Re: Just learned my mare is IR/cushinoid


Hi Tracy,

Welcome to the group!  You will find a wealth of information and support here about how to take care of your mare.  Sorry to hear that you're having trouble accessing that file.  Try this:  That's the "start here" file, and will give you a good solid amount of information.  Also, our website contains a great deal of information and is a great place to send your vet if he/she needs some updated information about Cushing's (PPID) and IR.  Here's the link:  So, you've lots and lots to read!!  Prepare yourself for a whole different way of horsekeeping to maintain your PPID/IR mare in optimal health!  To help you the best, we need to get a some more details about your mare.  Here's a link to join ECH8, our sister site where we store the case histories.  If you would fill out a CH and let us know when you've got it done, that would be great!  It's just a storage site, keep conversation on this main list.

Our philosophy is called DDT/E, which stands for Diagnosis, Diet, Trim and Exercise.  All 4 aspects must be in place to see optimal results.  You have a diagnosis of both PPID and IR.  This is a common time of year for PPID horses to have symptoms due to the "seasonal rise", a period of time when all horses have a natural rise in their ACTH, but PPID horses have an exaggerated and often prolonged rise in theirs. You can read more about the seasonal rise on our website.  It's great to hear that your mare is not having any symptoms other than the puffy eyes.  Have you started her on pergolide yet?  This is the medicine that treats PPID.  We recommend that you wean her onto it slowly, starting with 0.25mg for 3 or 4 days and increasing it by 0.25mg every 3 or 4 days until you reach your target dose.  This helps to avoid the "pergolide veil", (depression, lack of appetite) that some, but not all horses have when starting on the medicine. 

Another great thing that helps with the pergolide veil is a product called APF.  It's an a adaptogen and is available at many local and online tack/feed stores now, and also on their website:  Once at your target dose for 2 weeks, we recommend retesting to make sure your ACTH has come into the optimal range.  PPID is a progressive disease and the ACTH is not a stagnant number.  The goal is to keep it in the middle of the normal range.  Here is a great post by Patti that can help you by using the subtle symptoms to determine if you are at your target dose:  When you retest, recommend you add a leptin to your ACTH, insulin, and glucose.  Those are the 4 tests we recommend for a complete diagnosis.  The leptin helps to determine if you mare is IR at baseline, or if the elevated ACTH is driving the insulin level up.  It would be no surprise if she is IR at baseline since Arabians are one of the breeds in which IR is commonly found.

Since your mare is also IR, her new Diet will be supremely important as well.  The diet that an IR horse needs is low sugar/starch hay, tested to be under 10% sugar+starch, and low fat (under 4%) with minerals added to balance the excesses and deficiencies in the hay.  She will also need salt added and to replace the fragile ingredients lost in hay curing, she needs Vitamin E, and ground flax seed.  The proper amounts of all these ingredients can be found on our website, under "diet."  Just as important, if not more, is what you don't feed her anymore!  No pasture, no high sugar treats, including apples and carrots.  No red/brown salt blocks.  You are going to want to start the "emergency diet" now.  You'll be feeding her 1.5 to 2% of her BW in hay.  If you haven't had your hay tested, you need to soak her hay for 60 minutes in cold water or 30 minutes in hot water to remove up to ~30% of the sugar content.  Add the other ingredients in the emergency diet (salt, Vit E, ground flax seed, magnesium) in weight appropriate amounts.  The details can be found here:  Hopefully, once you get your hay tested, you will able to stop soaking her hay.  Our goal is always to find low sugar starch hay so we can stop soaking!  We have lots of other members in Maine, so maybe someone can hook you up with a good source of low sugar/starch hay!

Ok, the Trim.  Your mare has not had laminitis, and that's great!  The trim must still be optimal!  Toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures.  If you'd like, you are welcome to post pictures of your horses feet in the PHOTOS section of ECH8 so one of our hoof gurus can take a look and see if you have the most optimal trim in place.  Here's a site that shows how to take great hoof photos:

And last but definitely not least, Exercise!  The best IR buster there is!  But a laminitic horse should never be forced to move!  You are so lucky to have a diagnosis and are able to begin treatment before your mare had to experience the pain of laminitis!  Many, many horse owners find us when they are already in that desperate situation.  The best way to avoid that is to get all four aspects of our philosophy in place asap!  I've given you a lot of information and resources, not in attempt to overwhelm you :), but so that you can get the knowledge that you need to take the best care of your mare!  You should peruse our files and website, but if you have any questions, just ask!  We are here to help you help your horse!  Thanks for signing your name and general location. We ask everyone to also add their date of joining and also, once you get it done, a link to your CH, so your signature will eventually look similar to mine below.

Maggie, Chancey and Spiral in VA
March 2011
EC Primary Response



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