Understanding and treating depression in horses

Introduction

While depression is widely recognised in humans, it is a condition which is often overlooked in animals. The symptoms and clinical signs of depression vary from species to species but recent studies have shown that humans and horses share some characteristic warning signs which are important to recognise.  

Horses are prey animals with a well-developed fight-or-flight response and their behaviours are controlled by the nervous and endocrine system.  Like all animals, behaviour is influenced by many external factors that include genetic predisposition, environment, physiology, experience and learning. Foals are neurologically mature at birth and soon after birth can identify and react to dangerous stimuli, but like humans, the horse’s brain function does decrease with age resulting in increase in anxieties and fears. 

The brain and its neurotransmitters play an instrumental role in the temperament and behaviour of the horse; therefore, abnormal levels of various hormones can lead to a change. Normal survival instincts for the horse fall into two broad categories that includes ‘something to fear and must flee’ and ‘something not to fear and should be explored or ignored’. New research has also demonstrated that there is not a linear dominance hierarchy but rather the herd communicates with positive reinforcement and less from punishment.

In order to achieve the best results when training, it is important to consider these natural behavioural instincts. Maintaining a positive mental attitude in both training and management regimes for the horse will have considerable benefits to performance and reduce negative behaviours. 

What is depression? 

Depressive disorder (also known as depression) is a mental disorder that can occur in horses.  It involves a depressed mood or loss of pleasure or interest in activities for long periods of time.  Depression affects how the horse thinks and behaves and may lead to a variety of potential physical problems.  

While depression is widely recognised in humans, it is an illness which is often overlooked in animals.  The symptoms and clinical signs of depression vary from species to species but recent studies show that humans and horses share some characteristics. With racehorse welfare being a key topic at present, understanding and recognising small behaviour changes can allow for small management adaptations to be made thus enhancing the horses wellbeing. 

The research 

Recent research from France alongside the growing body of research, suggests that horses may develop something similar to depression in a response to physical or social discomfort.   

Researchers have observed horses that become withdrawn because of undergoing a cognitive shift.  It has been found that horses tune out to their surroundings due to physical or psychological stress.  Horses have the cognitive ability to be attentive; however, with the presence of chronic stressors there is a delay in a horse's response as they have “switched off” from their environment and demonstrated sensory inattention. 

Because we do not truly know how the horse is feeling, the hypothesis currently being considered is that the horse develops an “inward-oriented attention” when subjected to chronic disorders.  It must be stressed that this long delay in attentiveness does not indicate a state of calm for the horse but a withdrawal from its surroundings. 

Dr Georgia Mason from The Ontario Veterinary College has suggested that a horse may respond similarly to humans with depression.  It is thought that the horse’s withdrawal can be a result of a ‘learned helplessness’ in that responding to negative stimuli does not make any difference.  Thus depressed people are prone, for example, to judge ambiguous stimuli as being unlikely to be positive and to recall unpleasant memories more readily than pleasant ones.

In addition, a number of studies have assessed cortisol levels in those horses that are withdrawn. Cortisol acts to assist in relieving stress by increasing glucose metabolism to provide energy, which then enables the horse to escape from the stress. In the short-term, cortisol release is beneficial to the horse to help it cope with a stressor. This study found that abnormally low levels of cortisol (hence a physiological depression) were found in withdrawn horses that are in a pathological and depressed state.  These depressed horses also expressed anhedonia, which is the loss of pleasure to feed on an appetent substance.  

Further studies and research are needed to better understand the pathology of depression in horses.  It has been suggested that the life conditions, such as food, space, social conditions and health problems should be questioned and observed in order to identify potential acute or chronic stressors that may lead to depression. 

However, there are reviews that question the current animal models of depression and suggest that ethological models of mood disorders based on animals living under natural conditions need to be improved and developed. 

Symptoms of a depressed horse 

It is important to become acquainted with potential signs of depression in the horse so that you can identify them quickly.  By identifying the symptoms of depression, one can rapidly begin the task of identifying the underlying cause such as an injury, illness, social or environmental stressor.  With these tools, one can reduce the risk of the short-term and long-term negative effects that could ultimately hinder the horse’s health and performance.  

Lack of response

In humans and animals, being attentive is one aspect of subject cognitive abilities and capacities. The delay in responding to stimulation shows that withdrawn horses ‘switch off’ from their environment and show sensory inattention. Such lapses of attention are likely to be associated with the chronic effect of stressors, which might be expected to induce a lowered state of arousal.

A French study from the Universite de Rennes, demonstrated that depressed horses that were subjected to a series of five new, unique and unusual sounds were significantly less likely to pay attention to the noises compared to normal horses.  Their findings demonstrated that the withdrawn horses had undergone a cognitive shift that they were so physically or psychologically stressed that they developed sensory inattention. 

Heightened anxiety 

While the depressed horse will often be disinterested in everyday activities, people and companions, they are likely to demonstrate heightened emotions towards challenging situations and new stimuli as they try to express their discomfort. Stimuli that are usually unremarkable to the horse may become uncomfortable for the horse and make them “spooky”, anxious or fearful when they weren’t before. 

Lack of interest in food 

A change in mental well-being in your horse can lead to a loss of appetite.  The potential complications are the loss of weight, condition, muscle development, fitness, energy levels as well as the increased susceptibility to infection and prone to other health conditions such as colic or gastric ulcers. 

There are other illnesses and ailments that can lead to inappetence; hence, it is worth seeking veterinary advice in order to rule out any other physical problems.  

Anhedonia

Dr Carole Fureix looked at anhedonia which is the loss of feeling pleasure from experiences that used to be pleasurable.  This symptom is prominent in the depression of humans. Her study demonstrated that horses who are at times withdrawn are more anhedonic than those that are not withdrawn.  She concluded that this is a key symptom of clinical depression and suggests that withdrawn horses are indeed in a depression-like state.  

The horse may show unwillingness to work or no longer take pleasure in work they used to enjoy. This is especially important when considering rider and horse safety too as a withdrawn horse may not react appropriately to potentially dangerous situations.

Posture

Standing facing the stall wall for periods of time while demonstrating a withdrawn posture showing a fixed gaze, neck stretched out level with back, eyes open but lack of eye and ear movement. This differs from a content horse that is resting and displaying relaxed muscles, laterally rotated ears, the drooping of its eyelids and lips and holding its neck such that it slopes lower and rounder.  

Physical changes are perhaps somewhat easier to spot with a withdrawn posture being one of the typical signs of depression.  A healthy and content horse will stand with their head up and ears moving inquisitively.

Causes of depression 

The domesticated horse is often managed in such a way that they cannot express their natural behavioural instincts, thus exposing them to stressors which can lead to depression.

Lack of adequate positive social interaction with other horses 

A study from Michael Steger and Todd Kashdan explained that dysfunctional social behaviour has been implicated in the experience of depression. 

In addition, Timothy Elmer and Christoph Stadtfeld described individuals with depressive symptoms are more likely to be isolated from their social group(s), which can further increase their symptoms.  

Similarly, lack of social interaction without conscious choice for extended periods of time can lead to depression in humans.

Lack of adequate exercise and/or turnout 

It is well documented in human medicine that exercise and physical activity can improve many health conditions. Research on depression, anxiety and exercise demonstrates that the mental health and physical benefits can help improve mood and lessen anxiety.  The link between depression, anxiety and exercise are not entirely clear.  It has also been shown that exercise and physical activity may help keep depression and anxiety from coming back. 

Companionship reduces stress in the horse, hence naturally  living in a herd.  Horses are able to form companionships with their own species and other animals including humans.  In fact, horses kept in isolation, such as in closed stables, can become anxious, flighty and difficult to manage. 

Exercise releases endorphins which are feel-good chemicals in the body and also allows for more social interaction.  A recent University of London study demonstrated that people with low aerobic and muscular fitness are nearly twice as likely to experience depression.  

Illness or injury that causes pain or discomfort 

In humans studies have found that anywhere between 30-85% of patients suffering from chronic pain are also clinically depressed. Other illnesses in humans such as nutritional deficiencies, cushing’s disease, lyme disease, chronic pain, and insulin resistance can cause depression.

Stress during training, competing or in the daily routine 

If there is chronic stress in which the horse’s physiological stress response is taxed beyond what it is designed to do it can begin to impair the horse possibly leading to depression 

Inflammation and depression 

There is evidence that there is a link between inflammation and depression. Inflammations that lead to serious depression in humans can be caused by infections such as those caused by bacteria, viruses or even parasites.  There is increasing evidence that inflammation can cause depression because of the increase of cytokines setting the horse’s brain into “sick mode”.   

Treating depression

Simple changes in management can help treat the underlying cause of depression and can substantially improve the horses well-being thus having a positive impact on performance.

Light therapy

Modern management methods mean that horses can spend a large amount of time stabled which impacts the horse’s circadian rhythm (body clock). 

A study was performed at Nottingham Trent University where trial horses were put under an hour of high intensity broad spectrum light every day for six weeks. Their behaviours regarding feeding, sleep patterns and attitude to being handled and ridden were compared to a group of horses that had not received the therapy. The untreated horses were noted to be sleeping longer, lazier at ridden exercise and grumpier.

Light therapies have many positive benefits that can reduce signs of depression and improve overall well being; better daytime alertness and improved rest and sleep pattern, extending summer coat and body condition and encouraging the body to convert feed to muscle mass, noticeably fewer stable vices such as box walking, cribbing, weaving and reduced bacterial pathogens and fungal load leading to improved respiratory function.

Management

Racing is already making moves to ensure the best welfare conditions for horses, with German trainers now having to comply with regulations regarding size of stable, the amount of light in the stable, the provision of windows enabling horses to socialise and turn out capacity for a minimum two hours per day.

Increasing turnout time is reported to have positive effects on their horses' mental wellbeing, reduces stiffness and lowers the rate of stable vices. It also allows the horse to make social connections whilst allowing them to show their natural instinctual behaviours. 

With horses in varying routines in large yards, this can sometimes become stressful to some individuals. By providing company of other horses when stabled, this can help with social interactions and reduce stress. Stable enrichment and adlib forage can also replicate positive behaviours in the stable. 

It is known that exercise releases ‘feel good’ endorphins, thus, keeping the horse in a regular training regime complimented with the correct nutrition will be beneficial. 

Veterinary advice

It is important to seek veterinary advice should the horse be exhibiting signs of depression to help identify the underlying cause. Diagnostics such as blood tests can ensure there is no infection present and work-ups will highlight any pain or discomfort.

Conclusion 

While depression is widely recognised in humans, it is an illness which is often overlooked in animals. Depression in horses can be significant and harmful regardless of the underlying cause and can be temporary or long term. It is vital to ascertain the underlying cause of depression in a horse in order to treat and remedy the illness. 

Nutrition and the new science of the "Gut-Brain connection"

Article by Scott Anderson

Trainers are always looking to gain an edge in performance. But what about their mental state? Are they jittery, distracted or disinterested? No matter how strong the horses, their heads must be in the game to succeed.

Surprisingly, much of that mental attitude is driven by gut health, which in turn depends on the collection of microbes that live there: the microbiota. In a horse, the microbiota is a tightly packed community of about 100 trillion microbes, composed of bacteria, archaea, fungi and protozoa. It colonises the entire GI tract but is largely concentrated in the hindgut, where it works to ferment the prebiotic fibre in forage. The microbial fermentation of fibre into fatty acids produces 70% of the animal’s energy requirements and without it, the horse couldn’t get sufficient energy from simple forage. Intriguingly, byproducts of that fermentation can affect the brain. 

It is easy to be sceptical about this gut-brain connection, but over the last decade, research has made it clear that gut microbes have an outsized influence on mood and behaviour. Microbes that improve mental state are called psychobiotics, and they may completely change the way you train and manage your horses. A horse’s health – and consequently its performance – starts in the gut.

Inflammation

When the microbiota is unbalanced by stress, diet or sickness, it is said to be dysbiotic. It loses diversity, and a handful of bacterial species compete for domination. Without the pushback of a diverse population, even beneficial bacteria can become pathogenic. Surprisingly, that can affect the brain. Multiple studies in various animal models have shown that transmitting faecal matter from one animal to another also transmits their mood. This demonstrates that a dysbiotic microbiota can reliably cause mental issues including anxiety and depression, thereby affecting performance. 

An important function of the microbiota is to fight off pathogens by outcompeting, starving or killing them. However, a dysbiotic microbiota is less diligent and may permit pathogens to damage the gut lining. A degraded gut lining can leak, allowing bacteria and toxins into the bloodstream. The heart then unwittingly pumps them to every organ in the body, including the brain. This makes the gut the primary source of infection in the body, which explains why 80% of the immune system is located around the intestines. Over time, a leaky gut can lead to chronic systemic inflammation, which weakens the blood-brain barrier and interferes with memory, cognition and mood. 

Inflammation is a major component of the gut-brain connection, but not the only one.

Neurotransmitters and hormones

Horses and humans use neurotransmitters to communicate between nerve cells. Brains and their attendant nerve bundles constitute a sophisticated network, which makes it somewhat alarming that microbes also produce neurotransmitters. Microbes use neurotransmitters to converse with each other, but also to converse with their host. The entire gut is enmeshed in nerve cells that are gathered up into the vagus nerve that travels to the brain. Microbial neurotransmitters including serotonin and dopamine thus allow certain microbes to communicate directly with the brain via the vagus nerve. We know this happens with specific bacteria, including Lactobacillus species, because when the vagus is severed, their psychobiotic effects disappear. 

As well as neurotransmitters, hormones are involved in gut-brain communications. The hypothalamus-pituitary-adrenal (HPA) axis controls the stress response in animals. The hypothalamus is located low in the brain and responds to stressors – such as a lurking predator – by producing hormones that stimulate the neighbouring pituitary, which then triggers the adrenal gland to produce cortisol, the stress hormone. Cortisol acts as a threat warning and causes the horse to ramp up glucose production, supplying the energy needed to escape a predator. This is the same hormonal circuit that trainers exploit for racing.

The HPA axis produces cortisol in response to stress. Cortisol inhibits the immune system, which in combination with a leaky gut allows pathogens to enter the bloodstream. Susequent systemic inflammation and vagal feedback lead to stereotypies.

The production of these hormones redirects energy to the heart, lungs and muscles at the expense of the immune system. From an evolutionary point of view, the tradeoff makes sense: first escape the predator and deal with infections later. After the danger has passed, cortisol causes the HPA to return to normal – the calm after the storm. 

However, continued stress disrupts that cycle, causing anxiety and diminishing the brain’s ability to store memories. This can dramatically interfere with training. Stress can also induce the release of norepinephrine, which promotes the growth of pathogenic bacteria including Campylobacter jejuni, Listeria, Helicobacter pylori, and Salmonella. Prolonged high cortisol levels can increase gut leakiness, potentially leading to infection and further compounding the situation. In the long term, continued stress leads to systemic inflammation, which is a precursor to problematic behaviours.

Short-chain fatty acids

When microbes consume proteins and fibre, they break them down into their constituent molecules, such as amino acids, fatty acids and sugars. These are the metabolites of the microbes. As well as neurotransmitters and hormones, the gut-brain conversation is mediated by metabolites like butyrate, an important short-chain fatty acid which plays multiple roles in the body. 

In the gut, butyrate serves as a preferred nutrient for the cell lining. It encourages the differentiation of stem cells to replenish gut cells that are routinely sloughed off or damaged. It plays an important role in the production of mucus – an essential part of gut protection – which coats the gut from mouth to anus. In the muscles, butyrate boosts the growth of skeletal muscle, crucial to athletic performance, as well as inducing the production of glucose, the primary muscle fuel. One-quarter of systemic glucose is driven by butyrate. In its gut-brain role, butyrate passes through the blood-brain barrier, where it nourishes and enhances the growth of new brain cells. 

These factors make butyrate a star player in the gut-brain connection. They also highlight the benefits of prebiotic fibre, especially when high-energy, low-fibre feeds are provided.

Starting a microbiota

We’ve explored the major pathways of the gut-brain connection: inflammation, neurotransmitters, hormones and fatty acids. Some of these pathways are at odds with each other. How does such a complicated system come together?

As mentioned, the microbiota is an animal’s first line of defence against pathogens, attacking and killing them often before the immune system is even aware of them. That means a healthy microbiota is an essential part of the immune system. However, the immune system is designed to attack foreign cells, which includes bacteria. For the microbiota to survive, the immune system must therefore learn to accept beneficial microbes. This lesson in tolerance needs to take place early in the foal’s development, or its immune system may forever fight its microbiota.

There are multiple ways nature ensures that foals get a good start on a microbiota that can peacefully coexist with the immune system. The first contribution to a protective microbiota comes from vaginal secretions that coat the foal during birth. After birth, microbes are included in the mare’s milk. These microbes are specially curated from the mare’s gut and transported to the milk glands by the lymphatic system. Mare’s milk also includes immune factors including immunoglobulins that help the foal to distinguish between microbial friends and foes. An additional way to enhance the microbiota is through coprophagia, the consumption of manure. Far from an aberration, foals eat their mother’s manure to buttress their microbiota. 

Microbes affect the growth and shape of neurons in various brain sites as the foal develops – a remarkable illustration of the importance of a healthy early gut microbiota. 

The cooperation between the immune system and the microbiota is inevitably complex. Certain commensal bacteria, including Clostridiales and Verrucomicrobia, may be able to pacify the immune system, thus inhibiting inflammation. This is a case where microbes manage the immune system, not the other way around. These convoluted immune-microbial interactions affect the mental state – and consequently the behaviour – of the horse, starting at birth.

Stereotypies

A 2020 study of 185 performance horses conducted by French researchers Léa Lansade and Núria Mach found that the microbiota, via the gut-brain connection, is more important to performance than genetics. They found that microbial differences contributed significantly to behavioural traits, both good and bad. A diversified and resilient microbiota can help horses better handle stressors including stalling, training, and trailering. A weakened or dysbiotic microbiota contributes to bad behaviours (stereotypies) and poor performance. 

The horses in this study were all carefully managed performance horses, yet the rates of stereotypies were surprisingly high. A kind of anxiety called hypervigilance was observed in three-quarters of the horses, and almost half displayed aggressive behaviour like kicking or biting. 

The study found that oral stereotypies like biting and cribbing were positively correlated with Acinetobacter and Solibacillus bacteria and negatively correlated with Cellulosilyticum and Terrisporobacter. Aggressive behaviour was positively correlated with Pseudomonas and negatively correlated with Anaeroplasma. 

Some of these behaviours can be corrected by certain Lactobacillus and Bacteroides species, making them psychobiotics. That these personality traits are correlated to gut microbes is truly remarkable. 

Intriguingly, the breed of a horse has very little impact on the makeup of its microbiota. Instead, the main contributor to the composition of the microbiota is diet. Feeding and supplements are thus key drivers of the horse’s mental state and performance. 

The gut-brain connection and training

How might the gut-brain connection affect your training practices? Here are some of the unexpected areas where the gut affects the brain and vice-versa:

High-energy feed. Horses evolved to subsist on low-energy, high-fibre forage and thus have the appropriate gut microbes to deal with it. A high-energy diet is absorbed quickly in the gut and can lead to a bloom in lactic acid-producing bacteria, which can negatively impact the colonic microbiota. High-energy feeds are designed to improve athletic output, but over time, too much grain can make a horse antisocial, anxious and easily spooked. This can damage performance—the very thing it is trying to enhance. Supplementary prebiotics may help to rebalance the microbiota on a high-starch regimen.

Changing feed regimens quickly. When you change feed, certain microbes will benefit, and others will suffer. If you do this too quickly, the microbiota can become unbalanced or dysbiotic. Slowly introducing new feeds helps to prevent overgrowth and allows a balanced collection of microbes to acclimate to a new regimen. 

Stress. Training, travelling and racing all contribute to stress in the horse. A balanced microbiota is resilient and can tolerate moderate amounts of stress. However, excessive stress can lead, via the HPA axis, to a leaky gut. Over time, it can result in systemic inflammation, stereotypies and poor performance.

Overuse of antibiotics. Antibiotics are lifesavers but are not without side effects. Oral antibiotics can kill beneficial gut microbes. This can lead to diarrhoea, adversely affecting performance. The effects of antibiotics on the microbiota can last for weeks and may contribute to depression and anxiety. 

Exercise and training. Exercise has a beneficial effect on the gut microbiota, up to a point. But too much exercise can promote gut permeability and inflammation, partly due to a lack of blood flow to the gut and consequent leakiness of the intestinal lining. Thus, overtraining can lead to depression and reduced performance.

Knowing how training affects the gut and how the gut affects the brain can improve outcomes. With a proper diet including sufficient prebiotic fibre to optimise microbiota health, a poor doer can be turned into a model athlete. 

References

Mach, Núria, Alice Ruet, Allison Clark, David Bars-Cortina, Yuliaxis Ramayo-Caldas, Elisa Crisci, Samuel Pennarun, et al. “Priming for Welfare: Gut Microbiota Is Associated with Equitation Conditions and Behavior in Horse Athletes.” Scientific Reports 10, no. 1 (May 20, 2020): 8311.

Bulmer, Louise S., Jo-Anne Murray, Neil M. Burns, Anna Garber, Francoise Wemelsfelder, Neil R. McEwan, and Peter M. Hastie. “High-Starch Diets Alter Equine Faecal Microbiota and Increase Behavioural Reactivity.” Scientific Reports 9, no. 1 (December 9, 2019): 18621. https://doi.org/10.1038/s41598-019-54039-8.

Lindenberg, F., L. Krych, W. Kot, J. Fielden, H. Frøkiær, G. van Galen, D. S. Nielsen, and A. K. Hansen. “Development of the Equine Gut Microbiota.” Scientific Reports 9, no. 1 (October 8, 2019): 14427.

Lindenberg, F., L. Krych, J. Fielden, W. Kot, H. Frøkiær, G. van Galen, D. S. Nielsen, and A. K. Hansen. “Expression of Immune Regulatory Genes Correlate with the Abundance of Specific Clostridiales and Verrucomicrobia Species in the Equine Ileum and Cecum.” Scientific Reports 9, no. 1 (September 3, 2019): 12674. 

Daniels, S. P., J. Leng, J. R. Swann, and C. J. Proudman. “Bugs and Drugs: A Systems Biology Approach to Characterising the Effect of Moxidectin on the Horse’s Faecal Microbiome.” Animal Microbiome 2, no. 1 (October 14, 2020): 38.