Date   

Re: Thoughts on laminitis episode for Canadian mare

Pat
 

#file-notice
#photo-notice

I took photos of her front feet and posted it to the Pat and Willow album.
https://ecir.groups.io/g/CaseHistory/album?id=253325
--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: Thoughts on laminitis episode for Canadian mare

Pat
 

I took photos of her front feet and posted it to the Pat and Willow album.
https://ecir.groups.io/g/CaseHistory/album?id=253325


--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: V/M supplement/ diet help

Cindy Q
 
Edited

Hello Kristin

Welcome to the group! Thank you for getting your signature up.

I'll be sharing our group's welcome letter below. It is long but there is a lot of detail on diagnosis, diet, trim and exercise (where applicable). There are links embedded to pages/files with more elaboration and options as well. It sounds like you have found some of them already but it is still worth a read in the order in which it appears and is a useful reference you can bookmark to refer back to. I hope you will be able to work on your case history as there's some gaps in the information that could be helpful in providing you with advice (eg. whether he has other symptoms, was he ever footy, diagnosed with laminitis before? Tested for IR? His body condition?)

A few comments:
- non-healing scratches. My previous lease horse (warmblood) also had a lot of ongoing scratches but they eventually cleared up. You may find that being on prascend helps to resolve some skin issues (with appropriate care as applicable).
- Prascend (pergolide): To know whether he has reached the right dose needed for him, his ACTH can be retested 2 to 4 weeks after you reach your intended dose. Read more about it here: https://www.ecirhorse.com/pergolide.php
- hay testing. For people who have constantly changing hay due to supply, regional hay analysis might be the next best thing but only if the hay is coming from the same region and only for mineral balancing. Another method worth trying is to test periodically so that over time you build an average for hay in your area. I would do this even if you end up feeding one of the safe mineral supplements which are like best estimates/best guess types. It's hard to say which of the acceptable balancers will suit you more since they are all not based on precision of your actual hay analysis. Dr Kellon may be able to comment more based on regional information. You may also want to approach the companies for a sample as some of them do give samples for you to check palatability since you already know your horse is very picky. The 3 companies you named are reputable and the iron if listed is naturally occurring and not added.
- You need vitamin E, salt and since your horse doesn't graze much anyway omega 3 (flaxseed meal). Flaxseed meal may also be a useful thing to help his condition (I'm guessing he's not over-conditioned since he is a stressy ottb and picky eater) and skin. You can read that more in the diet section below. You asked if a textured feed as a carrier is ok as it's only 1 cup - that depends on your horse. It's not recommended but some horses are less sensitive than others. You could try reducing the amount if it's just a taste tempter to eg. half a cup or 3/4 cup. Maybe you will be lucky and he likes flaxseed and that could be your taste tempter. Omega Horseshine contains stabilised flaxseed meal and is safe specs and seems quite palatable. If your horse is PPID but not IR and his PPID is controlled with Prascend or pergolide at a suitable dose, you have a little more wiggle room in my experience. A safe carrier you may want to try is stabul 1 which comes in a range of flavours. I know you said he doesn't like hay pellets soaked or dry but some members have also reported that the
Ontario Dehy Timothy Balance cubes or TC Naturals Timothy Balance cubes (same product with the latter marketed under Triple Crown so you may be able to get this easily) are very palatable and break apart with only a little water and can be served pretty dry.
- magnesium: this depends on whether your current feeds are short. But if using magnesium oxide, it's quite safe to add. If you have too much, you will see loose stools. I haven't so far had that experience after feeding magox to several different horses/ponies.
- The alfalox forage at minimum 7% fat is also not within the recommendations here. But on TC's website they say over several months they will be phasing this out anyway and replacing it with another product. No information on sugar or starch levels but molasses and wheat middlings are ingredients.
Some horses are sensitive to alfalfa in that they get footy/footsore on it. I have to defer to Dr Kellon or the other mod volunteers on recommendation here.
- Also have a look at our picky eaters checklist: https://ecir.groups.io/g/main/filessearch?q=Picky

Here is the full letter:

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 and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*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.



--
Cindy and Glow - Sep 2017, Singapore
ECIR Primary Response





Re: How to Protect Our Horses During Heavy Smoke?

Trisha DePietro
 

https://ecir.groups.io/g/main/message/213421 

Hi Kim. I posted the link to Dr. Kellons recommendations for smoky conditions....I hope this helps you. 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories https://ecir.groups.io/g/CaseHistory/files/Trisha%20and%20Dolly%20-%20Hope
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: THIRD TRY.... Dosing of Kaolin-Pectate

larkstabatha
 

Thank you Dawn... makes good sense.  Thank you for the three day guideline.
--
Sally in Big Park, Arizona/April 2013

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

  

 

 


V/M supplement/ diet help

Kristin Horton
 


-- 
I’m new to Cushings life and have not stopped reading. 18 yr old, OTTB, history of ulcers, non-healing scratches, super anxious, picky eater. Current diet: 1#Triple Crown 30, 1 cup Outlast (am and pm), succeed, U7, 1 cup Seminole DynaSport (flavor), 2#s AlfaLox (dessert), salt, 2000iu Vitamin e and Copper/Zinc.  Forage: access to grass (FL bahai)- typically only grazes in the AM, free choice Timothy hay and small amount of alfalfa. Prior to Cushings, he was on a high amount of alfalfa for ulcers. 1 week into Prascend (1tab). Since he has major anxiety, similar to panic attacks, locking him in a stall or dry lot would be terrible for him mentally- however he is not a grass hog and can come and go from his stall as he pleases. I have looked through the acceptable V/M supplements and trying to choose which would be best to replace the TC30. Trying to get a hay analysis however, it’s challenging here because I can’t store a large amount and it comes from different suppliers. Vermont Blend has salt, magnesium- but no vitamin A or Vitamin E. I have Vitamin e for my other horse, so adding that is not a big deal. Cal Trace plus- does not have salt or magnesium. MadBarn listed has added iron. Am I correct that I need magnesium, vitamin e and a and salt? So would it matter which one I choose- being I add the items? He does not like any hay pellets (dry or soaked), Hates beet pulp, So finding a carrier for the V/M may be a challenge. Can I still use the textured feed as a carrier, since it’s only a cup? Or sprinkle it on his AlfaLox? Or does this defeat the purpose of using a V/M supplement and maybe sticking to TC30 is best? I need to make small changes at a time, As he is super sensitive and gets upset easily, so trying to prioritize. Any advice is appreciated!! Thank you.
Kristin Horton, FL, 2020


Re: prepping drawn blood at local hospital lab

Bonnie
 

Thanks! I did remember that part!
--
Bonnie and Lad
North Ontario
Dec 2008
 


Re: THIRD TRY.... Dosing of Kaolin-Pectate

celestinefarm
 

Sally, once you have firm manure for a few days, discontinue the Kaolin Pectate. Three days of good manure, stop using it. I'm not a vet, but experienced in diarrhea in horses and in foals.  If your horse's diarrhea returns you need to have the vet look somewhere else for the cause. 
--
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: New, Overwhelmed, seeking help for my OTTB

celestinefarm
 

Anna, 
I would also urge you to read the sidebar selections in the ECIR website that was linked in your welcome letter. It will help you understand better what is Cushings, what is Insulin Resistance, when the two overlap and what symptoms are unique to each issue. 
The information in the website is based on best veterinary practices as the result of what valid studies are currently available for both Cushings (PPID) and IR.  The definitions, physiological symptoms , changes. etc. are science based from research here and in other countries . If you have a better understanding of what may be happening with your horse, you can make better decisions for him and be able to judge better if you have professionals you are working with that are up to date in recommendations. 
https://www.ecirhorse.org/

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: THIRD TRY.... Dosing of Kaolin-Pectate

larkstabatha
 

Thanks for responding Kirsten.  Did not find anything pertinent to my question on either this group or horsekeeping.
--
Sally in Big Park, Arizona/April 2013

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

  

 

 


Re: Request for Guidance for upcoming blood tests

hdavis
 

Thanks Lavinia for the info on my blood tests.  Makes sense.  Also I have added new trim pics of Rio.  I added a pic of the edge of one foot too that I think shows old damaged laminae??? Do I keep going further into this? Can u let me know and maybe provide a markup on the sole to how much further I go.

I will poultice storms foot and take some new hoof pics and post them and get her album link fixed up.  Thanks again folks!!
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

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

 Photos

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


Storm

Case History



photos

 
 

 




Re: Question for the Canadian folk

Lecia Martin
 

Hi Judy,    As Kirsten as said it is the wool felt pads from Equine Fusion and I do have more that one pair to switch them out.  Another option is to buy the felt liners for Sorel boots mens xtra large and cut pads to fit.  This works really well too.   As for the socks I buy the warmest ones in mens xtra large when I can find them. I have also purchased the Helly Hanson extreme wool socks.  I will be test driving those this year.  I have hesitated to use the hand warmers or battery powered socks, especially if I am not around to check on them. Not sure how hot they get.  

Not looking forward to the cold either,  had a taste last nite, got to 0 here.   Was a crispy morning to be sure.
--
Lecia Flyte and Flame
Alberta, Canada


Re: Request for Guidance for upcoming blood tests

hdavis
 


Re: Question for the Canadian folk

Bobbie Day
 


Re: New, Overwhelmed, seeking help for my OTTB

Anna Dolly
 

Thanks, Kirsten, I guess this is why I'm here! I was under the distinct impression that early onset could be managed with diet. And fully admit I know nothing, just lots of input from well meaning friends.
I DO intend to get my hands on the labs/radiographs. The lab who offers the test is who offered it to the vet clinic for free (I think they got 3 spots and we were one of them), so I do not know if maybe it was new, for a study, or what. 
Babe's second abscess has started draining, but it's obvious that he's pretty sore from over three weeks of having to compensate for abscesses in two different feet. I haven't seen him lay down today, and there was a lot of that yesterday. He's standing slightly camped out and there's still considerable inflammation around the coronet band where the abscess blew.
I still want to visit with a vet not associated with that clinic, to see if I can get a better grasp on understanding the mess we've been in here.
I am still working on those data sheets.
Anna
--
Anna Dolly
Keyser, WV
Sept. 2020


Re: Request for Guidance for upcoming blood tests

Lavinia Fiscaletti
 

HI Heather,

The only test you can use during the fall for PPID is the ACTH - the TRH stim shouldn't be used, even if your vet could do it, as there are no adjusted seasonal ranges available to use as a guide.

For Storm, you could test her ACTH to see if it is coming back within the normal range on her current dose of pergolide. If it's too high, you know to raise the dose. Pergolide won't lower the ACTH too far, even if the dose is higher than is needed.
Has her trim been corrected since the last posted pix in her album? The issues were very similar to Riosa's, with the underrun heels and long toes, just not as severe. It would help if you would add the link to her second album on the Hoof sub-group to your signature:

https://ecir.groups.io/g/Hoof/album?id=10181

The lameness in one foot, coming on very quickly is classic for an abscess, so that would be my first thought. Soaking, then wrapping the foot while damp with a drawing poultice would be the best way to try to encourage an abscess out.

Subject to correction by Dr. Kellon, for Riosa, her insulin and glucose are the most important numbers. As she tested normal ACTH last fall, retesting now probably won't tell you anything significant unless her numbers skyrocket - unlikely as she is already on pergolide.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Insulin high and epm titers up

vicky monen
 

Hi there,

I wanted to ask a few questions regarding Samson's recent blood work results.

Insulin 80.80 UlU/ml
ACTH  12.8 pg/ml
Leptin 20.73 ng/ml

EPM Pathogens came back better, but his EDS kentucky lab came back at 1:1000, which is where we have had to treat several times in the past since 2017 due to showing neurological symptoms at 1:1000 titers.

With his insulin so high, do I need to wait to start Epm meds? Vet wants me to do a decoquinate powder which they use as maintenance. He thinks Samson keeps getting re-exposed.  I am uncertain why he keeps relapsing.

I believe that his Insulin is high due to the hay he was on, was higher than what he is use to for starch and sugar.  He has had issues in the past with hay that had 7.6% s/s and above.  I just recently got new hay at 6.1% and he usually does well on this %. He has been on the new for 1 month now. 

We also went off property and he had about 1 hr on grass on 8-2-20.  His blood was drawn on 8-19-20 for labs.  Could that hour on grass caused his insulin to be that high 2 weeks later? 

I just increased his prascend back to 3/4 pill per day on 9-5-20.  I had dropped it down to 1/2 pill per day for a short period, which was a mistake!  He has done well on the 3/4 pill per day in the past. 

How long do I need to wait to retest the insulin?  How long do I need to wait to start the EPM meds? 

Could the EPM cause the insulin to be high?  or can the High insulin cause the EPM to relapse or increase in titers? 

I am assuming that getting the insulin down is priority and then work on the EPM?  Also he has constant skin issues, legs stocking up,  parasite issues and is battling the neck threadworms, which is a large part of his chronic skin problems.  

He is fed out of hay net and hay is regulated and weighed.  He is in a small dirt holding pen with no access to grass or weeds. His hay is mineral balanced.  Currently trying to add back in his supplements, as he recently went off grain prior to any prascend changes.  Believed his teeth were bothering him and had them done and he started eating better.  

Just started him on Adequan due to vet thinking he has arthritis in right front, which he is showing lameness on when trotting.  This should not have any affect on insulin, correct?

I did update my H/P and uploaded labs and hay analysis. 

Thank you for any insight you can give me on these several challenges we face. 
--
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

https://ecir.groups.io/g/CaseHistory/album?id=1226

https://ecir.groups.io/g/CaseHistory/files/Vicky%20and%20Samson


Re: Question for the Canadian folk

Judy and Bugsy
 

Thanks Bobbie. 


Could you post a link?  We might be able to get something similar at Amazon Canada. 
--

 

Judy and Bugsy

Regina, Saskatchewan, Canada

Feb. 25, 2020

https://ecir.groups.io/g/CaseHistory/files/Judy%20and%20Bugsy
https://ecir.groups.io/g/CaseHistory/album?id=243358

 




Re: Cadet has PPID and he is only 11 years old

 

Hi, Aunna,
My mini, Tinker, was diagnosed with PPID at age 5. He's 12 now and I just bumped him up from 2.5mg to 3mg compounded pergolide. I test him at least twice yearly and have, fortunately, been able to keep his ACTH well controlled.
--
Fran in Texas

ECIR Board of Directors

7-2005

Ford, Tinker and Dancer

Ford Case History https://ecir.groups.io/g/CaseHistory/files/Fran%20and%20Ford%20-Tinker/Ford

Tinker Case History https://ecir.groups.io/g/CaseHistory/files/Fran%20and%20Ford%20-Tinker/Tinker

Dancer Case History  https://ecir.groups.io/g/CaseHistory/files/Fran%20and%20Ford%20-Tinker/Dancer%20Case%20History.pdf


Ford Photos:

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1214900120

 

 


Re: Question for the Canadian folk

Bobbie Day
 

Not directed at me but I buy felt rug material from amazon several feet at a time I cut a new insert every time I change/ clean out Desi’s boots. First pair I got from EF but I think I bought a six foot piece last time for twenty five dollars, cheap enough that I just throw them out.
I’m sure if you can’t order there you could find something similar?


--
Bobbie and Desi
NRC March 2020
Utah, Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi

https://ecir.groups.io/g/CaseHistory/album?id=78821

31081 - 31100 of 282352