Hello all, 

Longtime lurker, first time poster/uploader. I lost my 30 year old PPID gelding, Red, in January to a combination of distal sink in the LF complicated by severe ataxia. My attempts to upload a case history for him were frustrated by 2 computer crashes, but I did use the information available here to advocate for him and keep him as healthy and pain-free as possible until it just wasn't possible anymore and I am very grateful for that. 

I just uploaded a case history (at least, I think I did) for Artie, one of my school horses, and while I think I know what the blood work will show, he's presenting somewhat strangely for a classic metabolically-induced laminitis. I manage a 30 stall boarding facility and in addition to my own horse, I am directly responsible for the schoolie string of 8 horses. Artie is 22 and until 3 weeks ago was in steady light to moderate work 5 to 6 days a week. He was a very robust and healthy weight until I cut his grain after the COVID shutdown last year when he suddenly lost weight/condition. I adjusted his diet again, wormed him and had his teeth checked - they were normal. He regained some weight with a switch to senior feed and some condition when we were able to resume our lesson program but he hasn't ever completely recovered the muscle tone that he had in early 2020. He shows no other symptoms of PPID, and I was going to test his blood anyway in the winter, but he went lame 3 weeks ago. At first he only presented lame in the right front and we (me and the vet) suspected abscess, but he progressed very quickly to being very sore in both front feet and assuming the classic laminitic stance. I removed all grain from his diet and he is eating low-starch hay from a slow feed net while we wait for blood results. His LF radiographs normal, but his RF shows some mild rotation with a shadow at the tip of the coffin bone that could be a gas pocket. It also appears to be connected to an odd triangular shaped lucency in the toe area that we can't explain. He has no sensitivity to hoof testers, at all, and he's been squeezed on several times by both vet and farrier. 

Given this is a road I'm familiar with, I know that if his ACTH is high (and I'm sure it will be) getting him on meds and under control will be key to helping his comfort, but Artie is much thinner right now than I'd like and I'm not at all confident that he will be able to maintain a healthy weight on hay alone. He was extremely malnourished when we got him 10 years ago, but all it took to fix him then was deworming, a lot of good groceries and time. I feel like my feeding options have become extremely limited due to his suspected metabolic status and once we get him stabilized, I'm not sure where to go from there to get some weight back on him and would appreciate any suggestions. 

I also have some questions about hay testing - we feed primarily large squares of grass mix hay from a local farmer. We also keep a stash of first crop alfalfa in small squares and first and second crop orchard/red clover small squares from our own field to be used for travel, winter feeding in the paddocks and emergency stash in case the large bale delivery is late. I plan to test all the different small square crops but is it worth testing the large bales? I know they all come from the same farmer who is less than 3 miles away, but I have no idea what field they are all from and we get deliveries 2-3 times a week. 

Thanks very much in advance and I hope I did my upload correctly!

https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20Artie