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Re: 15 yo RMH with worsening squirts

 

Hi Judy,
I know you've been a member since 2012 but it's been a while since you've posted. You will be getting some replies that will hopefully give you good suggestions to help your horse. I do suggest that while you wait that you do some searching of the messages here in the main group using terms like "gut", diarrhea, squirts, etc.

This newer ECIR group format has some basic requirements we ask of all members. We ask all members (yes even returning members) to provide more info about their horse. The easiest way for me to pass this "How-to" info to you is by giving you our "New Member" welcome post. It has all the links and info with the document below. Please get your signature created, join the case history group and begin a case history for your horse. The info you provide in your horse's case history is needed by our experienced volunteer moderators. They need diet info, etc, which you will put into your horse's case history.

Welcome to the group! 

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.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know 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.

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. 

--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Re: MightyCause Donation

Joy V
 

I also signed up on MightyCause and my account shows nothing.  I don't understand how I can manage my donations when they don't even show up under my account?  I followed the link you posted and signed, but it shows nothing about ECIR.  I'm usually pretty computer savvy but this webpage has me stumped...  Any guidance?

Thank you!

--
Joy and Willie  
(aka FLS Boxcar Willie)

Nevada County, CA - 2019


Re: Feeding older horse file by Linda S.

gypsylassie
 

Hi Joella, hopefully your vet can get Oliver fixed up and back to eating hay.   If it does turn out that he has to switch to soft, mash type meals, your best bet is probably the Timothy Balance Cubes.  There are a good number of senior horses doing well on them. Also several who do very well on a mix of softened cubes and r/s/r  beet pulp.  
If Aurelio is able to find a way for you to get them, you may have to get a fairly large amount at a time.   At one point I had to buy a pallet at a time.   I'm just using them as part of Chappie's small bucket meals, but the cubes have a very good shelf life if you store them as you would hay.
Aurelio has also set them up to be distributed by Triple Crown Feeds.   They are packaged and labeled as Triple Crown Naturals Timothy Balance Cubes.  
Laura K Chappie & Beau over the bridge
2011 N IL


15 yo RMH with worsening squirts

minipop10 <stbn5108@...>
 

My 15 yo RMH was diagnosed with Cushings in 2018 with an ACTH of 60.6. Testing was initiated due to a couple of mild episodes of laminitis which resolved completely and quickly. His Insulin at the time was 101.52 and Leptin 23.53 both of which are now within normal range with diet management and a dry lot. He has been on 1/2 mg of Prascend since 8/2018 with no issues until this summer when he developed progressive and worsening squirts (normal manure but squirting liquid all day). There was no change in his hay or diet. I am a long time member of this group and have tried many of the suggestions offered in the files including adding the following to his Balance Timothy Cubes and California Trace Supplements (plus salt and vitamin and Mg): probiotics (Ration Plus), Uckele GUT, Uckele Psyllium Powder, L-Glutamine, Ucklele Absorball. I added each one at a time until he was accepting all of them with no improvement. My vet offered a trial of Metronidazole and 'Bo' went off of his feed when the pills were added. I managed to get one dose into him and noted a 4 day break from the squirts. He does not tolerate having anything syringed into his mouth so that is not an option. I live in northern New England and since the temps are now below freezing I can not hose him off (I was hosing twice daily). I have used Horseman's lab to test for worms and the tests have always come back negative. I will have my vet test for parasites but he is on a dry lot alone next to my mare and manure is picked twice a day. I am not confident that parasites are the issue. Am I missing anything? I can not see going through the winter without being able to hose his backside and legs. He's a mess. I need solutions asap. 
Desperate,
Judy


Re: Feeding older horse file by Linda S.

J Foust
 

Thank you ladies!  That helps a lot!  For the next few days we’ll have to get by.  :-/ 
--
Joella Foust 
Montana
2015
Bronwynn
https://ecir.groups.io/g/CaseHistory/files/Joella%20and%20Bronwynn/Bronwynn/Bronwynn%20Case%20History.pdf
https://ecir.groups.io/g/CaseHistory/album?id=91706&p=pcreated,,,20,2,0,0
https://ecir.groups.io/g/CaseHistory/files/Joella%20and%20Bronwynn/Hay%20Analysis/Lewistown%20Hay%202018.pdf
Houston
https://ecir.groups.io/g/CaseHistory/album?id=116873
Negrette, Houston, Oliver, Riley, Graybee, Diesel, Zsa Zsa, Bronwynn
Asleep: Hunter, Snip, Frisky, RyeLee, #5


Re: Feeding older horse file by Linda S.

Buzz
 

The Timothy Balance cubes are from Ontario Dehy. 877-299-3349. They are very helpful and may be able to send to you. They also have a web site. 
--
Marsha Brandt. TN  2017


Re: Feeding older horse file by Linda S.

Lorna Cane
 

Joella, I don't know if Aurelio ( Ontario Dehy) is around, but he frequently reads here.

If I were you, I'd contact him. He can often sort things out for our members who have had trouble sourcing his cubes.

www.ontariodehy.com

--

Lorna Cane
Ontario, Canada
2002


 


Re: MightyCause Donation

Nancy C
 

Hi Reta

Thank you so much for your support.

Our records show you have signed up for $5 recurring monthly donations. You shoudl receive a receipt every month.

How to check and manage your donation status is here:

https://support.mightycause.com/hc/en-us/articles/360015176772-How-to-Set-Up-and-Manage-Your-Recurring-Donation-on-Mightycause

Or go directly to your dashboard in the upper right hand corner of your MC home page and click on your name, scroll down to DONATIONS.  The link above will also walk you through these steps.

Thanks again, Reta.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA


Re: Stabul 1 Plus OK to give to ECIR horses in work?

Lorna Cane
 

Thank you, Kelly. That is so good to know.

And thank you, Randy. I've heard only good things about your company's customer service.
Now , if we could just get your products up here.😊

--

Lorna Cane
Ontario, Canada
2002


 


Re: Feeding older horse file by Linda S.

J Foust
 

I’ve called the three feed sources in 100 mile radious.  No balanced cubes of any kind.  No grass hay cubes for that matter.  So I guess I’ll have to feed the standlee timothy pellets.  Apparently that’s the only thing grass around.  Sigh! Anyone know how much to feed? 
--
Joella Foust 
Montana
2015
Bronwynn
https://ecir.groups.io/g/CaseHistory/files/Joella%20and%20Bronwynn/Bronwynn/Bronwynn%20Case%20History.pdf
https://ecir.groups.io/g/CaseHistory/album?id=91706&p=pcreated,,,20,2,0,0
https://ecir.groups.io/g/CaseHistory/files/Joella%20and%20Bronwynn/Hay%20Analysis/Lewistown%20Hay%202018.pdf
Houston
https://ecir.groups.io/g/CaseHistory/album?id=116873
Negrette, Houston, Oliver, Riley, Graybee, Diesel, Zsa Zsa, Bronwynn
Asleep: Hunter, Snip, Frisky, RyeLee, #5


Re: Stabul 1 Plus OK to give to ECIR horses in work?

Kelly Kathleen Daughtry
 

Randy offered to send me two bags of Stabul 1 to make up for the Pro that I purchased. I wanted to let everyone know about the good customer service! 
Kelly & Micah, Clayton NC

April 2016

Case History: https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20%20Micah 

Photos: https://ecir.groups.io/g/CaseHistory/album?id=1829  .

 

 

          


MightyCause Donation

Reta Heaslip
 

I recently signed up to donate funds to ECIR as part of their year end campaign. I opted to send $5.00 on a monthly basis, however, the receipt that I received from MightyCause shows a donation of $5.00 only. How should I interpret this? Should I have received a receipt for $60 for the year; will MightCause acknowledge my $5.00 donation each month? Is there a way to check to see if my donation was monthly or a one-time $5.00 donation?
--
Reta
Sept 7, 2017
Gananoque, ON, CA

https://ecir.groups.io/g/CaseHistory/files/Reta%20and%20Whistler .

https://ecir.groups.io/g/CaseHistory/album?id=10035


units of measurement for hay testing

aphena89@...
 

I'm about to send in a hay sample to Equianalytical. Which units of measurements is preferable? English or Metric?
TIA,
--
Jennifer Teis
Austin, TX, USA
Joined 2019


Re: Was Ana's Test Results Now: She's Gone

Kathy Thomas
 

So sorry, Polly.
You did absolutely the correct thing. Ana was so very fortunate to have you as her mom. You spared her from additional pain.
Run free, Ana.


--
Kathy 2017 and Donna

Harrowsmith, Ontario

https://ecir.groups.io/g/CaseHistory/files/Kathy%20and%20Donna


Re: EXTREME MARISH BEHAVIOR

Eleanor Kellon, VMD
 

Kelly,

I really can't tell for sure what's going on with her.  She has many of the features other IR mares with ovarian involvement have shown (hence the estrogne supplement, which apparently has helped).  She may also be showing exaggerated reactions to the seasonal changes in ovarian activity, quite possibly with painful cysts because anovulatory cysts are common then in all mares.

If possible, an ovarian ultrasound at a time when she is clearly painful could be very helpful. I doubt she has a granulosa theca cell tumor but that can't be completely ruled out at this point.

Since her estrogen tested normal on her current dose I'd be more inclined to try adding Vitex (Chastetree berry) at this point rather than increasing the estrogen. This would address the prolactin that is blowing up her udder and disrupting her hormones. Try 6 g twice a day of the 5X extract https://uckele.com/chasteberry-extract-5x-180g.html to start (5% off with coupon code ECIR).
--
Eleanor in PA

www.drkellon.com  2 for 1 course sale
EC Owner 2001


Re: Was Ana's Test Results Now: She's Gone

Nancy C
 

I am so sorry Polly.  You must be reeling.  Agree completely with Lorna your quick, focused actions helped her in the end.

Sending hugs.  May you have many memories to fill the hole in your heart.

Run free Ana.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA


Re: Was Ana's Test Results Now: She's Gone

celestinefarm
 

Polly, i'm so sorry to hear this. Sometimes these things are out of our hands. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Re: Was Ana's Test Results Now: She's Gone

Portagecreek
 


Uckele product return issues

celestinefarm
 

As I have posted before on here, I'm a 30 year plus customer of Uckele, which is headquartered about 30 minutes south of me in Blissfield MI. I was a customer when they were simply a white pole barn on the Uckele farm , with metal shelving holding their supplement products , and everyone simply scotch taped horse show notices, etc. on the wall next to the door. I've watched them grow and become multiples in size of what they once were, including purchasing a separate production facility in Toledo. I have encouraged members on this list to purchase from them, often touting their return policy, 100% guarantee as a big plus.

As they have gotten bigger, their processes have gotten more complicated, they have a lot of turnover of employees, and now their office process seems to be a mess.  

Over two weeks ago I personally returned a one gallon jug of Cocosun and a container of pelleted Phytoquench, both unopened and with almost two years before expiration left that I decided I did not want.  I have typically not had issues with returns as I have noted here previously. There was yet again, another new person at the retail desk window( this folks are also who answer the ordering phones) and when I explained that I wanted to return the supplments, she asked an experienced coworker how to process a return. The coworker was going to walk her through it, warned me that it would take a long time for which I didn't need to wait and  that I should expect to wait 3-5 days for the credit to appear on my card. They kept my receipts and the product and told me they would call me when the refund was complete to let me know. Yes, that is weird.

Two weeks have gone by and I stopped in this am to inquire why I have yet to have the items credited to my card. The new person was there, recognized me, and then talked to a coworker, who then had to call the accounting department and speak to one of the accountants. She was told to tell me that the accountant was "working on it" and she would move my credit paperwork to the head of the list. I can expect to see a credit come through by Friday of this week. I told her this was ridiculous, and she said that returns have to go through six or seven different individuals and departments in order to be properly put back in their "system" and then a refund issues.

It's what, $130 of return product?  Which is in fully saleable condition as it is unopened. Returned by me personally with my purchase receipts demonstrating they were not ordered or shipped, but purchased by me several weeks earlier in their retail store at the plant. Discounts, etc. are obvious because I had the receipts demonstrating the exact price I paid. It's also not what has happened in the past, this appears to be "new" policy.

I have not experienced this kind of credit delay at either retail or online store for decades. I'm not happy about it, and if this is the policy going forward with Uckele,  members here should be aware of it.  If you purchase a uckele product at a tack store, etc, find out their return policy. Purchasing at a tack shop might be a better situation, as returns should be processed on a credit card POS machine. However, if you order directly from Uckele, be aware that returns are not being handled expediently. I don't know if this is something Dr. Kellon can discuss with Mike Uckele, but I can confidently say their return policy is broken. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Re: Latest ACTH/Insulin test results, seeking advice on next steps

Eleanor Kellon, VMD
 
Edited

1.  It's been shown to be extremely difficult to get on top of ACTH when starting pergolide during the rise as you did. I would suggest holding at this dose for a couple months longer, then retest. That will still give you enough time to fine tune the dose before the rise begins again.

2. I would stop the CTB. There's no good evidence it helps with ACTH control and a few people have actually had issues with probably interfering. Since you're  getting no benefit, no reason to keep it up.

3. Can't say for sure how much of her insulin is related to PPID since we don't have any prior blood work and if she has had laminitis before it was over 10 years ago.  It does look like the PPID is a major factor though. If her foot pain is not controlled, definitely start metformin now. Otherwise, it's reasonable to wait until you see what her numbers are like a couple months from now. Cold weather also makes insulin difficult to assess.

4. Yes, Jiaogulan can be given with pergolide.  However you give it, just make sure to match dose to gum color and be aware her hoof growth rate will likely increase. She may also get more uncomforrtable initially if she has unresolved collections/abscesses.

--
Eleanor in PA

www.drkellon.com  2 for 1 course sale
EC Owner 2001

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