Cory's tests results are back from April 15th blood work, using new vet.  She came highly recommended and when I told her Cory was IR at age 5, she was very concerned and thought we should really carefully check his ACTH in case it was driving the IR.  At least she thought there was a problem!

When she came out she wondered if the previous clinic, who pulled blood for me three times prior (Aug 2013, Sep 2013 and Jan 2014), did not handle the samples correctly.  I mentioned that degraded samples usually give falsely low numbers, not high numbers.  All work except glucose was done at Cornell.

She finally texted me the results today and said all numbers were normal, except Leptin, but given his normal insulin levels, this was not significant.

Below is a summary of his glucose, insulin and leptin numbers (updated CH also available, see link below).  

The vet appears to think he is normal.  Plugging the numbers, he is G:I = 3 (severely IR), but his IR status is compensated IR, laminitis risk.  I have not discussed this any further with her yet but it will be interesting to hear what else she says.  

I would love for him not to be severely IR, but considering that he was most likely IR as a skinny 2 YO when I bought him, I am happy that we may have achieved compensated IR status!  I am so grateful to have the information and advice provided by this group.  Otherwise, I might once again take the vet's advice and put this poor boy out to eat grass to his death!  Cory's appearance and behavior are consistent with him doing much better than in January when he was getting only 10.3% s/s hay and no grass.  Current hay is a record low of 5.1% s/s fed very slowly with our new hay pillows.  I don't know if he can tolerate a hay higher than that but at the moment I have no need to ask that question.  The individual results thrilled me but the G:I brought be quickly back to earth.  It means no mistakes permitted!  

It looks like we have diagnosis and diet pillars strong but I am still worried about the trim.  Trimmer will be here on Friday, so after that I will take a good set of photos for feedback.  She seems frustrated with his tendency to break over the outside of his right foot instead of the front.  I keep wondering if the laminitic wedge or whatever you call it puts pressure on the front and he is avoiding it.  She has started suggesting I need a vet/chiro/accup to work on him because the problem is from his body and not his feet.  I have a chiro that does work on Cory once a month and Cory's shoulder was out, but I am still thinking it is his feet.  She thinks my current chiro is not getting the job done.

Question:  How soon do I need x-rays?  The last ones were January 8th. The new vet is not on board, thinks his feet are too small as it is, and now seems to think he is not IR anyway, so not much help there.  His feet do look better, I think, but the exercise part of the program is limited by my concern for his feet.  He walks down the drive for turnout (turned out with a taped muzzle and only for 45 minutes to avoid his pasture mate helping him get the muzzle off) and I hand walk him for 20' about 5 days a week.  We have been increasing the hand walking over the last couple of weeks, but he can be a little challenging to hand walk even after turnout.  He does occasionally trot and canter during turn out and seems comfortable with no obvious negative consequences as far as I can tell.  He has not been on pain medications in months and he is no stoic, so it would seem he is fairly comfortable.  He has gotten sore after some of the trims.  He eats boots, literally, so that is not a great option for him.  

I have studied the mark ups but do not understand enough to try to trim him myself at this point.

Any feedback or suggestions on how to proceed from here?

Thanks to everyone, Dr. Kellon, volunteers, members who share their questions, stories, losses, successes and failures.  I have learned so much and you have helped Cory so much!  I am inspired and infinitely grateful!

Paula  (Cory IR and Onyx no ECIR) in Bucks County, PA, USA

EC 2014     NCRplus2011         

https://groups.yahoo.com/neo/groups/echistory8/files/Paula_Cory/

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/275503778