Date   

Re: Introducing ourselves

LJ Friedman
 


-- following 

, perhaps you can request samples of some of the products you want to try? Rather than waste money on it not eaten?
LJ Friedman  Nov 2014  San Diego, CA

Jesse's Case History 
Jesse's Photos

 


Re: Introducing ourselves

 

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, substituteadiponectin 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! 

Ask any and all questions, and, again, welcome!
--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711


Re: Introducing ourselves

 

Hello, Annette, and welcome to the group!  Thank you so much for that fab case history - well done!  

As soon as I saw that Alley was a Connemara X TB, I was hoping she was more TB (very insulin sensitive breed) vs Connemara (more prone to IR)  However.....

An ACTH of 95.3 pg/ml in the middle of the seasonal rise is, sadly, squarely in the grey area. It could be normal; it could be early PPID.  The very high insulin and glucose point more to EMS/IR, that has been sneaking up on you for a while, but got pushed over the edge by the seasonal rise in ACTH.  In my opinion (and this is only an opinion), she is baseline IR, and has just been tipped over the edge by the fact that as horses age, the ACTH tends to increase (without being PPID), but this also can cause insulin to increase to above the level where laminitis occurs. Your excellent description of how she has been a bit "off", and had the wee bit of a crest, plus tightness in muscles in September 2015, sounds like a classic case of low-level IR that has been getting worse in the last couple of years.

If funds permit, you can determine if she is truly PPID by doing a TRH stimulation test between February and July. You would first wean her off her pergolide over a period of 4 weeks, starting in January.  

Laminitic horses don't always respond to hoof testers. However, they will often respond markedly (or even violently) to a bit of a tap on the front hoof wall with a hoof pick. The bounding pulses and foot-soreness are pretty clear indicators of laminitis. 

You are clearly a pro-active and thinking horse mum, and Alley is very lucky to have you as her human. I am so glad she is feeling better already!  I think we can help you to make things more perfect with regard to diet, and, once the hoof pics are up, tweak the trim if necessary. 

My experience (and that of others), is that once on pergolide, horses do get much more finicky about what they eat (besides hay). This does not seem to be related to the Pergolide Veil - just one of those observations. However, the copper and zinc components of a mineral mix don't seem to be an issue with many; mono-sodium phosphate (used to supplement phosphorus) seems to be a huge yuck factor for many. Since your mare is already Ms. Picky, you might have some supplement gymnastics to do before she is readily accepting what she should be eating. Here is one post from Michele and Eli on that subject:  https://ecir.groups.io/g/main/message/221717   And go here for the Picky Eaters Checklist: (third from the bottom of the Pulling it Together folder )   https://ecir.groups.io/g/main/files/9b%20Pulling%20it%20Together 

Now, regarding diet:  I know that TC 30 is guaranteed to be below 10% ESC plus starch, but anecdotal evidence has shown that some horse will definitely get footsore on one pound of TC 30.  Here is a list of safe and really good ration balancers that one can use. The California Trace Plus has been readily eaten by my picky-pants mare, but Alley may, of course, be different. Keep on with the magnesium, 

Acceptable Ration Balancers (but very much second best to hay analysis and custom mix). These all have no added iron, a very important consideration for our metabolically challenged equines.


Uckele U-Balance Foundation  
http://equine.uckele.com/vitamin-mineral/u-balance-foundation.html (some horses don’t like the taste)

 

California Trace Plus  https://californiatrace.com/about/california-trace-plus/  (will need to add magnesium)

 

Colorado Mix  (no selenium) https://horsetech.com/equine-supplements/custom-non-stock-products/colorado-mix (will need to add magnesium)

 

 

Colorado Se Mix https://horsetech.com/equine-supplements/custom-non-stock-products/colorado-se-mix (will need to add magnesium)

 

 

VermontBlend   https://customequinenutrition.com/products/vermont-blend

 

  VifArgen Le Cheval au Naturel http://lechevalaunaturel.blogspot.com/p/blog-page_13.html 

 

Mad Barn AminoTrace+  https://www.madbarn.com/ca/product/aminotrace-pellet/

 

  For areas where added manganese is necessary:

Equi-VM  http://equine.uckele.com/vitamin-mineral/equi-vm.html

 

Sport Horse Grass  http://equine.uckele.com/vitamin-mineral/sport-horse-grass.html

Equi-Base Grass  http://equine.uckele.com/vitamin-mineral/equi-base-grass.html

Arizona Copper Complete (contains manganese)  https://horsetech.com/equine-supplements/custom-non-stock-products/arizona-copper-complete (will need to add magnesium)

 

Note that one should find out if one is in an area needing selenium, or if you are in a selenium-rich area; the same applies to manganese. Your agricultural extension office should be able to tell you.

 
 Also, some horses get footsore on alfalfa. I know she has been on it for a while, but while you are trying to figure out exactly what is contributing to her current issues, removing alfalfa would be prudent.

If she has been on the Equioxx for a month, she should be weaned off it. There is a phenomenon called NSAID rebound, where humans and horses who have been on NSAIDs like such as previcox, ibuprofen, naproxen etc (and bute in horses) get much worse pain after stopping the NSAIDs cold turkey, than the pain was at the beginning. In order to wean off, one stays at the same dose, but increases the time between doses.  So.... if giving the dose every 12 hours, then go to every 24 hours for 2 days; then every 36 hours for 2 doses; then every 48 hours for 2 doses; then every 3 days for 2 doses; then every 5 days for one dose; then stop.

Just a note: Bute and Equioxx (Previcox, firocoxib) are both NSAIDs, and both work in very similar ways. If Alley is getting both, that is a double-overdose. Plus, the dose for Equioxx is .045 mg/lb,  or 0.1 mg/kg, so for Alley would be 42.75 mg, or 3/4 of a 57 mg tablet. Furthermore, firocoxib  takes more than 24 hours to even partially clear from a horse's system, so there is a virtual increase in dose every time you give it once daily. (which is why the manufacturer states not to give for more than 14 days).

If Alley were mine, I would immediately go to 3/4 of a Previcox/Equioxx tablet, and stop the bute (if she is still on it). Then I would wean her off as above.

Synopsis:

Stop the TC 30, and stop the alfafla. 

Continue with magnesium, Elevate E, flax, and salt.Add in an acceptable ration balancer until you can get a hay analysis, and custom balance.

Stop bute (if she is still on it). Go to 3/4 tablet Equioxx, and then wean off as above.

Continue pergolide; wean off starting in January; do a TRH stim test Feb - July.



And, just in case you thought that this was TMI, the big and comprehensive official welcome letter will follow in the next post. 

Thanks again for being such a good horse mum.

--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711


Re: Extreme flank sensitivity and tenderness in IR horse during cycle

hdavis
 

Hello,

No I have not had her eye examined and never thought of that.   Was thinking maybe she is having a rib issue or a diaphragm issue which could be causing the issue. I have a call into an osteopath as well as a vet appt lined up. Any other thoughts or ideas are welcome!

Hope your pony gets back to normal Ronelle!  Hugs and healing wishes!!!
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

 Photos
https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .



Re: Winter care for ppid ir horses?

 

Hi Leslie,
Don’t the socks and felt get wet? I have lots of pea gravel and river sand in the paddocks that keeps puddling and deep mud to a minimum but . . 
These sound like a good option to try for dry conditions in the cold. 
--
Robyn & Toons
North Bay, CA

April 2016

https://ecir.groups.io/g/CaseHistory/files/Robyn%20and%20Toons

https://ecir.groups.io/g/CaseHistory/album?id=9117

 


Re: Winter care for ppid ir horses?

 

Hi, Leslie. How do the Easyboot Trails do in the rain? Once a boot gets wet, it pretty much does the opposite of keeping the hoof warm.
--
Cass for Cayuse (PPID/IR) and Diamond (IR)
Sonoma County, Calif. Oct. '12

Cayuse Case History                Cayuse Photos
Diamond Case History              Diamond Photos


Re: Cindy and Snickers Rads Added for Mark-ups from Lavinia

cindy@floodfarm.com
 

Hi Lavinia,

We took out all the excess supplements and have tightened up his diet to only the mineral mix, Vitamin E, salt, flax, and the tested hay. I have updated the Case History to reflect all changes including reducing Previcox amount to 56.75 mg/day. We also swapped supplement carrier to Haystack Low Carb/Low Fat Blend. One thing I forgot in the Case History is that we also have him down to 16 pounds of hay per day through a slow feeder net. The hay was definitely balanced by a professional who uses a program called FeedXL, I'd have to look through records for her name. The next trim is scheduled from November 18th, my trimmer is monitoring this case online and we look forward to seeing the mark-ups.

Thanks,

Cindy
--  
Cindy and Snickers
Washington, USA
Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Cindy%20and%20Snickers

https://ecir.groups.io/g/CaseHistory/album?id=77459


Penny had her trim. Lavinia, Jaini are we on the right track or is LF toe still too long?

Patty Cravens
 

I posted pics taken 2018-11-08 right after her trim. My trimmer said if she trimmed anymore toe on LF she would be in live tissue. She said the difficulty with relying on mark-ups is they were only 2 dimensional and "Lavinia can't see what she is seeing." If you think she needs more off her toes, I will either try myself or have a more assertive discussion with my trimmer (or find another trimmer).  I put her in boots on all 4 as directed by Lavinia (was only wearing boots on fronts prior)  She is moving well. How will I know how much to trim off her boots for breakover? Do I rasp or nip the boot material?  I tried to find info in the files on how much to shave off, but only found a picture of the whole toe cut out. I understand the importance of  this, but must admit I am a bit fearful of cutting off the toe of these boots. She is wearing Easy Boot Clouds on her hinds and Cavello's on her fronts. Thank you in advance for any advice. 
--
Patty and Penny in Mazon, IL
Feb 2018

Case history: https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny   

 

 https://ecir.groups.io/g/CaseHistory/files/Patty%20and%20Penny


https://ecir.groups.io/g/CaseHistory/album?id=27571. 

 


Re: Introducing ourselves

Annette
 

Dawn, thanks for the tips.

I have been going back and forth on the Vitamin C. I initially incorporated it into my rations after the wildfires in August created so much smoke, but kept it up at a low level since Alley is now 17. Coincidentally, I decided to cut it out of her ration today myself. It was good to have that step confirmed by someone else!

The ration balancer is more problematic.  We have a choice of about 3 feeds locally (within 50 miles): Purina, LMF, and Triple Crown, so choice is limited.  The timothy hay I am feeding is low starch/sugar but pitifully low in protein (around 4-5%) and high in iron.  I am able to balance the hay out for protein and  vitamin/minerals for my non-insulin resistant horses if I feed 4 lb of alfalfa hay as part of the diet together with a vitamin/mineral balancer - I currently use Mega-Cell  for my other horses on timothy + alfalfa but am considering moving over to the Uckele U Balance for them.  Alley was on this ration until she came down with laminitis. Then the vet said cut the alfalfa. That led me to a search for a balancer that would balance the protein too. I looked at some possibles that I could order shipped to me but the shipping cost to my location was prohibitive. Triple Crown 30% is the only one so far that I can find that comes close to meeting my needs. It is really disappointing to find that sugar/starch may be higher than claimed, but at the moment it seems like it is the best I can do while I search for an alternative. 

I have three other batches of grass hay in my barn and they have been sent for analysis. If any of those prove more suitable, I may be able to work with a different ration balancer and quit the Triple Crown. Here's hoping that they work out!


Annette and Alley
October 2018, Moscow, Idaho
Case History: https://ecir.groups.io/g/CaseHistory/files/Annette%20and%20Alley/Alley%20Case%20History.pdf  .


Lowering extremely high insulin

Sheila
 

I'm at a loss on making Daniel comfortable.  We are making progress on his trims but he remains very sore.  His insulin is >200 .  We've had his hay tested and are feeding a balanced custom mineral supplement.  We even tried Prascend although he does not have Cushings.  That did not help at all. I'm hesitant to try thyro-l as he remains a little thin.   Would it be appropriate to try Metformin? 
--
Sheila
October 2017
Central CA Sierra foothills

https://ecir.groups.io/g/CaseHistory/files/Sheila%20and%20Daniel


Re: Extreme flank sensitivity and tenderness in IR horse during cycle

Ronelle
 

Years ago, my horse was deemed "girthy" and we discovered he had two crossed ribs that were squeezed no matter what saddle was used.  In the past several years he started to be weird spooky on his left side, more than usual.  I had had his eyes checked by a regular vet who said there were cataracts, but I finally had his eyes checked by an ophthalmologist a few months ago.   It was discovered his left eye was destroying itself and causing him pain.  With the type of damage he had, the ophthalmologist told he most likely was seeing flashes of lights and strange darkness as floaters moved around in the eye, nothing "normal".   A chiropractor took care of the ribs and the eye was removed about a month ago.  Fingers crossed I'll get my quiet horse I know he can be.   Have possible structural and eye issues been ruled out?
--
Ronelle and Yoyo
2015 Bend, Or, US


Re: Introducing ourselves

celestinefarm
 

Annette, one of the vets will advise you regarding the Equioxx. Your case history is great, a couple of things I noticed that you might want to reconsider. Triple Crown 30 has been tested several times by members here who have sent it in to Equi Analytical and it often is higher in sugar and starch despite the company's claims it is 10%.. One member sent a sample in after her previously comfortable IR horse suffered an episode of laminitis which is what alerted us to the possibility of 30 being a problem.
Also, if you are concerned regarding high iron in your hay, you do not want to feed supplemental Vit C. Vit C has been shown to increase blood stores of iron in the horse.

I would discontinue both of those items. You can use a different ration balancer or have a custom one built for your hay. See the files for a list of balancers and carriers , and the two bagged feeds that are safe for IR and PPID/IR horses.
https://ecir.groups.io/g/main/files/6%20Diet%20Balancing/Commercial%20Supplements%20SAFE/Acceptable%20Commercial%20Supplements%20for%20Ration%20Balancing.pdf
https://docs.google.com/spreadsheets/d/1IwQi2duYVTjPhQT_Q8EJBHYnSINnqGU50wVVj24c4kA/edit#gid=0
https://ecir.groups.io/g/main/files/9c%20Analyses%20of%20Various%20Feeds/Triple%20Crown%20Products/Triple%20Crown%2030%20Percent%202016-09-03.pdf

Vit C caution via Dr. Kellon's website, Horse Sense.

Vitamin C has low toxicity, the major issue being gastrointestinal irritation and diarrhea at high doses (typically 20 grams/day or more in an average sized horse). Caution should be used in insulin resistant horses or other horses known or suspected to be iron overloaded.  Vitamin C increases bioavailability of inorganic iron by changing its electrical  charge and directly stimulating absorption. 

Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History


Introducing ourselves

Annette
 

Hello.  My name is Annette and my 17 year old Connemara x TB mare is called Alley. I have owned Alley since she was a weanling and use her for backyard dressage, natural horsemanship and trail riding.  We joined the group at the end of October.

A little background: Alley has always done well on grass during May to September, (our grazing period here) building up to around 8 hours. She doesn't get overweight and always performs well during the early summer months. She had her first laminitic episode at the end of this September. Although not overweight, she did have a small crest (noticed late summers since 2015) and seemed lethargic when ridden. I first noticed bulges over her eyes the week before she became lame.  Since she is a pony breed, I have always worked to keep her starch and sugar low and avoided grain supplements.  In September of 2015, I increased the magnesium in her diet because her muscles and tendons seemed tight. The addition made a remarkable improvement to her muscle tone and fluidity.

Fast forward to this September: The vet exam found bounding digital pulses, but no response to hoof testers and minimal rotation was seen on X-rays. Based on her background history, the vet suspected that Alley had insulin resistance made worse by the seasonal rise in ACTH (which I had never heard of till then!) resulting in laminitis. Blood testing showed high ACTH, high insulin and high glucose. We started Alley on Prascend, building up to 1 mg a day, and I have been working to further reduce sugars/starch and balance minerals in her diet. At my request, when Alley got worse after two weeks, we did a full blood panel, plus a Vitamin E/Selenium test. I was concerned that there may be more going on with her muscles than the laminitis alone. The blood panel was normal as was the Selenium, but she was deficient in Vitamin E so Elevate WS was added to her supplements. The farrier has shortened her toes and an Equine Rehab Practitioner has worked to relieve her muscles.  

I am pleased and relieved to report that Alley is much improved.  She is walking around actively in her Easy Boot Clouds, eating well, and is bright and alert.  My guess is that several factors have led to the improvement - the changing season, the Prascend, and the Vitamin E and massage, and also tightening up her diet. We still have a long way to go, but I am hopeful.  I want to take her off Equioxx as soon as the vet gives the OK, and I am still working to balance the minerals in her diet to my satisfaction.  My main challenge now is to compensate for the high iron in the hay and our water, knowing that my fussy mare will detect every addition of mineral to her diet and rebel by refusing all supplements!  I have uploaded Alley's case file and will try to fill it out with more details as I get time.  I don't have any emergency questions, but am still feeling my way as to how to proceed from here. I am also wondering if Alley is fully PPID at this time or just has a high seasonal rise that pushes her over the edge in the fall. I worry that there is not much more I can do to her diet to help her situation and don't know how much it is a contributing factor. I know the iron is something that needs balancing with copper and zinc, but also know that will be hard to put into practice. I look forward to receiving your input as we go forward.  Thanks!
--
Annette and Alley
October 2018, Moscow, Idaho
Case History: https://ecir.groups.io/g/CaseHistory/files/Annette%20and%20Alley/Alley%20Case%20History.pdf  .


Vitamin supplements/ herbal supports/ flax found vs seed

Cheryl Oickle
 

Hi I am overwhelmed with information regarding the above.  I currently use Dr. Reeds pelleted vitamin/mineral supplement and have for years.  My mare is currently on half a cup a day. I am considering a trial of herbal remedies produced by silver linings herb from the US , and the two I am interested in are laminae support and pituitary support.  Is there contraindications to these while on the vitamin supplement? As well lots of information on flax.  Do you recommend ground or whole and how much do you feed.?  My mare is on 1 mg pergolide and doing well...this last week.
--
Cheryl and Jewel
Oct 2018

https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel


Re: Extreme flank sensitivity and tenderness in IR horse during cycle

hdavis
 

Hello Dr. Kellon,

She isn't bothered when I groom her as I can touch her anywhere with no issues.  Blanketing bothers her as well.  She doesn't appear sensitive when approaching from behind without a blanket or saddle pad.  

As for the spookiness it happens anytime.  She can be standing quietly and spook at anything.  A crow flying over, a tree snapping, a squirrel, the wind blowing anything... which is so not her as she previously was a mare that was not afraid of anything.  

Originally her flank sensitivity was on the right side and when my vet examined her and manipulated the ovary back into its normal position her sensitivity on that side stopped. But not it is on the other side.  I have her rechecked and the ovary seemed ok position wise.  So not sure.  My next step was the hormone testing.  I am perplexed.  I guess if I did the testing it would rule that out.  

I did have her on chastetree berry but her spookiness almost seemed to increase while on this so I stopped.    No idea what is going on. Just thought maybe someone had some ideas.  Thanks for all the help!!!
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

 Photos
https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .



Re: Extreme flank sensitivity and tenderness in IR horse during cycle

Eleanor Kellon, VMD
 

 Does she do this when you are just grooming her or approaching her from behind for reasons other than saddling?  Can you put a blanket on her?  When did this start?

if it's not tied to where she is in her cycle and you can tell she is cycling I doubt it's related to her ovaries.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


ECIR Group - Equine Cushings and Insulin Resistance #FACTS

main@ECIR.groups.io Integration <main@...>
 
Edited

By ECIR Group - Equine Cushings and Insulin Resistance

There has been lots of discussion about this on the ECIR forum. Thanks for the timely article Dr. Kellon!


Re: Extreme flank sensitivity and tenderness in IR horse during cycle

hdavis
 

Thanks Dr. Kellon.  She also has an issue with increased spookiness which she was never like before (previous to 2017) and extreme flank sensitivity.  They are both constant and I don't see a difference really during her cycle as always seem to be an issue.  The flank sensitivity is especially prominent when I saddle her - doesn't matter what saddle - western, dressage, Spanish or what pad- she gets super fearful and holds her left hind in tucked towards her body.  She stands frozen worrying about moving during saddling and then when saddled does the same and even sometimes humps up a little.  If I untie her and walk her straight she is better but if she turns and the saddle pad touches her flank she bolts forward or jumps or scoots sideways in fear.  She is like this no matter where she is in her cycle.
I should also mention all her saddles have been fitted by saddle fitters as wanted to rule that out as well. 

When unsaddling her she stands frozen again and I have to be super careful when taking the saddle or pad off as if anything touches her flank she looses it in fear.  

She is sound and happy in all other other ways.  She runs and plays, rears and bucks and enjoys herself.  The spookiness and flank sensitivity is our only issue but it has become a major issue as has become almost dangerous to tack her and ride her.  My sweet andalusian who nothing phased before is now a fearful spinning and reactive horse.

I am beyond perplexed at this point as have been tracking both the spookiness and flank sensitivity closely and they don't seem to change much.  Just looking for options but I guess for now I should get the hormones tested and then go from there.  Then at least we have ruled that out.  Thanks for all the help!!!


--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

 Photos
https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .



Re: New here

 

Hi, Kelly, and welcome! I am so glad you found us.  You have done a fab job on your case history and signature.

Yes, you can upload the hay analysis pictures and x-rays in the Photos section of the Case History site = that would be grand.

It looks like you are well on your way to making things better for Bella, and with some tweaking it can be made even better.  I do suspect that the high insulin, despite the dry lot and other changes, is related to the seasonal rise; things might look better in the spring.

EMS/IR -prone breeds often have signs show up when they finish growing, so anywhere from 6 to 8 years for breeds like warmbloods. This seems to fit the time-line.

The (very full!) official letter will be below, but the first thing that struck me in the case history is the use of Purina Integri-T, and the Fat and Fibre Chunks.  Although Purina states that the Integri-T is less than 10% ESC and starch combined, they never have given the actual starch analysis. It could well be that the starch is over 6% or higher, which would be enough to keep the high insulin ticking over. I couldn't find the ESC and starch for the FFG Chunks, either. I have emailed Purina Canada to ask if we could please have those numbers. Here is the infamous "2 apples" story: https://ecir.groups.io/g/main/message/228585 

Here is a list of safe bagged feeds (not all of which we can get in Canada):

Rinsed/soaked/rinsed beet pulp

 Soy hull pellets

 Triple Crown Naturals Timothy Balance Cubes https://www.triplecrownfeed.com/products/timothy-balance-cubes/  

Ontario Dehy Timothy Balance Cubes  http://www.ontariodehy.com/tab02-07.htm  

 Nuzu Stabul 1 http://stabul1.com/stabul-1/   

 LMF Low NSC Stage 1  https://lmffeeds.com/low-nsc-stage-1/     

 LMF Low NSC Complete http://lmffeeds.com/products/low-nsc-complete/ 

Haystack Low Carb/Low Fat Pellets  http://haystackfeeds.com/?page_id=69      

Good on you using the Mad Barn AminoTrace+.  Once your hay analysis is up, we can have a closer look at how well it fits your hay.

And now, as promised, the long letter. There is lots of information here, so grab a cuppa, and enjoy.

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, substituteadiponectin 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! 

Ask any and all questions, and, again, welcome!

--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711


Two Apples Story

 

Hi, folks - thank you for your indulgence. I just wanted this in a post so that I could find it more easily, as searching for "two apples" brings up all of the official welcome posts.

Also, (and here comes the two apples story again - I can just hear everyone groaning), even a small amount of seemingly safe treats can make a difference. I was privileged to rehab an IR Swedish Warmblood who had an episode of laminitis secondary to a rich clover pasture.  Things seemed to be going well (he was at a boarding barn), but he was still hesitant when turning around on the concrete barn aisle. I then discovered that he had been receiving two weeny little apples a day (not the kind you buy in the grocery store - theses were the dinky little things that are just about all we can grow up here). Those two apples a day, in a 1300 pound horse, were enough to stall the healing process. Once the apples were removed, within 2 days he was turning with ease in the barn aisle.  Make sure your gal isn't getting anything besides feed that is below the !0% ESC plus starch, with starch less than 4%; and no apples etc as treats.

--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711

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