Nutrient content changes from steaming or soaking timothy-alfalfa hay: effects on feed preferences and acute glycemic response in Standardbred racehorses1.

Soaking hay and steaming hay are strategies that are used to reduce respirable dust particles for horses but may result in variable nutrient losses, including nonstructural carbohydrates (NSC) and minerals. Since these losses have not been quantified in Canadian hay yet, the first aim of this study was to identify nutrient losses from first-cut timothy-alfalfa hay grown in southern Ontario, Canada, after soaking for 30 min or steaming for 60 min. It is uncertain whether horses prefer hay when it is dry, soaked, or steamed. To address this, 13 Standardbred racehorses were offered 2 of these hays side by side for 30 min on 6 consecutive occasions until all possible combinations had been offered. Quantity of hay eaten was determined and horses were video recorded during feedings to assess time spent eating and investigating hay. Additionally, consumption of feeds with differing NSC levels has been observed to influence glycemic response in horses; however, this has not been measured in horses consuming steamed hay before and the results from soaked hay studies have been inconclusive. As such, the final aim of this study was to examine acute glycemic response in horses after being fed dry, soaked, and steamed hays. Blood glucose was measured every 30 min from 9 Standardbred racehorses for 6 h following a meal of 0.5% of their body weight of treatment hay on a dry matter basis (DMB). Soaked, but not steamed, hay had lower concentrations of soluble protein, NSC, and potassium in contrast to the same dry hay (P < 0.05). Peak glucose, average blood glucose, total area under the curve, and time to peak did not differ among treatments (P > 0.05). We conclude that acute glycemic response of racehorses was not influenced by soaking or steaming hay. Horses also consumed less soaked hay (DMB) than dry or steamed hay (P < 0.05) and spent less time eating soaked hay than dry or steamed hay (P < 0.05).

Reduction of amputation rates among Alaska Natives with diabetes following the development of a high-risk foot program.

OBJECTIVE: The prevalence of diabetes is increasing rapidly among Alaska's Indian, Eskimo and Aleut populations. Approximately half the Native people with diabetes have no road access to hospitals or physicians, presenting a challenge in the attempt to prevent lower extremity amputation as a complication. In late 1998 funding became available for diabetes prevention and treatment among Native Americans. The tribal health corporations in Alaska decided to use a portion of this funding to implement a high-risk foot program to decrease the amputation rate. PROGRAM DESIGN: The program initially involved a surgical podiatrist who provided training to local staff and performed preventive and reconstructive surgery on several patients with impending amputations. The program then provided training for a physical therapist to become a certified pedorthist. This individual established the long-term maintenance phase of the program by conducting diabetic foot clinics routinely at the Alaska Native Medical Center, a referral center in Anchorage. He also travels to other regions of the state to provide training for village and hospital-based health care providers and to conduct field clinics. A system was established in a common database management program to track the patients' foot conditions. Patient education is emphasized. RESULTS: The overall amputation incidence among all Alaska Native patients with diabetes decreased from 7.6/1,000 in the pre-program period (1996 to 1998) to 2.7/1,000 in the post-program period (1999-2001) (p<.001). The rate among Aleuts, who previously had the highest amputation incidence, decreased from 17.4/1,000 to 3.1/1,000 over the same time periods (p<.001). Among people who had had diabetes at least 10 years, the overall amputation incidence decreased from 16.4/1,000 to 6.8/1,000 (p=.021); among Aleuts the rate fell from 24.5/1,000 to 2.6/1,000 (p=.01). CONCLUSIONS: Though longer follow-up is needed, these data suggest that even in populations living in isolated regions, diabetic amputations can be prevented by a coordinated system to identify high-risk feet and provide preventive treatment and education in the context of a comprehensive diabetes management program in an integrated health system.