Date   

Re: footing for dry lot

Cheryl Oickle
 

We use field dressing.   It’s a sand....not too fine doesn’t pack nor wash away easily with rain....my laminitic horse loves it!
--

--
Cheryl and Jewel
Oct 2018

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

https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: Bloods & xrays

Eleanor Kellon, VMD
 

You're doing a very good job with diet and meds for hormonal control. The major problem is sinking so need to keep to a trim program of aggressively backing up the toe without removing any hoof height from the sole, boot and pad for comfort.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: How much flax seed oil can I feed 2 cups ok?

 

Thanks for the suggested alternative, Chris.  I’ve been using the Cashel bag, which has been fine for the most part.  It’s only getting used in his stall.  I had some old canvas feed bags that belonged to my MIL which I think I may have unfortunately discarded.  Should you ever get the brilliant idea to set the the feed in a small feed bucket inside the feedbag, I advise you to control yourself.  I read about it somewhere and it seemed perfect for facilitating cleanup.  Once your horse floods his stall by submerging this get up into his water bucket, you will understand why.  
--
Martha in Vermont
Logo, Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)
July 2012

Logo's Case History: 
 


Increase Prascend to improve shedding?

Marion.grau1@...
 

Jingles has been on Prascend, .5 mg, since November, after testing borderline for cushings last October. The horses at her barn are now starting to shed as days get longer here (Vancouver Island, Canada).  However, Jingles still has a longer coat than normal and is shedding minimally, much less than the others. 

Is it useful to increase the dosage of Prascend if shedding seems to be slow? How quickly will it be effective? Or should I wait for the next annual tests, not due until fall!
Her case history has just been updated and posted.

Thank you!
--
Marion
Victoria, BC. Canada

Joined October 2018

Case History: https://ecir.groups.io/g/CaseHistory/files/Jingles%20and%20Marion
Photos: https://ecir.groups.io/g/CaseHistory/album?id=75938


Re: How soon should I re-test ACTH levels after starting on Prascend?

Pauline <takarri@...>
 

Hi  patcyr1(?)

I see that Dr Kellon has answered your question regarding the retesting- thanks Dr K!

As this is your first post to the group, I’m going to share with you the new members primer that brings you up to date with the current management  practices for a horse with PPID/IR.

 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. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

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. 

 -- 

Pauline

Geelong. Vic

Australia Aug 07

ECIR Mod/Primary Response

 

 Harry, Jack and Spur's Case Histories   


Re: Shetland pony with laminitis

Pauline <takarri@...>
 

Hi Karina & Welcome!

Sorry you have to be here- but you’ve come to the right place.

Without a bit more history it’s hard to give you definitive answers for your particular pony- but we can make a start.

Firstly, how old is this pony?  When the vet came out to take the bloods, did he test for PPID as well? (ACTH test)  The reason I ask this is, currently in the Southern Hemisphere, we are entering what is known as the seasonal rise https://www.ecirhorse.org/seasonal-rise.php,  and so if she has tested positive for PPID as well- she will need to start on treatment of pergolide as soon as possible. Once you get a copy of her blood results, please add them to her case history.

In the meantime- you are doing a great job of being proactive with the soaking of the hay & the dry lot. It’s possible that the gorging on the green grass (and what pony can’t resist that!) was enough to tip her over the edge.

Here is some information regarding grass breakout to keep on hand- should she decide to play Houdini again.

https://ecir.groups.io/g/main/files/Emergency%20Protocols/Protocol%20for%20horse%20that%20got%20out%20on%20grass.pdf

 I would also be looking at stopping the bute if she has been on it longer than 5 days. This is covered in the Exercise section of the letter below and offers alternative options for pain relief. You may also want to consider booting or padding her feet for more comfort.

You are correct about the oaten chaff. The sugar/starch is an unknown entity so best to stop that as well & just keep to the emergency diet for now. 

I hope that you don’t also currently have to deal with any bushfires in your area; you have enough on your plate without having to worry about that.

 Please have a read of the following to bring you up to date with the management of a horse/pony with PPID/IR

 

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. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

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. 

 -- 

Pauline

Geelong. Vic

Australia Aug 07

ECIR Mod/Primary Response

 

 Harry, Jack and Spur's Case Histories   


Bloods & xrays

Leonora B-C
 

Hello All

I've been able to have some xrays done for Guinness and I've added them to his album - I'd be grateful for any comments.  I've also had repeat blood tests, results shown below.  Again, comments, observations would be really useful.

As per my previous message, #230744 · Jan 6, I can't update Guinness's case history.

FYI

Blood tests

 

Date

Test

Result

Normal range

27th September 2013

ACTH

63.1 pg/ml

<47 seasonal adjust

21st May 2014

22.1 pg/ml

<29 seasonal adjust

15th October 2014

22.0 pg/ml

<47

31st December 2016

20.9 pg/ml

<29

31st May 2018

43.7 pg/ml

<26 season adjust

12th September 2018

61.2 pg/ml

<47

16th January 2019

15.2 pg/ml

<25 season adjust

31st May 2018

Insulin

(resting)

12.1 mIU/l

<20

12th September 2018

41.4 mIU/l

<32

16th January 2019

11.4 mIU/l

<32

31st May 2018

Glucose

4.4 mmol/l

2.3-6.8

12th September 2018

5.6 mmol/l

2.3-6.8

16th September 2019

4.5 mmol/l

2.3-6.8

31st May 2018

HMW Adiponectin

1.93 ug/ml

>3.2

12th September 2018

3.45 ug/ml

>3.2

16th January 2019

2.82 ug/ml

>3.2

 




Leonora & Guinness
Oxfordshire, UK
Joined May 2018
https://ecir.groups.io/g/CaseHistory/files/Leonora%20and%20Guinness 
https://ecir.groups.io/g/CaseHistory/album?id=52789 


Re: How much flax seed oil can I feed 2 cups ok?

Nancy C
 

Thank you for reminding me of this Martha.  I used a feed bag as well for Beau.  it was to make sure he ate all of his pergolide/Nuzu mix, but I can see how well it would work for the need to get in extra meals.
--
Nancy C in NH
ECIR Moderator 2003
DDT+E = effective treatment for PPID and EMS/IR equines: https://bit.ly/2J4ZgYT

 


Re: New PPID Diagnosis

Pauline <takarri@...>
 

 

Hello  Stefanie

Welcome to the group! 

Thanks so much for filling out a a case history and supplying a link. It’s a big help.

I see that Dr Kellon has made some suggestions regarding the salt consumption- so please do reduce the dose to the 2 oz and keep a daily record of results.

As soon as you get a copy of the blood results, please add them to your case history. Did the vet run a glucose and insulin test as well? It is rare for a TB to be insulin resistant unless he is also PPID.  Once you get the PPID under control, his glucose and insulin may return to normal.  Meanwhile he needs to be treated as both PPID and IR.  That also means no grass access until you have a definitive answer.

With the group, we have found that a majority of horses are not well controlled on a dose as small as .5mg- so please have a word to your vet about increasing the dose to at least 1mg and retest the ACTH in 3 weeks time (add a Glucose & Insulin test as well)

Regarding the diet- below in this message is the emergency diet- start to implement that- it does include beet pulp & stop the 12.8 pellets all together. They are not suitable for a horse with a metabolic issue.

With the hay- it may be prudent to soak it – one hour on cold or half and hour in hot- until you can find a away to store more bales(3-4 months worth)  to make it worth while testing. Many members are in the same position & have come with ways to store hay- in a car port, garden shed, rented loft space, etc. 

Below is the rest of the new members message:

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. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

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. 

--

Pauline

Geelong. Vic

Australia Aug 07

ECIR Mod/Primary Response

 

 Harry, Jack and Spur's Case Histories   


Cushings, IR, DSLD

Deirdre O'Malley
 

My Spanish Mustang mare, Kesa is 20.  She has allergies and heaves & coughs at the slightest thing so needs to take a Dexamethasone tablet almost every day  sometimes she needs several pills when she gets an attack..I've been steaming her hay  .. Not sure if it's making a difference. The cold weather can cause her to heave and cough too.  She is IR, (the vet put her on Metformin) she has Cushings and is on Pracend and developed DSLD last winter!  She has responded very week to Dr. Kellon's treatment for DSLD. She actually will run around every once in a while, but I'm afraid to exercise her because of the DSLD. She was so badly in pain that she couldn't stand for very long.  Joints were the size of small grapefruits! 
I don't know what to do with her! 
She NEEDS exercise because she's FAT!  I'm afraid to exercise her because of the DSLD!  She's not ridable, we would have to do ground work, but i don't know how much to do or what to do with her. Long line lounging? Walk only? For how long ? ?   Is trotting ok? 
I'm terrified to aggravate her joints, but i also can't starve her to get her weight down. I'm just so confused. I feel like I'm slowly killing her, and i love her so much  I live in North Carolina. The vets around here are STUPID! I moved her from Long Island, NY three years ago and she literally fell apart here. No pastures on Long Island.... Nothing but pasture here! I created a dry lot for her, but she grazes at night. I've been feeding her Bermuda Coastal hay, a very little taste of beet pulp/alfalfa pellets soaked (which is for my old goes to keep weight on him)  and  something called Metabolic Miracle which is for Cushing/IR horses...  Its mostly 90% finely shredded, chopped alfalfa with some essential oils and a trace of wheat & soy meddlings.
Please help! I would appreciate ANY input! 


ECIR Group - Equine Cushings and Insulin Resistance - ECIR Group - Equine Cushings and Insulin Resistance updated their cover photo. #FACTS

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


Re: Two new videos loaded on YouTube of Savannah walking and trotting after January trim.

Pat Gauvreau <pgauvreau@...>
 


Re: New PPID Diagnosis

Stefanie Delasandro <sdel4521@...>
 

We did.  The vet didn’t feel she’d been given on average more than 2 gms/day.  The drinking/salt is not new but has been a feature since I bought her and is the ACTH.  I just was just wondering if the drinking/salt was keeping her wet. And if there was anything I could do to help heal her gut.

--
Stefanie D.
central TX
Jewel's Case History


footing for dry lot

Tucker
 

My pony is doing so well and she is moving around very nicely with her softride boots on, For part of the day, she has been going in a large makeshift stall at the end of the barn aisle so she has more room and a change of scenery. We are sticking to her emergency diet, she will hopefully be getting another trim this week. What I am wondering is how to go forward in getting her some exercise? I lead her up and down the soft shavings covered aisleway of the barn, but how do I determine how much to increase the distance and when?? Should I keep her soft ride boots on? I am afraid to turn her out in the small lot I made for her outside as she had a flare up late December when she was spending time in it. I would like to designate an area that can be a dry lot which would be fairly small and half circle shaped behind a round pen. What kind of footing would work best? I was thinking a fairly thick layer of screened sand rock and another thick layer of pea gravel on top of the sand rock. We would have to have a drainage area through it from the round pen. I appreciate any advice and tips from all who have made a successful dry lot!
--
Tucker and Indigo
NC, Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Tucker%20and%20Indigo 
https://ecir.groups.io/g/CaseHistory/album?id=80036


Re: New PPID Diagnosis

larkstabatha
 

Hi Stefanie,

Having witnessed this same behavior of salt and water consumption in a friend's horse in what turned out to be Kidney Disease, and with your mare's history of being overly medicated with Bute by the boarding barn, I might recommend the additional precaution of doing blood work to test her for kidney function.
--
Sally in Big Park, Arizona/April 2013

https://ecir.groups.io/g/CaseHistory/files/Sally%20with%20Tabby%20and%20Maisie 

  

 

 


Hair Mineral Analysis Testing

Bev and Skeeter and Magic
 

I am wondering how effective a Hair Mineral Analysis (HMA) would be or a PPID or IR horse. I have been told by an Equine Cushings Disease (PPID) Facebook group that it is a scam and a waste of money and that the company that provides HMAs for horses is only out to sell us their products (I won't name the company but it is a well known one). I am interested because I had heard that it was a good way to find out what is going on inside a horse, in addition to blood work.

Thanks for any thoughts.
--
- Bev and Majestic (IR) and Skeeter (PPID)
May, 2017
Prescott, Arizona
https://ecir.groups.io/g/CaseHistory/files/Bev%20and%20Majesttic 
https://ecir.groups.io/g/CaseHistory/album?id=6597


Re: How much flax seed oil can I feed 2 cups ok?

Lavinia Fiscaletti
 

Hi Chris,

I've added the link to his photo album to your signature.

To make links clickable, you need to hit Enter after the url (it will show up highlighted in blue when active).
To change your signature, go to the Subscription tab at the top left of the page. When it opens, scroll down to the signature box and make any changes you want. Then need to scroll to the bottom of the page and hit Save.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team


Re: New PPID Diagnosis

Eleanor Kellon, VMD
 

No. The salt is not causing the edema but it might be contributing to the drinking. Try taking the block away and just putting 2 oz of salt in the bottom of her feed tub every day. If that doesn't resolve the drinking and urination issue it might be a sign of uncontrolled PPID. Need to make sure the ACTH is controlled. The usual procedure is to get them up to 1 mg/day then retest in 3 weeks.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: How much flax seed oil can I feed 2 cups ok?

 

I’m dealing with similar issues.  Someone suggested a feed bag for Logo because he spills so much.  I’ve been playing with one for awhile, sometimes with better results than others.  He’s had this adorable habit, as long as I’ve owned him, of sharing his food with his neighbor and I have a hard time controlling that horse’s weight as it is.  This limits the sharing.  When I began researching feed bags, I learned that many people use them on horses in groups to alllow some of them extra feed.
--
Martha in Vermont
Logo, Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)
July 2012

Logo's Case History: 
 


Re: New PPID Diagnosis

Stefanie Delasandro <sdel4521@...>
 

Bute was stopped months ago.  She will drink 5 buckets dry in a 24 hour period.  She got a new salt block a week ago and has already licked the top eighth of it gone.  Considering the continuing edema, is that much salt consumption contributing to the edema?


--
Stefanie D.
central TX
Jewel's Case History

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