Re: Help

Lavinia Fiscaletti

Hello Mags,

Welcome to the group! 

Sorry to hear your pony is having such a hard time of it. Because she is only 7yo, PPID (aka Cushings) is not a likely scenario. IR is definitely a problem with an insulin of 670. Has glucose and adiponectin been tested? What we are going to need from you is a lot more specific information in order to be able to give you the most specific help. What we will need is in the remainder of this rather long message but in the short term, here are the DO NOW suggestions to get you moving in the right direction:

  1. Put your girl on the emergency diet (complete info below): soaked hay (already doing); stop all the other supplements you are currently feeding, as well as the Safe and Sound - use a small amount of Speedibeet to mix the emergency diet ingredients instead:
  2. If 366kgs is an appropriate weight for your girl (she has a b0ody condition score of no more than 5) then she shouldn't need more than 2% of that in total feed per day - so 7.5kgs total. The current 11kgs+the 2 scoops feed is a lot of excess feed and will make keeping her weight down difficult. Using small mesh hay nets to hold the hay, splitting it into 3-4 meals per day will help keep food going thru her system in a more regular fashion without creating a fasting situation.

  3. Keep up the Metformin for now - it may be helping/won't hurt but is only  a temporary solution as its effects diminish over time.

  4. Danilon (phenybutazone) is not recommended for more than a few days and is not very helpful for laminitis stemming from endocrinopathic issues anyway. We recommend stopping that - taper off rather than an abrupt halt.

  5. Please add the radiographs and a set of hoof pictures so that the trim can be assessed. Good that the shoes have been removed - recommend using boots and pads for now, or taping pads to her feet in the short term until we can assess the trim and be sure it is optimal.

  6. BREATH. There is a lot you can do to help you girl get better, so let's get started.

The ECIR provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

In order to help you and your equine quickly and effectively, we need you to explain your equine's situation by following the instructions you were sent upon joining. Your completed case history form and ECIR Signature will save days of back and forth questions. If you haven't done so yet, please join our case history sub-group. Follow the uploading instructions so your folder is properly set up and then upload your case history. If you have any trouble, just post a message or email the case history group explaining specifically where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.


DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 


DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less)
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + 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 soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.


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 equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet.

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.


EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.


There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask ANY questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

We ask all members to sign their first name, general location, date of joining and link to the case history and photo album every time they post. It helps us to find your info faster to answer your questions better. You can set up an automatic signature so you don't have to remember to do it. 

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have ANY technical difficulties, please let us know so we can help you.

Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team

Donkey photo?

Cindy McGinley

Hello, group,
      I remember a photo of a donkey with obvious fat pads from the Conference, but do not remember which presentation he was in. Does anyone recall? I’d love to get a copy of that photo for a presentation I am doing for an equine nutrition class on Thursday, if possible...
- Cin (with Alf's Entourage) in Central NY
ECIR Support
May 2006

Syringe for minerals

Sue Hansen

Does anyone have a recommendation for a type of syringe (other than the plastic tubes) so I can get the needed minerals into my mare?   I have a hard time using the plastic ones because the plunger gets stuck in the tube and by the time I get it unstuck, I've shot the minerals everywhere but in her mouth.   I oiled the tube before adding the minerals and oiled the plunger.  Any suggestions?
Sue H.
June 2017. Markle, IN USA
Case History  .
Dawn's photo album  .

Re: Help

Eleanor Kellon, VMD

You will get a formal welcoming message soon but I just want to emphasize we will need a lot more detailed information to help you, You can also use the Photos section of the Case History group (details in your welcoming message) to post a body photo, detailed photos of her feet and her radiographs. We'll do our best to help you with her but need that information.
Eleanor in PA 

EC Owner 2001

Re: Looking for help getting weight on my picky eater, who is IR and PPID

Lorna Cane

On Sat, Nov 25, 2017 at 03:14 am, Emma B wrote:
sorry for all the questions
Hi Emma,

Never be sorry. That's what we're all about ! 
I think we're all in trouble if we never have any more questions. :-)

Just wanted to butt in here to say I've never had a horse who doesn't like ground flax , although I know a few other horses on this forum who don't like it.

My horses also adore soy hull pellets . You may be surprised at how easy the switch over will be.
I prefer the soy hull pellets to beet pulp (although their profiles are virtually the same) because all you do with SHP is add water,and serve.No soak/rinse protocol.

Lorna in Eastern Ontario, Canada
ECIR Moderator 2002


Re: Looking for help getting weight on my picky eater, who is IR and PPID

Emma B

Hi Jaini, 

sounds good to stop the buckeye. Really the Brooks Fibre o is the thing Noisette will gobble up. It is 17% NSC but I've risk balanced giving it to her just to get her to eat. I don't have the breakdown of the 17%, but do you think it's ok to continue with the 2 lb per day or even increase it when adding in the soy hulls and flax? I don't think she'll eat ground flax without it being mixed in well. Do you think the Brooks Flax Appeal would be a good option for flax? It's stabilized and also contains soy hulls. 

Ive always been concerned with Noisette getting enough protein especially as she ages. I guess the additional soy hulls will accomplish this? What about adding alfalfa pellets too? I'm trying to also think of other things that would get her interested. She's done well on alfalfa cubes previously and also her second cut hay in her stall has more alfalfa in it. also re protein, would a hay around 20 % protein be too high? 

Im seeing reference to too much fat being bad for IR. I've always thought it'd be helpful for Noisette with her weight issues. Just wondering why it would be bad?

i will pick up one of those mineral mixes you suggested and try to attach my hay analysis. Having trouble from my phone.

sorry for all the questions and thanks again for your time!



I have a 7 yr old welsh part bred pony home bred she has suffered with laminitis most of her life she is again suffering and has been for the last 3 months despite numerous vet visits and following their professional advise x rays we don’t seem to be making any head way
Her recent blood sample approx 10 days ago have revealed an insulin result of 670 she is now been prescribed metformin 15 tabs twice daily along with danilon twice daily 
I have weighed her and she is approx 366kgs I keep a close eye on her weight as she has been up to 469kgs in the past
she receives lami pro along with vitamins and minerals from global herbs she has Dodson and Harrell safe and sound one scoop twice daily along with soaked hay a 4kgs in the day and a 7kgs overnight 
She hasn’t left her stable for approx 3 months her bar shoes have been removed 
can you offer any advise to help me try and improve this highly emotional and distressing situation
many thanks
Mags Jones 

Re: gone

Lesley Fraser

I'm so sorry to hear the sad news about Elf.  I lost my boy suddenly last year to colic - it's shocking and heartbreaking.  An achievement of No Colic, too, would be terrific.
What a lovely tribute to him.  I can just picture Elf's acrobatics when he was out playing with his friends.   Fly free, beautiful Elf.
Look after yourself and your gelding.
Lesley & over -the-bridge Omar,

Norfolk, UK

Omar - Case History

Re: Jaini and history on my horse a recent advise

LJ Friedman

You can make your own boots with styrofoam for immed relief..  search the site and you will see some videos on how to..

On Fri, Nov 24, 2017 at 09:43 pm, Jaini Clougher wrote:
Hi, team!  Tara is getting the farrier out, cutting out the Nutrena, and adding some of the other stuff as she gets it (cubes, beet pulp, etc).  Gavilon's vet recently said to up bute from 1 g daily to 2 g daily.  The case history and hay tests (he is on 2017 hay only ) are now uploaded:  

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support



LJ Friedman  Nov 2014  San Diego, CA 


Re: Jaini and history on my horse a recent advise


Hi, team!  Tara is getting the farrier out, cutting out the Nutrena, and adding some of the other stuff as she gets it (cubes, beet pulp, etc).  Gavilon's vet recently said to up bute from 1 g daily to 2 g daily.  The case history and hay tests (he is on 2017 hay only ) are now uploaded:  

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support



Re: gone

Donna Coughlin

Oh, Tara, such a wonderful tribute to a very, very special horse, and to your love for him. He was such a lucky fellow to have had both you and such a great fan club! Colic is so cruel, but at least you were with him. I lost my Obi (the only one of my 3 who was not IR or PPID) to colic in May, caught it right away, got the vet, trailered him to the clinic, into surgery. I was able to be in the OR with him, but his secum and intestine had twisted and he couldn't be saved. He was my dream horse, bought him when he was 10 months old and he died just short of his 21st birthday. He taught me so much about life and confidence and love. It is an honor and a privilege to share a life with such magical beings.

May Elf stay with you in those joyous memories; I keep reminding myself how very, very lucky I was to have shared my Obi's life, and I know you'll do the same when thinking about Elf. The loss and pain does get slowly better, I promise. It takes time. My heart is with you.


Donna Coughlin, Duke and Robin Goodfellow, Obi over the Rainbow Bridge (5/17)

CT 2009

Re: Winter pasture possible with these values?


Well, rats! Still, better than a bout of laminitis. 

There is a big niche here waiting to be developed: boarding facilities with tracks and dry lots for IR and PPID horses. 

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support



Re: Looking for help getting weight on my picky eater, who is IR and PPID


Hi, Emma - yes, generally speaking, pelleted and extruded feeds can be the best bang for the buck when dealing with toothless horses; however, if they are too high in sugar, starch, or fat, they do more harm than good.  Beet pulp and soy hulls are highly digestible, and so are good choices, as are the ODTB cubes.  Unfortunately, I have yet to find another pelleted feed in Canada that cuts the mustard (sad, but true). Hi Pro Pro Fibre Crunch is supposed to be 5% starch (which is a little high, even so), but more than half a pound of that makes one of my IR horses very foot sore, so can't recommend that. That leaves us with the only 3 I have found so far: ODTB cubes, beet pulp, and soy hulls.

I would not so much gradually stop the Buckeye feeds, as totally stop them and start the others (half a pound at a time, increase every few days), and use the Buckeye in small amounts only for taste tempting.  Also, continue the free-choice hay, especially at night when she is in her stall. 25 isn't ancient, but it is getting up there, and I have found that our older horses just take a lot more time to eat. Stall time at night is the ideal time to provide the feed.

If she likes the Brooks Fibre O , you can either continue with that (not ideal, but helpful if it gets her to eat), or just switch to ground flax and see if she likes that.

Oh!  I meant to add in my last post (but forgot) the link to the Picky Eaters Checklist:   This is at the bottom of the first page of the Pulling It Together folder:   

Providing sufficient iodine, selenium, copper, and zinc (and vitamin E) are crucial to over-all immune health and hoof and coat quality; iodine is particularly crucial for metabolism.  We are so lucky in so many ways in Canada; however, the availability of acceptable ration balancers is not one of those things.  You have a few choices, most of which are short term: 1) Start with the Cheval au Naturel  2) Get some Source and use half of the enclosed scoop, while waiting for your hay analysis and balancing  3) Once you get your hay balancing info, you can mix the minerals yourself, using a variety of ingredients; or you can get Mad Barn to do a custom mix for you. My custom mix from Mad Barn at the moment costs $1.44 per day, but it has a lot of monosodium phosphate in it, which is expensive.  (it is still only $43 per month per horse, which is a lot less than many over-the-counter supplements that don't actually do much good).

I just went over (once again) all the supps available from Greenhawk, and couldn't find anything useful. I have emailed Herbs for Horses to find out their copper/zinc etc content of their HoofMaster.  

At this point in Noisette's journey, reducing the sugar and starch is key, as is getting her to eat more. You will find once you get all the other vitamins and minerals on board, she will start to bloom; for now, work on the Temporary Emergency Diet (no need to soak if your hay is lower than 10% ESC plus starch).  Just as an FYI, here is a link to commonly available ration balancers in Canada, vs what an regional Alberta mix would need (which wouldn't be wildly different from Ontario, except the selenium and maybe the manganese):  (in the Diet Balancing folder )  

I still yearn for the days at the Greenbelt Riding School when life was horses at pasture, warm bran mashes and oats, and we kids ate Twinkies and those weird pastry things from the store down the road. Sometimes it is hard to change our horse-keeping methods, but it is very much worth it.


Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support



Re: gone


I am so sorry to hear about the loss of your precious pony.  My thoughts and prayers are with you during this time of loss.  Hugs:(
August 5, 2017, Brandon, Manitoba, Canada


 Photos,,,20,2,0,0  .

Re: Looking for help getting weight on my picky eater, who is IR and PPID

Emma B

Hi Jaini, thanks for taking the time to go over our info and for your detailed response!

yes we had her CBC done and nothing was flagged for liver or kidney. 

Thanks for the infp on decreasing previcox. And yes she did have another appetite decrease at 1.5 mg pergolide, but it's come back up to Normal-ish now.

darn re the buckeye feeds. Is your recommendation to eventually stop feeding those and switch Noisette to a diet of beet pulp, the hay cubes, soy hulls, flax, and mineral mix? Do you  think that will keep weight on her? I thought a pelleted feed would be the most bang for my buck. Is there another pelleted feed you would recommend? She's been so picky that I've been having to add in the Brooks Fibre O Plus to keep her interested. She also hasn't been willing to eat too much beet pulp at once. 

I do have hay analysis and will upload soon. It is under 10% NSC.

thanks again,


Re: caring for an IR horse


Regina, I actually do something similar to Bonnie.  I have 2 horses.  I use a Chinese soup takeout container to measure my ODTB cubes.  I keep the cubes in the barn but measure out the cubes into a small feed bucket.  I bring the small bucket in to the mud room of my house.  Every morning I grab the bucket and put extremely hot tap water in the bucket.  By the time I get the vitamins/minerals ready, put on my hat and jacket, and walk to the barn the cubes are nicely fluffed and cooled off.   In the summer I use warm water instead of hot.

Its been a routine for years so no extra work.  Never have to worry about forgetting the hot water and no extra expense for the coffee pot or tea kettle.

Don't know why I didn't share that before, but here it is now.  We get creative don't we? 

Pam in Va
Butters/Frosty over the bridge
Story IR/Roscoe PPID 

ECIR Group - Equine Cushings and Insulin Resistance #FACTS Integration <main@...>

By ECIR Group - Equine Cushings and Insulin Resistance

Here's what's possible when following the ECIR protocols for PPID and IR horses - Diagnosis, Diet, Trim, and (when appropriate) Exercise. For more examples, click here: #GivingTuesday

Re: caring for an IR horse


You've already gotten a lot of good advice and I'm sure as you implement parts of it here and there you'll start to notice the pay-off in a more manageable workload. If you're going to go with a tarp over the 4-wheeler, consider if you want to attach one end of the tarp to the spreader. Then pull the tarp forward over the 4-wheeler and attach it under the front of the 4-wheeler. When you want to use the rig, detach the front of the tarp and bunch/scrunch it as you walk back to the spreader and tie the bunched-up tarp to the front of the spreader so it is secured out of the way. Then unroll and reattach the one end of the tarp when done - saves time and hassle moving the tarp about, especially in windy conditions. Bungy cords work well for this.

Its great that you have the geotextile to work with. I used a lot of that material when we made our long driveway and also in the 40x60 dry lot area in front of our run-in shed. Geo works best when it is laid in a wall-to-wall carpet style ... with overlaps of all edges so it carpets the area to be stoned. But even if you're doing just patches here and there for now, it is still way worth using to keep stone from disappearing under the mud. Also, if you have any buildings or run-in sheds near the area you're trying to improve, it will be a world of help if have gutters and downspouts on the buildings to direct storm water away from the area. Personally I would do gutters and downspouts alongside or even before doing geo+stone in order to keep the area as dry as possible.

I put in a paddock track last Dec. and it has worked well for me, but I had the luxury of the small drylot for when the ground is really saturated. I put the paddock track along the high ground in the pasture rather than around the perimeter. This was a hassle to put up (more fencing!) and it's not a 'classic' rectangle shape... but it works for us by draining storm water away from the track.

I have a bit of arthritis in my hands - sorta crept up on me over the years. ;-) and I didn't even really notice how difficult the lack of grip strength was making the work. Then I wised up and got really grippy work gloves coated in rubber - cheap and washable. Such a simple thing but makes a world of difference for me in grasping tools effectively without straining. I can work a lot longer and more easily when I have the gloves on.

You're definitely not alone in your thoughts and concerns about the labor involved in caring for your horse. Good luck on your changes and making things better!
MaryS and Hoover

Sept. 2016,  South Central PA

Hoover's Case History:

Photos:  .


Re: Winter pasture possible with these values?

Karin & Inky <ksherbin@...>

Thanks for the feedback Paula and Jaini! Sounds like if I want to give Inky a break it has to be only when I am able to get to the farm where he is boarded and let him run around muzzled for an hour while I do chores. I can muzzle him with or without treats in the dry lot. The hired help at the farm don’t have time to deal with muzzles and treats and leading him to a pasture. :(



Karin & Inky

Forest, VA


July 27, 2015




Re: gone

Cindy Q

Very sorry for your loss. It sounds like you gave Elf a really wonderful life.
Cindy - Sep 2017, Singapore

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