Re: Understanding Bonnie's insulin results


Dear experts. I'm still confused by Bonnie's IR results and was wondering if somebody could confirm whether she is or is not IR.

Her lab results were as follows:-

Glucose 4.7 mmol/L
Insulin <2.0 mU/L (2.0 - 30.0)

The IR calculator results are as follows:-

G:I ratio = 2.35
RISQI = 0.71
MIRG = -4.30
IR Status = Normal, not IR

The reason I am confused is because the "G:I ratio" is less than 4.5 which, according to the calculator, means she is severely IR but the "IR Status" says she is "Normal, not IR". I'm so confused!!

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015




Re: low insulin test


Thank you Kerry.  Star's insulin blood draw for test was taken 5/15/15.  It was handled by Clinilab in Valparaiso IN.  Report date is 5/16/15.  Units are uIU/mL, CPS 260,443, equine range 10-30, result 6.18.  I feed Triple Crown Senior.  She does eat some hay.  She was put on Pegolide first but it affected her appetite a lot.  I've had 3 horses on pergolide or cypro and it has always lowered insulin, so I'm surprised you've never heard of them for IR.  My first one was in 2003.  His insulin was over 300 and he was too heavy at that time.  On cypro, his insulin came down to normal and he lost a lot of weight which made him a normal weight.

So I wonder if it's OK to give less than 100 mg a day.  I was thinking of every day and a half.

Thanks again,
Judy Beumer

Re: poor fat digestion and shiny manure

Eleanor Kellon, VMD

---In EquineCushings@..., <bmeyer@...> wrote :

Hi Dr. Kellon,
I'm so interested in your reply that ALCAR has no impact on fat metabolism. .........

I didn't say ALCar has no impact on fat metabolism. I said it doesn't mobilize fat or cause it to be excreted into the manure.  It doesn't do either of those things.
= = = = = = = = = =

Could it be different for horses than other animals and humans?  Or maybe the acetylated form acts differently then L-Carnitine?
I've used Acetyl-L-Carnitine for decades with Insulin Resistant clients and athletes in large part for its effects on fat metabolism, transporting fats into the cell to be burned for fuel. ..........

Neither ALCar nor L-carnitine transport fats into the cells.  L-carnitine is the carrier for long chain fatty acids derived from triglycerides to be carried into the mitochondria.
= = = = = = = = =

 It utilizes Pantothenic Acid (B5) as part of Acetyl-CoA which is why earlier I mentioned B5 and fat metaboof fat................

ALCar and L-carnitine have nothing to do with B5 either.  B5 is needed to synthesize Coenzyme-A but is not part of CoA and CoA synthesis has nothing to do with ALCar or L-carnitine.
= = = = = = = = =
This is  the process:

Fatty acids are cleaved from the glycerol backbone of triglycerides.  They are picked up by specific transporters on the cell surface and carried to the interior of the cell.  To be burned, they must cross the membrane of the mitochondria inside the cell.  For long chain fatty acids, this requires an L-carnitine as a carrier.  The fatty acid and L-carnitine combine to produce an acylcarnitine which can cross the mitochondrial membrane.

Once inside the mitochondria, the long chain fatty acid is serially broken down to acetyl groups.  The acetyl groups can combine with CoA to be burned for energy or bind to the free L-carnitine to produce acetyl-L-carnitine which is transported out of the mitochondria and back into the body of the cell.

One of the effects of acetyl-L-carnitine is to activate the AMPK enzyme complex which encourages the burning of glucose as a fuel.  This in turn increases the demand for glucose and the uptake of glucose by the cell, a favorable effect for IR.

Activation of AMP kinase enhances sensitivity of muscle glucose transport to insulin | Endocrinology and Metabolism


ALCar can also be converted to L-carnitine, further enabling entry of long chain fats into the mitochondria.  ALCar and L-carnitine are also known to have long term effects of encouraging increased production of mitochondria in the cells, which improves the capacity for fat burning and improves the efficiency of glucose burning.  In summary, processes for burning glucose and fat as fuel are enhanced, decreasing the accumulation of fat as weight gain.

Eleanor in PA
EC Co-owner
Feb 2001

Re: The IR blues...

Kerry Isherwood

Thanks everybody! Mercifully his pulses are much better tonight, almost normal. He's doing the same thing my mare did when on the Emergency diet--it appears the weight is dramatically & very rapidly melting off of him. He looks 50# lighter in only 24 hrs and his skin & body "feel" different when i groom him. Hard to explain. But makes me think the something in his diet was too high in the sense that now that the offender has been removed, he's experiencing a major metabolic shift of some kind. Something has triggered his body to rapidly transform itself. Maybe Im just crazy from lack of sleep....but to have two horses do this...idk, food for thought. But after some very needed sleep

Thx to everyone, as always,
Kerry in NY
Sept 2014

Re: The IR blues...


---In EquineCushings@..., <kerry.isherwood@...> wrote :

Crap.  I get one IR stabillized and the other falls apart.  I have no idea why, but now my 8yo gelding's insulin is 70uU/mL, the highest its ever been.  I just dont understand....

Kerry in NY
Sept 2014

Hi Kerry,
I know exactly how you feel... I focus on one, start to feel smug and the other one starts to slip...
Hang in there, you are doing great and you will get it under control.
Regardless of what's driving the high insulin, soaking hay for an hour in cold water would be the first thing I would do.  The ODBT cubes are under 10%, but may be too high for your boy, with whatever is going on at the moment.  You know his out of control symptoms, so you'll be able to tell when he starts feeling better, calmer and more like himself.
Great that you are venting your frustration on the grass.  If he can reach it at all and you've been getting the strange weather we have, it may be adding to his misery.  After you scalp it, you may find it helpful to treat it with the vinegar, salt and soap solution, known at my farm as  "Dawn vinaigrette" (1 gal vinegar, 1c salt and a squirt of dish soap).
Good luck and post what you figure out.  It really helps to learn from each other.
Best regards,

Paula with Cory (IR) and Onyx (IR) in Bucks County, PA, USA

EC 2014     NCRplus2011



Re: I have been away, ponys feet are a mess...

Lavinia Fiscaletti

Hi Julie,

So sorry to hear things have taken a slide back for Pony. So frustrating when those you trust to do the job just don't...for whatever reason.

Please post the new pix in her album when you get the chance and give a shout to let us know they are up.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team


Re: poor fat digestion and shiny manure

beverly meyer

Hi Dr. Kellon,
I'm so interested in your reply that ALCAR has no impact on fat metabolism. Thank you for responding.
Could it be different for horses than other animals and humans?  Or maybe the acetylated form acts differently then L-Carnitine?
I've used Acetyl-L-Carnitine for decades with Insulin Resistant clients and athletes in large part for its effects on fat metabolism, transporting fats into the cell to be burned for fuel.  It utilizes Pantothenic Acid (B5) as part of Acetyl-CoA which is why earlier I mentioned B5 and fat metabolism.
I'm excited to see if it will help Ginger's stubborn IR and fat pads. I think it will! Thank you so much for introducing me to these supplements.  You've saved my pony's life. I dragged up a few snippets here from my ALCAR files on fat and insulin.  I don't have much on ALCAR as a neurotransmitter.
Beverly 6/14     

Acetyl-l-Carnitine1 (ALC) is a special nutrient with a high level ability to positively influence brain health, stress tolerance, and metabolism – especially of fat. Unlike plain l-carnitine (an amino acid), acetyl-l-carnitine is fat soluble and highly active in nerves; it offers superior protection from stress and excitotoxic damage. 

ALC is highly synergistic with the nutrient pantethine, which makes CoA. CoA latches on to fatty acids and turns them into something that has the potential to be

Carnitine plays a critical role in energy production. It transports long-chain fatty acids into the mitochondria so they can be oxidized ("burned") to produce energy. It also transports the toxic compounds generated out of this cellular organelle to prevent their accumulation. Given these key functions, carnitine is concentrated in tissues like skeletal and cardiac muscle that utilize fatty acids as a dietary fuel [1-2].

Session 3: Carnitine, Fat Metabolism, and Obesity
Chair: Michael J. Quon, Chief, Diabetes Unit, Laboratory of Clinical Investigation, NCCAM, NIH, Bethesda, Maryland

Carnitine in Type 2 Diabetes
Geltrude Mingrone (PDF, 1.27 MB)
Istituto di Medicina Interna, Catholic University, Roma, Italy

Insulin resistance plays an important role in the pathogenesis of type 2 diabetes. One question is whether mitochondrial dysfunction might be a factor in the development of type 2 diabetes, and whether insulin resistance is associated with a defect in muscle fatty acid oxidation. Research shows that insulin resistance in skeletal muscle cells from children of patients with type 2 diabetes is associated with altered fatty acid metabolism, possibly because of an inherited defect in mitochondrial oxidative phosphorylation. Preliminary data suggest that supplementation with L-carnitine can improve insulin sensitivity in individuals with type 2 diabetes, as evidenced in part by its ability to decrease intramyocellular lipid levels.

Fat metabolism and weight loss 
Because of its vital role in fat metabolism, another obvious benefit of L-carnitine supplementation is in weight loss. Numerous animal and human studies have shown L-carnitine to promote muscle deposition instead of fat.

Re: Now: colick Trouble Jasper's Journal of Pulse & lameness last 10 days.

Lesley Fraser

Hi Corrine

What a great idea to get him a goat friend. I hope Jasper settling a bit takes at least some stress off your shoulders.

Fingers crossed he lies down some time soon…..

Lesley & Omar
UK, 2012

On 12 Jun 2015, at 15:24, sassafrass45@... [EquineCushings] <EquineCushings@...> wrote:


Thank you Dr kellon,i talked to my vet this morning he didn't reccomend dormosedan so wont use it not taking a chance. He has settled down this morning got him a goat yesterday, he's now decided he really likes the goat. Was for first time standing resting next to the goat while it was eating.

Calls for the mare yet but not as often,think he's figured out she's gone and not going to anwser. He's figured out to he's in pretty good pain,so not moving much. He's scores a 5 on the pain scale this morning.

Still haven't been able to change bandages on feet he can't pickup either foot long enough,waiting for him to lay down. He's been up for almost 2 days now so should be laying down here pretty soon.

Thank you everyone for the support and help.

Corrine & Jasper
MN 4/2014

This is ECHistory8, the current ECHistory Group to upload NEW case histories or move an existing case history to. This group is for ECIR Group members only. ...
View on
Preview by Yahoo

Re: Miniature on Prasend


If you can get your vet on board with using compounded pergolide, that is about the only way to get pergolide cheaper.   It's legal to dose in any amount, except 1mg, the amount in Prascend.  

I guess, you can get it a little bit cheaper through a few of the pharmacies, Thriving pets has 60ct Prascend for like $110 (two 30 cts @ $55 each).  Heartland Vet has Prascend at $130 for 60 ct.  Smartpak has it at: 60ct for $120. (there are other pharmacies, but these are on bookmark)     But, check with your vet, some charge a fee for outside prescriptions (my other vet did, so using an outside pharmacy on Prascend didn't work, but was still cheaper for the compounded).  


MT 9/04

Tori and Orion - hay analysis

Tori Cullins


I have been following and studying up the ECIR group for the past month+ and am just now getting tests back to seek help with. Orion's case file needs updating, and I still need to get current radiographs and hoof photos posted. In the meantime, all i have learned from the group has this pony back on his feet and making a great recovery. THANK YOU!!

Can i please get help with supplementing the Teff hay he will be transitioning to today? He has been on the emergency diet, with soaked Bermuda, waiting for the Teff results. The Teff was bought on Oahu, Hawaii, but came from Anderson Hay in Washington.

Teff analysis -

Tori Cullins (Orion)

Oahu, Hawaii - May 2015

Tori and Orion Case History

Re: Miniature on Prasend

Connie Martley

Thank you so much got the info. She is doing very well on prasend had her hooves trimmed he said some rotation in right front but not bad. Any great suggestions to find cheaper presend my vet said 160.00 for $60.00 days 
Mini on prasend
Connie June 1, 2015

Sent from my iPhone

On Jun 11, 2015, at 1:47 AM, janieclougher@... [EquineCushings] <EquineCushings@...> wrote:


"Wow that is great info so do you think we can back track from now prasend to Equinox?"


Hi, Connie - Nope,  Equioxx and Prascend are two totally different drugs.  The /Equioxx is a non-steroidal anti-inflammatory, firocoxib (same drug as in Previcox).  It is a newer pain reliever, similar to phenylbutazone (bute)  It is used to help relieve the pain of laminitis while people are figuring out the actual cause of the laminitis (ie Cushing's disease or insulin resistance or infectious disease)  Long term use of these anti-inflammatories has been linked to gastric ulcers, colonic ulcers, and kidney damage.

Prascend is the drug pergolide, and is used to control Cushing's disease. Getting control of Cushing's disease is often a very important step in allowing the laminitis to stop, along with correct diet and trim.  Once the horse or pony is diagnosed with Cushing's disease, it is important to keep them on Prascend for the rest of their days. So far, there have been no documented adverse side effects with long term use of Prascend (although there can be transient mood changes and appetite loss at the beginning of therapy, and a very few horses can have neurological signs at the beginning of therapy and have to be taken off the drug.  However, I believe that is in the order or 2 horses reported on this list, out of thousands on pergolide)

So.... Previcox = Equioxx = firocoxib = a non-steroidal pain reliever

Prascend = pergolide = the drug used to help control Cushing's disease.

Sorry for the confusion there!

Re: The IR blues...NOW: the complete picture

Nancy C

Hi Kerry

I should clarify, was not necessarily speakling just to you.  I think I know you know what ECIR conerns are about testing for PPID.  Wanted also to speak to folks who are mostly new to us or had not considered the variations in lab testing and the impact it may or may not have on PPID diagnosis.  Or IR diagnosis for that matter.

Besides sneaking the green or forbidden stuff and uncontrolled PPID, high insulin can be driven by lyme disease, iron overload and mare issues.  I know you know that. :-)

Nancy C in NH
ECIR Group Moderator
February 2003

Learn a lot more at the 2015 NO Laminitis! Conference, November 6-9, 2015, Georgetown TX.



Re: The IR blues...

Eleanor Kellon, VMD

SPEP = serum protein electrophoresis.  The lab that does your CBC and chem should be able to do it.

Eleanor in PA
EC Co-owner
Feb 2001

Re: Clippers for Cushings Coat

Donna Powell

Thank you.

From: "Dee Kenville ndeewoods@... [EquineCushings]"
To: EquineCushings@...
Sent: Friday, June 12, 2015 12:47 AM
Subject: [EquineCushings] Re: Clippers for Cushings Coat

Yes I do, but it is super easy and there are only a couple things to oil like that....:)
Dee from Santa Cruz, CA


Re: The IR blues...NOW: the complete picture

Kerry Isherwood

Hey Nancy,

Believe me, I do not want another PPID horse! I really dont think my gelding is truly PPID at 8 yrs old, but want to be thorough w the bloodwork work-up. He has no other PPID symptoms other than this new (possible) refractory hyperinsulinemia.

A reknown show hunter trainer I chatted with recently remarked that she has many of her horses on pergolide, especially her ponies. She puts them on it "whenever their insulin gets high". Holy crap! Who's prescribing this? Scary!

Anyway, i do appreciate your input. I think there was a slip in my gelding's routine and his IR flare is just that, a temporary flare. Unfortunately he's boarded, is in the front paddock along the road, and has the friendly 'please feed me' face that he uses without shame. He even ate my "No Treats" sign off the fence but luckily left the more serious "Im diabetic!" one in place (thought using bigger medical terms might help with compliance).

Ill post my CH, rads, body/hoof photos, bloodwork hay analysis etc later today.

Thx again,

I have been away, ponys feet are a mess...


Hello Groupies,

I have been away for a while, in the mean time my farrier has been doing ponys feet which were looking pretty good , 

I think she must have had another bout of sinking or something, but on with the request.

her feet are seriously a mess I think my guy who does great with the mark ups went back to his old ways of treating founder feet..

she is not lame but careful and short striding..her feet look deformed.

I would like some advise on a trim for her with some mark ups for farrier if anyone has the time...

will post pics of feet when told to do so 

Thanks so much...


in oregon


Re: The IR blues...NOW: the complete picture

Nancy C

Just a reminder for young diagnosed horses. The complete picture needs to be taken in to account: symptoms, how the horse was diagnosed, time of year, what test, and under what conditions. . Even which lab. Why we want you to understand the differences in recommended tests.

Sticking my neck out here but suspect that there are more than a few horses, hopefully not on this list, that are unnecessarily on pergolide because the whole picture was not looked at.

It's why we are so tough in asking for your updated case history.  We want to help you look at the whole picture, with all details in place, before you make a decision.

Nancy C in NH
ECIR Moderator 2003
FACT:  With over 12,000 members and thousands of detailed case histories the ECIR Group has made it possible to spot patterns, many of which have been confirmed later by formal study.  See  E. M. Kellon, VMD, The Internet as an Epidemiological Tool, 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.


Re: The IR blues...

Kerry Isherwood

Is SPEP aka Chemistry?

I have fresh serum in freezer to send out on Monday for iron et al at KSU. Ill also draw & send for

Lyme titers
Ehrlichia (?) my local vets idea
& the iron

Anything else?

Kerry in NY

Re: The IR blues...


LOL Yes that young.  I'll pick your jaw up from where mine fell when I first saw that too!

I've cleaned up your case history folders.  You now have one folder with two sub-folders for your two horses.  This was done to cut down on the need for having your hay analysis posted in two different folders.  This way any documents about the individual horses can go in their individual sub- folders and documents that apply to both can be in the Kerry Isherwood folder.  

Your link is 

- ​LeeAnne, Newmarket, Ontario

ECIR Archivist 03/2004


Are you in the Pergolide Dosage Database?

View the Database Stats 

Taken For Granite Art - Lightweight Cement Sculpture and Memorials 

Re: The IR blues...

Eleanor Kellon, VMD

Don't forget we're also in peak tick season.  Lyme is the most well known of tick borne infections but likely only the tip of the iceberg.  Infection of any sort will worsen IR.  Could check a CBC, maybe SPEP too, for any signs of infection.

Eleanor in PA
EC Co-owner
Feb 2001

91381 - 91400 of 282327