Date   

Re: repost for dr kellon

Daisy Shepherd
 

thank you; the answer from you about  tiko blood work makes me feel safe.   daisy, tiko, whisper
--
-- 
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: sugar and starch in leaves/ dr kellon please

Daisy Shepherd
 

thank you for this info; guess this is not as bad as the russian olive berries at his last boarding place. !!.  daisy, tiko, whisper
--
-- 
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


Puzzling Foot Soreness - Need Advice

Lynn
 

To recap - back in August i noticed Relevante starting to develop a slight crest. It was in response - as I discovered - to new hay/first cutting from the farm - it had tested at 9.9 - technically below the safety cut-off but apparently too rich for him....at that time his numbers were: 
June ACTH test - 19.4 pg/mL
June 30, 2021 Hay Analysis - ESC 9.0, Starch .9
August 5, 2021 Insulin  - 44.74 ulU/ml
                     EMS Calculator - RISQI 0.15
Began soaking hay right away - retested insulin 8/25 and it came back at 18.71 uIU/mL from 44.74 ulU/ml on Aug. 5 - crest has continued to soften and diminish and appears nearly normal. He has continued to be walked during the week - starting at the end of September I began to ride him every weekend - carefully, slowly at first - more for my sake/security than his ...since although I've been cleared to ride ..my doctor said "Let's not fall off and no emergency dismounts right now."
This past Thursday I gave Relevante his first bath of the season. When I walked him out of his stall he appeared to be experiencing some foot soreness in his front feet (where he had laminitis almost 5 years ago). Today, when I took him out he seemed okay. I put the Cavallo boots with gel pads back on his front feet and walked him out to the grass and he seemed fine - in fact he acted quite frisky to the point where I walked him a bit before getting on. He even expressed himself via a few bucks. I got on. I was with another boarder who is a certified massage therapist for equines. She observed us from behind and from beside us and saw no signs of soreness. He wanted to gait so I let him blow off some steam and we just rode around the farm a bit until he relaxed - then we went on the trail. I know they don't always know what is best for themselves but since my friend continued to observe us and saw no signs of soreness - and i didn't feel any signs of discomfort I let him choose when he wanted to go - we stayed on grassy trails and gentle hills. A couple times he gaited faster than I've ever felt him go and it was smooth and collected. We were out about 2 hours and it was a wonderful ride. When we got back I left his boots on until I was ready to put him up - put some extra bedding in his stall etc. 
When I took the boots off and started to lead him into his stall he acted foot sore again. Should I be concerned? We were going to ride again tomorrow. Should I not try to ride him? I'm trying to build back his physical fitness for the purpose of helping to keep his insulin down but I don't want to do anything to damage his feet or work him if he's hurting. Not sure what to think about this.. Thanks for any advice. My case history is up to date.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Triglycerides and liver values

dr.kellylear@...
 


Re: Sourcing of Devil’s Claw? (Phyto-Quench pelleted is backordered)

Eleanor Kellon, VMD
 

Yes, you can. All herbals have a wide range of dosages depending on whether standardized or not and if not it will vary widely. Ten grams is a good place to start.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Triglycerides and liver values

Eleanor Kellon, VMD
 

Kelly,

I wouldn't do anything about these enzyme elevations. They will resolve as her energy balance normalizes.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Triglycerides and liver values

dr.kellylear@...
 

Hello everyone, 
Saddie is home and making improvements and eating! Major accomplishment for us. I had her triglycerides checked today and they are at 84. I am so excited right now. However her GGT is elevated at 69. Is there something I should start supplementing her liver with to help it heal? Her ALP is 690. But at least she is eating. 

Thank you for everyone’s help, she sure is trying! 

Kelly 
--

 

Kelly Lear in Texas 2021

https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20Saddie

https://ecir.groups.io/g/CaseHistory/album?id=267371


Re: Sourcing of Devil’s Claw? (Phyto-Quench pelleted is backordered)

Marie
 

Can I use a whole dryed devil claw or powder only? 8000-10000mg to start twice a day? Can it to use continuously? What is the maximum amount per day?


--
Marie Volsicka
Mid Europe
2021


Re: G’S WIRX For Insulin Resistant Horses

Lorna Cane
 

Hi Suzanne,

If you search our archives for WIRX,you'll bring up a lot of helpful messages about this product. 

--

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


G’S WIRX For Insulin Resistant Horses

Suzanne and Pilgrim
 

Hi,

Just wondering if this product has been tested to be an effective  preventative tool in helping keep glucose and insulin  levels down naturally.

I just saw it today at an open house at a barn. It has cinnamon and cranberries…


Anybody have any knowledge?
--


Re: Chicy (in foal) blood results coming in

Eleanor Kellon, VMD
 

The usual recommendation is to stop pergolide 30 days before foaling and resume it again 30  days after foaling. The major problem is it will suppress lactation so the foal will probably need appropriate supplemental feeding after it is restarted.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: New Member -- Need Alternatives to Soaking Hay

Kirsten Rasmussen
 

Hi Heidi,

You've made great progress, and all 3 things (removing pasture, soaking hay, starting Metformin) are why.  If you remove 1 of these variables (ie soaking hay), I would retest insulin after 1-2 weeks to see how much of an effect it has.  Your hay is definitely risky at 10.3% ESC (what is the starch?), and I would not advise stopping soaking.  However, you don't know how much of an effect it will have if you don't try it and recheck insulin.

That said, many of us have figured out how to have hay soaked at a boarding barn, and/or through the winter...not sure what reasons you have for not bring able to soak, but maybe we can give more advise if you can specify them.  It's not necessarily easy, but it's easier than dealing with laminitis/founder.  You could also try buying your own low sugar hay if you can find some.

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


Re: Chicy (in foal) blood results coming in

Kirsten Rasmussen
 

Hi Janet, 

I looked at your Case History for Chicy to get a refresher on when this started etc and found that there really isn't much information in there.  Now that you know she is PPID could you please update it with the last few months of information?  Use the Comments section to put in a timeline of events.  You have posted 57 messages here but there's no way we can go through and read them to get the details, so it would be best to summarize them in your Case Hx.

Fortunately, spring is when ACTH will be at its lowest and it's possible Chicy will be fine without pergolide starting in Feb/Mar.  You can continue to monitor her ACTH through that time, but she might be just fine until next September.  I would start her back on pergolide no later than mid-August and make sure she is at the full dose by the end of August. 
What this means for feeding the foal, I don't know.  Hopefully Dr Kellon can advise.

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


Re: Supplement Changes/Sore?

Kirsten Rasmussen
 

Hi Kathleen, 

Are you soaking her hay?  You will probably see an improvement in pain very quickly if you start.  Can you physically block her from accessing the dry lot where the grass is growing at the edge?  At least until you get the grass killed?

Excessive mechanical force on the hooves during a laminitis flareup can cause more pain.  That is why we don't want other horses pushing them around or any forced exercise, and any spook or startle could have the same effect.  Her hooves are already tender and the laminae are already compromised, so you can imagine that excess force could worsen it.  Is she in boots with pads?

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


Re: Carrier for vitamins and minerals

Eleanor Kellon, VMD
 

Looks fine.

Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: IR horse Rusty’s case since January 2021

Lavinia Fiscaletti
 

Hello Sntkennel,

Welcome to the group! 

Sorry that your boy has been going thru this for so long. No need to apologize for long posts - the more information we have to work with, the better. Attachments do not come thru on the main group so you will need to join the case history sub-group, where you can create a photo album to upload photos and radiographs. That's where you will also need to upload a filled out case history form so that we have all the pertinent details in one easy-to-locate place over time. Blood work results will go in the case history folder or on the form itself, as will the hay analysis. Don't worry if you don't have all the info, just fill in what you can as you can update the form later as more information becomes available. (See link to case history group below)

A horse with laminitis doesn't necessarily react to hoof testers. Thin soles and/or subtle trim issues may also be part of the problem, so seeing the photos and radiographs will be super helpful.

It looks like you've made a good start to helping get your boy's diet tightened up. As he is IR, there are a few more things that can be done to tighten it even further. The TC Senior Gold needs to be stopped immediately as the ESC+starch is not guaranteed to be below 10%; it contains added iron; high levels of fat (min 12.5%); inverted omega 3 to 6 levels. If you need a carrier for supplements, rinsed/soaked/rinsed beet pulp is a good, safe option to use. Ontario Dehy Balanced Timothy Cubes (also sole as the TC Naturals Balanced Timothy Cubes) are another safe alternative. What type of vit E are you using? The DIET section below has more specifics.

The Vermont Blend or CA Trace are good basic options but until we see the hay analysis it's unknown whether they are a good match for your hay or not. If your current hay has ESC+starch values that total under 10%, then it's OK to feed it not soaked. Good that you're spreading the hay amount out over the entire day What is your guy's ideal weight and what is it now? You want to feed a daily total of no more than 2% of his ideal weight in total food per day (hay+feeds) if he is at a good weight.

Why are you feeding chia seeds and ground flax? Why is your boy on Previcox?

Let us know once you have uploaded the photos, hay analyses and case history so we can take a look to see where else things can be tweaked to improve things for your guy.

The remainder of this note contains our Official Welcome, which contains a lot of more in-depth info and links to explore. It's helpful if you stash a copy somewhere easy to access for future reference. It will answer many of your questions, and likely also suggest other questions. Please don't hesitate to reach out so we can help you help your boy.

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.

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


Re: Positive for early cushing`s?

Kirsten Rasmussen
 

Hi Anthie,

I'd say that ACTH result is pretty borderline.  It was done a few weeks after the peak of the rise, so it's possible it was higher, but it will be coming down now.  Next year you might want to consider putting Erin on 0.5 mg pergolide in late July to be proactive, then retest right at the peak (fall equinox).  I'm not sure why her glucose would be lower than normal unless there were issues during shipping that may have caused it to be partially metabolized, in which case your ACTH and insulin would also have been affected a bit.  If you call Cornell they can probably tell you when the sample was received.

The increased peeing could be explained by the increased salt consumption.  But not sure why she would be craving salt at this time of year.  It's definitely something to keep an eye on and make note of since it's seasonal and unusual behaviour for Erin.

The lack of forward movement you mention in your Case History could have many causes, but it's possible that her consistently elevated insulin (>40 uIU/ml) is keeping her in the sub-clinical laminitis zone and that alone could result in hoof tenderness.  What does her whiteline look like?  Is it nice and tight, or is it stretched?  Does she have any rippling in her hoof walls?

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


Re: repost for dr kellon

Eleanor Kellon, VMD
 

Don't change a thing!
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Carrier for vitamins and minerals

Joan Hornby
 
Edited

Is this a suitable carrier for forage plus laminate plus balancer? Ranger won't eat speedibeet and the recommended safe feeds are not available in the U.K.
Thanks,
Joan

https://keyflowfeeds.wpengine.com/wp-content/uploads/2018/11/KF_Pink_Mash-V6.pdf
--
Joan Hornby
UK North West
December 2020
https://ecir.groups.io/g/CaseHistory/album?id=268474 


repost for dr kellon

Daisy Shepherd
 

good morning,  tiko blood done 10/05/2021 all cornell  insulin 21.79, glucose 101, T4 1.07, actn 20.5, leptin 4.29, gi ratio 4.64, risqi 0.21, mirg,7.9; last nite feeding low s&s hay 11 # at 730pm, next am 730 same hay  5#,  to pasture at 830am with muzzle 1 inch hole in at 1030 with same hay, vet drew blood at 1115. thank you for you review and recommendations.    daisy,tiko,whisper
--
-- 
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

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