last few years with his comes the increase in costs and horse insurance premiums which has attracted many of the larger issuance companies. There is an obvious need for specialist accommodation and veterinary equipment when dealing with horses, something which is reflected in both the maximum payouts and horse health plan premiums.

Horse Accident Cover

Horses are finely tuned animals which are susceptible to strains as well as serious injury. Even the cost of a small strain can prove to be expensive when taking into account vet call out, transport, medicine and time, something which has attracted many to the ever competitive horse insurance UK market. While the increased cost of care is reflected in the premium levels, this is a market where a comparison of horse insurance cover on offer can yield rewards.

Lost Equine Passport

The Equine passport market is one of the largest in the country and as more and more horses travel overseas it is essential to keep a check of their movements and ensure that the correct procedures are adhered to. Equine passports can be very expensive to replace although many equine insurance policies will have provisions to ensure that replacements are sought as quickly as possible, with the costs covered by the horse insurance companies.

Its estimated that in the UK the horse population is almost
one million. Due to the greater value of horse compared to
dogs, cat or other common pets and the fact that vet fees
are greater too has made the UK equine insurance market is
very competitive. Most horse owners will have some form of
horse medical cover as a way to cover the high horse
treatment fees.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

Don’t let your horse stand on wet or hard stall floors. Horses need extra cushion and dryness in their stalls to help promote healthy hooves and overall general health. Horse bedding provides comfort and warmth for your horse and provides traction to help keep your horse from slipping.

Bedding materials today are excellent for maintaining such conditions. Traditional straw bedding is still available and popular, and provided it is clean and dust free, makes an excellent bed. The disadvantage of straw is the amount of waste that is generated with its use, which in turn may result in more work for you and increase in cost to dispose.

Many horse owners have turned to sawdust and wood shavings to help eliminate horse health concerns of dust and spores often present in straw and for better absorbency and reduced waste. Though saw dust does improve upon absorbency, it does not eliminate the dust problem entirely. Wood shavings on the other hand cut down further on dust, but do not absorb as much moisture and are slow to decompose in the compost pile.

Good Characteristics of Horse Bedding:

• High absorbing bedding will absorb urine better and reduce the level of ammonia odor in your horse’s stall. The more absorbent the bedding is, the less bedding required, which means you use less and don’t have to dispose as much.
• The bedding should be low in dust. A horse’s respiratory system is not well suited for high volumes of dust.
• Ideally the bedding is easy to cleanup with waste.

A horse bedding with a high level of absorbency allows liquid waste to be contained in small areas so less bedding becomes dirty. The smaller amounts of contaminated bedding is quicker to clean and makes the bedding less expensive by reducing the amount of bedding required, and saves on the time and effort required for mucking out.

Rubber matting is a fairly new innovation providing a warmer, softer and more comfortable stable floor for your horse than concrete, brick, dirt, or wood flooring. Rubber matting also greatly reduces the amount of bedding required. A downside is horses don’t like to lie down on bare mats. They prefer the comfort of a bedded area. So even though mats cut down on the amount of bedding needed, be kind to your horse and provide him with enough soft bedding to make him feel comfortable enough to lie down.

The most important factor to consider when choosing bedding is the health of your horse. Damp or wet bedding softens the horse’s hooves and provides a bacterial breeding ground. Bedding that does not absorb well also allows more ammonia to be released and can irritate your horse’s respiratory system, not to mention yours. Dusty or moldy bedding can also be a respiratory irritant. As a horse owner, the reality is you also have to factor in the cost and maintenance required to keep your horse’s bedding in good condition. Good mucking methods will help to reduce waste and though some bedding products are seemingly more expensive at first, are often cheaper in the long run since it results in less waste.

What are Some of the Horse Bedding Choices?

• Straw. Common bedding used by many; however, it is not quite as common as it once was with many horse owners turning to processed wood shavings. Straw is not as absorbent as other commercially available bedding, but is often relatively inexpensive and decomposes quickly in your compost. Straw provides a nice soft bed for your horse.
• Sawdust and Wood Shavings. Sawdust is high absorbing, but if your horse is prone to respiratory problems it should not be used. A better alternative is wood shavings. Wood shavings are easy to muck out and can be found easily at lumberyards, feed stores, and bedding suppliers. Processed wood shavings are preferred over shavings found at lumberyards. The shavings at lumberyards may have harmful debris or toxic wood chips and dust. Processed wood shavings are more expensive, but are clean and dust free and do not contain any toxics that may be harmful to your horse. Sawdust and wood shavings do not decompose well in your compost pile.
• Shredded Paper and Cardboard. Very inexpensive as well as absorbent. It provides comfort for your horse; however, it compresses easily and requires a large amount to create a bed and to keep the bed maintained. Paper and cardboard bedding keeps your horse cleaner than other bedding products and does provide warmth. Disposing the bedding can be problematic and the most effective method is to burn it. Some horse owners use straw or wood shavings to supplement the paper and cardboard.
• Rubber Matting. Many advantages such as being completely dust free, drains well and is warm. The initial cost to put in rubber matting can be high, but the recurring costs to maintain bedding can be very low. It is very safe for your horse. Many horse owners add a little bedding, such as straw, to make a bed comfortable enough for you horse to lie in or if the drainage under the matting is not adequate.

No matter your bedding of choice, it needs to be cleaned at least once-a-day to keep it safe and dry for your horse. You don’t want to promote a bacteria breeding ground or to allow soiled bedding to cause your horse health problems. Horse bedding that is consistently looked after does not take long to maintain each day.

Don’t let your horse stand on wet or hard stall floors.
Horses need extra cushion and dryness in their stalls to
help promote healthy hooves and overall general health.
Horse bedding provides comfort and warmth for your horse and
provides traction to help keep your horse from slipping.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

After years of practicing both conventional and holistic medicine for horses, I decided to compare the cost, effectiveness, and net results of managing and treating horses holistically versus conventionally.

In this article I compare results for the average trail horse that is ridden about 2-3 times a week. I have used average feed and veterinary costs for my area (Austin, Texas), and drug and supplement costs from a major horse supply catalog.

I then discuss the issues related to each area of care, including feed, supplements, vaccines, dewormers, and first aid. Stay tuned for different profiles in coming months, when I will compare horses in different disciplines, young horses, older horses, and broodmares.

>>> Holistic Horse <<<
Oats (2 lbs/day): $131
Hay (3 bales/week): $780
Super Blue Green Algae (1-2 tsp/day): $156
VEWT, West Nile Vaccinations: $48
Spectrabiotic Natural Wormer: $115
2 Fecal Exams: $32
Acidophilus (for occasional immune support): $7
TOTAL ANNUAL COST: $1269

>>> Conventional Horse <<<
Oats (4 lbs/day): $262
Hay (2 bales/week): $520
Hoof Supplements and Dressings ($30/month): $360
VEWT, West Nile, Flue, Rhino, Rabies Vaccinations: $80
Dewormer (6 times/year): $92
2 Bottles Penicillin: $20
A Course of Sulfa Antibiotics: $32
Fecal Exams: $32
12 Grams Bute: $10
TOTAL ANNUAL COST: $1408

COST DIFFERENCE: Holistic care costs $139 less per year
DAYS OFF FOR ILLNESS: 3 days for holistic care versus 21 days for conventional care

<><> Feed Costs <><>
Grain is slightly cheaper to feed and easier to store than hay, which makes the conventional horse slightly cheaper to feed on the one hand. On the other hand, the holistic horse, which has access to more hay, stays happy and entertained and is less likely to develop expensive habits and vices such as chewing on wood, cribbing, or weaving.

<><> Supplements <><>
In the past, hay and oats provided all the nutrition a horse needed, but these days common farming practices do not produce feeds that are high in vitamins and minerals. Hoof quality is the first area to be affected by such poor nutrition, and few horses can maintain healthy feet on a diet of hay and oats alone. If you doubt this, just check any horse supply catalog. The one I checked offered 22 topical hoof conditioners and 28 separate supplements. Cell Tech’s Super Blue Green Algae offers a wide range of vitamins, minerals, amino acids, and antioxidants in a whole food form. It is inexpensive to feed, promotes healthy feet, and supports the horse in all aspects of health.

<><> Vaccines <><>
Some people will choose not to vaccinate at all while others will choose to use more vaccines than the ones I’ve listed in the trail horse comparison. I believe that over-vaccination is one of the most common triggers for chronic diseases such as laminitis and uveitis, and contributes to allergic conditions. Stressing the horse’s system with over-vaccination can also affect the digestive system, leading to mineral deficiencies. Stress also decreases the amount of healthy bacterial flora in the gut, increasing the likelihood of colic.

<><> Dewormers <><>
We are fortunate to have some fairly safe chemical dewormers such as Pyrantel and Fenbendazole, yet some people still prefer using natural products to support the horse’s digestive and immune systems rather than using chemical dewormers. Regardless of which method you use, it is wise to double check your program with fecal exams at least twice a year.

<><> First Aid <><>
When I practiced strictly conventional medicine I found that most horses suffered from minor injuries or infections at least several times a year. These minor emergencies kept me busy, and because they were so common most of my clients started keeping drugs on hand and learned to treat these conditions themselves.

When I began to treat my patients more holistically, with fewer vaccines and better nutrition (including the use of probiotics such as Acidophilus), I noticed that the horses had less and less need for drugs. My patients no longer needed bute or antibiotics for minor cuts and punctures. These wounds healed quickly and easily with no loss of riding time. Gone also was the aggravating chronic nasal discharge that often kept horses out of work for weeks at a time.

A holistically managed horse with a healthy immune system will often run a fever for a short period of time when exposed to a virus or bacteria. This response slows the pathogen’s growth and deprives it of nutrients. A short course of probiotics will help support the horse during this time. Once the fever breaks, the horse bounces back quickly with little nasal discharge or cough. These horses then go right back to work without concern about relapse. Conventionally managed horses taking anti-inflammatories and antibiotics will often get better in the short term, but then relapse or develop a chronic nasal discharge.

<><> The Results Are In! <><>
The trail horse example I have used above precisely demonstrates what I have experienced in my practice. While it costs about the same to manage a horse either conventionally or holistically, I’ve found that holistically managed horses are much healthier overall, which means fewer chronic problems and more days of riding time. In fact, conventionally managed horses have about 7 times the number of sick days as holistically managed horses.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

We’ve all heard the expression, “No foot, no horse.” In the wild, horses don’t have the benefit of vet or farrier. A horse that goes lame in a wild herd is likely doomed to die, since he will no longer be able to keep up with the herd or outrun predators.

Domestic horses, while they have weaker feet than those in the wild, have the advantage of human care. When done correctly and taken seriously, most hoof problems can be avoided with preventive maintenance. A horse with bad feet is a burden to everyone, including himself. Therefore, proper hoof care might be the most critical thing you do to take care of your horse’s physical needs.

When you think about hoof care, there are some basic things to consider:

1. To shoe or not to shoe?

Most regular riding horses don’t need shoes. Barefoot is best. The types of horses that commonly need shoes are:

* Those with a foot deformity (like club foot or weak hoof walls), where a vet and farrier have recommended corrective shoeing as a remedy; * Those recovering from a bad founder (aka laminitis); * Those that are star athletes (like jumpers or racing horses); * Those that are regularly ridden on very hard surfaces (like a carriage horse or police horse).

There’s a common perception that white feet are weaker than dark feet. There is no scientific evidence to support this, but many people swear it’s true, and so will shoe a horse for no other reason than that it has “weak” white feet. The bottom line: Unless a vet or farrier tells you to shoe your horse, don’t.

2. To supplement or not to supplement?

There is no evidence (other than anecdotal) that giving your horse oral vitamins or supplements do anything to change the feet God gave him, but if you have money to throw away on that stuff, go right ahead. The best way to improve your horse’s feet through diet is simply to make sure he is eating all the things a horse is supposed to, and is getting all the vitamins and minerals a horse should get from that diet.

For example, all horses need to eat grass and other roughage (hay and whole grains). All horses need fresh, clean water, and lots of it. All horses need certain minerals in their diet, and if the soil where your horse is pastured doesn’t provide them, you need to give him a mineral block or add loose minerals to his feed. If your horse is not thriving on a diet like this, consult your veterinarian.

If a supplement is recommended, by all means, try it. Perhaps it will improve your horse’s digestion or help him grow more foot faster, but it won’t change feet that were bad from birth.

3. How often does the farrier need to visit?

Your horse’s feet need to be trimmed or shod anywhere from every four weeks to eight weeks. This will depend largely on how fast your horse’s feet grow. If you have more than one horse, and want them all on the same schedule, every six weeks will usually work for just about everyone. However, if your horse has a foot problem and needs special care, follow the advice of your vet or farrier on the frequency of trims.

4. What are some common hoof problems and how do I spot them?

Some of the most common hoof problems are:

* Thrush: Your horse’s frog will be mushy, will smell bad, and look eaten away. In bad cases, when you pick your horse’s foot, it will bleed. An old fashioned remedy is to kill the fungus by applying bleach water to the affected hoof, but this can be very hard on your horse’s feet and really dry them out. These days, there are lots of thrush remedies available at the local feed store. Coppertox and Absorbine both make hoof rinses that do a good job of getting rid of the fungus that causes thrush.

* Bruised sole (or “Stone Bruise”): This is caused when a horse steps on sharp rock and bruises the bottom of the foot. If your horse is shod, and the shoes aren’t fitted correctly, this can increase the chances of injury to the sensitive sole of your horse’s foot. The treatment, in most cases, is rest: turn him out in the pasture and give him a few days off. Most horses do not need to be kept stalled unless the bruise is very deep and the horse is totally lame. If this is the case, it’s best to get the vet to test the hoof, evaluate the severity of the bruise, and possibly give your horse some pain and anti-inflammatory medications.

* White-line (or “seedy toe”) disease: This one can be a real pain to get rid of once your horse has it. It’s characterized by a “white line” that becomes visible around the edge of the underside of the foot, and can cause weakening of the hoof wall if left untreated. Horses that chronically founder are more susceptible to this ailment. Your farrier will have to help you with this one by digging out the bad part of the wall and putting on special shoes that support the hoof while allowing the wall to re-grow. Keeping your horse’s feet as clean and dry as possible, and keeping his feet regularly trimmed so that the toe cannot grow too long are the best ways to prevent this condition.

* Abscesses: When your horse punctures the bottom of his foot, and the top seals over before the wound heals, an abscess can form. Depending on the severity of the wound, you might be able to treat it yourself. Scrape off the top of the abscess and drain the infected fluid. Soak the foot twice a day for a week in Epsom salts and warm water. If it doesn’t look significantly better by the next day, or three soakings (even though you should continue the treatment for a week to be sure you kill all the bacteria causing the infection), call the vet or farrier and get help.

5. How often do I need to pick out my horse’s feet?

The answer is simple: every day! If you are caring for your horse’s feet every day, picking them out and removing rocks and other debris, you will be more likely to spot and prevent problems before they have a chance to start.

The final word in hoof care is “prevention.” The recipe for healthy feet is: Pick them out daily, have the farrier out regularly, and feed a balanced diet.

We’ve all heard the expression, “No foot, no horse.” In the
wild, horses don’t have the benefit of vet or farrier. A
horse that goes lame in a wild herd is likely doomed to die,
since he will no longer be able to keep up with the herd or
outrun predators.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

Many horse owners don’t know that there are at least four types of Equine Herpesvirus. The ones that we associate the most are EHV-1 and EHV-4. EHV-1 is the most prevalent and often the most destructive to the horse. EHV-1 causes severe respiratory problems, abortion in mares and neurological disease. EHV-4 causes upper respiratory infection only. Most horses, however, contract EHV-1 and is it usually first diagnosed by runny noses, fevers, coughs and broodmares that are aborting.

The neurological disease of EHV-1 is a mutant strain and has caused many stables and racetracks to have to be quarantined around the country. The University of Findley in Ohio has reported the most devastating outbreak of EHV-1 where one-third of the schools 140 horses displayed the neurological symptoms in 2003. Twelve of the horses died from the disease.

Once the virus has infected the horse, the horse will be a lifelong carrier. This is very similar to the herpes diseases found in humans. The horses may no longer show signs of being ill, but they will continue to shed the virus, especially during times of high stress. The horses sporadic shedding of the disease is often considered the cause of many outbreaks that occur randomly. Many veterinarians believe that nearly three-quarters of the equine population are thought to be carriers of the EHV-1 non-neurological form of the virus.

The disease is spread by infected horses through their respiratory secretions. Horses can contract the disease through nose-to-nose contact, sharing buckets, bits, lip chains and even on handlers. Once the virus has made it into the horse, the virus travels through the bloodstream. The early symptoms include nasal discharge and a slight increase in temperature. The fever does not remain consistent, so if you believe that your horse is showing symptoms, you will want to check their temperature every six hours. The nasal discharge will begin clear, but will turn to thick and milky. Your veterinarian can obtain swabs of the discharge and blood samples to test for the disease.

If the horse is infected with the neurological strain, the horse will begin to show symptoms in six to twelve days. The initial progression of the disease may happen quickly and within 24 to 72 hours. Fevers are generally over 102 degrees Fahrenheit and other symptoms include the nasal discharge, depression and loss of appetite. The first neurological symptoms may begin in the hindquarters and may include toe dragging, a floppy tail, incontinence and weakness in the hind legs. Eventually, the horse will not be able to stand. If the horse is down for more than twenty-four hours, it is not likely that they will survive the infection.

As the disease is caused by a virus, there is no cure for it. Many vets will give horses immune modulator shots that will help to boost their immune system and will help them to attack the disease through their own immunity. Many horses with only the respiratory problems will do well with the shots. Antibiotics are not going to generally help these horses, as they do not kill viruses, only bacteria. While the horse is ill with the respiratory condition, all that owners and vets can do is to treat their symptoms. Your vet will provide you with strong anti-inflammatory that lessens swelling and pain.

There are also no vaccines that are capable of preventing the neurological form of the disease. Studies have been done on small groups of horses to compare the effects of the modified-live vaccine versus the inactivated killed vaccine. The modified-live version of the vaccine seemed to be more effective to prevent the respiratory disease, while neither had an effect on preventing the neurological symptoms. The vaccine will help to minimize the spread of the virus.

To prevent your horses from becoming victims to EHV-1, it is recommended that your horses be placed on a food vaccination program as well as good herd management. The American Association of Equine Practitioners recommends that all pregnant mares be vaccinated in order to prevent abortions. Foals, weanlings, and yearlings should also be vaccinated. Foals should receive their first dose at four to six months, their second dose at five to seven months and their third dose at six to eight months. They should also receive the vaccinations at three-month intervals. Yearlings and performance horses should receive booster shots every three to four months or annually depending on the amount of stress that they are under. Broodmares should be vaccinated at their fifth, seventh and ninth months of gestation with the inactivated EHV-1 vaccine. You may also give them an optional dose at their third month if the mare is under stress. Mares should also be vaccinated before breeding and four to six weeks before foaling. Breeding stallions should also be vaccinated prior to the start of their breeding season as well as every six months.

Other preventative strategies include sanitizing your barn at least three times per year. Barns that have experienced outbreaks may sanitize six times per year. If you show horses and their was suspicion that horses at the show may have been sick with the virus, you will want to quarantine your own horses from the rest of the herd for up to twenty-one days. You will also want to disinfect every area of the barn which suspects sick horses have been housed or worked.

If an outbreak does occur at your barn, you will want to instruct all owners, handlers and visitors to wear leather or rubber boots that can be disinfected in chlorine or bleach. You should have disinfectant tubs located at every entrance to the barn. You will want to disinfect all stalls, floors, walls and possibly even arenas and fencing. Disinfect all grooming supplies, buckets, water troughs and tack that may have been shared. One horse in a large herd can spread the disease throughout the whole herd.

Many horse owners believe that they are covered from the
Equine Herpesvirus when they have their horses vaccinated
for Rhinopneumonitis. They don’t realize that the
vaccination is only effective on the respiratory end of the
disease. In fact, the most devastating part of Equine
Herpesvirus is the neurological effects that the disease can
have on horses.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

I recently received a letter from a reader on the East Coast who is facing a challenge that every horse owner is going to face at least twice each year if your horse spends any time on pasture. In the fall and early spring, every horse owner is going to face the challenge of switching their horse from pasture to hay and back again from hay to pasture.

“…I recently bought my first horse (morgan/perch cross). He is VERY solid and has always been on pasture board (with run-in). I live in Pennsylvania and the grass is starting to get yellow. At what point should he be getting hay(my barn manager insists it’s still good)? He also is just starting to get a handful of grain… He’s getting very fit and has lost a little weight (which is good in that he was getting too big), but just think he should start getting hay. Thanks so much. I look forward to hearing from you.

Martha”

Hi Martha,

Good to hear from you and congrats on purchasing your first horse! As for grass vs. hay, there are two things I would recommend:

1. If you call your local ag extension office and ask them to run a test on the grass in the pastures this time of year to determine the nutritional value, this will eliminate all the guesswork. Of course, many barn owners will be offended if you do this, but you are ultimately responsible for your horse’s health.

2. You can call your local vet and ask him what he thinks about the nutritional value of yellow grass.

At the end of the day, if you horse is in good flesh and his energy level is good, he is probably fine on the diet he is currently on. If he is not thriving on it, I would at least call the vet to ask the general question about when he thinks horses should start to transition off field grass onto hay for the winter (in your part of the country).

Remember to ease him onto hay, if he hasn’t been on it for the summer, especially if he is on yellow grass now. If there is little or no nutrition in that field grass this time of year and you start him on alfalfa hay (which is a very rich hay), you run the risk of colic or founder, so in a perfect world, while he is still on pasture most of the time, I would add 1/3 of a flake a day of the hay (for two days), increase that to 1/2 flake for another two days and then continue to increase incrementally in two day phases until he is on whatever his full daily hay ration is going to end up being. If this transition is hard for the barn staff to do, you can always arrange to swing by the barn yourself during the transition period to ensure he is eased onto the new diet.

In horses, it is not so much what they eat that is a danger, it is the transition from old diet to new diet that generally causes the most medical distress. This is true in the spring when the horses have been on hay and suddenly the pastures are filled with rich, wet, grass everywhere. The same cautious transitional rule applies, ease him onto the new grass in small bits each day until you eventually have him onto the new diet.

Whether you live on the East Coast or on the West Coast or in Europe, the same rules apply where diet change is concerned — slow is best. The last thing you want to do is find yourself with a horse that has a stomach ache or worse. The simple formula is to divide the total amount of the new feed that you plan on feeding each day into a fourteen day transitional period (assuming you will feed the same amount for two days each time you increase the amount). In other words, if you intend to switch from no grain to 7 pounds a day (used here as an example only, you should follow the quantity recommendations on the feed bag), split the 7 pound ration over a 14 day period. This would mean that on the first and second days, you will feed 1 pound of grain. By day three and four, you will be feeding two pounds a day, etc, etc. Remember that if your horse was on another grain product and you are switching from one to the other, remember to decrease the amount you are feeding of the old product, proportionate to the amount you are feeding of the new. In other words, if you start to feed one pound of the new brand of grain, reduce by the same amount what you were previously feeding of the old brand. If the goal is to transition from one product to a new product, reduce what you feed of the old as you increase what you feed of the new, in order to keep his diet balanced and to avoid colic or founder risks.

Another tip when you are transitioning your horse’s diet — keep an eye on his water intake and output and keep an eye on his stools to ensure he is not showing any signs of diarrhea or worse, is not producing any stools at all. For most horses, if you exercise the basic common sense detailed in this column, your horse will transition from grass to hay and back again, or from one grain product to another without any problems. As long as you exercise common sense and caution, it should be a very uneventful transition. If you short cut, you can expect expensive vet bills, lots of sleepless nights and the possibility of lifelong founder issues as a result of taking that short cut.

I want to hear from you! If you have any questions, comments or suggestions that you would like to share with the rest of us, drop me a line at:

Bonnie Marlewski-Probert
P.O. Box 548
Yellville, AR 72687

Or you can contact me directly on the Internet at BRMP@AOL.com or by visiting our web site, TheCompletePet.com

For more information on any of Bonnie’s books,

A Parent’s Guide to Buying That First Horse
Debugging Your Horse
The Animal Lover’s Guide to the Internet
Horse Tales for the Soul, Volumes 1 — 5
Dog Tales for the Soul, Volume 1

Or for her videos,

Debugging Your Horse and
Trail Riding, Rules of the road
Visit, http://TheCompletePet.com.

Tips on how to safely change your horse’s diet

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

Do you worry every time you see your horse eating green grass? Do you include checking digital pulses in your daily routine? Do you have nightmares about the only farrier who knows how to trim your horse moving to another state? The list could go on and on in the life of the owner of a horse affected with chronic laminitis. Even with good holistic treatment, relapses can and do happen. In this article I would like to address what conditions may bring a horse from health to chronic disease, and what it takes to reverse the process. These conditions apply to all horses with chronic disease and not just those with laminitis.

Basic Constitutional Makeup Animals are born with a basic constitutional make-up which determines their overall strength and vitality. This constitution is inherited from the parents and not easily influenced after birth. The best way to produce horses with strong constitutions is to breed only healthy, strong, emotionally stable individuals. Unfortunately, this is not usually what breeding animals are selected for. So, from the very beginning, most horses have some level of weakness in their constitutions. Where and when these weaknesses will surface depends on the way the horse is managed. If a horse grows up under natural conditions with minimal stress, then symptoms may not appear until late in life. If, however, the horse is brought out of his natural environment and put under stress, chronic disease symptoms can appear much earlier. Some other triggers of chronic disease, such as horse laminitis, include drugs, vaccinations and inadequate or inappropriate nutrition.

In my experience, homeopathy is the only healing modality strong enough to permanently change an animal’s constitution. Classical homeopathy addresses underlying constitutional weaknesses and imbalances. Other management tools, such as diet, housing, hoof care, chiropractic care, and exercise, can support the healing process for chronic horse laminitis.

Let’s assume your horse has just come through an episode of laminitis. He is currently walking well and his hooves are growing out nicely. What you want to be watching for are other subtle signs of chronic disease which could indicate that additional treatment is needed. These would include symptoms such as poor hair coat, eye discharge, change in temperament, stiffness, sensitivity to hot or cold weather or weather changes. Horse laminitis is often just one symptom of chronic disease.

If your horse is really free of chronic disease, you should be able to decrease supplements down to maintenance levels. If you continue to need therapeutic levels of supplements or many different supplements, then more work needs to be done on a constitutional level. A healthy horse showing no sign of chronic disease can also handle reasonable amounts of fresh grass and grains in the diet.

It is not unusual for chronic horse laminitis cases to maintain a low-level digital pulse. This indicates some continued inflammation associated with a continued healing response. If the pulse becomes strong or is associated with increased lameness, it could indicate a problem.

Managing Chronic Horse Laminitis Cases If your horse is doing very well overall, I believe a good management plan would include the following elements.

Diet for Horse Laminitis The best diet is simple, low in carbohydrates, and high in fiber Small amounts of equine senior feed is acceptable for some laminitic horses, while others do well on a small amount (8 ounces) of oats or barley. At the same time, some laminitic horses can not tolerate any grains. A probiotic/enzyme supplement like FasTrack or Simplexity Spectrabiotic supports the digestive function and limits the production of endotoxins. Simplexity animal algae provides a source of food-based vitamins, minerals and antioxidants. Small doses of antioxidants such as Q10 may be indicated. You should not need to give more than 60-120 mg a day of a good quality Q10 product like those produced by Simplexity, Nutramax Comal, or Thorne brands. Generic brands of Q10 may not be active.

Hoof Care for Horse Laminitis I prefer to keep laminitic horses barefoot as long as possible. They must be trimmed regularly. If their toes are allowed to grow long or their heels allowed to get too high, then the normal mechanism of the hoof is impaired. Overly correcting angles on overdue hooves creates unnecessary discomfort for the horse and sets back his effort to establish new laminar attachments. Don’t expect to be back riding too quickly. It takes close to a year to grow a new hoof.

Turn-Out Schedules for Horse Laminitis Turn-out on lush grass should be approached cautiously. Many horse laminitis cases have hormone imbalances that affect their sugar metabolism. Fast-growing, lush grass is high in sugar. As your horse gets healthier he will be able to tolerate fresh grass. I suggest gradually increasing exposure to grass over several weeks and monitoring digital pulses. It is also best to avoid hay that has been heavily fertilized.

Drugs and Vaccinations and Horse Laminitis It is best to avoid drugs and vaccinations in horses with a history of laminitis. If drugs or vaccines must be given, then it is important to watch the horse closely to determine if any chronic disease has been triggered.

A Final Note About Horse Laminitis In closing, I want to say that cure is always my desired outcome with chronic horse laminitis cases. This would look like complete return to full function without need for continued treatments or expensive management practices. Sometimes it is simply not possible, especially with advanced pathology such as pituitary tumors or severe bone damage. With these cases, palliation with remedies, special hoof care and high levels of antioxidant nutritional or herbal supplements may be needed. Most cases, however, can be cured with good homeopathic prescribing and proper management. The challenge is staying alert to shifting symptom patterns and resisting the temptation to palliate with large doses of herbs or supplements. I know I have many cases I have brought through crises but not totally cured. In my experience, chronic horse laminitis cases are perhaps the most difficult to work with and they can be the most rewarding.

Chronic horse laminitis cases can be difficult to heal, but
with the right combination of homeopathy, diet, hoof care,
and management, the road back to health is possible. This
article gives the specific management details for helping
horse laminitis cases recover.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

Three standard indicators of a horse’s health are temperature, pulse rate and respiration. These can be used not only to determine if your horse is ill but also can indicate the type of illness.

Horse’s Temperature

The normal temperature for a horse is about 38C (100.5F). Individual horses may vary half a degree either side of this, so you may want to take your horse’s temperature when it is healthy so you know what its healthy temperature is exactly. There can also be a variation of up to half a degree due to time of day and activity. Variations of more than one degree indicate a problem, which should be treated accordingly..

An elevated (abnormally high) temperature usually indicates that the horse has an infection. In such cases, keeping the horse warm and comfortable is important. In particular, one should protect it from being chilled by cold, wet or windy weather. The higher the temperature is, the more serious the condition, and the more likely that veterinary assistance or antibiotics may be required.

A depressed (abnormally low) temperature is unusual, but can occur in cold weather (especially if it is wet or windy) if the horse is unable to maintain its temperature. Horses which are old, sick or weak can be chilled easier and faster in cold conditions. A drop in temperature should be taken seriously as even small changes can easily result in secondary issues such as colic, or even be fatal. The horse should be moved to shelter and covered with a warming rug. If you have mash, mixing a small quantity with some warm water (but not hot!) and feeding it to the horse can help it warm up, partly due to the warming effect of the water and partly from the quick energy of the mash. The horse should be closely monitored until it warms up and fully recovers. To prevent a reoccurence, one should ensure that the horse has adequate shelter from the weather, consider using a horse rug on colder days (especially if wet or windy) and consider giving it a quantity of high-energy food (such as mash or grain) during cold periods (note that any dietary changes should first be discussed with a veterinarian to avoid potential dietary related problems such as laminitis).

If a horse shows signs of illness or abnormal behavior, but does not have a temperature, the problem is probably not infection related. In other words, it could be an injury or a non-infection illness such as colic or laminitis. Consequently, even a normal temperature is is useful diagnostic tool, as it helps to eliminate infections (e.g. strangles) as possible causes of the problem symptoms.

If you are not experienced in taking a horse’s temperature, you should first do this with an experienced person, to minimize risk of injury to yourself or the horse. Some tips:

• An electronic thermometer is better than a glass thermometer, as it is faster and does not have the risk of breaking and associated injury. If you only have mercury thermometer available, first shake the mercury below 37.4 and take care that it does not break when inserting into or removing from the horse.
• If possible, have someone at the head end to distract the horse with a bit of food. If working on your own, consider first tying up the horse to minimize movement or risk of it running off.
• Put some lubricant on the bulb-end of the thermometer to make insertion in the rectum easier.
• Raise the tail with your left hand and insert the bulb into the rectum with your right (if you are left-handed, hold tail with right and insert with left). With mercury thermometers one needs to wait about half a minute and not remove until the mercury stops moving. With electric thermometers readings are normally quicker and depending on type it may beep to tell you that the reading is complete.
• Horses can be startled by this procedure and may kick, so one should watch and be careful of the horse. Standing slightly to one side rather than directly behind the horse is a safer position.
• Make sure that you hold onto the thermometer firmly, as otherwise movement of the sphincter muscle could draw the thermometer inside the horse.
• Wash the thermometer and if possible wipe it with alcohol (or appropriate disinfectant) to sterilize it before putting it away.

Pulse Rate

A horse’s pulse rate should be taken when it is resting, as the pulse rate during exercise or shortly thereafter is not a good indication (unless one is using pulse recovery rates and maximum pulse rates as part of a fitness evaluation). The normal pulse rate for a horse is depends on various factors such as breed (e.g. ponies tend to be faster), age and physical fitness. Consequently, it is wise to take your horse’s pulse rate when it is well and write this down, so that you know the normal pulse rate of your horse. Then, if you suspect illness, you will know the normal pulse of your horse which you can test against. If you don’t know your horse’s normal pulse rate, consider the range of 36-42 beats per minute as normal.

To take the pulse, gently press your fingers against an artery and count the number of beats. You will need a watch with a second hand to measure the time. The easiest places to feel the pulse are:

• Under the top of the lower jaw, gently pressing the artery against the underlying bone
• On the horse’s cheek, just above and behind the eye
• The inside of a foreleg, level with the knee, where the artery runs over the bone.

One can also use a stethoscope, pressed gently against an artery, to listen for the pulse rather than using one’s fingers to feel for it.

An elevated pulse rate can be associated with illness or pain (as well as exercise or fear). A high pulse rate combined with a normal temperature indicates a non-infection illness. A high pulse rate combined with a high respiration rate but a normal temperature is often associated with pain.

Respiration Rate

The resting respiration rate of an adult horse is 8-15 times per minute. This is a wide range as the normal respiration rate for an individual horse is dependent on its breed, age and general condition. Consequently, it is wise to take your horse’s respiration rate when it is well and write this down, so that you know the normal respiration of your horse, which you can then test against if at a later date you suspect illness.

The easiest way to measure a horse’s respiration is to stand behind it and watch its flanks, while timing with a watch. You may need to first move the horse into an area where it is quiet and away from other horses, as excitement or sniffing can make an accurate count difficult. Likewise, on a hot day you may need to move it out of the sun, as a hot horse breaths faster.

An elevated respiration can be associated with illness or pain (as well as exercise or fear). A high rate combined with a normal temperature indicates a non-infection illness. A high respiration rate combined with a high pulse rate but a normal temperature is often associated with pain.

How to check a horse’s health by measuring its temperature,
pulse and breathing. Some tips on what each of the values
mean.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

Colic is the most common cause of pre-mature death in domestic horses. It is also the most frequent cause of major veterinary bills. However, the vast majority of colic cases could be easily prevented through correct management. A study of the existing research into this illness, including case studies covering thousands of cases of horse colic, which has identified the most common causes of colic, is the basis for the following recommendations.

Worming. Ensure that the horse is on a regular deworming schedule. All other horses which share the same pasture should be on a synchronized deworming schedule, to prevent cross-reinfection. If a horse has a heavy infestation of worms to start with (e.g. if it has not been dewormed for a long time), then the actual deworming itself can be dangerous, so one should use a laxative to reduce the worm population prior to starting a deworming schedule.&nbsp;

Food and Pasture. Horses have evolved to eat and digest throughout the day. Their digestive systems are based on ‘continuous processing’, rather than periodic feedings (such as one finds in people or large carnivores). Consequently, restricting them to feedings only twice or even a few times per day is unnatural and places a strain on their system. The ideal situation is for the horse to spend the majority of its time on pasture, constantly eating and moving. If this is not possible, it should be fed as often as possible so that one comes as close as possible to the ‘continuous processing’ it has evolved for. One should never feed food which has gone off (e.g. moldy, fermented).

Hay before Grain. The horse digestive system is designed for ‘high volume, low calorie’ food such as grass and hay; foods which are ‘low volume, high calorie’ such as grain do not provide the volume they require and can lead to various medical conditions (in particular, ulcers). Consequently, use high-roughage foods in preference to grains, unless there are specific reasons otherwise (e.g. for intensive sports, grain may be necessary).

Furthermore, if one is providing both hay and grain, the hay should be fed first. One reason for this is that by reducing appetite with hay, it is less likely that the horse will ‘bolt’ the grain (see ‘bolting’ below). Another reason is that there is evidence that hay following by grain is digested much better than grain followed by hay.

Soak Pelleted Food. It is advisable to soak pelleted food before feeding to horses. The main reason for this is that pelleted food expands in contact with water, so if a horse ‘bolts’ a large quantity of dry pelleted food, it can rapidly expand to an excessive volume upon contact with fluids in the stomach. By pre-soaking the pellets, the food is expanded before it is eaten. This also reduces the rate at which the horse eats, reduces the risk of choke and ensures that additional water is ingested (for horses that are poor drinkers).

Excessive Feed. Horses sometimes manage to get into the feed stores (e.g. where you store grain or other high-calorie food) and stuff themselves, which can result in colic. It is wise to keep the room with feed locked, so that if a horse gets out of its stable or pasture, it will not be able to get into the feed room.

Bolting. If your horse ‘bolts’ (swallows without chewing) its food, discuss options with your veterinarian. For example, with hay pellets one can pre-soak them in water.

Water. Ensure that the horse has access to water at all times. If for some reason the horse has not had water for some time, provide water in small amounts at first rather than allowing it to drink a large amount at one go (particularly after exercise). Likewise, if a horse has not been drinking for some time (horses often refuse to drink during transport), ensure that when it resumes drinking that it is gradual.

During winter, try to provide warm drinking water. A study by the University Of Pennsylvania School Of Veterinary Medicine determined that this increased water consumption by 40% (warm water compared to near freezing water). As inadequate water consumption is an important cause of colic (impaction colic), providing warm water is advisable. Further, there is strong anecdotal evidence that consumption of large quantities of cold water in a short time (e.g. after exercise or after water deprivation) can cause colic.

Exercise. Colic can be caused by inadequate exercise (e.g. horse spends most of day in stall), excessive exercise (especially if horse is out of condition), or rapid changes in the amount of exercise. Consequently, one should avoid these extremes.

Bedding. Ensure that the horse does not eat its bedding, certainly not in large quantities. If it persists in eating its bedding, change to another bedding type which it does not eat.

Sand and Dirt. Do not feed the horse on sand or dirt surfaces. Avoid stabling the horse on sand or dirt. Do not leave a horse on over-grazed pasture.

Dental Care. Correct and periodic dental care (e.g. annual examination, with work if required) will minimize the risk of horses not chewing their food properly due to dental pain.

Trapped. A horse will sometimes lie down or roll so that its back is against a fence or wall, with the result that it cannot get up. Remaining in this position for a lengthy period risks serious colic (e.g. movement of colon into a dangerous position), so if one sees a ‘trapped’ horse one should quickly move it, taking care to avoid accidental injury to oneself. Likewise, a horse that lies down in a paddock sometimes gets its legs trapped under or in the fence rails and needs to be freed.

Temperature. Extreme temperatures (very high or very low) and rapid temperature changes can cause stress on a horse, particularly those which are weak (old or sick). During extreme weather, consider keeping the horses in their stalls. Alternatively, there are a range of horse jackets to protect from rain and/or cold. These should be used if there are sudden extreme changes in weather or if a horse is weak. In addition, although stables should have good ventilation, they should not be drafty (in general, drafts are more of a risk than simple cold).

Change. Finally, one should be aware that horses do not react well to change or stress. One should minimise these as much as possible; if a period of change or stress is necessary (e.g. long distance transport, changes to feed), one needs to monitor the horse much more closely than normal and take special care of it. The ways in which change can affect a horse negatively are numerous. For example, horses will often stop drinking during periods of stress or if they are moved to another area where the water tastes different. As another example, adding or removing a horse from a herd can upset the herd social dynamics, resulting in considerable stress.

Colic is a complex illness, with many different causes. Currently, there is no management programme which has 100% success in avoiding it. However, following the above guidelines will greatly reduce the risk of colic.

Horse colic kills more horses than any other disease, and is
a common cause of large veterinary bills. However, most
cases can be easily prevented.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health

Grooming your horse is an essential part of good horse care. Your horse will enjoy a good groom, and you will be able to see if there are any new marks, cuts or rubs on your horse. It is important to give your horse a good groom before you ride as to ensure that there is no dirt around his saddle and bridle areas as well as having clean legs if you are putting boots or bandages on. Having a well groomed horse makes you look very professional at shows and proves to everyone you have pride in your horse!

Your grooming Kit should contain:

1. Rubber Curry Comb2. Body Brush3. Metal Curry Comb4. Dandy Brush5. Hoof Pick6. Hoof Oil and Brush7. Mane and Tail Comb and Brush8. Shampoo, Bucket and Sponge9. Sweat Scraper

Each of the above brushes have a specific use and each one should be used accordingly.

1. Rubber Curry Comb – Use this on his body and neck in round circles. This will loosen all the dead hair and skin in his coat and get rid of tough mud if he has rolled in the field. Do not use this brush on his bones (face, spine or Legs) it will hurt him. This brush also acts as a massage for your horse. It will relax him which makes him feel good. It will also encourage his skin to produce natural oils which will make his coat look fabulous.

Tip: Groom your horse every day and you will not only have a happy horse but the best looking coat ever!!!

2. Body Brush – Use this brush his face, neck, body and upper legs in long strokes going with the direction of the hair. This will remove all the dead skin and hair that you have loosened with your curry comb.

Tip: flick your wrist at the end of your stroke – this will removes more dirt and hair!

Tip: If your horse is really muddy – just hose or sponge him off. You may have to dry his saddle area before riding but this could save you lots of riding time!!!

3. Metal Curry Comb – This is NOT made for use on your horse ever! This is to clean your body and dandy brushes while grooming. To clean your brushes while grooming simply run your body brush across the metal curry comb and watch the dirt and hair fly!!!

Tip: Keep your Metal Curry dry and clean – this will stop it from rusting and it will be more effective for cleaning your brushes. (You can wash in water but dry immediatley after)

Tip: Hold your Metal Curry Comb in your left hand while using your body brush in your right hand and scrap your body brush every third stroke or so – aim at getting quicker – but be careful not to loose QUALITY in brushing!

4. Dandy Brush – This brush is a hard bristle brush and should not be used on anything other than legs. Use it gently because it can hurt but you can be a little more vigorous with this brush especially if your horse has had a mud bath!

5. Hoof Pick – Your Hoof pick is used to clean your horses hooves, which is one of the most important things you can do and should be done at least once a day whether you ride or not. To use your hoof pick, pickup your horses leg and locate the frog. Run the hoof pick from heel to toe along side the frog. Be careful not to puncture the frog. Dirt can seriously stuck on your horses hoof so do be careful of yourself and yourhorses foot.

Tip: If your horse is kept in a stable then hoof picking should occur at least twice a day.

Tip: If your horse’s foot is smelly or is ‘chalky’ this could be due to wet ground. If the hoof is smelly it could be thrush, and if the hoof if chalky it could be seedy toe. Some iodine spray from the local horse/produce store can help. If your horse is visibly sore then you will need to call your vet or farrier.

6. Hoof Oil and a Brush – Hoof oil does not have to be used every day, unless your farrier has specified. It protects the hooves from becoming dry and brittle. it provides moisture which some horses need more than others. Apply with a small paint brush. Hoof Oil is different from Hoof Black. Hoof Black is used at shows to blacken horses hooves – this dries the hoof out and should not be used often. It would be a good idea to use hoof oil after using hoof black to replenish moisture in the hoof.

7. Mane and Tail Comb and Brush – The mane and tail comb is used to pull your horse’s mane and top of his tail. This keeps his mane and tail tidy.

To pull your horses mane correctly is hard and takes practice but is much better than shortening your horse’s mane with a pair of scissors! When you use your pulling comb – brush through the hair, Hold the longer bits between your fingers and push the rest up as if you were teasing his mane. Next wrap the longest hair around the comb and while still holding the comb and the hair pull down sharp and quickly pulling the hair out. Only grab a small amount of hair when pulling, this wont hurt your horse.

The brush (usually just a hair brush) is used just to run through the mane and de-tangle your horses tail. When you brush his tail, grab little sections at a time and start from the bottom and work your wayup to his tail bone. Be careful as some horses do not like their tails brushed let alone the top pulled!

Tip: If your horse is getting annoyed then leave it for the next day. Don’t leave pulling a very long mane until the day before a competition, if you do need to stop you will only have half a mane pulled!

Tip: When brushing his your Horses’ tail, spray some show shine in his tail. This helps de-tangle his tail with very little breakage of the hair. All horses have different kinds of tails, so work with what you have and keep your horses tail healthy and shiny!

8. Shampoo, Bucket and Sponge – Obviously these are used when you want to wash your Horse. To wash your horse, soak him with a hose from head to tail. Make sure you wet his mane and tail but be careful of his ears. Have soapy water in your bucket ready to go with your sponge and body brush in the water. Scrub his body with the body brush and use the sponge on his face being careful of his ears! Wash his tail (if he lets you). Ensure all the dirt or mud is off and then hose all the shampoo off your horse. Make sure that there is no soap left on him! This will make his skin itch.

Tip: Try not to wash him too often as this will wash away all the natural oils that are protecting your horses skin. Your horses coat will loose its shine if you wash him to often and he may also get dandruff or itchy skin!

Tip: A good groom will always be better than constant washing with shampoo.

9. Sweat Scraper – The Sweat Scraper is used after you have washed your horse. Scrap down his body to get all the excess water off. This will help him get dry quicker. Only use this tool on his body, not his legsor head!

Extra things that you can have in your horses grooming kit are:1. Moisturizer2. Show Shine (for his tail)3. Iodine / Antiseptic cream.

This is not an extensive list. You should also have a first aid kit at your horses stable or in your car if he is in a field. I will go through What a first aid kit should have in a later article.

If you intend to Show your horse you will need many more items. This is just a basic kit to keep your horse happy in the field!

If your horse is lame or has any serious cuts or injuries, please call a professional to help you. Once you are more experienced you will learn to tell when you need the vet or farrier.

Grooming your horse is an essential part of good horse care.
Your horse will enjoy a good groom, and you will be able to
see if there are any new marks, cuts or rubs on your horse.

Technorati Tags: Horse Care, horse care 101, horse care tips, horse health