Re: Ground Flax addition to feed

Diane Pingrey <dianehorsevol@...>

Hi Laura,

In addition to being high in Omega 3s, flax is an anti-inflammatory which can help reduce laminitis or other types of "itises" or inflammation.  Curcumin also helps reduce inflammation which helps arthritis. Chia seeds are also high in Omega 3s, but are also high in calcium, so if your horse is deficient in calcium and in Omega 3s and doesn't like flax, then chia seeds can be a good alternative to flax.  Chia seeds are also good for digestion.  

Soy products on the other hand are very high in Omega 6s and contribute to inflammation.

Diane and Denny 30 yr QH mare (parathyroid problem causing excessive calcium in the blood causing IR; excessive calcium level reduced by vitamin A of all things)

Diane P in CA 2021

Dr Kellon Help


I've been unable to email attachments to Dr Kellon so I've uploaded all of the pertinent info to my case file. I will also email her directly but I'm not sure if my messages are being received.
Looking to get a consult and recommendations of mineral balancing for most recent hay results.
Jennifer Teis
Austin, TX, USA
Joined 2018

Quiana Case History: Quiana
Photo:Quiana May 2021 Photo

Re: TRH Response test

Sherry Morse

Hi Helen,

We have had horses on much higher doses than 8.5mg with no issues related to the amount of pergolide they're taking.  If this were my horse I'd find a nice way to tell the vet to stuff it and that I would be continuing on the current dose as it's keeping her PPID in check. 

If I read your timeline correctly you dropped her dose over 4 days, then put it back up for 2 days and then she was tested.  For a valid TRH test she would have needed to be off of pergolide completely for 3 weeks as there's no adjusted scale for horses who are on pergolide.  That's why we always say once a horse has a positive diagnosis for PPID the only thing that needs to be done is the basal ACTH test.

You may want to refer to these messages:

Re: X-ray photos added to ..... Re: Ann and Nahar New case history added - looking for help for cortisone induced laminitis episode

Kirsten Rasmussen

Hi Ann, thanks for getting the xrays and hay analysis uploaded.

His xrays do look quite good to me, but others with more experience can comment.

The old hay analysis looks great so hopefully your new hay is similar.  It was a bit high in protein but not sure if it was high enough to be an issue.  When you get your new hay analysis,  I definitely recommend having one of our trained balancers come up with customized minerals to match it.  It's likely the Ca Trace is doing a decent job and you can keep using it, but it will still benefit from some fine-tuning the amount to feed and whether anything else needs to be added to make up for any shortfalls. 

I like your plan for trying to modify the muzzle! 

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

TRH Response test



My vet insists that the 8.5 mg of pergolide mesylate I had Josie on since September of 2020, was too high for her and it could be "toxic". I had her tested in January 2021, and the ACTH came back at 14.6 at the 8.5 mg.  I agreed to try to lower it and retest to see what it was in April, if he would come with a centrifuge to be sure it was spun down within a hour.  He agreed, but said he wanted to do a TRH response test to perhaps get more accurate results.

I lowered her at 1 mg./day for 4 days until I got to 3.805 mg., (partly compounded pergolide mesylate 2.5 mg. and 1 Prascend tablet) when her appetite became very depressed, she developed diarrhea which progressively worsened over the 4-day period, became lethargic and would stand with her right front foot in front of her, when before she was standing square.  No heat or pulse in the foot.  I bumped her up to 5.11 mg/day (2.5 mg. pergolide mesylate & 2 Prascend tablets).  She was on that dose for 2 days when she was tested for the TRH response test.  The results were Pre:  14.6 pg/mL with a reference of 9-35, and Post:  275.0 pg/mL, reference 9-110.  She was tested at Cornell.

Her appetite is good and she has sporadic diarrhea.  I use the appetite and diarrhea symptoms as bench marks, because that is the way it seems to affect her when I skip a day or the dose is too low.  One day last winter I missed a day because I ran out of meds, and she did not eat a thing and had watery stools.  I got my meds in and within 2 hours after giving it to her, she was eating normally.  She was on the 8.5 mg. at the time.

What do these results mean?  The vet is coming again on the 25th and I would like to know how I should proceed before his next visit.

Thank you for any help you can give me.

Helen, Josie and Kyra
May 2016
Brunswick, VT, USA
Case Histories: 
Josie's Photos: 
Kyra's Photos:

Re: Testing Insulin and Glucose for Dutch

Kirsten Rasmussen

The best thing for Dutch to eat before testing is his regular forage, in this case the mixture of TBC and LMF.  If his first meal is at 730am, he can have blood pulled any time after 1130am.

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

Re: Ground Flax addition to feed

Kirsten Rasmussen

Hi Laura, we suggest it for all horses whose main diet is hay, because after grass is cut and dried the omega-3 fatty acids degrade quickly.  As most IR horses are kept off grass, it becomes even more important for them.

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

Re: Fermentable NDF and high VFA in hay - good science or bad science


Hi Sarah, 
There are also straws which test higher in sugars and starches than our 10% cut off for safe hay and the ponies bedded on that straw will eat it preferentially.  Not sure about miscanthus but it seems to be a grass and I saw a report that it is related to bamboo and sugar cane.  Something to consider.
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: Fermentable NDF and high VFA in hay - good science or bad science

Eleanor Kellon, VMD

Except for black walnut, which causes problems within 24 hours, I don't know of any toxins in any type of bedding that cause laminitis. There could be toxins we don't  know about but a dead giveaway is elevated GGT and yours were normal.

Early Spring (March and sometimes into April) can be difficult for some IR mares because of the tendency to develop cystic follicles. Once their ovaries straighten out, the foot pain abates.

Eleanor in PA 
EC Owner 2001

Re: Fermentable NDF and high VFA in hay - good science or bad science

E Sarah Howell

It's been some weeks, but I think we may at last have an answer to what is going on.  At least it is a working hypothesis.

Since my last post, M remained the same but Blossom and Mandy continued to go downhill.  Eventually both ponies went to our local veterinary hospital where they were diagnosed with active laminitis and some rotation.  

The conclusion that we have reached is that all three were being affected by toxins in the bedding.  The ponies had been stabled  for many many weeks because we haven't got Mandy's PPID under control (despite pleas to the vet to increase her dose) and of course are close to the ground so inhale dust.  M is out at night, comes in during the day and sleeps flat out every day, with her head on the bedding.  We have 3 other horses, all apparently unaffected; but none of them lie down.  

Our working hypothesis, therefore is as follows:
  • Mandy's PPID is not under control which has caused her insulin to be high
  • Blossom's is elevated (but for her not particularly high) because her body is under stress from toxins in the bedding
  • M's is as Blossom, and her endocrine system is impacted by toxins in the bedding.
The bedding that we have is made from straw pellets but since November has been made from miscanthus due to a shortage of straw in the UK.  Perhaps the straw / miscanthus is sprayed with pesticides, either during its life or to desiccate it prior to harvest ?  Perhaps there is something in the manufacture process to turn straw and miscanthus to pellets ?   

We have changed all bedding, reverting to wood shavings and have persuaded the vet (at last !!!) to increase Mandy's prascend dose.  After 2 weeks all three are much much better.  Ponies are walking and trotting around well.  M's coat is better, she looks more healthy and less 'puffy' and has begun to lose weight.  My vet, who saw her on Tuesday, reports that her whole body and system is much less toxic.  

My trimmer has today told me of another mini which she has seen with active laminitis.  It is on soaked hay, no access to grass but has been stabled on straw (for a reason I do not know) since Christmas. The laminitis has developed in recent weeks.  

I appreciate that to consider toxins in the bedding as the cause of the problems is a controversial hypothesis,  But we have no other sensible explanation.

I'd be interested if anyone has ever come across a similar experience.

E Sarah Howell

Cambridgeshire UK
NRC Plus, NAT and NPH 2019

Re: Vinnie Update with 37.5mg Invokana

Nancy & Vinnie & Summer

We decided to increase his dose of invokana to 56.25mg which is 1/8 +1/16 of a 300mg pill.

I am going to order the 100mg so we can half dose that to 50mg.

Thanks Nancy 
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018


Re: Ground Flax addition to feed

Laura H

Thank you both!! That's helpful.
Laura Heit - Ontario 2021

Soft Rides vs Clouds


Hi group,

Many questions, posting separately.

My horse has significant rotation in both fronts and sinking in LF.  He is ten weeks post-acute episode and comfortable in Clouds in a stall 24/7.  His insulin levels have been less than 20uU/mL last three checks (3/12/21; 3/26/21; 4/22/21).  Rad images are loaded, and I am working on his CH at this moment (has been delayed due to lack of wifi at my new farm).  Being a new farm, I used a new vet clinic for rads, and a new local vet.  She rec'd SoftRides over Clouds after looking at my gelding's rads.  I'm not familiar with the former but vet said SoftRIdes are made specifically for laminitis & its rehab.  Although my gelding is very comfortable in the Clouds, if SoftRIdes offer better support, I'll order a pair.  Therefore, I'm soliciting opinions on experiences with both/either.  

(Another question will be whether adding an extra thin pad to the "sunken" hoof makes sense, given it appears 0.5" lower into capsule than the opposite hoof.  There's also apparent hoof capsule distortion on hoof opposite the sunken P3 but I have to figure out how to upload the hoof photos.  Will ask specific questions regarding rads and extra padding in separate post).  

Many thanks,
Kerry in NY
Sept 2014

Rads: | Album

Testing Insulin and Glucose for Dutch

Rebecca Reddicliffe Bigelow

The vet will be out Monday the 10th to draw blood to check Dutch's Insulin and glucose and to see how he's doing with his laminitis. I have been slowly increasing the TBC's and decreasing the LMF Low Carb Complete so that the Cubes are a bit more than half of his meal. He's getting 4 meals a day with the last one at 10 pm and the first one at 7:30 am. What should I do as far as timing of the blood draw and what would be best for him to eat before the test? He's had a trim to help align the rotation we saw on the x-rays and he's been on stall rest with a few minutes of hand walking in a sand arena. He seems comfortable.
July 2009, Sacramento, California
Case History,  .
Dutch Photos,  .

Re: blood work, dr kellon please

Daisy Shepherd

muzzle back on.   since the calculators  are not available now, are there other resources to use to look at insulin/glucose numbers.  thank you,, daisy nd tiko
Daisy, Tiko and Whisper
CO, April 2019
Case History: 
Photo Album:,,,20,2,0,0

Lydia Tuggle

Trisha DePietro

Hi Lydia. I see that you have been a member since January, but you might not have received a welcome letter from us :)  This letter contains lots of information about PPID and IR that you may find helpful as reference to in the future.  Grab a cup of whatever you like to drink, and settle in for some interesting information organized to answer lots of questions about PPID and IR. If you find that you have more questions, just let us know, through this main forum...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. 


Trisha DePietro
Aug 2018
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder

Re: Ground Flax addition to feed

Cheryl Oickle

I am to understand it is for the omega 3's. I feed dry one half cup daily with her pelleted vitamins. 

Cheryl and Jewel
Oct 2018
Port Alberni BC Canada


Daisy Shepherd

thank you. what is your best recommendation for my horse. he is not lame, has not been lame, he is IR, will be 14 8/01/.2021. he is ridden 5 to 6x per week arena and lite trail,  arena is non competition dressage.  i want to do what is best for him; tried barefoot 11/2019. was too sore, do you think maybe his soles have increased enough to try again, can the underrun heels be fixed barefoot, if stays shod will a 2 degree wedge all 4 feet help his heels and not compromise his toes; when you say to horizontally shorten toes is that the same as the 45 degree from underneath that dr bowker talks about. i am soon to be 75 years old and wish for my horse and myself to  stay sound and rideable as long as we can. do you ever email/talk/text with  farriers if they are receptive. my farrier has been a farrier for about 10 years.  sorry to be so wordy/needy, i greatly appreciate all  of your help, all the moderators, dr kellon and dr jaini.  daisy and tiko
Daisy, Tiko and Whisper
CO, April 2019
Case History: 
Photo Album:,,,20,2,0,0

Re: Excitability on Mad Barn amino trace plus?

Sherry Morse

Hi Pat,

It's more likely that she's feeling better than she has in quite a while than a supplement is causing the spookiness.  If you want to rule out Lyme disease you can always pull blood for that (assuming it's in your area).

Re: Question about supplements

Sue Neidlinger

I’ll check to see if my container has any batch number on it. I’ve been using it but basically force feeding her!! Lol 

Sue and Spirit 

Burt, NY, USA
Aug 2017
Spirit's Case History: 
Spirit's Photo Album: .

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