Date   

Re: Bloodwork drawn once yearly?

Eleanor Kellon, VMD
 
Edited

Just to play devil's advocate - or rather veterinarian's advocate! - signs don't trump blood work. This is especially true of very nonspecific signs like goopy/tearing eyes, sensitivity to touch or not running around. For example, if you tell your vet something like "I've been increasing the dose every week because she still has runny eyes" you can expect some pushback and it's justified. If it's something like "I can tell she doesn't feel good", same scenario. You may be 100% correct that she doesn't but there are many, many possible explanations.

It will help if you can be more precise and organized when talking to your vet.  Instead of "I think she needs more because she has runny eyes", "Her eyes have always been an early sign her ACTH is out of control and that is soon followed by laminitis" would be more convincing.

If your horse has a significant problem like PPID there is always going to be a tendency to blame everything you see on PPID. Same thing happens with other disorders like EPSM/PSSM.

Pergolide is generally well tolerated but the real potential for harm here is that something else will go undiagnosed. For example, horses that are not eating well and not feeling well could have a simmering colic issue that could kill them.

If lab work is not an option for whatever reason, talk to your vet about putting together a list of danger signs that fit your horse's presentation as well as known red flags for PPID in general.  For example, unexplained weight loss, loss of topline and weakness of the abdominal muscular wall, slow shedding or other coat changes.  You should both agree on this ahead of time and you should at least let your vet know when you see something and adjust a dosage.
Shop around until you find a vet to work with you on this.

As an aside, horses don't have symptoms. A symptom is something the patient verbally complains about.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Appetitie aid

Eleanor Kellon, VMD
 

Hope that's just a typo. The problem is glycyrrhizin and deglycyrrhized is the process to remove it!

What is the base liquid?  Maybe that's the aloe. Can't tell because there is no list of active and inactive ingredients. Ask about sugar or molasses. Better yet, ask for a full list of  ingredients.

There's no such thing as peppermint or apple chlorophyll. You can get sodium copper chlorophyllin (which is  semisynthetic, not natural) https://en.wikipedia.org/wiki/Chlorophyllin but not pure chlorophyll, and that may have flavors added.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Aragon's hoofs

Myriam Desrosiers
 

Hi everybody, first i'm so thankfull for this group...
Aragon had laminitis diagnosed in 2017, he had a very bad crisis after eating hay full of alfalfa. He had weared reversed horse shoes since january 2018 until june 2020, under farrier recomandation. He had another bad crisis starting mid january soil was pure ice and very hard.. Farrier came and put back his reversed horse shoes, did'nt help very much... i feel helpless... i'm waiting for his diet to be balanced to start somewhere... and his four hoofs flares as they grow...

After radios from his front feets in august, it was determined that the laminitis had evolved. I tought it was gone for good. And that he has very thin sole (7mm) He suffers from hypo thyroid, acceptable low limit of thyroid test... vet gave him Levrothyroxine sodium for three months.
And also i have been literally fighting with some kind of mud scabbies on his pastern since this summer... seems to be better with local cream application.

Since about a year, he does coprophagia, it worrys me since in summer his paddock is on sand...

Please help me to help him... i'm not shure that his horse shoes are the best for him... he talso take previcox, an anti-inflammatory  and this either does'nt seem to help much...and he can't do any exercise, except for walking... this is the only exercise i do with him, is going walk him with a leash half hour every day hoping to have his blood at least circulating a minimum... He has hoof boots, but farrier said not to put them on since it was keeping hoofs very hot, and it was no good for him. 
And he suffers from obesity, he is a 6-7 quote. Cresty neck, fat deposit on shoulders... no muscles, even when he was doing exercices... 
Thank you so much for help and support
--
MyriamD. QC, Canada, 2021

Aragon case history.pdf (groups.io)
CaseHistory@ECIR.groups.io | Album


Re: New blood results not good - advice pls

Lorna Cane
 

Hi Francine,

Are you planning on trying the two at the same time?
If so,it might be better to try them one at a time, so you have an idea of the efficacy of the  one, or maybe both .
You're probably ahead of me on this.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Re: Hay analysis please!!!

Maxine McArthur
 

Hi Myriam
Thank you for getting your case history done for Aragon, and also for setting up a photo album. Could we please trouble you with two final steps?
1. Please rename your photo album to "Myriam and Aragon", just like the case history. You can do this by clicking on the blue 'edit album' tab, and typing the revised name in the box, then clicking Save.
2. You'll need to add the link for a) your case history:
CaseHistory@ECIR.groups.io | Files 
and b) for your photo album: 
CaseHistory@ECIR.groups.io | Album [but rename this as per 1. above]
to your signature (like mine is below). Just copy the link, go to the 'Subscription' tab on the left, and paste the link into your signature box. Make sure you hit enter after pasting the link, to make it 'live'. Do that with both case history and photo album links. That way, whenever you post a message, readers will be able to go directly to your folders. The reason we ask you to do this yourself, is that if someone else does it, you end up not being able to edit your own folders, which is not ideal. 

Okay, now that bit of housekeeping is out of the way, with regards to your hay analysis: It looks like the analysis does not list trace minerals, such as zinc, copper, iron or manganese. In the 'hay testing' section of our website (www.ecirhorse.org) , the recommended labs for Canada are A&L Laboratories and Nutrilytical. However, if the lab you used still has your sample, you could ask them to test the trace minerals also. And some of our Canadian members may chime in with alternatives for testing. 

In order to use the hay test results to balance Aragon's diet, you'll need to know what else he eats, other than that hay, and in what quantities--please weigh everything accurately. You'll also need to know his current and ideal weight (if they are different). There is information on estimating a horse's weight and body condition here: Body Condition Scoring Guide.pdf (groups.io) 
and https://ecir.groups.io/g/main/files/Case%20History%20Tools/Tools%20and%20How-To%20Help/Horse%20Weight%20Calculator.xlsx

Once you know this, you can ask one of the trained balancers on our list in the Files here: HAY BALANCING (groups.io)
to balance the diet for you. Note that you don't need to be in the same country as the balancing person. 

Now, as this is your first post since joining the group, I am sending you our welcome message for new members below. It contains a LOT of important information plus clickable links to more information, so please take your time to read it through, and if you have further questions, let us know. 

Hello 

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/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 Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/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 EMS/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: EMS 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 EMS/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 EMS/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 EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR 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. 

 


--
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: Bloodwork drawn once yearly?

Patricia Evans
 

Thanks Kristin and Gail,
I did the s/s and dose increases with my previous vet and she got very upset with me. She said that was not a good way to do it and that the symptoms I used were probably due to other reasons. She was so rude that I took offence and changed services. I can understand and agree with her opinion, but not the manner in which it was delivered.

There are three vets in my current service and one is agreeable with that method, one absolutely against, the third unknown. I routinely use the symptom list to check my three horses and I've still increased based on symptoms when the bloodwork was not an option.   

Thank-you for your thoughts everyone. This group is incredible!
--

Patricia 

North central Florida

July 7 2018

https://ecir.groups.io/g/CaseHistory/files/Patricia%20and%20Dancer%20and%20Nathan
Dancer:  https://ecir.groups.io/g/CaseHistory/album?id=66069

Nathan:  https://ecir.groups.io/g/CaseHistory/album?id=94152
Snickers 
https://ecir.groups.io/g/CaseHistory/album?id=241740 


Re: Bloodwork drawn once yearly?

Patricia Evans
 

Thanks Lorna and Sherry,
I agree that June sounds good and I will have more time to save my pennies ;-)
Sherry,
Dancer stopped eating with the correct dose of metformin, whether it was in her food or syringed. I was giving her omeprazole also, but the only thing she would eat was her hay. No, her bloodwork was not drawn again. I still have some metformin on hand and was going to restart it if I needed to when her labs came back, but so far I have been unable to get it done, hopefully soon.
--

Patricia 

North central Florida

July 7 2018

https://ecir.groups.io/g/CaseHistory/files/Patricia%20and%20Dancer%20and%20Nathan
Dancer:  https://ecir.groups.io/g/CaseHistory/album?id=66069

Nathan:  https://ecir.groups.io/g/CaseHistory/album?id=94152
Snickers 
https://ecir.groups.io/g/CaseHistory/album?id=241740 


Re: New blood results not good - advice pls

lamarleau@...
 

Thank you Kristen.  Will try Wirx as well.  Sent the info on invokana to my vet.
At least he is well. 
--
Francine & Magic in Quebec Nov 2020
Was a member 10 yrs ago with Shamy


Hay analysis please!!!

Myriam Desrosiers
 

Hello! Please i need my hay analysed for Aragon... Here's the link for the pictures and results of analysis.. thank you so much!! 

CaseHistory@ECIR.groups.io | Photo
 

--
MyriamD. QC, Canada, 2021


Re: Appetitie aid

Ronelle
 

I just contacted the company, and their reply was quick!.  I first asked if their products would help a Cushings horse thru the "veil".  I also asked about the flavorings (since no flavoring was listed on the product's packaging.  After seeing Dr Kellon's reply, I then asked about the licorice.  Here are their emailed answers.

All deglycyrrhized has been removed !! 

On Sat., Feb. 20, 2021, 5:56 p.m. Ronelle Dietsch, <rkdietsch@...> wrote:
Thank you for the quick response!  One more question.  Is the licorice deglycyrrhized?
 
- Ronelle Dietsch

On Sat, Feb 20, 2021 at 8:59 AM Steve Binkley <greengoop4horses@...> wrote:
Hi yes this will definitely help your horse... the 2 flavor are peppermint and apple the flavor is in the chlorophyll  that's why it's not listed so no added chemicals or flavoring.
Hope this answers your questions.
If you have any other questions please let me know thanks 
Steve

On Sat., Feb. 20, 2021, 11:50 a.m. Advancedappetite, <notice@...> wrote:
 
--
Ronelle and Yoyo
2015 Bend, Or, US


Re: Bloodwork, PPID, EMS Invokana and Pergolide

Nancy & Vinnie & Summer
 

Thanks Cass, knock wood right now he js eating heartily..no changes.  Today will.be day 2 on .50, last time I noticed a change right away. It seems like Vinnie is like Cayuse where he needs higher doses of the herbals to get the optimal effects 
--
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: Bloodwork, PPID, EMS Invokana and Pergolide

 

Nancy, I'd give what you need to see an effect, up to roughly double the labeled dose. Maybe 6 ml twice a day, or 10 once and a second dose of 4-6 ml. My experience with APF was that double the labeled dose really helped when one horse experienced a serious pergolide veil (non-PPID horse ate the PPID horse's full 5 mg pergolide dose). I'm not being cavalier with herbal dosing, but my experience is that starting doses are fairly conservative. While starting doses may work for some herbals for some horses, especially with Cayuse, failures with strong and effective herbals  (CTB, J-Herb, Devil's Claw, Canadian Ginseng, Spirulina, Mov-Ease) have all been cured by increasing dose and doing it fairly quickly after I notice a failure of effectiveness. 

Also, I'll just put this out there again (forgive me for repeating myself-it's my age) as a possibility. Failure to eat a mash isn't something I'd initially blame on the pergolide veil. Does he seem spacey and distracted? You know Vinnie the best, and I take your word for it when you say you think it's from the veil. Just remember that the veil rarely lasts for weeks. Refusal to eat the usual bucket meal can be a result of pain, an early warning when your horse still wants to eat hay. I get serious fast about the pergolide veil (and about pain!) when my horse won't eat hay. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Bloodwork drawn once yearly?

 

My vet prescribes pergolide based on symptoms.  She says, by looking the horses in the eye to see if they look like they do not feel well.  Thus far, her diagnoses have been predictive of elevated ACTH. 

--
Gail Russell 8/30/2008

 

 https://ecir.groups.io/g/CaseHistory/files/Gail%20and%20Brother%20-%20Odin%20-%20Decaffe%20%20-Gunthar .


Re: TC Safe Starch Forage

Maxine McArthur
 

Hi Sara
Lavinia has answered your question about the Safe Starch. What follows below is our standard welcome letter for all new members, chock-full of useful information and clickable links. It also has links to the directions on creating a case history for your horse, so that when you ask a question, we can check on the horse's details and give you a more individually targeted answer. 
Let us know if you have further questions after reading it. 
Quick question from me--what is a Savvy box? I found a "Savvy feeder" online, which is a box with holes in the front for the horse to pull out hay--is it similar to this? 

Hello 

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/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 Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/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 EMS/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: EMS 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 EMS/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 EMS/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 EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR 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. 

 

--
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: New Hay - results. Does his current diet align to this new hay well enough?

ferne fedeli
 

I mentioned using a spreadsheet recently and may have given people the wrong idea.  I actually use the spreadsheet as something to look at while I am calculating (it would also help me to catch something I have calculated by hand that is WAY off) and then when I have everything completed, I plug all my final figures into the spreadsheet to document what I have done & so I can easily see what I need to order when I contact Horsetech for my actual mineral order.

Ferne Fedeli  Magic & Jack   2007

No. California
Case History

 

 


Re: Purina Outlast

Bonnie Eddy
 

Dr Kellon
Regarding giving U Gard instead of Outlast, it says to give Outlast 3-4 times a day up to 6 doses, the U gard 2x.
The Outlast doesn't give the exact amounts of calcium and magnesium in each serving. If it only works just a short time, could the U Gard be as effective?
Thanks, 

--
Bonnie with Racham (over the rainbow) from Southern California, Nov/2016

Case History
Racham's Photos 
Ω 

 


Re: Dewi - latest blood test results - high resting insulin - what to do next?

Kirsten Rasmussen
 

Almost certainly 7.9% ESC+starch is too high for Dewey unsoaked.  Maybe after starting pergolide and invokana you will find he can manage that hay without soaking, but definitely for now keep soaking it and don't stop until you have bloodwork proving his insulin has normalized.

I'm glad you are building a more local support team because that is critical, but yes we are all here for you, too!  :)

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


Re: Bloodwork drawn once yearly?

Kirsten Rasmussen
 

I would push the ACTH testing to late July-early August personally, if I had a PPID horse and a choice of when to test.  Summer solstice (Jun 20th, 2021) is technically the start of the seasonal rise but I would not expect to see much of an increase in ACTH until it's a little more closer to the fall equinox in late September (Sep 22/2021).  It's a balance between testing too early and not seeing if ACTH is rising abnormally fast, or testing too late and not being able to increase the pergolide dose in time to be effective on the full ACTH rise.  It's hard if you can only test 1x a year but that is the reality for many people.  My vet only visits our area 2x a year (spring and fall) and I don't get to chose the dates, so I just get the tests done when I can even if the timing is not ideal.

Other members with large herds of PPID horses have said that they based pergolide dose increases based on tracking signs/symptoms rather than bloodwork because of the cost, and that is a reasonable strategy if you are willing to do a weekly assessment of PPID signs in each of your horses, document your observations, then watch for trends/changes.

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


Re: Bloodwork, PPID, EMS Invokana and Pergolide

Nancy & Vinnie & Summer
 

I thought I should also note Vinnie is slightly improved from yday so we are making progress ever it be small.  I was expecting more soreness today too so that was a nice gift.. 

I think prascend is working.. knock wood.  Next time follow gut.. that nagging feeling is probably right. 
--
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: Bloodwork, PPID, EMS Invokana and Pergolide

Nancy & Vinnie & Summer
 

Cass, would you do 10ml twice per day?  I am doing 1 time rn and did increase jherb too as gums are a little less pink. 

Kirsten, I too got soooo much out of that podcast. And then I went in to listen to the two others Alicia noted in the beginning of the podcast.  So enlightening and inspiring and of course daunting.  But, it is so relieving to know we are not alone.  I think the comrades here and the support provided is what keeps me going.
--
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

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