Re: Cornell panel back, should I treat?

Kerry Isherwood

Hi Lavinia,

Thank you so much for the reply.  I am writing out my CH now but here's some quick replies to your queries:

Before I found this group, I was resorting to what I called the "Starvation Diet" with my mare whenever her insulin spiked as a means to quickly get her numbers down.  Its just a term I gave it b/c she would drop a tremendous amt of weight within a few days, her neck crest would soften, and her insulin would usually fall into the 20s.  I know the drastic drop in metabolism isn't good but I didn't know what else to do.  My mare would be winning horse trials one weekend and lethargic, depressed, and stumbling badly the next, not even able to get through her dressage test, and I'd be too afraid to even *attempt* the jumping phases for fear of one of use getting hurt.  It wasn't making any sense.  Granted, I was having to feed her for energy's sake but what I used was (supposedly) analyzed and all low s/s (for energy I was feeding 10lbs/day Chaffhaye, plus 4lbs Alfa-Lox (Triple Crown) b/c we were travelling so much.  This was in addition to her usual 30lbs/day chopped grass hay, which I soaked for 12 hours--the grass hay was Lucerne Farm's new-ish 'Premium Hay' that I had analyzed twice and its NSC was abt 13%, so with 12 hours of soaking I think it was def under 10% NSC).  The mare did wonderfully on the soaked chopped hay + Chaffhaye + Alfa-Lox regimen for showing all spring & summer until about mid-August when we went to the Championships (a 6-hr drive).  We were stabled in temp stalls on a hayfield and despite pulling up what I could, my mare still spent every free minute digging up her bedding to eat the nubs of grass (She has been in a drylot w/run-in shed in my backyard for years, so her diet is strictly enforced; no grass, no treats from neighbors, etc).  The first day of Champs she was fantastic--a roaring maniac as usual.  Second day, she was so stiff & lethargic we could barely get around the 1-mile cross country course (she actually hit one jump, which she never, EVER does, and fell to her knees at another point).  It was so bad I had to withdraw from the rest of the show.  No doubt, the little bit of grass she dug up sent her insulin through the roof.  On Monday when we got home I drew blood first thing and her insulin was in the 60s.  So, as has been my protocol for the recent past, I stripped out the alfalfa products from her diet and just gave her the soaked grass hay (~30lbs/day).  That's what I'm referring to as the "Starvation Diet", the 30 lbs soaked hay and nothing else.  For a hardworking, very fit horse, it *felt* like starvation it my mind b/c she was requiring an add'l 14lbs/day of alfalfa-based legumes to supply enough energy!  And it had worked: her insulin would drop back into 20s and by day three she was back to her usual great supple self under saddle. 

Historically my mare ("Pinky") has not handled any fat supplementation well -- within a day or two she's stiff & lethargic, so no, I do not give ground flax.  I have not looked into the Vit E yet, but plan to.  She's on a multi-vit so I'm hesitant to add addition "stuff" without thorough research--though if I'm remembering correctly Vit E is water-soluble, so it should be safe(?)

Backing up a bit, since Aug with the disaster trip to Champs, Pinky hasn't been responding to my "Starvation Diet" -- her insulin has actually gotten worse (as high as 126) and she's consistently spilling glucose now, which had only happened occ in the past.  Historically this mare's threshold for feeling crappy is when her insulin gets into the 60s, so when I got the results in the 120s I was devastated and was out checking for digital pulses about 10 times a day.  However, she wasn't clinical (lethargic, depressed, stiff, stumbly) but I was so afraid to stress her I have stopped showing and even trailering out (I do still ride her out from my property though, so she is getting exercise).  When it became apparent the soaked hay-only diet was no longer working I ramped up my internet research and found the group and switched over to 20lbs/day TimBal cubes, a little extra beet pulp (4lbs/day dry wt, then soaked) to keep something in front of her, and 2oz/day iodized salt (vs. un-iodized which is what I had been feeding).  Even with the changeover she rather quickly gained weight, became PU/PD, and her insulin is still in the 60s (the Cornell panel).  At present she is not clinical, but as I said, I haven't been putting her into "stressful" situations of showing, trailering out, etc.  But that also means she hasn't been working as hard as she has its the chicken or the egg, is her insulin higher b/c she's not working, or is something elevating her insulin into her typical 'danger zone' and that's scaring me not to work her?  I truly feel its the latter b/c I know this mare so well & can feel within seconds of getting on her what her insulin levels are doing b/c it manifests so consistently in her performance (please note, mare has never outright foundered but will become tender on rocks and seeks out the grass edges when her insulin is up.  When insulin is normal, she will trot and canter right over very rocky uneven terrain w/o a care (barefoot), is its very easy to tell with her when she feels icky using her foot tenderness as a barometer).

I will post pics of her body & feet ASAP.  I did have her shod all around through the summer months so I could put caulks on for competing, but also did last year w/o problem, and we always pull shoes end of Nov after hunter pace season b/c she does so well barefoot.  This year b/c there have been so many problems I pulled them early and had planned to boot her (Easyboot Epics) for shows & paces but alas, we have had to put a moratorium on going out anywhere...

The Lyme reference is an interesting point, as last summer (Aug 2013) she suddenly felt awful and my vet and I started doxycycline while waiting for full bloodwork to come back.  She responded exceedingly well to the doxy so we are pretty sure she had a good brew of Lyme bugs causing havoc (we did not test beforehand, jsut started doxy on a hunch).  She already felt 90% back to normal when we got her insulin back a few days after which showed her to be IR.  So that's a very interesting coincidence:  once the 6 weeks of doxy finished I didn't give Lyme another thought, figuring all of these subsequent issues were IR related, b/c she always resonded to stripping her diet back down to soaked hay.  I will look into Cornell's Lyme multiplex--perhaps they can add the test on to the plasma sample they currently have for her ACTH sample.

Additionally tidbits:
--my trainer whom I've been with for over 8 years has been telling me Pinky isn't sweating correctly or enough, over the last couple years.  Im not sure I totally agree, but I keep it in mind.  Pinky always recovers well, and within mins of a cross country run--she just doesn't lather like a TB does (she's part draft).
--Pinky has not tested for positive for parasites via lab fecal egg count/O&P for many years, even though she has travelled extensively (exposure) over the years (although I never let her eat grass).  However, last month she was 3+ on egg count for strongyles.  I was very surprised!  I actually had to call my vet to ask what dewormer to use b/c its been so long since I've had to use one!
--Im pretty confident that her performance dips are not a training issue, as I work consistently with the same trainer year-round and she's the first to call/(scream) me out for my riding impeding Pinky's performance.  Overall we had a fantastic year with many wins and a great deal of improvement (until August, anyway) so I'm fairly certain training or injury is causing issues.  Pinky does get Legend IV every 28 days and is on oral Cosequin ASU but these are used prophylactically.  Mare has never been lame (when her performance falters it manifests as severe lethargy, stiffness, stumbling, depression, lower leg edema, etc but not overt orthopedic or soft tissue soreness; its more like a general whole-body malaise that screams "leave me alone".)

OK, hopefully that sheds some light into Pinky's history.  As soon as I can figure out how to post her CH I will. 

~Kerry, NY, Sept 14

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