Date   

Re: Trouble addling minerals to feed-Dr. Kellon

Tina Bachmann
 

Thanks everyone for your help and suggestions!


--
Tina Bachmann in VA 2021
https://ecir.groups.io/g/CaseHistory/files/Tina%20and%20Griffin


Re: Desmosphyrine?

Rita Chavez
 

Thank you, Nancy! I guess if there’s a buck to be made and a clever website/ad campaign then a few fish will be caught. 
--
Rita C. and Stetson (2001 Tennessee Walking Horse/Gelding, diagnosed IR)
Aiken, South Carolina USA
June 2021

https://ecir.groups.io/g/CaseHistory/album?id=265166 

https://ecir.groups.io/g/CaseHistory/files/Rita%20C.%20and%20Stetson


Re: Desmosphyrine?

Rita Chavez
 

Hear that? It’s another one of these laminitis fluff ads going into my garbage can! Thanks!! 

--
Rita C. and Stetson (2001 Tennessee Walking Horse/Gelding, diagnosed IR)
Aiken, South Carolina USA
June 2021

https://ecir.groups.io/g/CaseHistory/album?id=265166 

https://ecir.groups.io/g/CaseHistory/files/Rita%20C.%20and%20Stetson


New Body and Hoof Photos Added and Case History Updated

Karen Turner
 

I am guessing that since I did not receive any comments on the hoof and body photos that I added to my photo album, that they were fine...?  Not sure how this works or if I did it correctly.
--
Karen M and Montana Rose in TX 2021

https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Montana

https://ecir.groups.io/g/CaseHistory/album?id=267866


Re: Hay Analysis

Karen Turner
 

Thank you Cass and Sherry.  I will look into the course you mentioned.

--
Karen M and Montana Rose in TX 2021

https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Montana

https://ecir.groups.io/g/CaseHistory/album?id=267866


Re: Laminitis

 

Hi Yvette,
All this information should end up in your case history but I’m interested in knowing whether Molly is on pergolide as you don’t mention that.  You also state that she has Lyme but no mention of having treated her for that.  I know it’s tricky to decide what to put into an introductory post but those are some details I’d want to know next.
--
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

Trisha DePietro
 

Yvette- if Molly is not interested in walking about, I would just let her be. She will know when the time is right. In the beginning you want her to heal and the lamina are very sensitive in the hoof...so any additional walking may need to wait until she is way more comfortable. 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Laminitis

Trisha DePietro
 

Sorry Yvette! I was thinking about Molly as I typed up the response...sorry about that !!!!! :)
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Laminitis

Trisha DePietro
 

Hi Molly. Here is our welcome letter that will highlight all the pieces of this puzzle. And it is a puzzle....BUT you are in the right place at the right time :)  please pay special attention to the blue links as they bring you deeper into more information about that particular topic. As far as your current hay...you should not need to soak it. As long as your ESC + starch numbers added together are less than 10% you should be fine and no need to soak. 

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 (look under the Hay Balancing file if you want professional help balancing). 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
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Desmosphyrine?

Nancy C
 

Hi Rita

I will admit that his bandying about oxidative stress, a hydraulic system, and Desmosomal  bonds, has confounded me for the moment. The first thing that jumped out at me that I knew was an issue however, was matrix metalloproteinase

"First, all swelling involves oxidative stress. Secondly, it creates a hydraulic system. The oxidative stress activates the matrix metalloproteinase. This stress causes the breakdown of the Desmosomal bonds in the lamina if left untreated."

matrix metalloproteinase is a product of laminitis in cases other than metabolic (high insulin) laminitis.  MMP occurs in hind gut driven laminitis like feed room break-in, black walnut, systemic inflammation and lamintis via fructan bolus like that done in the early years by Pollitt.  The testimonial on their page is a case of feed room break in.  https://www.beatlaminitis.com/about

80-90 percent of laminitis cases are caused by metabolic issues, not hind-gut disruption.
____
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021

Recordings of the 2021 NO Laminitis! Conference released to attendees 09.03.21.
Veterinary Professional CE certification hours submitted to AAVSB Race 09.08.21


Re: Desmosphyrine?

Eleanor Kellon, VMD
 

Total nonsense and a major ripoff at $600 for 24 days - or at any price for that matter. Matrix metalloproteinase is not activated in endocrinopathic/metabolic laminitis. Even if it was, spraying SOD on the feet is a total waste of time. There's no way it would get in. There is also no evidence that oxidative stress activates metalloproteinase.

https://pubmed.ncbi.nlm.nih.gov/21333362/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Desmosphyrine?

Rita Chavez
 

This website presented to me as a suggestion on FB today. Could one of our experienced EC/IR members comment on this novel product being offered as a treatment? I question everything these days. 

Thank you! 

https://www.beatlaminitis.com/
--
Rita C. and Stetson (2001 Tennessee Walking Horse/Gelding, diagnosed IR)
Aiken, South Carolina USA
June 2021

https://ecir.groups.io/g/CaseHistory/album?id=265166 

https://ecir.groups.io/g/CaseHistory/files/Rita%20C.%20and%20Stetson


Re: HIgh Insulin - looking for recomendation

Eleanor Kellon, VMD
 

Liz,

Next week is fine. That's when the seasonal rise peaks. Just do ACTH.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Trouble addling minerals to feed-Dr. Kellon

Jennifer Green
 

My picky boy seems to like things better when I add fenugreek powder.  He’s kind of a little prince :)
--
J.Green 
MA, USA
2021
https://ecir.groups.io/g/CaseHistory/files/Fergus%20Case%20History
CaseHistory@ECIR.groups.io | Album


Re: Pabatsa's ACTH jumped up to 98.4 -- Dr. Kellon help with CP

Laura and Pabatsa in CA
 

Thank you everyone for your advice. I’m waiting for my vet to phone back at which time I’m going to suggest he get 5.5 mg. And I will put him back on the APF Pro. I have serious Scleroderma and Lupus; a lot of hospitals lately so have been relying on grooms for updates. I think when he’s on the higher dose he will be better.



--
Laura and Pabatsa in California
Feb 2012
Case History https://ecir.groups.io /g/CaseHistory/files/Laura%20a nd%20Pabatsa ( https://ecir.groups.io/g/CaseHistory/files/Laura%20and%20Pabatsa )
Pabatsa's Photos https://ecir.groups.io /g/CaseHistory/album?id=1740 ( https://ecir.groups.io/g/CaseHistory/album?id=1740 )


Re: HIgh Insulin - looking for recomendation

Liz7033@...
 

I reread the ECIR web page for seasonal rise.  Regarding the subtle signs, Dante does have an increase in appetite (not leaving as much hay), insulin resistance worsening (per test results), lethargic and possible some change in shedding. I suppose if I can't get blood drawn this week to confirm rise in ACTH, I could start pergolide now or right after blood is drawn based on symptoms I am seeing. (This is when it is handy to have a horse already on the medicine)  Since I would be chasing the rise, not sure of dose or if it would work. But I would start pergolide at approximately .5 mg and go from there to resist the veil. 

From Sherry response above and rereading the webpage, looks like the Stim test should not be done but the ACTH at this time of year.

Any comments or disagreements?

Liz
SW Washington
January 25, 2020
https://ecir.groups.io/g/CaseHistory/files/Liz%20and%20Dante
https://ecir.groups.io/g/CaseHistory/album?id=268141 Dante photos


Tasha photo album
Case History


Trimmers located in the Dallas/Fort Worth area

 

Hi all,

Can anyone recommend a trimmer experienced with laminitis located in the Dallas/Fort Worth area?  I am balancing for someone in that area who needs one. 

Carol Broyles 
Spring Valley,  Ohio 
August 2007


Re: Rose update

Thurstonjs@...
 

Hi Sherry,

What I meant by that is she got water and hay, no grass or grain. The vet called that fasting.
--
Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose


Laminitis

Yvette G
 

My mare, Molly, was diagnosed with Cushings 7/2020 and negative for EMS when she was having a laminitic episode.   I had her retested 2/2021 and she was negative for Cushings and positive for EMS.  I had some trimming issues, but that has been corrected as of April, 2021.  I found a trimmer who recommended this group.    Molly, is having another laminitic episode that began 8/27/21, the day after she was trimmed.  I did notice a couple of days before the trim that she seemed a bit off walking up hill so I don't believe it was due to the trim & Farrier said she did a very mild trim.   I have her in iCloud boots with a 12mm pad.   I was hand walking her a couple of times just for a few minutes, but t I just read an article that said confinement is best in the beginning.  She did not want to walk the other day.  She does have to move to get her hay and her water.  Not too far, but she has to move and she does.  Eating and drinking normally and no temperature.  Her feet are warm to the touch and I try to ice them a couple of times a day too.  I've been using Equine Light Therapy on her 2x a day for 15 minutes since 9/7/21.  The directions say 2x a day for the first 2 weeks and then 1x for up to a month if improvement.   My vet is coming out tomorrow to take xrays since it has been a year since her last xrays were taken.   Should I have her blood tested again for Cushings and EMS?  It seemed strange to me that she was positive for Cushings and negative for EMS this time last year and then in 2/2021 it was the reverse.   She does have Lyme as well.  

I have also been soaking her hay since this happened.  I just got a new batch of hay the day before the episode happened and the analysis just came back yesterday.  The combined ESC & starch is 3.9 so I'm wondering if I need to continue soaking it?  The aNDF is 54.8 and ADF is 35.4.  NFC is 15.9.  


Her current diet is 1/4 cup of Timothy pellets, 1 cup of ground flax, 1 cup of Omega E from Custom Equine Nutrition, salt & free choice salt and supplements 1x a day.  Her and her mini companion split one bale of hay a day in slow feed hay nets.  

Thank you for any suggestions! 
--
Yvette G in NY 2021


Re: HIgh Insulin - looking for recomendation

Liz7033@...
 

Eleanor,

Dante was tested on July 5 for ACTH and his result was 23.6 pg/mL.  When I retest should it be the regular ACTH or TRH Stimulation test?  Vet is on vacation till next week, based on your ASAP note I guess I need to find someone else to draw blood.

Noted exercise is probably not vigorous enough for him, but due to age and his conditioning, we are steady increasing. 

--Liz
SW Washington
January 25, 2020

https://ecir.groups.io/g/CaseHistory/files/Liz%20and%20Dante/Dante%20Case%20History%20.pdf
https://ecir.groups.io/g/CaseHistory/photo/268141 Dante photo


Tasha photo album
Case History

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