CASE STUDY: Gastroparesis

Tinne (pronounced “tiny”) is the first registered Arabo-Friesian mare born in the U.S.  She belongs to and is treasured by the Kafka family of Kafka Farms.  She started life tiny.  Her mother had to have emergency colic surgery in 2014 and she was born prematurely, weighing only 45 lbs at birth.  A foal this premature has no chance of surviving – but she did survive because of the efforts of a committed veterinarian team, the devotion and determination of her owner, and the sheer grit that is Tinne. 

Tiny premature Tinne, fighting for her life in 2014.

Not only did she survive, but this mare with such a difficult start in life became a talented athlete with an incredible diversity of skills.  In 2018 she won two World Championship titles in Intro Level Dressage under saddle, a third World Championship title in Training Level Driven Dressage, Reserve World Championships in Carriage Pleasure Driving Working and Timed Obstacles, and two third-place finishes in Ride and Drive and Dressage Suitability (

World Champion in 2018 in the loving and capable hands of Rachel Kafka.

But she did not. 

On September 25, 2023, her family messaged.

“Martha.  I need help with my mare in the clinic.  She is my heart.”

Tinne had been in the veterinary clinic for 6 days receiving supportive care because her stomach would not empty.  This condition is called gastroparesis.  Her last meal sat in her stomach fermenting.  Horses of Friesian heritage are believed to be more prone to gastroparesis than other breeds and Tinne’s mother had been euthanized for the same problem earlier in the year.  Euthanasia was discussed with her family to prevent gastric rupture – a catastrophic, agonizing, and life-ending event. 

Tinne in the hospital in September 2023 with unresolving gastroparesis; euthanasia had been advised.

“She is my heart.”

What can be done in this desperate situation?  Tinne’s history suggested that she had been struggling with gut motility issues as far back as Spring 2023 when she started to drop weight.  During the summer she developed an anaplasmosis infection and was treated with antibiotics.  After the antibiotics, instead of improving, she continued to decline until her clinic admission for what at first appeared to be impaction colic symptoms. 

The presumed vulnerability of Friesian horses to gastroparesis is believed to be the result of genetically-based abnormal collagen degradation processes that ultimately compromise the stomach’s ability to contract.  It is also thought to be the root cause of mega-esophagus and aortic rupture, other disorders more common among Friesians than other breeds (see and also

There is no way to intervene to fix collagen abnormalities, however. 

An alternative conceptualization of gastroparesis is that it is fundamentally a nervous system disorder.  Muscle contractions occur in response to nerve actions.  The stomach contracts in response to actions of the vagus nerve as well as higher brain centers (see ).  If nervous system inputs are inadequate, then a likely consequence is a stomach that does not contract.  This conceptualization leads to a potential intervention.

Supplements that stimulate nervous system regeneration and normalize nerve firing were overnighted.  Additional supplements that reduce gut inflammation and address a potentially leaky gut also were sent. 

The first doses were given on 9/27. 

On 9/28 Tinne’s stomach contracted.

On 9/29 she went home. 

Home from the hospital — finding her body again.
December 2023, out on turnout with her best friend. Tinne is in the green blanket.

“She is my heart.”

Tinne remains on her gut-supportive and neuro-protective protocol as well as on a carefully-managed feeding plan.  She is thriving and back to work.  She looks like a horse from a fairytale. 

Time to live happily ever after.

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Tinne — muscled up, thriving, and back in work.

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