Q: My horse has recently been diagnosed with EOTRH and needs some teeth removed. What can I do to support him nutritionally through this process?

A: Dental health problems in horses can be stressful to manage, but working closely with your veterinarian for medical care and considering how to support your horse nutritionally is a great start. Equine odontoclastic tooth resorption and hypercementosis (EOTRH) is a progressive and painful dental condition that primarily affects the tooth roots and surrounding gingiva (gums) in older horses. While the exact cause of this condition remains unknown, multiple factors likely contribute to its development.  

The treatment for EOTRH depends on the stage of disease. For mild cases your veterinarian might recommend more frequent dental examinations, pain management medications, or dietary modifications. As the disease progresses, surgical removal of teeth (typically incisors) and affected tissues might be necessary.  

When a horse has dental issues, evaluate his diet to ensure he can comfortably consume his feed and water. Make sure his roughage requirements are met and that he doesn’t have extended fasting periods.  

Adequate Roughage Intake for EOTRH Horses 

Horses have evolved to consume a fibrous diet with small frequent meals throughout the day. The severity of EOTRH and the number of teeth removed will determine what the horse can comfortably consume.  

A horse’s diet should contain a minimum of 1.5% of his body weight in forage daily. Whenever possible keep a portion of the horse’s diet as long-stem fiber to promote gastrointestinal health.  

Even after the removal of some teeth, horses often return to eating hay. Most can use their lips to eat grass and can grind forages with the molars. When they horse is not able to comfortably consume and chew the long-stem fiber, you need to introduce processed fiber sources . This could be chopped hay, hay cubes, beet pulp, or a complete feed. 

Nutritional Management Before and After Equine Dental Surgery  

When you schedule your horse’s dental surgery, it can be beneficial to add a fiber source that will be easy for your horse to chew. Make feed changes slowly. If your horse currently consumes hay but will be on mashes during his surgical recovery period, add some of those mashes into his program before surgery. This ensures the mash choice is palatable for your horse and his gastrointestinal tract has time to adapt to the changes.  

For example, if a 500 kilogram (1,100 pound) horse consumes 2% of his body weight in hay daily (10 kg or 22 lb), gradually introducing 1-2 kg (2-4 lb) of soaked hay cube mashes before dental surgery can help him adjust. Your dental surgeon can provide more detailed recovery instructions.  

Managing Severe Cases of EOTRH 

In severe cases where the horse can no longer consume hay and pasture is unavailable, designing a safe nutrition program can be challenging. In these cases use a combination of chopped fiber sources and complete feeds, which should be soaked and fed at a rate of 1.5-2% of the horse’s body weight per day (e.g., 16-22 lb for a 1,100 lb horse). 

To maintain digestive health and prevent long fasting periods, divide the daily feed amount into four to six small meals spaced no more than four to five hours apart. Soaking the feed reduces the risk of choke and encourages water intake. Prepare soaked feeds just before feeding to prevent them sitting for long periods of time and potentially going bad or becoming less palatable.  

Other Key Considerations for Horses With EOTRH 

Beyond feed amount and frequency, consider water temperature for soaked feeds and your horse’s feed preferences. Very cold water can cause discomfort to animals with dental issues and, because most of these horses are seniors, keep in mind their nutritional needs and feed preferences could change as they age.   

Outside of nutritional management, know your horse’s normal body condition score and recheck it to make sure he isn’t losing condition. Recognize when something is wrong so you can promptly contact your veterinarian. 

Long-term management decisions for horses that have had EOTRH will depend on whether the horse can go back to eating long-stem fiber. When the disease progresses to a point in which the horse can’t consume hay or even chew chopped forages, you might need to switch him to a complete feed that can be fed in many small meals daily. Consult a qualified equine nutritionist if you have questions about optimizing your horse’s nutritional management through dental health challenges.  

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