Re: Estradiol, Regumste and ad hoc use.

Nancy & Vinnie & Summer

Little update, the cycle symptoms have subsided while on estradiol and so I am now wondering of I should keep her on the 6mg dose or of I should taper off until spring and start a month prior to when she usually has her bad spring heat?

What are the harms vs benefits of keeping her on estradiol?

Thx Nan
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018


Star received her wings

Last week I lost my best friend Star. She had sedation for routine floating on Thursday but did strange side stepping in one direction as the sedative wore off. She seemed fine once recovered. We dismissed it, as she did a similar thing the year before while recovering from sedation. However, her routine bloodwork showed a new change, an elevated Calcium level, possibly indicating cancer. I received those results Saturday morning, which was not much warning for the cascade of events that followed, starting with what masqueraded as severe colic that Saturday night, but by Sunday, was neurologic signs (repetitive spinning and circling). Star's condition was intermittent, giving us hope for improvement several times. We treated her with IV fluids, steroids, also, and banamine for days, but we were never able to taper. She had a great day Wednesday, but relapsed Wednesday night, with no rest from the circling. By Thursday morning I knew what needed to be done, and that afternoon I released my dear friend to become an angel's trusted mount. 
I have been trying to recover from the shock of all this, but I know that my decision was right on time, not a day early or a day late. I am thankful I received a few extra days with my friend. I will do the final update on Star's case history at some point, but need some time. I wonder if advanced Cushings can present like this, with neurologic signs, but I guess we will never know, and perhaps it no longer matters. I want to thank the members of this group that helped me with keeping Star healthy to the end. She looked absolutely amazing. Having controlled PPID, good diet, and good hoof care helped her exceedingly.
Below is the obituary that my husband wrote for Star. Over the years he had trouble understanding the depth of my love for this horse, but seemed to understand and respect that at the end, and helped me make her departure better.

Ponaganset Nightstar “Star”
4-17-1989 to 10-8-2020
Amazing Morgan Horse and Beloved Friend
Ponaganset Nightstar, know by most as Star, was paired with her soon-to-be constant companion (an extremely excited 16-year-old Tina) when she was just a filly. A beautiful Chestnut Morgan, she had a white sock on her right hind hoof, and a white star on her forehead. While she was birthed in Rhode Island, she would also call Massachusetts, Vermont, New Hampshire, and finally Wisconsin, home.
Star was an amazing horse, with a calm temperament, and an industrious appetite (she loved grass, grain, apples, and carrots). Tina trained her for English riding, endurance trail riding, and even driving. When it came to driving, Star was a sight to see. She would pick up her front hooves as if she was a million-dollar show horse, and would take Tina anywhere she wanted to go.
Star later foaled Jasper, who was by her side from his birth, until June of 2015, when he was given to a gentle old man who needed a friend. When Star and Jasper were side-by-side, they became the perfect driveway alarms, as they would shrill, whinny, and nicker anytime a vehicle approached. Perhaps they thought a new friend was arriving, or perhaps they thought it was a grain truck. In any case, they were both there to greet you.
When Star moved to Wisconsin in 2015, she thrived on the abundant green grass, longer summers, and lowered allergens. She boarded at two different locations, across two years, before moving to her own barn and pasture. Despite being a senior horse at this point, Tina was still able to ride her and even drove her on occasion. While Star did not have any animal companions here, she did have a person who gave her the most exceptional care, attention, and love that any horse could imagine. She had many visitors that would take time to brush, feed, or spend time with her.
Today, the 8th day of October 2020, Star was laid to rest after a week-long battle with the sudden onset of neurological issues, potentially from cancer. She fell asleep looking into the eyes of her beloved human companion, Tina, and the sweet smell of fresh grass in the breeze. She will be dearly missed by many, but not to the extent of her owner and friend, who will never forget all the years of fun, companionship, and comfort that she brought. She is now loose in the fields of heaven, free of all pain, eating grass to her heart’s desire.
Jan 2018, Waldo, WI
Star Case History
Star Photos

Re: Free ACTH test - is it worthwhile this time of year?

Kirsten Rasmussen

Yes, I would test now.  This is a good time of year to detect early PPID in horses due to their exagerated response now, but that otherwise test normal at other times of the year.

Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History  
Shaku's Photo Album   

Re: APF Primer for Newbies

Bonnie Eddy

Hi Lynn,

I've just started giving the APF to start my 2 geldings on Prascend.
First dose I syringed it directly into their mouths, both weren't very happy about it. So I slowly introduced it into their supplements, dividing it up between 2 feedings. They both accepted it even being picky eaters. I now give full dose of 10 ml (as recommended by Auburn) in their feed once a day.
Bonnie with Racham (over the rainbow) from Southern California, Nov/2016

Case History
Racham's Photos 


Re: Squamous Cell Carcinoma


I am holding you and your precious horse in prayer. You have given your all and I can only guess how much your horse knows you love him. Praying God holds you in the palm of His hand  and gives you peace.

Nancy and Akira
3/20/2018  Burkesville KY

Case History:

Re: Blood tests of pony with cushings


Welcome to the group Marketa.

I do not see any information about your pony's past or current blood tests. You should have received instructions about how to join the "CaseHistory" subgroup. You need to follow those directions, create a folder within the Case History group and name the folder. You'll download the case history form and put the requested info into that form to upload to your folder.

Meanwhile, I am guessing that you have seen an increase in ACTH and Insulin levels? This is probably due to the annual seasonal rise. Here is a link to one document in the files section of this Main Group.

This is the FILES folder for Cushings documents
but you should know that Insulin Resistance
is frequently linked to Cushings.

Please start reading below and explore our site.

 You should search our files whenever you need information about any topic. See the Files and Wiki in the column to the left. The files will provide a lot of informational documents which are searchable. At the top of every page is a SEARCH box. Just enter a term or topic in the search box and hit enter. The Wiki explains how this Main Group works and how to use it to it's full advantage. This is the place to for HOW TO DO just about everything.

I have attached our NEW MEMBER document below. We ask each new member to read it and use the blue colored clickable links to access even more information about Insulin Resistance and Cushings. There is a link in the following paragraph to our groups web site. It has additional information that is detailed but easy reading.

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. 

Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album

Re: Success syringing metformin

Joy V

My horse did the same thing with his flax that your horse did.  He suddenly refused anything with flax it in it.  He started eating it again when I bought bulk flax seeds from the feed store that I grind fresh myself.  I can only think that the "fresh" ground packaged flax (it was human grade) that I had previously fed must have been off.  They are far more sensitive to smell and taste than we are.  Now my horse happily eats his bucket of supplements with a cup of ground flax 2x per day. 

It's worth a shot to try and it is much, much cheaper.  Good luck, I hope it works!  (fingers crossed on the blood work for your mare - and curb chain jingles for luck!)

Joy and Willie (PPID/IR)
Nevada County, CA - 2019

Case history:
Willie's photo album:

Re: Squamous Cell Carcinoma

Bobbie Day

I’m keeping you both in my prayers today. I’ve been thinking about you, I know how scared I would be doing this on my own. I am absolutely certain they will do their very best for both of you. You have been so brave and fierce in your care for him. I know that he feels your love and devotion and he will fight too. I like all the others will be waiting on word. 

Bobbie and Desi
NRC March 2020
Utah, Nov 2018

Re: Squamous Cell Carcinoma


Allison, if you need to talk, or if you need anything that I can help with my cell is 226-201-1766.  I'm in Cambridge, I saw that you are staying with a friend in town.  Thinking of you.
Teresa O in Ontario, Canada 2020

Re: Squamous Cell Carcinoma

Lorna Cane

Allison,we are all thinking of you and your boy .

I'm not sure if you've explored this or not. But when one of my boys needed emergency  surgery ( strangulation lipoma), at Ste. Hyacinthe , I was able to watch through the glass , and on the monitor hung on the wall in the corridor. The vet came out to discuss what she was finding. As she went 'back in' she found more lipomas,and the necessary decision  became clear . He was 25, PPID/ IR, had survived total hoof sloughing, and had ringbone. I couldn't play Russian Roulette with his life. But I was allowed to go into the room with him,and give him a good-bye word and hug.
Your boy has a much better chance. From what others have said,he is going to do well.
But I know how you are feeling about having to leave him, and thought you might not know that possibly you would be allowed to stay closer.


Lorna  in Eastern  Ontario
Check out FAQ :

Re: Squamous Cell Carcinoma

Nancy Kitchen

You are one brave lady... Know that we are all right there with you and sending the best kind of energy your way..  Looking forward to hearing good news this afternoon.
All the best to you 
Nancy K
Smoke and Tucky
November 2018, Southeast, MA

Smoke Case History:
Smoke Photo Album:
Tucky Case History: 
Tucky Photo Album:

Re: Squamous Cell Carcinoma

Nancy C

Hang in there Allison.  Thinking of you. Keep breathing.
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2021 NO Laminitis! Conference, August 12-15, Harrisburg, PA

Re: Squamous Cell Carcinoma


Thinking of you, Allison. 
Teresa O in Ontario, Canada 2020

Blood tests of pony with cushings


Hi! Could anyone help me identify why any some of the rates are raised? These are blood test results of a 25 year old pony with cushings. He's on half a pill of pergolide from prascend.

Thanks a lot for any help. -Markéta Köhnleinová
Markéta, Czech Republic, 2020

Free ACTH test - is it worthwhile this time of year?


This is for my 16 year old mare that I have not discussed before, she qualified for the free testing but Tane did not as he has other symptoms. I do suspect PPID with Paisley based on some symptoms - slow to shed and pot belly. We got good results with CTB in shedding

My question is: would it be worthwhile to test during the seasonal rise period? 

New Brunswick, Canada


Case History: Tane's case history

Photos: Tane's photos

Re: Success syringing metformin


Thank you to everyone for their helpful comments. A year or so ago, freshly ground flaxseed (organic golden, freshly ground from ND Flax) was part of her normal diet. One day she just stopped eating it. She wouldn't eat any of her food if it was in there. I will try again by buying a new unground, organic bag at at the heath food store and give it a go in a small amount. 

Also, with regard to the oil mixed in with Metformin powder: I add the contents of the suggested vitamin e capsules which does seem to lubricate the syringe and the mixture overall but not much. The Metformin overpowers it a bit as we are doing 16 per syringe. 

Today the vet comes for insulin blood draw and mouth check for ulcers. Keeping fingers crossed that the news is good and we can start lowering dose of Metformin. 🤞🏽
Pat and Frigga
Monkton, VT

Re: Squamous Cell Carcinoma


You have a huge heart ❤ for your horse.  May there be fair winds and good outcomes tomorrow.

Gail Russell 8/30/2008 .

Re: Squamous Cell Carcinoma


Oh Allison, what a long and courageous day you've both had.   That is a very long drive for even experienced trailer drivers.  I'm sure he knows how much you love him and how much you've done for him during this long ordeal.   Hopefully, tomorrow will be a success and he can feel better.   You have done everything in your power all the way thru this.   It sounds like you have him at the very best place.  I'm sure everyone here will be thinking of you both, thru the night and tomorrow.   
I'm still having a hard time getting to bed since my husband passed and am usually up pretty late.   Chappie will probably get his late night hay around 2am, and I'm often up for a couple of hours after that, if you want to email, text or talk please feel free.  I'll keep you both in my prayers.   Laura Knie 815-440-3389   lcknie@...
Laura K Chappie & Beau over the bridge
2011 N IL

Re: APF Primer for Newbies


I used Adapta-fuel 4+ times a day for several days when the most recent wildfire was about 4-5 miles away. The many stressors in that situation make it hard to be effective while preparing to evacuate your horses. I would use it again, and wouldn't hesitate to recommend it. Obviously I hope no one needs to use it.
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 

Re: Squamous Cell Carcinoma


We made it to the hospital. 10 hours on the trailer and he was such a champ though it all. And then all of a sudden  it was time to leave him there not knowing if I will ever see him again and for some stupid reason I was not prepared for that goodbye 😢 he goes under the knife tomorrow morning at 830. But I have tried all I could, I have poured out every last drop of me. I drove a horse trailer by myself for 10 hours today and I've never even driven a travel trailer before. I only wish he could truly understand how much I love him. Hopefully I will have a happy update tomorrow. 
Allison in Ontario 2020

Case History:
Photo Album:

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