Date   

Re: New Hay Analysis

 

Volcanic soil has the reputation of being incredibly fertile so it’s hard to imagine it has toxic levels of anything.  
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: ACTH rollercoaster!

 

Susan, I’m pretty sure I’ve shared detailed descriptions of my experiences, about a year ago, should want to search for messages re Cabergoline.  I can take a look tomorrow if you don’t find them.  My trial was short lived but what I noted ran the gamut from extreme veil to incredible positive changes I had not expected to see.  Considering how generally unflappable Logo was, this was a remarkable event.

However, I’m not sure I shared what you really asked about.  The dose giving was uneventful.  My vet gave the drug and watched for any signs of low blood pressure.  She had no experience with cabergoline and wanted to be cautious.  It was a day or two before I noticed anything related.  You are wise to give APF.  I did not, for whatever reason, but I had it on hand and began giving it a few days later, after collecting my wits.
--

Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: jesse mouth issues

Eva Stettner
 

I don't know if this helps much because it's more when he eats hay than pellets, but my horse looks sort of like your video of Jesse when he chews. Then a quid drops out of his mouth. At his last dental float, the vet tried to find a cause of this and identified one molar that had a cup in it and he said it's possible that's where the quids form. When he chews the top and bottom teeth don't grind flat against each other. He said he could grind the top of the tooth down to be flatter but that could cause other problems. So we just left it.

--
Eva and Apollo (PPID, IR)
San Diego, CA
Joined 01/24/2018

Apollo's Case History


Re: ACTH rollercoaster!

norcalpintabians
 

My vet is on board! She has ordered the Cabergoline :) Is there anything I need to know before we give him his first dose?
I understand there is a possibility of a veil, so Im increasing his feed just in case... Im also putting him on apf plus. Is there anything else I can do to get him ready for the switch?
My vet says we are going to give his first dose "at least 24 hours after last dose of pergolide. 2 doses at half dose, then 1 or 2 doses at 3/4 dose, then full dose"  Since we are going into seasonal rise we will not be testing acth until january (as we have done in the past). Will I be able to tell if its working or not? Is there anything in particular to look for?
What are the experiences of those who have horses on cabergoline? Ive read a few, but they dont elaborate on the reaction to that first dose.

(Knight has always had uncontrolled ACTH with the numbers going up and down regardless of any increase in the mg of compounded pergolide. Currently at 12mg with no improvement. He is still very thin, and did have a sole abscess that took forever to heal. But he feels good right now, not lame at all, and "eating like a horse"! )

--
Susan Morgan
June 30, 2018
Ione, California
Case History: https://ecir.groups.io/g/CaseHistory/files/Susan%20and%20Knight

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71655


Re: new with more questions

 

Hi Nancy,
Thanks for checking.  I think it got fixed sometime between when you  postEd and when you checked.  Thank you to the ‘fixer’.  It is blue on this message you just posted.  Unfortunately it’s not retroactive.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Switching from Pergolide to Cabergoline

norcalpintabians
 

Hi, Im making the switch to cabergoline very soon. Im just wondering how your mare is doing on it.

--
Susan Morgan
June 30, 2018
Ione, California
Case History: https://ecir.groups.io/g/CaseHistory/files/Susan%20and%20Knight

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71655


Re: New Member needing guidance

 

Hello Nancy,
I live in Michigan also, west central area, Newaygo county. I too board. Have you tested the farms hay? You can do a test of the hay being fed. If you at least test the ESC and Starch levels you will know if the hay is safe to feed as is. Those two tests and the "custom base fee" is $32 total.

Where in Michigan are you located? I have a hay probe which I am willing to loan.
--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Welcome to Paola was Re: Weather effects on ACTH seasonal rise

 

On Thu, Jul 9, 2020 at 06:18 PM, Paola Di Paolo wrote:
----------------------original message-----------------------
I have wondered about the effects of weather and seasonal rise of ACTH for a long time.  I found this article:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467217/?fbclid=IwAR1_TpCuWNXTY2z-HJ_7hWP4VpVutLv7fxeUcUbSdWuo_RKhl0KadvJvqgA
-- 
It is peer reviewed and while the subjects were mice, they are still mammals.  The study was motivated to study the effect of global warming due to climate change and apply the results to humans.  The study indicates that extreme heat does increase ACTH levels. I am considering the results of this study when applied to horses and I forwarded it to my veterinarian.   As a barefoot hoof trimmer, I have seen metabolic ponies and horses have stronger clinical signs of PPID and laminitis during extreme heat waves and for a few days following.  This article, while it does not study horses, does study the effect of extreme heat on mammals.  It's not the grass changing in sugar content but the stress created to the mammalian body during extreme heat events.  For me, this indicates and increased need to be able to get vulnerable horses and ponies out of the heat of the day whenever and wherever possible
--
Paola di Paolo CA - 2020
 Welcome to the ECIR site, Paola.  I appreciate your comments on the effects of extreme heat on metabolically challenged horses.  We get our fair share of that here, including today, and I’ve noticed my PPID horses tend to congregate around the fan that we blow on them.  I recall my vet once asking about Logo’s pasture buddy and zi replied that it was a fan.  Now that Logo is gone, Tobit has taken over the spot.  Those with fewer challenges seem to keep up their grazing.  I bring mine in for most of the hot summer days and they are quite comfortable in the cooler shade of the bank barn.  I am curious about what symptoms you note to be exaggerated by the heat.  I just notice that they seem more intolerant of it.
I’m including our general welcome letter for your information.  It’s not clear whether you have a challenged horse that needs attention but, if you do, please start a case history.  If not, that’s fine too.  We appreciate your participation.

I’m including a copy of your message here because I have changed the subject heading and want to make sure people can read your post.

Welcome to the group! 

The ECIR Group 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. 



--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Trouble finding suitable hay

 

Yes, please, if you don't mind. I see the one in Dually's photo album.

Thanks,
--

Kathleen (KFG in KCMO)

Director and Research Advisor, ECIR Group Inc.

Missouri, USA, 2005

https://scholar.google.com/citations?hl=en&user=3-I7UI0AAAAJ 

 


Re: new with more questions

nancy efrusy
 

Hi Martha....it was blue when I went to check????
--
Nancy E in Michigan 2020
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Honey


Re: Trouble finding suitable hay

Kim Leitch
 

I might be trying to relay too much i one post, but here goes..

Sally, it would be great if we could exchange hay results. My latest test was on NY Timothy, and it was 9.2% ESC and0.8% starch.

Kathleen, Do you want to see all my out of spec test results? If so, I can email you four of them. The fifth is in my pony’s (Dually) photo album.

Finally, a question, if I feed the Timothy in Dually’s photo album without soaking, how many days do I wait to have insulin tested to see if it is a problem?
--
Kim 10-2014

Clover, SC

Grits and Dually: IR; Bella: PPID, IR; and Eeyore (deceased, but not PPID related)

Case History https://ecir.groups.io/g/CaseHistory/files/Kim%20and%20Grits%20-%20Eeyore%20-%20Dually

Photo album Grits https://ecir.groups.io/g/CaseHistory/album?id=1314

Photo album Eeyore https://ecir.groups.io/g/CaseHistory/album?id=6586&p=Name,,,20,1,0,0
Photo album Dually https://ecir.groups.io/g/CaseHistory/album?id=9046&p=Name,,,20,1,0,0
Photo album Bella https://ecir.groups.io/g/CaseHistory/album?id=64978




Re: New Hay Analysis

Nancy & Vinnie & Summer
 

I am told the following:
"It was cored from a stack of hay in Acampo and I did not do the coring one of my workers did I don't know how he did it so I will talk to him tomorrow it may have been contaminated I cannot imagine the iron that high"

Will send an update :)

--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: Weather effects on ACTH seasonal rise

Paola Di Paolo <pfdipaolo@...>
 

----------------------original message-----------------------
I have wondered about the effects of weather and seasonal rise of ACTH for a long time.  I found this article:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467217/?fbclid=IwAR1_TpCuWNXTY2z-HJ_7hWP4VpVutLv7fxeUcUbSdWuo_RKhl0KadvJvqgA
-- 
It is peer reviewed and while the subjects were mice, they are still mammals.  The study was motivated to study the effect of global warming due to climate change and apply the results to humans.  The study indicates that extreme heat does increase ACTH levels. I am considering the results of this study when applied to horses and I forwarded it to my veterinarian.   As a barefoot hoof trimmer, I have seen metabolic ponies and horses have stronger clinical signs of PPID and laminitis during extreme heat waves and for a few days following.  This article, while it does not study horses, does study the effect of extreme heat on mammals.  It's not the grass changing in sugar content but the stress created to the mammalian body during extreme heat events.  For me, this indicates and increased need to be able to get vulnerable horses and ponies out of the heat of the day whenever and wherever possible
--
Paola di Paolo CA - 2020


Re: New Hay Analysis

Nancy & Vinnie & Summer
 


Re: New Hay Analysis

Nancy & Vinnie & Summer
 

Hi Dr kellon, no I don't have access to it. The sample was taken from a veterinary clinic in acampo. I asked my gal if we can retest it with the 603. She is going to find out.  But I think she won't get this hay in if we cant get a good test on it.

I can still get the blue grass for a little but so I will stock up.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: New Hay Analysis

Eleanor Kellon, VMD
 

Nancy,

Have you opened any of these bales? Are they obviously "dusty" or with clumps of dirt?  That iron is sky high and would kill the plant if it was all inside it.  It's also more than 3X above the toxic level for a horse.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: New Hay Analysis

Nancy & Vinnie & Summer
 

I am told the grass is grown near Lassen, and the may be volcanic soil. Could this cause high iron content in the hay?
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: Interpreting IR Test Results?

Sherry Morse
 

Hi Heather,

When you say you have attempted a low ESC+Starch diet in the past what did that diet consist of?  I think you've been here long enough to see a fair number of hay tests discussed and should realize it's not that terribly hard usually to find ESC+starch under 10% hay that will still support a healthy diet.  Part of that diet, of course, is feeding to the horse's needs - 2% of their ideal weight in hay+concentrate(+pasture if they can handle) for maintenance is the usual. However, we realize that amount may need to be tweaked up or down depending on the individual horse and their activity level. 

I know you said somewhere along the way that you thought Dot Com wasn't an easy keeper, but from my point of view if he's maintaining condition on pasture +7lbs of hay/grain a day he's an air fern. 

You may want to consider giving a diet change that includes more hay (tested to be low ESC+starch) as well as a different concentrate so you can safely give him more calories without including an excessive amount of sugar and starch in his diet a chance and see how he does on it both for condition as well as for his feet.




Re: New Hay Analysis

Nancy & Vinnie & Summer
 


Re: Intro and a question

 

Hello, WJ!

It's so nice to be remembered.  Hopefully, we can help you out with Whisper.  I will address a few things and then follow it up with our group welcome.  I know you have been here before but things change and I want to make sure you have all the latest.

First, you will want to set up a case history for Whisper so that everyone has access to the same details.  This introductory message from you will soon be buried under many others so it's important that the the details don't get lost.  If you have any difficulties, please let us know.

From our guidelines for diagnosing insulin resistance, dividing the Glucose test result by the insulin level gives a value of 2.86, which is below 4.5 and thus a high risk for laminitis.  I don't have access to your testing conditions or the units of your results, so these interpretations are subject to change.

Simply divide the glucose result in mg/dL by insulin in uIU/mL. (If your insulin is reported in pmol/L you have to convert it to uIU/mL by dividing by 7.1.). A value below 4.5 is uncompensated insulin resistance, high risk of laminitis. Values between 4.5 and 10 represent compensated insulin resistance - less risk of laminitis but still needs tight diet control.

As you are aware, the ACTH levels are also high and thus you have started her on Prascend.  How much of that insulin elevation is related to the high ACTH will become apparent with further testing now that she's been on Prascend.  Some horses are more likely than others to be IR 'at baseline' (without PPID) and Mustangs are among the hardy breeds that are, so controlling the PPID will help but probably not eliminate the need to follow IR guidelines in her care.  She should be on Prascend for 3-4 weeks after starting or changing the dose before testing again.  I would think a regular ACTH would be fine.  I would not waste any time after those weeks have elapsed before testing again as more Prascend adjustments might be in order and they should be done before you see effects of this year's seasonal rise.  Fortunately, she did not have an adverse response to the Prascend, simplifying those adjustments.

There are a lot of changes that you can incorporate into her feed plan which will help her but I will encourage you to read through our welcome letter to better understand what those options are.  Just let us know if you have any questions.

Welcome to the group! 

The ECIR Group 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. 

 

--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 

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