Date   

Re: Esc + starch vs NSC

Lorna Cane
 



>>EquiAnalytical still tests for WSC. Why is it that we are not supposed to be concerned about water soluble carbohydrates anymore?

Here is part of a discussion, in a post from Kathleen (Dr. Gustafson):

"NSC (nonstructural carbohydrate) is the sum of WSC + starch. 

WSC is the sum of ESC + fructan (somewhat oversimplified).


When dealing with insulin resistance, the concern is, "What carbohydrate 

fractions stimulate a glycemic response (an increase in glucose and 

insulin)?" The answer is simple sugar (ESC) and starch - these 

carbohydrates aredigested primarily to glucose (simple sugars) and entirely 

to glucose (starch). 


We don't have the same concern about fructan because mammals cannot 

digest fructan."


If you type WSC into the Search box,you will see a lot more messages about this.

Please,we need you to sign your messages with name,location ,and date of joining group.







Re: Esc + starch vs NSC

Angela Dailey
 

EquiAnalytical still tests for WSC. Why is it that we are not supposed to be concerned about water soluble carbohydrates anymore?


Re: New Leptin test over the moon!

Sharon Manning
 

I had ask about increasing his Mg a while back in another string concerning my high Ca hay (full of red clover), which if I got a answer I missed it. So, Second guessing myself I ask one of the Balancers off list to look at this hay. She didn’t think adding Mg was needed. And again mentioned his deterioration in a string about his large swollen sheath, wondering if there would be any comments on something I should do or stop doing. (other than excerise)  This last blood work is this string. Yes I know what the ratios are in the hay, I have always had my hay tested sense 2008. I have been trying to get to the bottom of this and tighten things up..somewhere.
Some improvements by visuals only. (sheath swelling and ademia is better) But his sheath is still very large and full of hard lumps/knots.
He has never had any foot issues, so it is not a improvement, per say. I just worry about that happening and want to prevent it.
I was talking about his attitude being fine….acting like he feels fine…even tho it is clear by his blood work he is not.
So is my attitude adjustment should simply be, don’t worry about the numbers as long as he feels fine and feet are fine? That would be a tremendous relief!!!! There certainly are others things that need to be done with the money that I spent/spend on blood work. 
I have added Mg as of yesterday after Dr. K’s post. Lets see if that helps down the road.
thanks
Sharon
Cushing/IR 05
NRC+11/08
NAT 2/09
CIR12/09
DEW 08/10
COH 04/11
BRR 2015
AAL 2015




Re: Intro of new member

Maggie
 

Hi Teah,

We do know that the information can be a little overwhelming!  Just take it all in one bite at a time.  You've made some good progress with Kellie already, so good for you!  And I promise, it does get easier!  Do take the time to get her CH up!  A carefully done CH fills in all the gaps for us when we are answering your questions.

Yes, some minis are very prone to being IR and laminitis/foundering.  It would be a excellent proactive step to treat your mini as though s/he is IR.  It's great that Kellie will have a friend in her dry lot!  Unless you test her, and know for sure that she is not IR, I would assume that she is IR and not be allowing Kellie to graze, even with a muzzle.  Always better safe than sorry.

There are very few bagged feeds that are appropriate for IR horses.  Even the ones that claim to be low sugar/starch are usually too high in sugar and/or starch (over 10% combined), too high in fat, too high in iron, too high in omega 6's and too low in omega 3's.....you get the idea.  The ODTB's are safe.  Nuzu Stabul 1, available at Tractor Supply stores is safe.  Rinsed/soaked/rinsed beet pulp is safe.  There are a few others, given in small amounts as a carrier for supplements or as a taste tempter that are safe, but very few.  Start reading the guaranteed analysis and the list of ingredients on feed labels and you will soon be able to evaluate the safety for yourself!  Over the years, we've had a lot of different feeds sent in for analysis.  Look in this file for a list:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Analyses%20of%20Various%20Feeds/ 

Let me give you a quick demo on how to examine a feed.  I think maybe you are referring to Blue Seal's Carb-Guard as the other feed for metabolic horses?  Scroll down in that list above to find the analysis on it.  It has 8% minimum fat.  We recommend 4% fat (or less) because that's about the same fat content of grass.  So for one, it's too high in fat.  We know that high fat feeding can actually induce IR, so best to stick with the 4% or under!  At least part of the fat content is vegetable oil--upside down Omega 3:6 ratio.  It also contains added Riboflavin and Niacin which we want to avoid in IR horses (check the list I sent you earlier for "things to avoid").  It doesn't list the iron content in the guaranteed analysis part, but it does list Ferrous Sulfate as an ingredient.  That's iron, which we want to avoid since IR horses tend to also be iron overloaded.  They get plenty in their diet (dirt) so we want to avoid any added iron in their food!  More information about iron overload here: https://groups.yahoo.com/neo/groups/EquineCushings/files/Iron%2C%20Iron%20Testing%2C%20Iron%20Overload/  

Long story, short, your $ is best spent on analyzing your hay and mineral balancing your diet.  When you are ready to do that, here is a list of people that can help you with mineral balancing (first file in this folder): https://groups.yahoo.com/neo/groups/EquineCushings/files/7%20Help%20with%20Mineral%20Balancing/  Here's one place that you can send a hay sample for analysis:  http://equi-analytical.com/  Call them and ask them for some "Forage kits"  They are free, and include postage for sending your hay sample in.  You want the #603, trainer's package when you send your hay sample in.

The red/brown salt blocks contain iron, and sometimes molasses (which you already know we want to avoid!) and they also contain unknown mineral amounts, which would interfere with mineral balancing Kellie's diet.

OK, I am giving you more information and I know you feel overwhelmed already!  Sorry!  Just take your time and read all the information I've given you.  Read the files and the website too.  Hang in there!  It will get easier!  Oh, and I looked at the photo you posted.  It's pretty tiny, so hard to tell much.  And one more thing--please take a minute to delete all or most of the previous message when you are responding.  It keeps the repeat information from piling up in the archived messages and makes the messages easier to search and read.  Thanks!

Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response
https://groups.yahoo.com/neo/groups/ECHistory4/files/maggie%20in%20virginia/ 




Re: Intro of new member

Teah <teahcrew@...>
 

Oh darn I forgot to sign off the right way !!!


Teah & Kellie dec 2015. NE Ohio

I posted a photo of her in the photo section


Re: Intro of new member

Teah <teahcrew@...>
 

Oh my goodness!!! I feel like my head is going to explode!!! All this information!! 
I will try my best to get her case story up as soon as possible. 
Thanks for the info on the tests. I will talk to my vet. I wanted clarification. 

I put an end to apples and carrots too. 

I got her one of those black nylon woven muzzles. I do not like it!! But she is most often in a dry lot. 

Kellie has natural hooves. No shoes. Gorgeous ones too!!! I will get photos. 

I am getting people to help me exercise her. I am disabled and get winded easily. I can't imagine life w/o a horse. 

I have a mini too and as precaution I have applied the same diet to him. Minis founder so easily!!!

I wondered about her feed. Blue seal has another one that is meant for metabolic horses. I couldn't find it at the time. I will pursue that again. I did find flax seed and vitamin E info and added it. I use loose salt but was using the mineral salt (red) why is that bad?

Please bear w me as I learn. This mare means the world to me!!!


Sent from my iPhone

On Dec 26, 2015, at 9:16 PM, spiral1957@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Teah,

Welcome to the group!  Glad that you found us, as we have lots of seasoned "Cushing's managers" here!  To get the best advice and answers to your questions, we need you to fill out a case history on Kellie.  It gives us all the details we need to give you the very best advice!  To fill out a case history, you will need to join one of our sister sites called ECHistory8.  It's a filing cabinet for storing case histories.  Here's a link to that group:  https://groups.yahoo.com/neo/groups/echistory8/info  It won't take long to get approved and then just follow the instructions for filling out a CH.  Meanwhile, I will explain our philosophy called DDT/E, which stands for Diagnosis, Diet, Trim and Exercise, and try to answer your questions.  

Diagnosis:  So you have a diagnosis of Cushings (PPID), but you did not test for IR, is that correct?  I'm guessing the "2 day test" was the DST (dexamethasone suppression test).  Though considered the "gold standard" test for diagnosing PPID, we do not recommend the DST as it does carry a risk of precipitating or exacerbating laminitis.  I'm glad you didn't have that problem!  Kellie is on the young side to have a diagnosis of Cushing's, which is not normally seen in horses under the age of 10, but we do have other horses in this group with an early diagnosis as well.  Since a horse can have just PPID, just IR, or both (or neither) we recommend the following 4 lab tests to get a complete Diagnosis:  ACTH, insulin, glucose and leptin.  They should be drawn on a NON-fasting horse, and be sent to Cornell, preferably.  The ACTH is to diagnose the PPID and the insulin and glucose for diagnosing IR.  The leptin helps to differentiate if the horse is IR at baseline or if an elevated insulin is being driven by a high ACTH.  Leptin is the hormone that says "stop eating", and is usually elevated in IR horses.  More information about leptin resistance in the first file in this folder:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Insulin%20Resistance/ 

So once you get a full diagnosis of IR and/or PPID you then know how to move forward with the appropriate treatment.  PPID is an enlargement or benign tumor in a part of the pituitary gland called the pars intermedia, and as you know, is treated with pergolide.  We do recommend that you retest the ACTH 3 weeks after you have her on a "target dose" which is often 1 mg to start.  As Kellie ages and PPID progresses, the pergolide dose will need to be increased, especially during the seasonal rise.  The goal is keep the ACTH in the middle of the normal range, which is 9-35 at Cornell, so low to mid 20's.  You can read more about the seasonal rise on our website here:  http://ecirhorse.org/index.php/cushing-s-disease/seasonal-rise  If you haven't visited our website yet, you should take the time to explore the entire site!  There is so much great information there!  It's also a great place to share with your vet for the most up to date scientific information on PPID and IR.

IR is not a "disease", but a "metabolic type" of horse, normally, but not always, described as easy keepers with abnormal fat pads such as cresty necks, puffiness in the hollows of the eyes, excessive drinking and urinating, etc.  IR is treated with a low carb, low fat, mineral balanced diet.  A horse that has both PPID and IR would need both pergolide and a carefully managed diet for the rest of it's life.  The Haflinger in Kellie could put her at a higher risk for IR.  In the absence of IR testing, it can never hurt to to treat her as though she is IR.  So that brings me to the Diet part our philosophy!

Diet:  To provide a low carb, (less than 10% sugar+starch) low fat (4% or less), mineral balanced diet, we use grass hay, tested to be under 10% sugar + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E.  This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse.   Until you can get your hay tested and balanced we recommend that you use the Emergency Diet.  Though not intended for long term use, the emergency diet addresses some of the most common deficiencies.  More details about the emergency diet can be found on our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diet  

A very important part of the IR diet is what you DON'T feed.  It's great that you took Kellie off all sugary treats!  That should include no apples and carrots and there are more no-no's too--no pasture, no grain, no molasses containing products, no unsoaked hay with an either an unknown ESC+starch content or ESC+starch that is above 10%, no brown/red salt blocks.  Is this the sentinel low starch feed you are using?  https://www.sentinelfeed.com/pdfs/blueseal_sellsheet_LS.pdf  If so, I would stop using that feed.  At a minimum of 12% fat--could be even higher, it's way to high in fat.  It also has an upside down Omega 3:6 ratio (more omega 6, which are pro inflammatory than omega 3 which are anti inflammatory).  We use ground flax seed to replace the essential fatty acids because it has the closest Omega 3:6 ratio to grass, about 4:1.

To answer your question about alfalfa cubes, we generally recommend avoiding alfalfa.  It can make some horses foot sore.  Plus, unless you test each batch, you don't know the sugar and starch content.  If you want to use hay cubes as a carrier for your supplements or to supplement your hay, you might consider using Ontario Dehy Timothy Balance cubes (ODTB's).  They are timothy hay cubes, guaranteed to be under 10% sugar+starch and each batch is mineral balanced according to Dr Kellon's specifications.  You can actually use them as a complete feed, needing only the addition of salt, Vitamin E and ground flax seed (in amounts outlined in the emergency diet).

Trim:  A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  Though important for all horses, it's essential for an IR and/or PPID horse to have a proper trim in place since they are at increased risk for laminitis.  You are welcome to post pictures of Kellie's feet so we can help you to determine if you have an optimal trim in place.  Here's a site that explains how to take good hoof photos:  http://www.all-natural-horse-care.com/good-hoof-photos.html   Any pictures or xrays that you post should go into the PHOTOS section (not the "files" section) of ECH8, the group that you join to fill out the case histories.

Exercise: This is the best IR buster there is, but only if the horse is comfortable and non-laminitic.  So happy to hear that Kellie has not had laminitis!  It's certainly something we want to avoid!

So, Teah, that about wraps up the basics of the DDT/E philosophy!  Now to answer a few of your questions!  I myself have been quite fortunate as to not have experience with ulcers.  Maybe someone else will chime in about that.  I did enter "ulcers" into the "search conversations" box and got 2,624 hits!  So lots of past conversation on the subject!  Here's one by Patti to get you started:  https://groups.yahoo.com/neo/groups/EquineCushings/conversations/topics/25318  And here's our file on ulcers:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Ulcers/ 

Here's a link to the "Avoid these items" file:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Avoid%20These%20Items%20/  You should find the answer to your question about what meds and dewormers to avoid there.  

What kind of muzzle are you using?  Maybe we can give you some adjustment tips.  Have you tried the fleece padding?

Ok, Teah, you have a lot of reading to do!  Let us know when you have your case history done!  Please sign each time you post with your name, date of joining and general location (which helps us to source products for you).  When you get your CH done, you will want to add a link to it in your signature so that we can find it faster and answer your questions faster!

Maggie, Chancey and Spiral in VA



Re: Intro of new member

Maggie
 

Hi Teah,

Welcome to the group!  Glad that you found us, as we have lots of seasoned "Cushing's managers" here!  To get the best advice and answers to your questions, we need you to fill out a case history on Kellie.  It gives us all the details we need to give you the very best advice!  To fill out a case history, you will need to join one of our sister sites called ECHistory8.  It's a filing cabinet for storing case histories.  Here's a link to that group:  https://groups.yahoo.com/neo/groups/echistory8/info  It won't take long to get approved and then just follow the instructions for filling out a CH.  Meanwhile, I will explain our philosophy called DDT/E, which stands for Diagnosis, Diet, Trim and Exercise, and try to answer your questions.  

Diagnosis:  So you have a diagnosis of Cushings (PPID), but you did not test for IR, is that correct?  I'm guessing the "2 day test" was the DST (dexamethasone suppression test).  Though considered the "gold standard" test for diagnosing PPID, we do not recommend the DST as it does carry a risk of precipitating or exacerbating laminitis.  I'm glad you didn't have that problem!  Kellie is on the young side to have a diagnosis of Cushing's, which is not normally seen in horses under the age of 10, but we do have other horses in this group with an early diagnosis as well.  Since a horse can have just PPID, just IR, or both (or neither) we recommend the following 4 lab tests to get a complete Diagnosis:  ACTH, insulin, glucose and leptin.  They should be drawn on a NON-fasting horse, and be sent to Cornell, preferably.  The ACTH is to diagnose the PPID and the insulin and glucose for diagnosing IR.  The leptin helps to differentiate if the horse is IR at baseline or if an elevated insulin is being driven by a high ACTH.  Leptin is the hormone that says "stop eating", and is usually elevated in IR horses.  More information about leptin resistance in the first file in this folder:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Insulin%20Resistance/ 

So once you get a full diagnosis of IR and/or PPID you then know how to move forward with the appropriate treatment.  PPID is an enlargement or benign tumor in a part of the pituitary gland called the pars intermedia, and as you know, is treated with pergolide.  We do recommend that you retest the ACTH 3 weeks after you have her on a "target dose" which is often 1 mg to start.  As Kellie ages and PPID progresses, the pergolide dose will need to be increased, especially during the seasonal rise.  The goal is keep the ACTH in the middle of the normal range, which is 9-35 at Cornell, so low to mid 20's.  You can read more about the seasonal rise on our website here:  http://ecirhorse.org/index.php/cushing-s-disease/seasonal-rise  If you haven't visited our website yet, you should take the time to explore the entire site!  There is so much great information there!  It's also a great place to share with your vet for the most up to date scientific information on PPID and IR.

IR is not a "disease", but a "metabolic type" of horse, normally, but not always, described as easy keepers with abnormal fat pads such as cresty necks, puffiness in the hollows of the eyes, excessive drinking and urinating, etc.  IR is treated with a low carb, low fat, mineral balanced diet.  A horse that has both PPID and IR would need both pergolide and a carefully managed diet for the rest of it's life.  The Haflinger in Kellie could put her at a higher risk for IR.  In the absence of IR testing, it can never hurt to to treat her as though she is IR.  So that brings me to the Diet part our philosophy!

Diet:  To provide a low carb, (less than 10% sugar+starch) low fat (4% or less), mineral balanced diet, we use grass hay, tested to be under 10% sugar + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E.  This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse.   Until you can get your hay tested and balanced we recommend that you use the Emergency Diet.  Though not intended for long term use, the emergency diet addresses some of the most common deficiencies.  More details about the emergency diet can be found on our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diet  

A very important part of the IR diet is what you DON'T feed.  It's great that you took Kellie off all sugary treats!  That should include no apples and carrots and there are more no-no's too--no pasture, no grain, no molasses containing products, no unsoaked hay with an either an unknown ESC+starch content or ESC+starch that is above 10%, no brown/red salt blocks.  Is this the sentinel low starch feed you are using?  https://www.sentinelfeed.com/pdfs/blueseal_sellsheet_LS.pdf  If so, I would stop using that feed.  At a minimum of 12% fat--could be even higher, it's way to high in fat.  It also has an upside down Omega 3:6 ratio (more omega 6, which are pro inflammatory than omega 3 which are anti inflammatory).  We use ground flax seed to replace the essential fatty acids because it has the closest Omega 3:6 ratio to grass, about 4:1.

To answer your question about alfalfa cubes, we generally recommend avoiding alfalfa.  It can make some horses foot sore.  Plus, unless you test each batch, you don't know the sugar and starch content.  If you want to use hay cubes as a carrier for your supplements or to supplement your hay, you might consider using Ontario Dehy Timothy Balance cubes (ODTB's).  They are timothy hay cubes, guaranteed to be under 10% sugar+starch and each batch is mineral balanced according to Dr Kellon's specifications.  You can actually use them as a complete feed, needing only the addition of salt, Vitamin E and ground flax seed (in amounts outlined in the emergency diet).

Trim:  A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  Though important for all horses, it's essential for an IR and/or PPID horse to have a proper trim in place since they are at increased risk for laminitis.  You are welcome to post pictures of Kellie's feet so we can help you to determine if you have an optimal trim in place.  Here's a site that explains how to take good hoof photos:  http://www.all-natural-horse-care.com/good-hoof-photos.html   Any pictures or xrays that you post should go into the PHOTOS section (not the "files" section) of ECH8, the group that you join to fill out the case histories.

Exercise: This is the best IR buster there is, but only if the horse is comfortable and non-laminitic.  So happy to hear that Kellie has not had laminitis!  It's certainly something we want to avoid!

So, Teah, that about wraps up the basics of the DDT/E philosophy!  Now to answer a few of your questions!  I myself have been quite fortunate as to not have experience with ulcers.  Maybe someone else will chime in about that.  I did enter "ulcers" into the "search conversations" box and got 2,624 hits!  So lots of past conversation on the subject!  Here's one by Patti to get you started:  https://groups.yahoo.com/neo/groups/EquineCushings/conversations/topics/25318  And here's our file on ulcers:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Ulcers/ 

Here's a link to the "Avoid these items" file:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Avoid%20These%20Items%20/  You should find the answer to your question about what meds and dewormers to avoid there.  

What kind of muzzle are you using?  Maybe we can give you some adjustment tips.  Have you tried the fleece padding?

Ok, Teah, you have a lot of reading to do!  Let us know when you have your case history done!  Please sign each time you post with your name, date of joining and general location (which helps us to source products for you).  When you get your CH done, you will want to add a link to it in your signature so that we can find it faster and answer your questions faster!

Maggie, Chancey and Spiral in VA



Re: Ovarian Syndrome

Eleanor Kellon, VMD
 

Please put up a  complete history on her on ECH8, including the answers to all the mare issue questions, and we'll take it from there.

Eleanor in PA
www.drkellon.com 
EC Co-owner
Feb 2001


-


Re: Ovarian Syndrome

montanadq
 

T


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

The "positive for luteal tissue" comment comes from the progesterone level, but the LH:FSH ratio only fits on or very close to the date of ovulation.  Do you know where she was in her cycle?  Did you do a second sample 10 days later?

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001

Unfortunately, 'no' to where she was in her cycle and more unfortunately 'no' to the second sample ($120/visit fee).  The snow brought to my attention that she has tiny close together laminitis rings though she has been 'sound' in boots 24/7 and on a balanced diet for 5 years.

Would it make sense to put her on estrogen and see if the laminitis quits or am I obliged to do the testing?  Thank you sincerely for considering my problem.


Re: Ovarian Syndrome

Eleanor Kellon, VMD
 

The "positive for luteal tissue" comment comes from the progesterone level, but the LH:FSH ratio only fits on or very close to the date of ovulation.  Do you know where she was in her cycle?  Did you do a second sample 10 days later?

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Muscle laxity with Cushing's diagnosis

Eleanor Kellon, VMD
 

Could you post a photo of your horse (from side, back)?

PPID related muscle loss is usually most noticeable in the muscles of support, like along the side of the spine and the abdominal muscles, rather than the muscles of locomotion. There could be more than one issue here.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


--


Re: New Leptin test over the moon!

Nancy C
 

Agree that communication may be an issue. You said in your opening message in this thread that he seems fine and his feet are great.

Nancy c in nh
Feb 2004
Ecirgroup mod


Re: New Leptin test over the moon!

Sharon Manning
 

he is not doing well otherwise....
I must not be communicating :-(
Sharon
E TN
2005
https://groups.yahoo.com/neo/groups/echistory8/files/Sharon%20and%20BLAZE


Re: New Leptin test over the moon!

Eleanor Kellon, VMD
 

No reason you can't increase his magnesium as long as you know where your ratios are.  That said, really the differences in his G:I ratio and RISQI are not very significant, despite the fact he was hovering on and just crossed the line between compensated and uncompensated.  Since he's doing well clinically I wouldn't worry unduly about this.

Leptin is an indicator that points to likely IR.  It's probably not as sensitive to diet changes as insulin but is influenced by many things including time of day (human data), time since last meal, size of meal, exercise, stress/cortisol and possibly other things.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001




Re: New Leptin test over the moon!

Nancy C
 

Yes. I did see your new acth. You may have read from experiences from others that mid twenties may not be low enough. Just food for thought going forward. Im glad he is doing well otherwise.

Nancy c in Nh
Feb2003
Ecirgroup mod


Intro of new member

teahcrew@...
 

Hi, I am Teah from NE Oh and my mare, Kellie, is a perch/haf cross, who is 9 years old and just in the past few months, has been diagnosed as having cushings by our vet. Her main symptoms were excessive thirst and urination. She was not ever foundered nor experienced any laminitus (knock on wood). She had a cresty neck and was well padded tho not obese, but all my vets over the past 5 years of owning her, have said that is her nature due to the breeds. AND they all said the same thing...she doesnt LOOK like a IR/Cushings horse and also she was too young to have cushings.

My vet now did a 2 day test and it came back cushings. We put her on a low starch low sugar feed by sentinel and took her off all sugar treats. We added pergoglide and at 1/2 a pill a day, she is doing excellent! No more 4 buckets of water in the day and 4 at night. No more flooded stalls. Her neck is going down, as well as the padding at the tail base, and above her eyes. Her personality has changed as well...more alert, less cranky, and definitely she is moving better. She was barely picking up her legs, often knocking into the wood poles we would trot over for practice. (we are just trail riders, backyard players)

At the time of her diagnosis I broke one of my toes so I couldnt walk. It gave her some time to get acclimated to the meds and change in diet. As I got better, I would lunge her. On Christmas day I rode her for the first time since her diagnosis. WOW! I have missed my mare and cannot wait for this spring to come so we can go back into the woods! Until then, we will be building up our muscle tones again (me AND her).

Throughout this, we have gotten SO close! I cannot believe it! We always had a wonderful connection but  now this mare believes in me. She knew (forgive the anthropomorphizing) I was doing everything I could to help her feel better.

I would like to know if there are any meds or wormers I should keep away from her. And I have heard such conflicting ideas about alfalfa cubes, wetting them down and giving them to her. She has 1st cut hay and is on a dry lot mostly. When she will go out on a regular lot she will wear a muzzle. But now I see how muzzles can hurt the face! What do you do to prevent that? What works?

Also, have you experienced any horses with Cushings who also develop or developed ulcers?

Thank you in advance...any advice or greetings welcomed!

Teah



Re: New Leptin test over the moon!

Sharon Manning
 

Yes I was chasing the seasonal rise. As you see in the CH it is now in low 20's. So ACTH is not the problem.
Sharon
E TN
2005


Re: Muscle laxity with Cushing's diagnosis

Maggie
 

Hi Reb,

Welcome to the group!  Glad to hear that you finally got a diagnosis and were able to start treating your boy!  Must have been a frustrating three years for you.  We have lots of combined experience in this group on the best way to manage Cushings (PPID) and IR (insulin resistance), so you've come to the right place for help.  I see that Nancy has already addressed the major concerns, so I will expound a bit on the details of the DDT/E philosophy.  But first, to get the very best answers to your questions we need some more information about your boy.  We ask everyone to fill out a case history on their horse so that we have the details to give you the best advice.  To do that, you need to join one of our sister groups called ECHistory8.  It's a filing cabinet for storing CH's.  Here's a link to that group:  https://groups.yahoo.com/neo/groups/echistory8/info  It won't take long to get approved and then just follow the instructions to fill out a CH on your boy.  Meanwhile, let's talk some more about the details of our philosophy, called DDT/E.  That's short for Diagnosis, Diet, Trim and Exercise.  It's extremely important for all four aspects to be in place for the absolutely best results!

Diagnosis:  So you have a diagnosis of PPID and have started treatment with Prascend (pergolide).  That's a great start and the cornerstone of treating PPID.  In your CH, you will share with us the lab values that got you a diagnosis of PPID and also how much Prascend that your horse is on.  Since a horse can have just PPID, just IR,  or both (or neither) we recommend the following 4 lab tests to get a complete Diagnosis:  ACTH, insulin, glucose and leptin, drawn on a NON-fasting horse, and preferably sent to Cornell (if you are in the USA).  The ACTH is to diagnose the PPID and the insulin and glucose for diagnosing IR. The leptin helps to differentiate if the horse is IR at baseline or if an elevated insulin is being driven by a high ACTH.  Leptin is the hormone that says "stop eating", and is usually elevated in IR horses.  More information about leptin resistance in the first file in this folder:  https://groups.yahoo.com/neo/groups/EquineCushings/files/Insulin%20Resistance/ 

The blood does require special handing and all of the details can be found on our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diagnosis   If you haven't been to our website yet, there is a TON of very helpful information there.  It's also a great place to send your vet for all the latest scientific information on managing PPID and IR.

Now that you have a Diagnosis and have started treatment with Prascend (pergolide) you need to know how well the treatment is working.  I'm happy to hear that your boy is tolerating the Prascend well!  Part of the *trick* to getting and keeping a Cushing's horse healthy is to keep the ACTH under control.  We like to see the ACTH in the middle of the normal range which is 9-35 at Cornell.  That often means increasing the pergolide dose to get and keep the ACTH under control.  We recommend that you have the ACTH rechecked after the horse has been on a stable dose of pergolide for 3 weeks.  Rechecking the ACTH is the only way to know for sure if the pergolide is controlling the ACTH.  Of course, in a perfect world, we would all have the funds to recheck lab work whenever we wanted to, but since that can get pretty expensive, you might want to read this post by Patti on monitoring the subtle signs of PPID:  https://groups.yahoo.com/neo/groups/EquineCushings/conversations/topics/111988?threaded=1&l=1  Also lots more information about pergolide on our website here:  http://ecirhorse.org/index.php/cushing-s-disease/pergolide 

Diet:  The other part of the *trick* to getting and keeping a PPID healthy is to get him on a mineral balanced diet.  Until you know for sure that your horse only has Cushing's and not IR, you should treat him as though he is IR as well.  We recommend a low carb, (less than 10% sugar+starch) low fat (4% or less), mineral balanced diet.  We use grass hay, tested to be under 10% sugar + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E.  This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse.   Until you can get your hay tested and balanced, we recommend that you use the Emergency Diet.  Though not intended for long term use, the emergency diet addresses some of the most common deficiencies.  More details about the emergency diet can be found on our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diet

As important as what you do feed is what you DON'T feed!  No pasture, red/brown salt blocks, sugary treats including apples and carrots, any products containing molasses, unsoaked hay with an either an unknown ESC+starch content or ESC+starch that is above 10%.  When you fill out your CH, you will be giving us more details about your horse's diet and we can help you to evaluate the feeds that you are using.

Trim:  A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  Though important for all horses, it's essential for an IR and/or PPID horse to have a proper trim in place since they are at increased risk for laminitis.  You are welcome to post pictures of your horse's hooves so that our hoof guru can help you to evaluate if you have a proper trim in place.  Here's a site that explains how to take good hoof photos:  http://www.all-natural-horse-care.com/good-hoof-photos.html   Please put any photos (and/or xrays) in the PHOTOS section of ECH8.  That's the group you join to fill out your CH.  The CH's are in the "files" section, pictures in the "photos" section.  

Exercise: This is the best IR buster there is, but only if the horse is comfortable and non-laminitic.  It's also a great way to keep a PPID horse in shape and help rebuild the topline!  

So that covers the basics of the DDT/E philosophy!  As suggested already, there are some helpful supplements that may help to address the loss of topline, but nothing takes the place of controlling the ACTH and a tightly mineral balanced diet.  This post by Jaini might be helpful for you as well:  https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/179643  She also links to some great messages from Dr Kellon in that post.  One of the links did not work for me (which may just be a Yahoo glitch), but if you enter the message # into the "message #" search box it does come up.  

There is TONS more information on our website, and in our files and archived messages.  Lots of reading and learning!  Hang in there, it does all get easier!  We ask that all members sign with their name (first is fine), date of joining and general location, which helps us to source products in your area.  Once you get your CH done, please add a link to it in your signature as well.  It really helps us to find it faster and to answer your questions faster!

Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response
https://groups.yahoo.com/neo/groups/ECHistory4/files/maggie%20in%20virginia/ 




Ovarian Syndrome

montanadq
 

I have suspected my mare of having ovarian syndrome, she is positive for every general symptom associated with it, and finely have some lab.  The sample was taken in November, she lives in the Pacific Northwest.  Progestagens = 4.9 ng/mL, Testosterone = 5.0 pg/mL, FSH = 1.6 ng/mL, LH = 9.0 ng/mL, results from BET Labs, Kentucky.  They also stamped the results with "positive for Luteal Tissue".


Does anyone have comments on these results??

Barbara

NRC Plus 0610



Re: New Leptin test over the moon!

Nancy C
 

Hi Sharon

IME some horses need this tighter ratio, mine included, but I found that uncontolled PPID, which I believe you had an issue with, will override significant benefit from this. 

Not that you shouldn't do it.  I'll bow to Dr Kellon.


Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
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---In EquineCushings@..., <partnernaturally@...> wrote :

Well finally here is the info I have been asking for:
"Increasing magnesium beyond the 2:1 Ca:Mg ratio has been helpful for some horses. The ratio can be brought as low as 1.2:1. " 

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