Date   

Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

jenny.comish@...
 

Thanks Eleanor and Kirsten. He is now on the Forage Plus Laminae Plus balancer and also jiaogulan (2g per day). He is also on a herbal Devil’s Claw, meadowsweet and white poplar bark liquid supplement to see if it helps at all with his pain levels and I will begin weaning him off the Danilon.  I will update my case history. He also had his feet trimmed again a couple of days ago so I have some more photos to add to my photo album. 


I’ve gone onto Forage Plus’s website and have paid for nutritional hay analysis. I was wondering if I ought to order 2 tests so I can soak some hay for one hour and dry it and then get that tested too just to see what the results are after an hour’s soak?

I am planning on changing my vet to someone cheaper (but who seems a lot more interested in Dewi’s problems), so that will help a bit with affording more x-rays. Should I be considering Invokana, and if so, would you mind sharing the information about it for me to send to my vet if I give you my email address? 

When you say about boots adjusted to best beak over, do you mean rasping the actual boots? 


Thanks very much.

Jenny




--
Jenny Comish
England, UK
Dewi Case History: https://ecir.groups.io/g/CaseHistory/files/Jenny%20Dewi
Dewi Photos: https://ecir.groups.io/g/CaseHistory/album?id=257833


Re: Hoof trim

deb@...
 

Thank you so much Lavinia for your time. I really appreciate it. This will definitely give me more confidence moving forward. He is now on tested hay and I have the vet booked for next week for x rays and bloods. Thank you once again.
--
Debbie Rainbow
Western Australia
2021
https://ecir.groups.io/g/CaseHistory/files/Debbie%20and%20Kody
https://ecir.groups.io/g/CaseHistory/album?id=259494
https://ecir.groups.io/g/CaseHistory/files/Debbie%20and%20Kody/Hay%20Analysis.docx


Re: Lavinia - hoof review request, 2nd request for Ero

Lavinia Fiscaletti
 

Hi Laura,

Can you give me an exact date?

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


Re: Had my hay analysed, what is the next step?

Sherry Morse
 

Hi Cari,

https://ecir.groups.io/g/main/files/6%20Diet%20Balancing - scroll down to the file that's labeled "Hay Balancing.pdf" and open that for the list of people who can balance for you.




Had my hay analysed, what is the next step?

 

I had my hay analysed and am looking for what is the next step? Where can I find someone to help me balance the diets of my horses to this hay?
Thank you in advance.

--
Cari Johnson
San Diego, CA
2019
Rio's Case History
Rio's Case Photos


Re: Ventral Line Edema and PPID

Nancy & Vinnie & Summer
 

Thanks Maria, I think Summer's situation was a little different, hers is already resolved. We also have not increased her pergolide.  Thanks for the info though.

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

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


Re: Heat Cycles causing laminitic episodes?

celestinefarm
 

Tribute lists Kalm and EZ pellets at 13.5% NSC and 8 % fat. The feed in addition to beet pulp/soyhulls contains wheat middlings, ground extruded soybeans, soybean meal, alfalfa meal. The wheat middlings average 23% starch according to Equi Analytical's data base and I think that is what helps to bump the starch numbers up, and the total NSC, although as was stated earlier, Tribute does not break down their sugar and starch numbers.
--
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: excess protein and insulin resistance

Eleanor Kellon, VMD
 

As detailed in the previous post, high protein has the potential to influence insulin release although the details are still to be determined. Magnesium will not have any effect on this. I would suggest you ask whomever told you that to provide the research to back it up.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: excess protein and insulin resistance

Eleanor Kellon, VMD
 

Leah,

Insulin facilitates amino acid uptake by muscle for protein synthesis and it is known that certain amino acids can trigger an insulin release. There is also some research showing very high protein intakes can increase insulin but none of these are of the same magnitude as a load of sugar/starch. What we don't have a good knowledge of is how much protein is too much for an EMS horse, in terms of hay % or an individual meal.

That said, higher protein intake won't cause weight gain. Protein is very inefficiently converted to fat. Weight gain is an issue of too much food in general, not too much protein.

It's true that the carbon skeletons of some amino acids can be converted to glucose in the liver. However, that glucose remains in the liver to be released, converted to glycogen or converted to fat. It will not be released into the blood stream unless there is a message from the hormone glucagon that blood glucose is too low.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: excess protein and insulin resistance

Sherry Morse
 

Hi Leah,

Could you please update your CH link to this one: https://ecir.groups.io/g/CaseHistory/files/Leah,%20Scooter%20and%20Blossom

We look at the ESC+starch number for hay, not NSC so that could be a piece of the puzzle.  I can't comment on the protein part of your question but it would be helpful if you could update Scooter's CH to reflect her current weight and feeding program.




Re: Lavinia - hoof review request, 2nd request for Ero

Laura and Ero
 

Hi, I'm following up to see where we're falling on the list for a hoof mark-up/review. My trimmer is out later this week or early next. Thank you!

--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Re: excess protein and insulin resistance

Cheryl Oickle
 

I just had mad barn balance my hay and they red flagged the high protein in the balancing as a possible problem with chronically high insulin too!
Suggestion was to add magnesium oxide in interim 1oz to offset.
Dr Kellon's opinion would be appreciated on this whole new finding
--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

Eleanor Kellon, VMD
 

Hi Jenny,

DDT

D = Diagnosis

He clearly has severe EMS. I don't see any convincing evidence of PPID but even the normal seasonal rise can be a problem for horses with elevated insulin and I suspect that is the case here.

D = Diet and Medications/Supplements

You're off to a good start but would definitely avoid alfalfa and ryegrass. Hard to tell without hay analysis but you may not be able to get good control without medication. Exercise is the most efficient way to control insulin but obviously not an option when you have hoof pain. To  make some decisions here you need to start with hay analysis. Forageplus.co.uk can handle submitting the same for you and in the meantime I would use their Laminae-Plus Balancer. Get off the Danilon. It doesn't help and can hurt in more ways than one. Switch to Jiaogulan ASAP https://forageplus.co.uk/product/jiaogulan-herb-for-horses/ .

T = Trim

 Your trim isn't horrible - we've seen much worse - but there is room for improvement.  Repeat radiographs if in the budget are always helpful but it's safe to assume your horse needs pads, boots and boots adjusted to best breakover to get the most benefit.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Hoof trim

Lavinia Fiscaletti
 
Edited

Hi Debbie,

I've added mark-ups to Kody's album:

https://ecir.groups.io/g/CaseHistory/album?id=259494

It looks like your trimmer has done some beveling of the outer walls to remove some of the weight bearing on them and that the toes were brought back to some degree. Those were good starts but now need to concentrate on getting the toe length realigned with the new growth coming in from above so that you stop compressing the wall from the excess upward pressure. Because the walls are detached, they cannot be in ground contact at all - Kody needs to have all his weight carried on his sole/heels/bars and frogs right now. To protect the leading edge of the coffin bones from too much pressure, make half-moon-shaped cut-outs in his pads, ahead of the tip of the frog, that line up with where the sole is the thinnest. That way, he will be carrying his weight on all parts of the bottom of his foot, except directly under the leading edge of the coffin bone.

Here are some links to more in-depth info regarding the lamellar wedge and breakover placement:

https://www.hoofrehab.com/Breakover.html

https://www.hoofrehab.com/HeelHeight.html

https://www.hoofrehab.com/HorsesSole.html

LF dorsal: Green lines follow the angles of the new growth coming in under the coronary band down to the ground. All the flared wall in the lower 1/3 of the hoof capsule (blue areas) can be removed to get it into alignment with the healthier, better attached growth. Any flaring above that point can be left in place until it grows down further.

LF lateral: Not a true lateral shot, so it's a bit difficult to see the actual heel parameters. The green line again follows the angle of the new, healthier, better-attached growth to the ground. This line is only a visual guide, NOT a trim line. Blue area is the excess toe length that needs to be removed to relieve the upward pressure that is constricting the horn growth, and to relieve the tearing forces on the fragile, new laminar connections. In the heel, the blue area is vertical heel height that can likely be removed - IF there is enough height available to do so. Need to measure both collateral groove depths at their deepest point: ideally, they should be the same depth = medio-lateral balance. If they measure more than 1", you can lower them to 1" depth, but no lower.

LF sole: Blue solid line follows the edge of the sole. Everything outside this line should be completely out of ground contact, with the major flaring removed completely - blue hashed areas. The red half-moon shape is approximately the area that you want to relieve from ground/pad pressure, so cut out the area of the pad in the boot that corresponds to this. Leave the frogs alone, except for any ragged bits that may be detaching. Leave the bars to help support and stabilize the foot as many of the other structures are too compromised right now to do their part. The heels can be lowered if there is enough sole depth in the back of the foot to allow for that.

RF dorsal: Lateral wall has the most visible flaring (blue area) that should be removed.

RF lateral: Same general discussion as the LF.

RF sole: Use the same criteria as on the LF to determine whether the heels can come down/back more or not. The bars have really expanded, esp. the lateral one. If they are crumbling, those areas can be cleaned up somewhat along their leading edges, but be very conservative with what you do with them.

LH dorsal: Medial wall had some flaring that needs to be removed (blue area) and the lateral wall back toward the heel as well.

LH lateral: Green line is again only a visual marker. Toe back, lower heel (blue areas). Again, first measure collateral groove depths to determine if you have the necessary depth to lower the heels.

LH sole: Blue solid line will be the outer perimeter of the hoof - nothing outside of this should be in ground contact, so blue hashed areas are flaring that will be removed and/or heavily beveled out of ground contact. Red half-moon area is where you want to relieve pad pressure.

RH dorsal: Blue areas are the wall flaring that can be removed - lateral more than medial.

RH lateral: Same as LH.

RH sole: Similar discussion to the other 3. Yellow hashed areas follow the leading edges of the bars - it they are crumbling or detaching, they can be judiciously cleaned up but otherwise, leave them alone at this time.

Although it may seem counter-intuitive, Kody's walls need to be completely removed from any weight bearing as they are detached. Any weight on them only serves to prevent the new growth from being able to grow in more firmly attached. By shifting his eight bearing to the parts of his foot that are designed to carry it - frog, heels, bars, sole - he will heal faster and more solidly.

Once those flares and the excess toe length is removed, his boots will have a lot more room in them, so you can use more diapers, different pads as needed. At some point, it will become necessary to downsize the boots.

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


Re: Metformin-When do you figure out if enough is enough.

Kandace Krause
 

Kirsten, good point on salt,  I have been slowly adding salt upping it by grains every couple of days, plus upping the pellets of AT+.  With the half pound of ODTB cubes (daily) I am also happy that she is getting tiny amounts of those minerals that our hay is so bad on.

It now seems like a bit of the non eating was a pergolide veil with dose increase as she is eating everything well now, except those darn minerals.  I am going to go very slowly forward and hope that I can keep her Laminitis at bay while continuing downwards trend of everything else.
--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K
https://ecir.groups.io/g/CaseHistory/album?id=259062


Re: Amino Acids

Eleanor Kellon, VMD
 

Suzy,

When you sign up for the course you also get a free balancing to hold you over so send all your information to my e-mail.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


excess protein and insulin resistance

Leah Bartel
 

Hello everyone,

Despite the NSC + starch levels being appropriate for my IR-prone horses at 5.8% (NSC) + 0.6% starch for a total of 6.4%, they have seemed to gain all the weight back in their cresty neck and fatty tailhead. I'll admit, I have been lax about just feeding a certain amount of bales and not worrying about measuring out hay exactly, but I will have to start doing that now to hopefully get their weight back to a 4.5-5 BCS. 

One thing I've noticed while balancing their minerals is the crude protein content in the hay is double their needs. For example, if I feed 12.14 kg hay/day to get the 21.97 Mcals/day for my 659 kg draft mare, then she gets 1,565 g CP from those 12.14 kg of hay when she only needs 830 g CP. Seems like the hay we bought just has too much protein and it's really affecting the insulin resistant horses in my herd which leads to my question, do we know the mechanism for why excess protein can exacerbate IR symptoms? 

In humans, I believe its been shown that when people eat too much protein, excess amino acids will turn into glucose via gluconeogenesis. Could a similar mechanism be at play for horses? Is there some other proposed mechanism explaining why excess protein can be problematic for equines with EMS/IR?
--
Leah
Ohio
2019

Scooter's Case History: https://ecir.groups.io/g/CaseHistory/files/Leah%20and%20Scooter
Scooter's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=240467


Re: Amino Acids

suzy zarek
 

Thank you Nancy and Dr Kellon. I have signed up for the NCR plus course. I would like to have someone balance my hay in the mean time. 
I have uploaded new hay analysiis for the hay I am feeding this year but wondering if it possible to add in the supplements I have giving to see if they are helping at all.
--
Suzy. Nebraska. 2019
Case history https://ecir.groups.io/g/CaseHistory/files/suzy%20and%20%20thor


Re: Amino Acids

suzy zarek
 


Re: Ventral Line Edema and PPID

Maria Duran
 

Hi Nancy,

If this is of some help, Yayo had ventral edema and swollen hind pasterns when I increased his dose from 0.25 to 0.50 of prascend. It was not horrible but it was obvious. It solved by itself and lasted about 15 days or so.

Best wishes.
--
María Durán Navarro 
Dec 2017
Madrid (Spain)

Plutón´s Case History
Plutón´s Photo Album
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