Equine Conditions: Free Fecal Water Syndrome (FFWS)

FFWS, or free fecal liquid, have 2 manure phases: one solid phase and one liquid phase.

While the cause behind FFWS remains to be identified, nutritional support may play a key role in clinical signs.

A 2013 case report from Italy (Valle, Gandini and Bergero, 2013) focused on 5 nutritional considerations:

1. Rebalancing the diet to ensure nutrient requirements are met.

   1. It's not uncommon for horses with digestive disorders to also be experiencing diet imbalances. While these imbalances alone are likely not responsible for the issues, they could be impeding progress made via other management changes by not providing the body with the essential nutrients needed for normal health functions.

2. Avoiding excess NSCs from both forage and concentrates.

   1. Hay testing and working with a qualified nutrition professional can help you accurately assess your horse's sugar & starch intake.

3. Balance mechanical and physical load on the colon through careful hay & alternative hay proportions in the diet.

   1. In addition to identifying NSC content in hay, hay testing can help you predict how your hay will behave in your horse's digestive tract.

4. Reduce feeding stress with special attention to feed consumption time, meal size, and providing turnout.

5. Increasing the proportion of n3 fatty acids in the diet.

   
   

The horse in question had a history of both chronic diarrhea and FFWS, with FFWS worsening when different species of hay was fed.

No improvement was seen when using FOS or insulin-based prebiotics, or L. acidophilus spp of probiotics, while S. cerevisae at 100g/day helped alleviate the chronic diarrhea (but not the FFWS).

This case report also explored the use of sulfasalazine, which is sometimes used for colitis in companion animal veterinary science, and the horse responded well to 15 days of treatment, after which the medications were discontinued due to owner preference.

Dietary management included 0.8% BW hay, 0.8% BW alternative hay source, and the addition of flaxseed oil with a vit/min balancer, with feed divided into 6 meals per day (timed every 3-4 hours). The diet changes helped the horse maintain more normal fecal quality and reduced FFWS, which lead to an attempt in increasing long-stem hay and decreasing the hay alternative, but had limited success.

The owner also reported a FFWS flare up when a different type of hay was fed with minimal transition, and treatment with sulfasalazine combined with more strict hay feeding helped maintain more normal fecal quality.

While case reports have different statistical strength compared with well-designed research trials, we can learn a lot from this case report:

• Prebiotics/probiotics may not elicit a response in FFWS. This is something I've seen a lot in the field - owners often try digestive supplements with little differences seen in FFWS horses.

  • Microbiome dysbiosis has not been identified as a consistent cause of FFWS. A 2020 study reported that limited microbiome differences were found between stable-matched FFWS horses and unaffected horses, regardless of season (Schoster et al, 2020). Another study reported that horses with FFWS did not have any significant differences in microbiota composition when compared to healthy controls (p > 0.05; Lausten et al., 2021).

• Hay changes and more fibrous hay can increase FFWS in sensitive horses. The structural carbohydrate fraction of hay (NDF) is fermented at different levels in the hindgut, with digestibility being affected by total lignin in the cell wall. Lignin is determined by factors such as plant species and maturity, and can vary between hay. Alternative hay forms can be useful for horses with a history of poor fecal quality, and may need to be maintained in the diet at levels dependent on the individual horse.

  • At Honos, hay testing is recommended for all horses with fecal water syndrome.

• Targeted omega-3 supplementation may be useful.

A 2021 study (Lindroth et al., 2021) compared feeding management of horses with and without FFWS in attempt to identify factors that may be involved in FFWS.

• FFWS horses were fed a lower average amount of straw compared to control horses (p<0.0001).

• More control horses were reported to be fed Brewer's Yeast (p=0.01)

• Control horses were reported to be fed half the amount of total concentrate per 100kg BW per day than FFWS horses (p=0.004).

• FFWS horses were reported to have higher WSC & starch intake compared to control horses (p=0.02, p=0.004).

• FFWS horses were fed lower daily amounts of NDF (p<0.0001), but daily forage intake was similar.

This study reported several strategies involved in a reduction or elimination of clinical signs:

• Changing from 1st to later cut hay (34%), from wrapped forage to hay (24%)and from wrapped forage to pasture grass (18%) was reported to result in a reduction or elimination of FFWS.

  • Changes to forage type may be reflective of certain factors in the hay, such as plant maturity, botanical composition, NDF and fiber content.

• 26% of FFWS were reported to show a reduction or elimination of FFWS signs when adding commercial gut support products such as probiotics & prebiotics, psyllium seed, linseed or thiamine.

Fecal microbial transplantation, which involves fecal material from healthy donor horses to affected horses, is sometimes used in effort to manage FFWS, with mixed results - some horses see symptom improvement (Lausten et al., 2021). Speak with your vet team if you are interested in exploring this option for your horse.

A 2016 field study using owner-reported data in Germany (Kienzle et al, 2016) reported that there was no significant difference between FFWS horses and control horses for parasite fecal load or dental problems. This study suggested that social stress may play a role in the development of FFWS, with 40% of affected horses considered to be low in herd dynamic. This emphasizes the importance of a holistic assessment when considering your horse's health, and oftentimes working with a professional will call attention to details that have become normal enough to be overlooked when you're there everyday!

Need a hand? Honos Nutrition Co has worked on numerous FFWS cases, and can help you with hay testing and total diet evaluation to eliminate as many risk factors as possible.

Learn more about my individualized equine nutrition services here:

The Feed Club [H-On Farm & H-Online]

Book Now

The Feed & Forage Club [Ontario]

Book Now

References

Kienzle, E., Zehnder, C., Pfister, K., Gerhards, H., Sauter-Louis, C., Harris, P. 2016. Field Study on Risk Factors for Free Fecal Water in Pleasure Horses. Journal of Equine Veterinary Science 44: 32-36. https://doi.org/10.1016/j.jevs.2016.04.098

Lindroth, KM., Lindberg, JE., Johansen, A., Muller, CE. 2021. Feeding and Management of Horses with and without Free Faecal Liquid: A Case–Control Study. Animals 11(9):2552: https://doi.org/10.3390/ani11092552

Schoster, A., Weese, JS., Gerber, V., Graubner, CN. 2020. Dysbiosis is not present in horses with fecal water syndrome when compared to controls in spring and autumn. Journal of Veterinary Internal Medicine 34(4): 1614-1621. https://doi.org/10.1111/jvim.15778

Valle, E., Gandini, M., Bergero, D. 2013. Management of Chronic Diarrhea in an Adult Horse. Journal of Equine Veterinary Science 33(2): 130-135. https://doi.org/10.1016/j.jevs.2012.05.061