Roxanna,
I believe you said your hay was under 10% ESC+starch but some horses/ponies cant handle it (mine) so soaking will reduce the sugars even more. Feed 2% Blitzen's body weight, 1.5% if he needs to lose a couple of pounds and 2.5% if he needs to gain or its going to be freezing cold! You have the scales, use polynets and snaphooks, an 18 gallon storage container and a cinder block to weight the hay flake down. Or some people use a Coleman cooler. His insulin was that high on soaked hay? Was he grazing also? No grains, treats, red salt blocks, treats etc. Bed him on shavings - not straw. You should be able to feel his pulses subside from this. Can you detect a digital pulse? Are his feet hot? or warm? or cool? Does he have puffs above his eyes? Cresty neck? PD/PU?

Re; soaking the hay...how should I make the decision
to soak or not soak...should I decide to do it based
only upon his insulin level....since we know it is
soooo high, whether he looks better (physically) or
not??? Just do it anyway and is there a do it until???
with a sky high insulin level like his????? I did soak
his hay in September and November...anything to aid in
the laminitis attacks..but I was not consistent. I did
not feel Blitzen got any better until I cut his hay
portions down to 7.5lbs/day, and moved him to a warmer
place.

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I am not a foot/hoof guru but heartbars are not indicated for laminitis or founder now. He will be more comfortable in pads and boots. You can cut pads out of almost anything. Some use neoprene, or Walmart exercise snap together play mats for kids, Lowes has the adult version in gray, I use antifatigue mats from Lowes...3 foot long roll, buy one foot and you can cut lots of pads! Is his trim correct? Have a look at www.hoofrehab.com for pictures and details. You want good circulation. You do NOT want to restrict blood flow! Hand walking him is good if he's willing and able. Exercise, controlled exercise is a good way to get the healing process started.

OK, interested in the hoof information..before I moved
Blitzen to an inside barn, I bought easy boots and
pads...prior to that, I did use the blue construction
foam and duct tape..religiously...but he still walked
like Frankenstein. Help me with the heartbar thing..it
may have just been a timing issue for me..maybe I was
in the right direction with the boots...What are you
suggesting at this point..decrease
circulation/restrict blood flow..ummmmm..talk to me,
give me your thoughts.

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Since he's 14, I would test him for Cushings. This is an age when it starts to show....subtly. The ACTH test is a simple blood pull into a chilled purple top tube. Please read the Cornell files to learn the special handling. It must be chilled, spun and seperated within 1-3 hours of the draw. Insulin can be tested from the plasma drawn. You'll need 2mls of plasma for this test. You need to fill a red top for glucose, thyroid and any other tests you might want. Wed. is not good unless the lab you're using is close to you. Many of us use Cornell. We recommend pulling blood on Mon or Tue. We ship samples overnight air so when they receive them they process them immediately. The plasma must be frozen and shipped on ice. The others (serum) can be cold. You don't need cortisol. A thyroid panel is about $35 at Cornell. Their prices are listed. Since Blitzen is sore, do NOT do a Dex Suppression test. It could push him over the edge into founder. The ACTH tells you more anyway and its safe.

Blitzen is 14. When I pull blood..why early in the
weeK? It is scheduled for this Wednesday at 1:00. OK
on the quiet barn,,got that covered..OK on the food
and the timing of it. Here are my blood questions..
When I pull the blood, how many of the tests listed on
the case study can I test for...I know this is going
to sound temporarily insaine..but can 1 blood draw
test for the all the items on the case study list..can
you help me organize this thing better? You know I
have information on T4, I have Cortisol and glucose
and insulin..should I start all over again? I am a tad
bit confused...Can you break it down for me? Give me a
plan of attack for these blood tests? I can pull the
blood and give it to the vet.......I want to tell the
vet what I want to do...not leave it up to him to tell
me. I was not planing to do the DEX test on
Blitzen..not until I feel more comfortable about it
and whether I am risking him for another laminitis
attack???
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Oh boy, thanks for being there!!!!!!!

Glad to help!
Mandy and Asher in VA