Date   

Re: Re Still Looking for answers and review of photos: TSF Metabolic Support, Bunch Grass, and Palmer Angle questions

Kirsten Rasmussen
 

Hi Shera, it's not just palmar angle that decides when riding is safe.  Looking at her hooves, I think she still needs to grow some more well-connected hoof before she can be ridden.  We generally recommend at least 2/3 to 3/4 grown out since the last laminitis, or to be extra safe make sure the last lamellar ridge line is no more than 0.5-1" above the ground (ie, below the coffin bone for most horses).

Until she is in regular exercise, I would not turn her out on this grass.  This photo of the pasture (I'm assuming that's the grass you are talking about?) is very helpful...it's more grass than I thought, plus I see too many warning signs that she is not ready for it:
https://ecir.groups.io/g/CaseHistory/photo/253720/3249636?p=Created,,,20,2,0,0
The way she is standing with her hinds tucked in like that is how my horse stands when his front feet are bothering him.  She doesn't look comfortable to me.  It also shows her crest and the fat pads above her eyes.  My horse's fat pads above his eyes went away when I got his insulin down to about 40 uIU/ml, but he was still having laminitis flareups and compromised hoof growth.  It wasn't until it was down below 20 that things changed for him.

You are moving in the right direction with Story, but tightening up her diet in any way you can is still important.  If you can turn the other horses out without her (can you set it up so that they are within eyesight of her, by using electric string to make the pasture smaller?) and keep her separated so you can start soaking her hay, she will probably improve noticeably.

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


Re: Falki's Recent Blood Work - Request Feedback

Connie Proceviat
 

Hi Lavinia,

Prior to this years blood test, Falki's previous spring ACTH in 2015 was mid range. It was sent to a different lab so reference range different. 
--
Connie Proceviat
2013 Manitoba, Canada
Case History: https://ecir.groups.io/g/CaseHistory/files/Connie%20and%20Falki
Falki Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=254861


Re: Falki's Recent Blood Work - Request Feedback

Connie Proceviat
 

Hi Sherry,

Falki is quite lean. I don't think we'd want him any leaner. Ribs are visible. He has some issues with chewing because of some nerve damage to his mouth from an accident as a yearling so maybe that is part of the reason he has some difficulty maintaining weight. He is not on soy meal currently because we're done feeding that particular hay but I could try to cut him back some to see what happens.
--
Connie Proceviat
2013 Manitoba, Canada
Case History: https://ecir.groups.io/g/CaseHistory/files/Connie%20and%20Falki
Falki Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=254861


lavinia and dr kellon; follow up from markups and 2nd vet opinion

Daisy Shepherd
 

all xrays, blood work. vet 2nd opinion posted case hx, and in photos. dr shafer was very impressed with your mark ups lavinia said they were spot on for what tikos feet needed , xrays done 2 weeks post last shoeing, will rexray after next shoeing due 7/8/2021;  i would like to make the additional changes on his hind feet if you agree lavinia; tiko is moving much better and much improved of hind  end on right  dropping out underneath him;  my local vet who is very familiar with epm does not feel he shows epm issues, agrees working on hind end strength best approach; dr kellon has checked his blood work.  my plan, if you guys agree is to work on hind in strength, continue to address and monitor shoeing needs( lavinia what do you see that needs more change from last xrays);  my farrier is willing to work with changes; continue with IR needs with diet and exercise;  dr kellon, my local vet reviewed the lipemia note on tikos glucose did not think needs follow up  in regards to triglyceride, do you agree?  thank you both for all of your help, daisy and tiko
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: Falki's Recent Blood Work - Request Feedback

Lavinia Fiscaletti
 

Hi Connie,

Based on the blood work results in his case history, Falki hasn't had a normal, within reference range, ACTH result since 2014. He should have been on pergolide year round since that time. Why has he been only had it during the seasonal rise period?

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


Re: Falki's Recent Blood Work - Request Feedback

Sherry Morse
 

Hi Connie,

Were he mine I'd start him on pergolide now and keep him on it through the seasonal rise and recheck him next spring to see what his numbers look like.  Given his ideal weight of 900lbs and the fact that his insulin is higher than we'd like to see, is there a reason he's being fed so much hay?  Is he still being fed soybean meal? 




Falki's Recent Blood Work - Request Feedback

Connie Proceviat
 

Hi All,

I've updated Falki's case history with his recent blood work. His insulin has certainly decreased dramatically over time but now it seems his ACTH is slowly creeping up with age. Is that an indication he should be on Pergolide year around rather than just during the seasonal rise?

ACTH 19.8 (2-10)
Glucose 5.3 (3.7-6.7)
Insulin 240 (<300)
--
Thank you,

Connie Proceviat
2013 Manitoba, Canada
Case History: https://ecir.groups.io/g/CaseHistory/files/Connie%20and%20Falki/Falki%20Case%20History.doc.pdf
Falki Photo Album: https://ecir.groups.io/g/CaseHistory/photosearch?p=title%2C%2C%2C20%2C2%2C0%2C0&q=Falki  


Re: J-Herb on Vancouver Island

Cheryl Oickle
 

Hi I get my J herb from  Mad Barn. There is a Canadian and American site fyi.
Good luck!
Cheryl and Jewel

--
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: Medicine update

Erica Reimers
 

Thank you Sherry! The vet was able to talk with the pharmacist at Pet Health and they confirmed the 4.6 mg of pergolide mesylate was correct in order to equal the 3.5 mg of prascend. I think there was some misunderstanding between the vets office staff and the vet. 
That does make sense about the safe starch however my horse won't eat Timothy hay pellets so I'm not sure that he would eat the hay cubes.(he's gotten super picky over the last couple years) He has been fine with baled Timothy hay in the past though which is why I thought he may do ok on the safe starch.(hay storage and severe human allergies to Timothy bales prevents me from simply feeding him flakes of timothy)  Another issue is that I board him and having them soak the hay cubes long enough for them to be softer would be difficult. 

Seems like my only option

On Tue, Jun 22, 2021, 1:59 PM Sherry Morse via groups.io <sherry_morse=yahoo.com@groups.io> wrote:
Hi Erica,

As previously noted you need to have your vet write the prescription as ""x mg of pergolide, as pergolide mesylate" (see message https://ecir.groups.io/g/main/message/264406).  You want to be sure the pharmacy is sending you exactly what you need so you'll want to confirm that they have the correct information prior to processing the order.  As far as TC Safe Starch - it is not on the safe feeds list because the ESC+starch can vary.  You can use Triple Crown Naturals Timothy Balance Cubes as a safe carrier or hay replacement (at a ration of 3lbs of cubes to 4 lbs of hay).

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



--
Erica H CA 2021


Re: Need help interpreting bloodwork and hay tests #file-notice

Maxine McArthur
 
Edited

Hi Laura
I agree with Martha —don’t give up on those dressage dreams quite yet. Ero is still a young horse—at 7, he’s only just finishing growing.

You said you haven’t ventured out on the trail yet, but you may be surprised how much some handwalking outside the arena can help develop his fitness, particularly if you have hills—starting with gentle inclines of course. Handwalking builds his fitness (and yours), it helps your relationship as you’re spending undemanding time with him, it’s a change of scenery from the barn, it sets you up for when you start riding out, and you can add various strengthening exercises as he gets fitter. You can also progress to long-reining down the trail, which is more like riding but allows his back muscles to develop before you put weight on them, which should help with SI issues. 

You mention that Ero had some damaging training experience in the arena, so getting out on the trail might also help to soften any residual connection in his mind between work and pain. 

I handwalk my horses at least once a week instead of riding—we usually do just a couple of miles, but it’s very good for all of us. 


Just a couple of thoughts for your consideration.
--
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: J-Herb on Vancouver Island

sally hill
 

Our farm “Crackin’ Yolks Farm’ is in Port Alberni, Vancouver Island. We stock J herb, among lots of other equine specialty items. We also sell and deliver tested hay. Feel free to see our website crackinyolksfarm.com or find us on Facebook. Happy to send our product and services list if wanting. 
--
Sally Hill
Port Alberni, BC (2018)


Re: Need help interpreting bloodwork and hay tests #file-notice

Laura and Ero
 

@ Martha - light walk/trot under saddle, some lunging and in-hand. He’s not very balanced at the canter and has slipped a few times so we’re effectively starting over (also to get him through and out of the BTV training he had). Hoping FormaHoof helps support the hinds and still looking for boots that fit the shape of his fronts.  Trails to come … wanted to give him time to settle in, get his feet sorted, and bloodwork done. 

@Cass - actually much less clover in the 2021 bales, but will continue to soak especially if/as these start to get mixed. 


@Dr Kellon - agree on hooves and angles, hence the FormaHoof to help with heel height and hopefully better angles overall. Anything more to be considered as it relates to DDFT strain? I’m starting back slow.  Would you change his diet with this new hay?

--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Re: Need help interpreting bloodwork and hay tests #file-notice

Eleanor Kellon, VMD
 

Laura,

Your horse is borderline for IR and insulin not high enough to cause problems. There is no evidence of laminitis. His major obvious issues are obesity and flat palmar angles with poor ground clearance.  That may also mean he has DDFT strain but either way the solution is to grow more foot and higher heels. Muscle definition comes with work and  getting rid of all the fat on top of it that hides it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Laminitis and Mare Hormonal Relationship?

 

Hi Lisa,
Thanks for the great tip!  I’ve posted a formal welcome to the ECIR group here.
--
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: welcome to Lisa in NY (was Laminitis and Mare Hormonal Relationship?)

 

Hi Lisa,
I know you’ve been a member for a few years but this appears to be your first post, which automatically generates a welcome from the ECIR group.  I’m not sure where you are in terms of needing help with horse care so please let us know if you need help.  In the meantime the welcome below will give you lots of reading material which may answer some of any questions you have.

We’ll be looking forward to hear more from you!

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. 

 

--
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: Laminitis and Mare Hormonal Relationship?

lisamurf@...
 

When my horse wouldn’t finish his food, I started using Uckele Equi-sweet. I use the peppermint flavor and he licks his bowl clean every time. There’s no sugar in it and it comes in peppermint or banana/apple flavor. Look it up. Great stuff.
--
Lisa Murphy
Prattsville, NY
5/25/18


J-Herb on Vancouver Island

Helen Connor
 

Hi Kirsten,

I'm trying to find a business on Vancouver Island that offers Jiaogulan (J-herb) for sale for cash. Can you help me? I'm in the US and am asking for a horse owner in the island that several of us are trying to help. Lavinia suggested I check with you. 

Thanks,
Helen 


--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847


Re: Need help interpreting bloodwork and hay tests #file-notice

 

Hi, Laura. I'd choose the first hay, SWF- MIXED CLOVER & GRASS- JULY 2020. 
That's based on the assumption there's clover in both and that you want to limit soaking (we all want that!).
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Need help interpreting bloodwork and hay tests #file-notice

 
Edited

Take heart, Laura.  At 7, he should just be getting started.  Can he be ridden at the moment?  Are you comfortable taking him out on a trail ride?  Walking up and down hills would be good for his hind end.

I would also agree that, if you feel he has lost weight on your program, you should continue that.  He looks like he’s carrying more extra weight than would be comfortable for him.  Go through your hay weights again to make sure he’s not getting extra.  The idea of the emergency diet is to give you a safe place to start while getting organized.  I test my hay and soak it when I am concerned it might pushing the 10% limit.  I’m trying to avoid an emergency by doing so.  Otherwise, I just balance the tested hay with mineral supplements and the recommended vitamin E, flax oil and salt.

I agree with your decision to move to a quieter barn.  Dressage riders tend to be competitive people (I know as I am one.) and full of advice (yup!), some of it more appropriate than others.  No one else is riding your horse, feeling what you feel and progressing with your skills and temperament.  We all pretty much need to follow our own paths, reaching out to others as we see fit.  In my mind, the dressage journey should not be about racking up scores and ribbons but rather, using the skills you’ve developed to ride the horse forward, straight and through.  The feel of the horse under me when all is good is better to me than a show score.  An Olympic dressage rider once told me that, now that she was done with the Olympics, she was going to learn to ride her horse through.  Her horse was considerably older than seven.

--

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: Laminitis and Mare Hormonal Relationship?

Eleanor Kellon, VMD
 

Jackie,

I am sending a longer mail to you and your veterinarian but long story short for those who are wondering the high estrone is also seen in human PCOS. Progesterone not changing is also suspicious.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

7021 - 7040 of 269456