Re: Weight loss


Kirsten Rasmussen
 

Hi Caitlin, I just want to add that your vet is not unusual and its rare to find one that is as current on dealing with EMS and PPID as this group.  You might find you can work just fine with each other, if she is open to trying new things or listening to you.

Here is a bit more info on lab normals (aka reference ranges):
https://ecir.groups.io/g/main/files/4%20Insulin%20Resistance/Dr.%20Kellon%20on%20lab%20reference%20ranges.pdf
My understanding is that lab reference ranges are good for determining normal healthy values in most blood tests, but not insulin because it is so easily influenced by the last meal (and other factors) and there is a wide degree of variation in a single horse in a single day, nevermind a population of horses.

You could share these papers with your vet showing that in a large population of ponies with the same living conditions, those with a history of pasture associated laminitis (PAL) have insulin higher than 12+/-1 uIU/ml at baseline.  This is well within the lab reference range, but these ponies are abnormal compared to ponies with no history of PAL.
ecir.groups.io/g/main/files/4%20Insulin%20Resistance/Insulin%20Resistance%20PONIES.pdf
https://pubmed.ncbi.nlm.nih.gov/16677122/

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Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
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