Date   

Re: Help my boy.

Eleanor Kellon, VMD
 

What's best for him depends on what is actually wrong with him. A 3YO QH foundering for metabolic reasons is pretty unlikely so your first step has to be blood work to confirm or rule out high insulin.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Guaranteed sugar content in concentrates

Maria Duran
 

Thank you Martha, Sherry and Dr. Kellon, I understand,

I have asked and they say they work with average levels of raw materials and content in batches can vary.

Thanks for clarirying.

--
María Durán Navarro 
Dec 2017
Madrid (Spain)

Plutón´s Case History
Plutón´s Photo Album
_._,_._,_


Re: Ideas for Ways to Keep Track of Useful ECIR Information

Brenda Gasch Mittelstadt
 

Oh I see my error was reading from within my email and not going to the web to read. The option to “read all” is not in the email. Rather online. Thanks for that. And emailing to myself with new topic to file a good option. I’ll get used to searching and apologize when I changed subject in a note I actually knew better. Just forgot. 😁😀😀😀. Have more questions but not found time yet to add to case. Stormy looking fabulous right now. Ultra spunky with cold fall beauty in WI
--
-Brenda

September 2020, Dodgeville WI USA

Case History: https://ecir.groups.io/g/CaseHistory/files/Brenda%20and%20Stormy


Re: Ideas for Ways to Keep Track of Useful ECIR Information

Brenda Gasch Mittelstadt
 


--
-Brenda

September 2020, Dodgeville WI USA

Case History: https://ecir.groups.io/g/CaseHistory/files/Brenda%20and%20Stormy


Re: 8 yo mare got laminitis as a complication from Potomac Horse Fever

Eleanor Kellon, VMD
 

Evy,

You can't do right by this mare without professional help. If she doesn't have underlying EMS (only testing can tell), you need at the very least  radiographs and an experienced farrier/trimmer for frequent trims.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Question about hoof white line

Amadadelsol@...
 

Martha,
I have all of her radiographs uploaded under Pat and Frigga. I checked this morning and they appear to be in the Case History photo album. So, I think they are where they are supposed to be but admittedly I’m not a pro at the groups, digest, folders, forms, etc. She has only front feet x-rays so they are simply labeled R and L. I have pasted the link below my signature for the photos in this email so it may create 2 signatures.

Pat and Frigga 2020
https://ecir.groups.io/g/CaseHistory/photosearch?q=Pat+and+Frigga

--
Pat and Frigga
Monkton, VT
2020
https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Frigga


Beet-E-Bites

Tori & Floss
 

I see on the website that Beet-E-Bites have been approved as a safe treat for horses with laminitis?
When looking at the information they contain 21.2% fat and 4.9% Starch?
I thought these amounts would be way too high for a horse with laminitis?
Are they safe or not please?
--
Tori

 

December, 2016

Adelaide Australia

Case History  https://ecir.groups.io/g/CaseHistory/files/Tori%20and%20Floss 

https://ecir.groups.io/g/CaseHistory/album?id=3347

 

 

 


Tarson PPID or EMS or both?

prtcKarla
 

Greetings,  I was unsuccessful getting my info in a file but will try again.  In the mean time I am hoping you can help interpret these results.  Tarson is a 24 year old Arabian gelding in healthy weight that gives 3-4 lessons each week.  His diet is free choice grass/alfalfa mix hay.  Occasionally he gets a bit sore footed, most often after a trim.  I recently got his test results back from Cornell.  Glucose 89mg/dL (71-122);  ACTH 33.6pg/mL (9-35)k;  Insulin 82.37ulU/mL (10-40);  Leptin 4.63ng/mL (1-10)  Would he be considered both PPID & EMS?  If so do we need to start on Pergolide?  Thank you!

Karla Stanley
ND 2013


Re: Maintain Bodie on 9 mgs pergolide or not?

LJ Friedman
 

In my view, Ppid is often progressive so you need more and more cp. With that being said, if the 9 mg has caused zero side effects ,then I would keep steady at 9 mg.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Cushings question

jonno17@...
 

Thanks Sherry, Yes, I didn't understand it either, I will try and get some clarification, my friend is of the understanding that the mare isn't IR but positive for Cushings, I have known the mare for a long time and I've always had my suspicions about her IR status although this is the first time she has shown outwardly signs of laminitis, in the past she hasn't been a very forward mare which I thought may be due to sore feet, she has a very tight crest and is an extremely good doer.
--
Clarissa
November 2018-Red, Poppet
Tasmania, Australia 
https://ecir.groups.io/g/CaseHistory/files/Clarissa%20and%20Red_Poppet
https://ecir.groups.io/g/CaseHistory/album?id=79540


Re: Maintain Bodie on 9 mgs pergolide or not?

 

Ellen and Lynn:
Bodie's photo album is at this link:
https://ecir.groups.io/g/CaseHistory/album?id=253481

Lynn, would you please click that link and change the album name to Lynn and Bodie.
You'll see a blue button +Edit Album near the top of the page.   Click that button and update the name of the album to Lynn and Bodie. Then be sure to click the Update button at the bottom of the page. 

Next, please add the link to the new photo album to your automatic signature. https://ecir.groups.io/g/main/editsub Don't for get to SAVE at the bottom of the page.

ECIR volunteers appreciate this help in locating information.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


Re: 8 yo mare got laminitis as a complication from Potomac Horse Fever

 

Hi Evy,
Welcome to the ECIR site.  It sounds like you have your hands full.  Hopefully, we can help you out.

Because this mare is not yours, we will need some reassurance that the owner is okay with your representing him here.  I’m not sure how this is best handled but you’re not the first person in this situation.  Maybe a note from the owner that you keep in your possession to protect yourself?  I’m sure someone will know.


The ECIR site is composed of four subgroups - the Main one, where we are now, which deals solely with IR/PPID cases, a Case History group where case histories of IR/PPID Horses are posted, a Hoof group, dealing with trimming of IR/PPID horses and a Horsekeeping group, which is where everything else is posted.  To post on the main group and receive appropriate feedback, you really need to demonstrate that your horse is either IR or PPID because that is our focus and most of us here don’t have the experience to advise on issues related to other types of laminitis.  

I have never encountered an issue with horse health that doesn’t cost money so please keep that in mind before you get too involved.  I’m sure you will receive some additional comments, maybe even from someone who’s been in your situation.  If you don’t, join the Horsekeeping subgroup and ask for help there.

I’m including our group welcome, which goes to all first time posters.  You will learn all sorts of information about the ECIR group and our mission to prevent laminitis due to metabolic issues.  Please don’t assume that what we recommend for our affected horses will work for yours.  Good luck with your project.

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 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. 




 

--

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: Help my boy.

Maxine McArthur
 

On Fri, Oct 9, 2020 at 01:25 PM, <carmentrobinson2@...> wrote:
He is wearing a cloud boot but is very destructive and will destroy one in 3 months.
Welcome to the group, Carmen. You'll get good advice here to help your gelding. I just wanted to comment that if he is wearing the Clouds 24/7 (with ideally an hour each day for his feet to air out), then three months is not too bad, especially with a heavier horse. I did find when I used the Clouds for my mare that the velcro tabs stopped sticking after a while and the stitching frayed in places, but use of duct tape over the velcro tabs each time I put them on extended the life of the boots. Equine Fusion are another comfortable boot with good padding and you can often fit another pad inside them. Cavallos can also be used for turnout with pads. Bell boots over the top of the boots is another method that can help extend the useability of boots. 

HTH
 
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Re: 8 yo mare got laminitis as a complication from Potomac Horse Fever

LJ Friedman
 

. Cold hosing does nothing for laminitic pain unless it’s caused by grain overload. So that’s probably a time waster. What about Padded boots??You can actually make your own boots by using duct tape and Styrofoam.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Help my boy.

 

Hi Carmen,

Welcome to the ECIR group.  We’re glad you found your way here.   I will begin with a few remarks related to your post and then add our group welcome which is sent to every member upon their first post.

 

The fact that your horse foundered when he was three is fairly consistent with insulin resistance as he finished most of his growing before then.  However, we really can’t say that definitively without seeing some bloodwork.  You don’t mention having done that but you can read more about what needs to be done in our welcome letter, under Diagnosis.  Before we can address the problem, we need to know what it is.

 

It sounds as though you felt it was important to keep him in shoes.  Is this as a result of the founder?   Have you had Xrays done of his feet?  If not, I think you will want them.

I would put him on our suggested emergency diet immediately.   Your vet’s mention of his weight suggests to me he is overweight.  You can read more about it in the welcome letter under Diet.  Begin by immediately soaking his hay for an hour in cold water (or 30 min in hot) and then rinsing it before feeding.  It’s important to calculate how much hay he should have by weight so he’s not being overfed but, before getting caught up in wondering whether or not you’ve guessed his weight correctly, start by soaking.   In addition to the soaked hay, he should have ground or stabilized flax seed, vitamin E and salt.  He doesn’t need anything else.  He should not be getting any grass.

You mention you are padding with styrofoam.   Is this inside a boot or under his bootless hoof?  We’ve successfully used a piece of 2” foam insulating board under each hoof, taped on with a number of pieces of duct tape, which criss cross under the foot.  It takes a lot of duct tape to secure it well.   Be sure his stall is well bedded.

Do you find the bute helps him?  If you decide to discontinue it, please wean him off slowly, increasing the length of time between each dose.  The only way to decrease the pain of a laminitic horse is to remove the cause of the laminitis.  Bute will not be of much help in that case.  


Here comes the welcome letter with all the reading.

 

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 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. 



--
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


 
 


8 yo mare got laminitis as a complication from Potomac Horse Fever

Ev91@...
 

I am looking after a mare (I am not her owner) who had Potomac Horse Fever 3 weeks ago. She made it through that ok but has now laminitis from it. Since her owner already had quite the vet bill to treat her for PHF, he now told me he doesn't want to spend any more money on her. If I want to look after her and doctor her, I can or else he would put her down. So I am looking for advice on anything I can do on my own without paying a fortune to save her.
While she was still being treated for PHF I started to give her bute (15cc 2x/day) and once she got good enough on her feet to move to the water hose I started soaking her legs with cold water as often as possible. She's been on bute for about 3 weeks now and I've been able to cool her legs for the last 10 days or so. Before that she was laying down most of the time and when she got up and tried to move she almost fell back down.
Since she is still underweight from having PHF I give her a whole bale of grass hay per day and some Step8 supplement feed (Step Right Product from Trouw Nutrition Canada; it's supposed to be for sugar sensitive horses). I've been told to wet down her hay so I'm gonna start doing that tomorrow. Is there anything else I can do for her without having to call out a professional (vet or farrier) to look at her or spend a fortune? Is there a way for me to be able to tell how bad it is and if she even has a chance of recovering? On good days she spends most of the time on her feet, moves around quite a bit between her food and water. On bad days however (like today again) she lays down most of the time and can barely move. She is definitely in a lot of pain in all four legs but worse on her fronts.
I've known this mare since she was 3. I trained her back then and she is just a sweetheart. It kills me to see her suffer like that. If I would know for sure that she will recover and if I could afford it I would just try to buy her and get her proper treatment. 
--
Evy M AB, Canada 2020


Help my boy.

carmentrobinson2@...
 

My boy is a 12 yr old AQHA gelding. He foundered when he was three and has worn shoes until now. My vet says it is due to his weight that his bones in his feet are deteriorating. He has reached a point were he is unable to wear shoes at all. Due to no hoof growth we can barely get them on anyway. We have tried glue on shoes but he can’t stand any pressure on his sole at all. He is wearing a cloud boot but is very destructive and will destroy one in 3 months. We are padding with styrofoam. The vet put him on the Hot Hoof 1. I can’t tell any change since starting it. He is also taking Bute daily to help control the pain. I don’t know what to do to help him.  Any help would be appreciated.

--
Carmen R joined 10/07/2020 Wiggins Ms


Re: Feeding the underweight PPID horse?

AMH
 

On Thu, Oct 8, 2020 at 08:38 PM, Martha McSherry wrote:
I had a few PPID horses come out of last winter thin.  I began feeding them Timothy balance cubes, either from Triple Crown or Ontario Dehy.  My horses love these cubes, which I soak in water before serving,  They are formulated to be consistently ECIR acceptable in sugars and starches as well as balanced so only flax, vitamin E and salt need to be added.  In my cases, they put the weight back on with little difficulty.  You can also get Stabul 1 from Chewy, delivered to your door.  Other information about Toby that might affect our advice is his age and breed.
Hi Martha, thank you for your message! So grateful for all the resources and reading.

Toby is a 19-year-old Thoroughbred (3/4) x Warmblood (1/4) cross. His insulin was 11.4 (Idexx range 4.5 - 20.0 uIU/mL) and endogenous ACTH was 348 (Idexx range is 9 - 35 pg/mL with >100 pg/mL is consistent with PPID between August and October). I think I just linked his case file in my signature, but let me know if it does not show up correctly. I know I can get the TC Timothy Balance Cubes at my local feed store. Toby is getting the TC timothy/alfalfa cubes currently but I can swap to the Timothy Balance ones. How much do you feed? Toby is currently getting 1 lb. but I could increase that and decrease his grain. 

--
Anna and Toby (PPID, dx'd 9/2020)
Vermont, joined 9/2020
https://ecir.groups.io/g/CaseHistory/files/Anna%20and%20Toby


Re: Feeding the underweight PPID horse?

 

Hi Anna,
Welcome to the ECIR group!  I will share a few thoughts and follow up with our group welcome which goes to a member after the first post.  You will find lots of reading material there, with links to more.  You may have read some of this already but I’m always finding new material to absorb.


My heart horse was also a PPID horse, managed with pergolide for over 15 years.  One of his issues was maintaining weight.  Shedding is generally an issue with later stage PPID and some of the other symptoms you mention are more commonly associated with insulin resistance, which often accompanies PPID.  It would be helpful for us to see the numbers that came back with the testing.  These test reports should go into the case history you post for your horse but sharing the numbers in a post will give us a head start.  That sort of information will often get lost in a message thread so don’t wait too long to start the case history.  It’s nice that you can handle the testing details yourself.

I had a few PPID horses come out of last winter thin.  I began feeding them Timothy balance cubes, either from Triple Crown or Ontario Dehy.  My horses love these cubes, which I soak in water before serving,  They are formulated to be consistently ECIR acceptable in sugars and starches as well as balanced so only flax, vitamin E and salt need to be added.  In my cases, they put the weight back on with little difficulty.  You can also get Stabul 1 from Chewy, delivered to your door.  Other information about Toby that might affect our advice is his age and breed.

Don’t worry about asking questions.  That’s what we’re here to help with!

And now for all the reading material!

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 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. 


--

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: Maintain Bodie on 9 mgs pergolide or not?

 

Lynn, do you have a photo album for Bodie?? 

Your case history is great by the way~
 

--
Ellen
Pal & Savvy
N. Alabama
Aug 2013
Case History 

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