Re: Updated Case History, Suggestions Needed
I'm not confused. Insulin is not a stagnant number. It goes up and down in response to the glucose. Again, the "normal" used by the labs are too high for use in determining IR. Our numbers are based on the pony field study which I linked to before. You can search the archives for more information on that.
I am confused about is Opie's ACTH. You state that his levels (plural) have always been "well within the normal range", but I only see one ACTH in his CH. It says "24?" and it was over a year ago, in July 2013. Do you have any other ACTH's? Any during the seasonal rise? All horses have a natural rise in their ACTH during the seasonal rise, but PPID horse can have an exaggerated rise in their ACTH, causing a risk for fall laminitis.
The fact that Opie's crest "continues to flair up" and that he has laminitis (which actually started during the seasonal rise period) means that something is driving his insulin up, either his diet, or a high ACTH. If Opie is early PPID, which is suggested by the fact that he is doing better on the Prascend, after your 60 day trial period, we will be out of the seasonal rise period. That, in combination with the Prascend may make his ACTH when you recheck it, come back normal. Some early PPID horses only need pergolide during the seasonal rise. Please go back to my original post and reread the information in all the links I sent you. There's lots of information in those links that will help you to manage Opie. IR and PPID are progressive diseases and require constant adjustment in management. There's lots of information in our files and archived messages on the subject. Several of the volunteers, as well as other members, frequently post wrt making these adjustments.
As far as the multi vitamin supplement goes, I'm not sure why you feel like you need it. In addition to balanced minerals, horses on a hay only diet need Vit E, salt and ground flax seed to replace the Omega 3 and 6 FA's that are lost in the hay curing process. If your hay is older than a year, you may need Vit A. Horses make their own Vit C and B vitamins, so no need to supplement those, and like I said previously, there are B vitamins contained in that Smartpac mix that you need to avoid in an IR horse. Have you looked at California Trace or Arizona Copper Complete to help balance your hay? Though they won't "balance" your hay without testing it, they do contain more Cu and Zn than what you are using, which are usually the most lacking minerals in hay. Here's a link: http://www.californiatrace.com/ingredients.html and http://www.desertequinebalance.com/az-copper-complete Still, balancing your hay is the best way to feed Opie. Lots of members have found innovative ways to store hay that they purchase and store for their own horses. Scroll down in this folder to find the "hay-finding and storing" file: https://groups.yahoo.com/neo/groups/EquineCushings/files/8%20Pulling%20it%20Together/
Here's the link to your CH: https://groups.yahoo.com/neo/groups/echistory7/files/Kendra-Washington/ If you put it in your signature each time that you post, it really helps us to find it faster.
Maggie, Chancey and Spiral in VA
EC Primary Response