Date   

Re: Cabergoline

Eleanor Kellon, VMD
 

The only source for cabergoline was BET labs in KY but I don't see it on their web site anymore. You could try calling https://betlabs.com/ .
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Cabergoline

Laura Sager
 

To anyone on here successfully using Cabergoline from a compounding pharmacy,...Can you tell me what pharmacy you use and what the cost is.  Thanks.
Laura L, NY 2021


Re: New and pretty lost

Joy V
 

Please don't beat yourself up Diane.  My horse likely was PPID/IR for YEARS before he was diagnosed.  He saw 4 different vets over those years and not one of them suggested testing.  You're here now, and this is the place that will help you help your horse.  Hang in there!!  


--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: ODTB cubes available

Nancy & Vinnie & Summer
 

Hi Valeree,

Just in case there aren't any takers, I believe there is an Arabian Horse Rescue in Mojave that maybe could use it.  It is Love This Horse Equine Rescue.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: Wanting to start updating file…

Nancy & Vinnie & Summer
 

There are programs you can purchase to edit pdf form that are not as expensive as Adobe, but you will have to convert to from pdf format to an editable version or have a pdf editor.

My phone allowed me to download a pdf and "save as"  a .doc file but some formatting was a little skewed.

You can also search your hard drive for the original .doc version that you created prior to saving as a .pdf file.

Hope that helps.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: New diagnosis pending

Maxine McArthur
 

HI Kelly
My condolences on losing Red, and I'm glad you were able to keep him healthy and pain-free until the end. 

Thank you for uploading Artie's case history--you did a great job! Just one more tiny step to get the link to show as 'live' (in blue), so we can access it with one click. You can do this by going to your 'Subscription' tab, and in the 'signature' box where you entered the link to the case history, position your cursor at the end of the link and either add a space, or hit 'enter'.  Then scroll down to the bottom of the screen and hit 'Save'. That's it. 

We will obviously know more about Artie's condition once you get the blood test results, but in the meantime it won't hurt to treat him as though he has metabolic issues. In a 22 year-old horse not holding weight, PPID is a distinct possibility, and when you add the timing of his laminitis--during October, the height of the seasonal rise--the possibility is even higher. 

Regarding his weight and feed--for the time being, non-molassed beet pulp (rinsed, soaked, rinsed) and soy hulls (soaked) are both safe for IR hhorses and excellent for adding weight (I don't feed them to my good doers in any quantity for that reason). You can then use either (or mix them, which is what I tend to do) as carrier for any supplements he may need. If he is not getting any pasture, you can add up to a couple of cups of ground flaxseed, which is also a good source of protein and calories. Many of us buy whole seeds and grind our own in a coffee/spice grinder. Please also give him salt and Vitamin E (to replace the Vit E lost in hay). For the Vit E, human gel caps (in oil) are relatively cheap and easy to toss in a feed. There are some good tips on feeding in the 'Core Diet' and 'Putting it all Together' folders in the Files. There is also a list of safe commercial feeds here: Safe Bagged Feeds.pdf (groups.io) 

You said that Artie is eating low-starch hay--has this particular hay been tested then? Testing your large bales would not only benefit Artie, but your other horses as well, as then you can put together a custom mineral supplement that will target any deficiencies and probably save you much money (when compared with buying off-the-shelf products that aren't targeted). You might be able to chat with the farmer and get him/her to bring you bales from the same field, so that once you test, you'll have a good idea what is in them. This may change with the next season, but at least you'll know about this year's crop. You're ahead in knowing your hay grower, rather than having to buy hay from various random sources, like many of us. 

If you would like opinions on his hoof rads, you can upload them (preferably with hoof photos also) to a photo album. Instructions here: main@ECIR.groups.io | Wiki
Sensitivity to hoof testers is not a reliable indicator of laminitis. 

Until we get his test results--and please let us know when you do by either adding a message to this thread or starting a new one--for now I'm including below our usual welcome message for new members. As a long-time lurker, you are probably familiar with much of the information in this welcome message, but I urge you to read through it carefully and follow up the links as new information is added frequently; often I find new discoveries upon re-reading. Let us know if you have further questions. 

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. 








--
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: Wanting to start updating file…

Sherry Morse
 

Hi Suzanne,

If you didn't keep an editable form on your device you're going to have to start over and create a new case history form for Pilgrim.  Sorry.




Re: Wanting to start updating file…

 

Hi Suzanne,
You can’t directly update your pdf as it’s more like a photo of your document.  You really need the word processing document.  Fortunately, there are ways to translate the pdf back to Word, which can be opened on your Mac with Pages.  If you want to give it a try, look for a free online PDF to Word converter.  The outputs are not consistently accurate.  I did this for someone else recently and found I already had a suitable app for doing that so I’d be happy to give it a try for you as well.  I can copy your pdf in your folder, convert it and send it to you directly if you like.  If the end result is usable, be sure to save it on your computer for next time.  I have a folder on my hard drive labeled ECIR and numerous folders inside it.
--
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


 
 


Chicy Coronary Band

Qhgirl
 

Gave Chicy a bath today. Afterwards I noticed her coronary bands looked white snd mushy. I ran my finger lightly on the front and some white mushy stuff was on my finger. I then took a picture of a rear foot as it has never had a boot.  Is this associated with pregnancy or PPID?
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


ODTB cubes available

Valeree Smith
 

I have a friend who has 6 bags of the ODTB cubes available.  She recently lost her horse.

They are $25.00 per bag, cash only.  You must pick up - she is located in Acton, CA which is north of Santa Clarita.

If there is any interest, please feel free to email me privately.

Thanks.

Valeree Smith
Southern CA
2003


New diagnosis pending

JoinTheHunt
 

Hello all, 

Longtime lurker, first time poster/uploader. I lost my 30 year old PPID gelding, Red, in January to a combination of distal sink in the LF complicated by severe ataxia. My attempts to upload a case history for him were frustrated by 2 computer crashes, but I did use the information available here to advocate for him and keep him as healthy and pain-free as possible until it just wasn't possible anymore and I am very grateful for that. 

I just uploaded a case history (at least, I think I did) for Artie, one of my school horses, and while I think I know what the blood work will show, he's presenting somewhat strangely for a classic metabolically-induced laminitis. I manage a 30 stall boarding facility and in addition to my own horse, I am directly responsible for the schoolie string of 8 horses. Artie is 22 and until 3 weeks ago was in steady light to moderate work 5 to 6 days a week. He was a very robust and healthy weight until I cut his grain after the COVID shutdown last year when he suddenly lost weight/condition. I adjusted his diet again, wormed him and had his teeth checked - they were normal. He regained some weight with a switch to senior feed and some condition when we were able to resume our lesson program but he hasn't ever completely recovered the muscle tone that he had in early 2020. He shows no other symptoms of PPID, and I was going to test his blood anyway in the winter, but he went lame 3 weeks ago. At first he only presented lame in the right front and we (me and the vet) suspected abscess, but he progressed very quickly to being very sore in both front feet and assuming the classic laminitic stance. I removed all grain from his diet and he is eating low-starch hay from a slow feed net while we wait for blood results. His LF radiographs normal, but his RF shows some mild rotation with a shadow at the tip of the coffin bone that could be a gas pocket. It also appears to be connected to an odd triangular shaped lucency in the toe area that we can't explain. He has no sensitivity to hoof testers, at all, and he's been squeezed on several times by both vet and farrier. 

Given this is a road I'm familiar with, I know that if his ACTH is high (and I'm sure it will be) getting him on meds and under control will be key to helping his comfort, but Artie is much thinner right now than I'd like and I'm not at all confident that he will be able to maintain a healthy weight on hay alone. He was extremely malnourished when we got him 10 years ago, but all it took to fix him then was deworming, a lot of good groceries and time. I feel like my feeding options have become extremely limited due to his suspected metabolic status and once we get him stabilized, I'm not sure where to go from there to get some weight back on him and would appreciate any suggestions. 

I also have some questions about hay testing - we feed primarily large squares of grass mix hay from a local farmer. We also keep a stash of first crop alfalfa in small squares and first and second crop orchard/red clover small squares from our own field to be used for travel, winter feeding in the paddocks and emergency stash in case the large bale delivery is late. I plan to test all the different small square crops but is it worth testing the large bales? I know they all come from the same farmer who is less than 3 miles away, but I have no idea what field they are all from and we get deliveries 2-3 times a week. 

Thanks very much in advance and I hope I did my upload correctly!

--
Kelly in SE Wisconsin 2017

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

 


Re: Chicy (in foal) out of stall first time in 5 weeks

Qhgirl
 

I called shavings dealer and inquired if ever a recall on the shavings I use and was told they sell thousands of bags and have never has one complaint or any recalls. 
I have moved Chicy to another stall my competition horse stays in and have moved him into her stall and dry lot.  I am going to put a sheet on her at night and in the afternoon which seems to be the times she lays down.
I started her on APF tonight and plant to give it to her 3 days and then start back with 1/4 Prascend to see what happens.
Thanks to all for hanging in with us while we try to get Chicy well.  
I will keep everyone posted.

What is the cost of a compounded pergolide? A friend I saw over the weekend has 2 PPID horses and gives them a compound that she just puts a scoop in their food and they eat it with the meal.  She said it regulated both horses great.  It is from Cameron Pharmacy in St Matthews SC. 
Each 5ml scoop contains Pergolide 1mg, and Cyproheptadine 120 mg.
Is this what is normally in most compounds and is this unique?  She said it regulates her horses great.  She had them on Prescend before and offered she could not get her horses regulated so vet changed her horses to this compound.
I will keep everyone posted on what happens trying to restart the Prascend.
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


Wanting to start updating file…

Suzanne and Pilgrim
 

Hi I’m ready to start updating info in Pilgrim’s file. I haven’t looked at it for close to 2 years. I don’t want to complicate my life or anybody else’s at ECIR.
Where do I start?  I only have a readable PDF form on my Mac computer…
Thank you in advance for your support and guidance,

--


Re: New member

Maxine McArthur
 

Hi Ann
Welcome to the group! This message is our usual welcome for new members. It contains a lot of information about our philosophy, recommendations, and links to more detailed information. One of the first things we need you to do is to fill out a case history for your gelding, so that we have more specific information. We ask members to fill out a case history so all of the information is in one place--this saves our volunteers from having to search through multiple message threads. Once you have downloaded the case history form and filled it out, please upload it per instructions into the Case History sub-group, and send a new message to the group with a subject such as, 'new member case history feedback please'. All the directions for doing this are in the welcome message below. 
Some of the things we'd be asking about your gelding are: his actual age, current weight, ideal weight, whether he had any bloodwork for metabolic issues and what the results were, what exactly is he eating (by weight, hay analysis if possible), and any other symptoms/issues. You can also create a photo album for him in the case history sub-group and upload hoof photos and radiographs to get feedback on his trim. 

It is difficult to comment on a timeline for recovery without all the above details, but if you have removed the cause of his laminitis, he should improve. Generally we do not suggest formal exercise after a laminitic event until at least 2/3 of a new hoof capsule has grown down (or longer, depending on the severity). Testing for EMS and PPID (Cushings) would be part of troubleshooting the cause of the laminitis. If he is older teens (over 16, say) and losing weight on an appropriate diet despite good dental care, deworming etc, PPID is certainly a possibility that should be explored. There are links to the blood tests we recommend in the welcome message below. 

If you get stuck navigating around the group, the Wiki has directions on everything you'll need to know. main@ECIR.groups.io | Wiki

So, here is the welcome message. You may want to save it or print it out for easy reference. There are many links to follow and a lot of information to process, but if you have any questions, don't hesitate to ask. 

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. 


--
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: New and pretty lost

Kelly Kathleen Daughtry
 

Don't be mad at yourself - you're doing great! Most all of us have been where you are before. You're on the right path to helping your girl. You've got this and this group is a phenomenal resource as you figure it all out. Hang in there.
--
Kelly & Micah, Clayton NC

April 2016

Case History: https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20%20Micah 

Photos: https://ecir.groups.io/g/CaseHistory/album?id=264981

 

          


Re: Timing - Dr Kellon

Starshine Ranch
 

I didn't get it but thank you both so much.
--
Linda in CA  2020  Midnight and Ostara
https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara


Re: Timing for dosing other than Pergolide

Starshine Ranch
 

Hydroxyzine...   7/am and 5/pm     I hope that's ok.
--
Linda in CA  2020  Midnight and Ostara
https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara


Re: Timing for dosing other than Pergolide

Starshine Ranch
 

Thank you!  That will make things a bit easier.
--
Linda in CA  2020  Midnight and Ostara
https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara


Re: New and pretty lost

Dianemetzel@...
 

Thank you so much. I’m still having a hard time wrapping my mind around it. I’m pretty confused. There is so much to learn. I bought a good set of clippers today. Then, I worried because we will have our first cool night tomorrow. I only clipped her neck and chest. But, with her going no sweater I have to hose her every hot day. The long hair stays damp😑
She’s likely to get sick being damp all the time ugh. I’m mad at myself for missing the signs. She’s was sweating
Like crazy, drinking a lot and super itchy. All things I had no idea were signs. I’m already learning so much here. Thanks to this group I put her back on the Prascend. I’ll try 1/4 tablet daily and see.Sent from my iPhone

--
Diane M in FL 2021


New member

A Growley
 


--
AnnG from Pa 2021
i have a teenaged TWH gelding who has been lame with swelling in the right fore. His lameness has had remissions and exacerbations since March, 2021 with a split hoof,& abscess blowout in April. Spring vet visit in April, and barely lame. Still lame in May w/ vet eval, X-rays suggesting laminitis. Had been turned out in a grazing muzzle since April. Confined to a dry lot,& on well solve feed w/1.5-2% body wt,& hay in a slow feed Hay-net. When sound, controlled exercise started and slowly increasing muzzled turnout. Shoes pulled, and feet trimmed per protocol. Has had ups and downs several times since. Wt down 180lbs, and still losing. What is the expected timeline for this,& what am I missing??

10961 - 10980 of 277882