How to analyze diet for Cushings/IR/laminitic pony

Katherine Frazier

Hi.  I'm brand new to the group.  I'm Katherine.

We have a 23 year old home bred pony who is at what seems a perfect weight, no external signs of any metabolic issues, but has Cushings (controlled with Prascend), is IR (not controlled even with very low NSC diet and my best stab at vitamin/mineral supplementation and Metformin even though his IR isn't being caused by a high NSC diet), and who is having repeated laminitic episodes.  We have a veterinarian who is also a farrier, so he's getting good balancing X-ray guided trims and glue ons to keep mechanics right as we continue to rebalance via trims.  His hoof growth is very slow.  We may soon go barefoot and  turn his paddock into a big sandbox.  We are in Ocala, FL.  

The missing link is any help in identifying the right supplement and vitamin/mineral balance he needs.  We've written for a consult hopefully involving our vet directly, and get no response.  Though I'm a retired college professor with some math and statistics background, I am having a lot of trouble even fully understanding how to read his feed labels to be able to totally describe (in terms of grams, mg etc.) what his current diet contains.  I have aimed at very low NSC.  And if I don't know how to quantify what he is eating already, and don't know how to target the balance and volume of supplements, how do I know which supplements to buy  to balance him? 

He is a 13'2" Welsh/Arab cross gelding.  Because of poor quality coastal hay (and I'm worried more about the higher risk of good old Coastal Colic than the nutrition content)  being what is grown close to us, and because the high heat and humidity make the testing/soaking hay route ill advised (and he's picky--he hates soaked hay), his entire diet is standardized.

He gets soaked plain beet pulp shreds--about 2 cups per day BEFORE soaking.  We use the pony dose of Seminole Equalizer concentrate since beet pulp is not fortified.  Equalizer has a NSC of 5%.  Plain beet pulp is hard to find hard numbers on, but should be consistently well below 10%.  He also gets powdered coconut oil (from the Cool Stance people), and a sacromyces probiotic supplement fed at 50 billion live organisms per day in two feedings, a horse dose of Remission (a supplement with a good bit of magnesium and then other minerals specifically designed for metabolic horses.  He also gets magnesium aspartate hydrochloride 30 ml 2x (made by a German company and it comes as a pump oil suspension).  For his main forage, he gets approximately 8-10 lbs/day of Triple Crown Safe Starch.  The NSC on that is under 10%.  So, his entire diet is standardized and TC Safe Starch and Equalizer are fortified.  I am concerned he may be getting too much iron in his diet since it's in both the Safe Starch forage and in the Equalizer, and to some extent naturally occurs in the beet pulp, and I understand iron can block receptors for some other minerals.  

He is recovering from his third laminate episode in a year.  Based on X-rays and venograms he doesn't appear to have suffered a lot of structural damage to his hoofs.  But, we need to address his metabolic issues intelligently.  It has been recommended we add Jiaogulan (J herb) to his diet for help with inflammation, and as a vasodilator, but we're not sure how much, and what form.  In human supplements, it takes a lot of research to understand exactly what form, strength, variety of the base part of the supplement you're giving, and I find no information about any of that, even from web sites which sell Jiaogulan or supplements which include Jiaogulan. 

He's been on antiinflammatories for too long.  Alternating bute (with Gastroguard) and Prevacox.  I really need to get him on a proper anti-inflammatory diet/supplement routine and drop the Metformin if it's not helping (and it logically shouldn't be since his high IR--not awful but last time it was 80 fasting --is on a low NSC diet--and we don't know if the higher than desired insulin is the product of underlying inflammation).  We even give him the Metformin an hour before meals and away from the beet pulp meal so it doesn't impair absorption.  Same for the magnesium oil.  ''

I feel like I've learned a lot about some of the main moving parts in this puzzle, but need guidance.  Everything he eats has a label with all ingredients and levels of everything including vitamins and minerals, fat, protein, NSC (either on the label or calculated by me or offered by company nutritionists).  The missing link is understanding what this diet contains in terms of vitamins and minerals, and if we need to reorganize his diet to remove something he's getting too much of, or keep our base and supplement specifically.  

I'd appreciate any help anyone could offer, particularly Dr. Kellon.  This pony is the brightest, dearest little soul and deserves the best care and state of the art diet known. His mother lived to 36 and had such a happy, healthy life until a tumor got her.  (He can be picky about what he'll eat mixed in his food but puts up with us giving him oral doses with syringes for the watered Metformin and the magnesium oil).  

Thank you all in advance for any help, guidance, articles you could point me to--anything.  I may find answers as I mine the links to articles available here, but am highly motivated to cut to the chase if someone here can help me put it together quickly.


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