Re: Managing hoof boots

Deb Walker

Hi Sue. My horse has been in boots (or other devices we tried that failed) basically 24/7 since the fall of 2017. I agree that a spare pair is essential to have something dry when they get wet. Scotty has a very large open barn area just for him, so if the snow is deep, or it's icy, I just lock him in. At first I was meticulous about thoroughly cleaning every single day...after over 3 years...I've become more lax when it's dry out. I have not had any problem with the Clouds rubbing, although I have changed the padding to a Soft Ride or other type of pad. Once recovery has moved along, I don't like the idea of the raised heel wedges in the Clouds. I too use a generic version of Gold Bond at times, and if his feet have gotten wet, I use No More Thrush powder. My farrier tried Stratus boots a couple of times, with strict instructions for me NOT to remove them in between trims. They were very difficult to get on...the Clouds are super easy. Right now his spare pair are Soft Rides, and although they work, I do not like them as well as the Clouds.
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:

Neurogan dosage

Bobbie Day

Ok girls I decided to jump on the Neurogan bandwagon, truthfully all my horses could stand to be on this but for pain is everyone just giving one scoop?

Excited to see if it will help my older ones.
Bobbie and Desi
NRC Plus March 2020
Utah, Nov 2018

Lavinia advice on Kodys trim


Hi Lavinia, our trimmer hasn't been available so we've been trying to get the feet in shape. He's walking better so I'm hoping we are on the right path. 

We are definitely getting into the laminar wedge when taking the toes back back but still a bit reticent to go to far so any advice would be good. I've added new photos to the album

Also, I am wondering if transitioning him to bare foot on the fronts just in deep sand could be an option. We are starting to get early rain and I don't want his feet to stay wet in boots. It could also be a way of starting to toughen his soles? Opinions please.

Cheers Debbie
Debbie Rainbow
Western Australia

Re: Giving Omeprazole To Horses Getting Phenylbutazone


Sara, my horse, Logo, had mild colics for awhile before he was tested for PPID.  My vet had me give him a small amount of cimetidine when he looked uncomfortable to see what his response was.  Within a short time, maybe 30-40 min, he would be back to his usual self.  I don’t recall the cimetidine dose but I can imagine you could do the same with GastroGard.  He invariably did this when I was away.  The first time he evidenced this discomfort, I had a vet out who felt it was an impaction and suggested I keep him away from hay and hand walk him where he could grab some grass.  He had no interest in grass at all and would drag me to the stacked hay.  At 17.2h, he generally won.  Looking back, I realized the issue was most likely the same.  I can’t say he had ulcers without scoping, and knowing how uncomfortable he was without hay in his stomach, I really did not want to do that but it might be an alternate means of checking.  I did not have insurance but gather you generally need to scope to get insurance to pay for the omeprazole.
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: Lavinia, request for trim markups

Lavinia Fiscaletti

Photos of the hind feet would be helpful.

There are several other people in line ahead of Callisto but I'll get something up for you late tomorrow..

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

Gunkie eyes with swollen lids.

Daune Gatenby

Name :  Daune
Location:  Southeastern Massachusetts 
year Joining:  2021

after looking at the photos on your site i am now convinced that my pony has cushings.   Thank you.

Lavinia when to take off abnormal hoof growth?

Jeanne Q

Really needing some help here.  As for all, it has been a rough cold winter and hard on Glo.  She had been maintaining fairly well until the -20 to -30 degree weeks set in.  She is now very ouchy on the RF and doesnt want to put much weight on it at all anymore(toe first and hardly any weight on heel).  We finally! got her heel down better this last trim on 2/22.  I hoped that would help but there was not much change.  My farrier glued a composite shoe on with frog support and I was hopeful.  However, it had a heel wedge that I was leery about and Glo did not do well in that.  Took it off after two days.  Tried a boot with a depression in the pad to relieve P3 pressure.  No relief.  Tomorrow I try a reverse wedge. 
How can I best relieve the pressure of P3 with it so rotated? 
Anyone know of custom made boots? 

Lavinia, could you please do one more mark up for me.  I would be happy to pay for your services.  Farrier is coming Monday 3/8.  I feel like that dorsal laminar wedge needs to come off but to what degree?  We did one small resection last spring.  Maybe that is what is necessary.  Dont want to destroy what hoof wall integrity we have and also I worry about protection for what is left of P3.  Also, with P3 in such a severely rotated position how far back does that put her breakover?  Wondering because of the boots she is in cant be helping with that.

I have been rasping myself on the toe and heel but her foot is hard as rock so Im not sure Im doing much in between trims.

I know the rotation and bone loss is really really bad.  But Glo is still maintaining an upbeat attitude with a healthy appetite and a serious will to keep I do.

Photos 3/1/21 Second page (in all RF photos she does not have weight on her heel.  She can fully straighten her leg, however.)
Xrays 12/18/20 First page
Last trim 2/22
Next trim 3/8 

Thanks so much!
Jeanne Q MN 2020

Re: Balance Cubes with Stabul 1 as complete feed?


Hello Cris,
You've asked a good question. Yes Stabul one can be fed as the only feed but it is higher in calories than the Triple Crown Balance Cubes. So if you feed just the Stabul one pellets you will probably have to feed less by weight to prevent him from gaining weight. As most IR equines need to be kept trim rather than fat you will need to keep an eye on his weight. What do you think about his current weight? Does he have fat deposits around his tail base or a cresty neck? You can find extra long measuring tapes at fabric stores (or online) and keep track of weight gain or loss by regularly measuring his girth for changes and watching for weight gain.

From personal experience: when my Mouse was over fed and allowed to get fat he became IR. I was able to get him to take his supplements in the timothy balance cubes soaked for a while. He also disliked wet feed of any kind. I found that I could use far less water on the hay cubes if I used a lidded bucket and poured HOT water on the cubes, stirred once then put the lid on the bucket. I made his PM feed in the morning and by evening his cubes had fluffed and expanded and were not soggy. In the PM I made his AM feeding. I would add the Stabul One pellets to the cubes to soften also as dry pellets could potentially cause a choke. I did use a small amount of Stabul One as a taste tempter and stirred those into his cubes.

I found that Brewers Yeast (Animed) is tasty and is safe to feed in a reasonable amount, like 2 Tablespoons. It is a good amino acid source. Also Fenugreek powder seems to be tasty and is one of the Stabul One flavors.

I have added an explanatory document for new members below. It is lengthy but packed with information and many links to more sections of this site. We ask that you join the Case History sub-group and create a case history folder for you and your horse in the files section. We also have a photos area within the Casehistory group. You can create a photo folder for Foster and upload body pics to the folder if you want to ask for weight opinions. Many members will upload hoof photos, radiographs, etc. At any time if you are struggling with how to navigate this group, how to make folders or upload documents you should use our Main Group WIKI. The Wiki is located in the column on the left side of this page. It explains "How To Do" most things.


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. 


Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album Deceased

Re: Lavinia, request for trim markups


Hi Lavinia, is there anything missing from my info/album that is needed for the mark-ups?
Lara W. in Vancouver Island, BC 2021
Callisto Case History
Photo Album

Balance Cubes with Stabul 1 as complete feed?


I have recently switched my 28 year old pony Foster from Mountain Sunrise Pellets as his feed to the Triple Crown Balance Cubes.
He has dental issues so he can't eat hay as his food source.
He has started rejecting the Balance cubes for the most part after eating them for a few weeks.
I have placed an order for Stabul 1, in the hopes that once it arrives I can make a mix of 50% TCBC with Stabul 1.

But I am still confused after spending many hours searching the site trying to see if Stabul 1 can actually be used as a complete feed or not for horses with dental issues. Some say it is a complete feed, and safe, while others say that as a complete feed it probably won't be tolerated. What does this mean? This is very confusing to me.
Stabul says it can be used as a safe complete feed.
I absolutely do not want to give him too much Stabul 1 if it is only safe as a carrier. If it can only be fed in small amounts to IR PPID ponies I don't want to over do it and create a problem.

But if it is actually safe as a complete feed, I would love to start using it to get him excited about eating again. He is being stubborn, and a perky handful, but not liking the Balance cubes anymore wet or dry. He doesn't like soaked beet pulp, and can't eat hay because of hit teeth.

Also what would be the feeding rate for 430lb. American Shetland of Stabul 1 if he is at a good weight now and if it is used as a Complete feed.
Like I said, my hope is to mix it with the Triple Crown Balance cubes once the Stabul arrives.

Sorry if I missed a post that explains this clearly, but I combed over the messages for hours and didn't find an absolute statement about the Stabul 1 as a complete feed.
Thanks in advance for helping me clear this up.

Best Regards,
Cris Bliss  California 2018

Re: Red Light Therapy


Hi Marsha, 
I'm a human and equine massage therapist.  Massage does not significantly improve circulation.  If your goal is to do that, a hand walk will do more than massage.  Massage is lovely for a lot of reasons, but circulation isn't one! 
Caitlin Cobb
South Carolina 

Re: Update on Cadet, insulin is higher after 4 months on Invokana


Dr. Kellon,

Thanks for the reassuring thoughts.  Like many of my colleagues, I find it hard to remain detached when I'm dealing with my own pets' health problems.  The Idexx assay is Millipore USA.  I have more details on it if you need them.
October 2018
Oakland County, Michigan, USA
Cadet Case History:
Ruger Case History:

Cadet Photo Album:

Re: Giving Omeprazole To Horses Getting Phenylbutazone

Sara Gooch


Thanks Dr. Kellon,

That research is enough to  make me suspicious of using omeprazole with Banamine.  I’m eager to get my mare scoped to find out if it is still ulcers causing her intermittent mild colic.  She initially responded well to a 28-day treatment with omeprazole.


Sara Gooch,  NE California, 2011


Sent from Mail for Windows 10



Dr. K truths and myths about alfalfa

Bobbie Day

Hi Dr. K 
Just wanted to thank you for this article, it was very informative and timely for our area. That’s all they grow here (less water, heat) except for a couple of ppl that don’t have to worry about making a ton of money off their fields. My friend that I get our grass hay from is very determined to not use chemicals on her grass hay and only sells to a few. But anyway, I wish I could get the horse ppl here (especially endurance riders) to get more informed about balancing but they look at me like I’m a three eyed monster. I have several friends with Arabians that ride endurance. And horses of all levels. I’m going to share this article with your permission. I wish more of them would let me balance their horses diets, I need the practice! 

thanks for the article 
Bobbie and Desi
NRC Plus March 2020
Utah, Nov 2018

Re: Urine testing and grazing muzzle

Patti SoCal 2020

Thanks, Aunna, this might work well for me since I only need it when I am hand walking him.  But down the road if he’s rideable again, I would need this too.  Before he was diagnosed and he was sound, he loved to graze and to snatch a snack under saddle wherever he could.  Alas, no more 😢
SoCal 2020                                        

Re: Red Light Therapy

Sherry Morse

Hi Marsha,

Just want to add one more comment here - if you LOOK at the photos you just added the other day, on the ones that the coronary band is clearly visible (,,,20,2,0,0 is one of the better ones) you can see new growth coming in from the coronary band down.  The key to getting his trim better is going to be finding someone willing to follow Lavinia's recommendations on getting that growth going in the right direction as it's coming down. 

As a reminder - when you take pictures put a sock or nylon or even vet wrap over all those feathers so the entire foot up to the coronary band is clearly visible. That's much easier than trying to hold them up and take a picture at the same time.

Re: Red Light Therapy

Nancy & Vinnie & Summer

I just echo what Nancy and others are saying about insulin.  Vinnie has had this long run of ups and downs (2 yrs) all coming back to insulin spikes causing laminitis and sore feet. If I knew then what I know now even what I keep learning just weeks ago. 

I tried earnestly with red light, mini pulse, acupuncture, Masterson method, and the only thing that works is getting the insulin down with meds and increasing the circulation using laminox and jherb. 

The other therapies are helpful palliatively when insulin is under control, but the only thing that will get the feet feeling better is addressing the insulin.

Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018


Re: Red Light Therapy

Nancy C

Hi Marsha

This is probably not what you want to hear, but I want to share that over 13 years, I tried everything I could to help Beau and foot pain.

What worked in the long haul was when the trigger for high insulin was removed and he had a correct physiological trim.

I know you have folks on the ground who have different opinions, so we don't need to go there again.  Just wanted you to know that I too drove myself nuts trying to find the miracle.

The miracle is to reduce the high insulin as best you can and a get a correct physiological trim.

I wish we had had Invokana for Beau
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room

Re: Update on Cadet, insulin is higher after 4 months on Invokana

Nancy & Vinnie & Summer

I was wondering about this too, since ships from UK and affordablerx ships from India and the packaging isn't temp protected.  Could we be getting product that in flight that could be less than optimal?
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018


Re: InsulinWise


Thank you for this.

My vet also recommended it for Haven and he developed a persistent cough after just a couple of days... persistent as in one deep cough every couple of minutes.  

Lisa and Haven
Independence, MN

Haven's case history: 

Haven's photos: 

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