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Something all horse owners need to be aware of if they are dealing with an underweight horse is that it is much, much more difficult to put weight on a horse than it is to take it off. And while feed is important, more may be required before an underweight horse is able to make a full recovery.
Severe malnutrition puts a strain on a horse's heart, kidneys, digestive system, and circulation and can result ultimately in death or the end of the usefulness of a once vibrant and healthy horse.

Because of the this potential damage to the digestive system and vital organs, high quality feed needs to be introduced gradually and carefully. Overloading them while they are weak is never a good idea. Imagine a weak heart or failing kidneys, suddenly assaulted with thousands of calories. Horses, just like humans, can withstand horrible malnutrition for years, only to die suddenly when attempting to digest the first healthy meal they've had in ages.
As if that isn't enough, malnourished horses often lose their appetite. There is nothing more heartbreaking and frustrating than trying to help a malnourished animal that just refuses to eat.
Good quality grass hay is usually a good place to start, with free choice water. The horse is at a high risk for colic, as his digestive tract has been abused and may not "kick in" instantaneously, so water is doubly important. However, if he hasn't had access to free choice water, once again, you must monitor him closely to make sure he doesn't founder on it right off the bat.
Almost as important as the feed is the care itself. Of course you must rule out obvious reasons for the initial weight loss. Bad teeth, abscesses, disease need to be ruled out. Many horses, however, are simply poor from poor care and poor quality or insufficient amounts of feed.
But once you have evaluated the horse and identified the reason for the malnutrition (although sometimes you will not be able to pin point it) and you've mapped out a nutrition strategy, it's time to address the other half of the equation, which is the whole horse.
I once had care of two elderly horses who were severely malnourished, to the point one of them was literally ready to drop dead at any moment. It took two years to put weight back on them, and untold quantities of supplements and high quality feed. But the thing they responded the most favorably to was a regular schedule which included gentle exercise and grooming.
I think it has to do with circulation and perhaps the calming effect, but there was no doubt it made a difference. When they were simply receiving increased high-quality feed, their recovery was slow and sporadic, and occasionally we would lose ground. As soon as they were in a situation where they received the feed AND a little extra hands-on care, they picked up immediately and never looked back. In fact, the mare is now 28 years old and enjoying her retirement in John Day, Oregon. The gelding went on to become a lesson horse for children.
What it comes down to is this: there are no easy fixes. What works perfectly for one animal may not work at all for another. Some may flourish using corn oil and sweet feed, while others may need grass feed and specialized supplements. But across the board, malnutrition is a serious condition that needs to be addressed with a well thought out and consistent plan that takes into consideration all aspects of the horse's health, and which requires commitment and dedication on the part of the humans involved in the recovery effort.

Learn more about this author, Allison Cox.
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