Date   

Lavina trim adivice please.

Julie Allen
 

hello, 

i uploaded new photos for cookies feet. she has been living in cloud boots 24/7 since January 15, on all four, only off to treat with artimud and clean. the last time I posted it was suggested I let her feet grow out well . they look a little gnarley on her hoof walls due to being in boots all day for 3 months. 

she does let us lift and clean all her feet now, she is recovering from her hip injury tho we still have zero idea what happened she is still walking a bit stiff. 

please advise on trim / markups/ where do go from here I resisted the urge to even up her feet and give her a good trim until advised ... 

thank you very much. 
--
Julie 
Boring , Oregon 
2009
https://ecir.groups.io/g/CaseHistory/files/Julie%20Allen%20and%20Callie%20and%20Cookie
Callie photo album:https://ecir.groups.io/g/CaseHistory/album?id=245704
Cookie photo album: https://ecir.groups.io/g/CaseHistory/album?id=271132


Re: Palatable Copper and Zinc

Ann Conn
 

Now thinking I'll try Uckele products again and go very slowly with it. He has always loved the Timothy balance cubes and California Trace Plus until recently, but ate some of both yesterday, so we'll see. I did try Stabul 1, years ago, and he ate it for two weeks or so, but once he decided it wasn't any good, that was it, period...NO...I told you it's bad and I'm NOT going to eat it.
I've never considered RSR beet pulp because of how hard it would be for me to properly prepare. But appreciate all the options.
A note about AVRIO. Spoke with one person yesterday and got some prices. Spoke with different person today to confirm script my vet had called in and price was $36.00 more than yesterday's
quote. So I told him that and he put me on hold and came back to say other guy's price quote was correct and my cost would be $36.00 less than what he'd told me two minutes before. I don't know how others might get the best possible price. Wish there was a way to compare costs among members for a variety of doses, quantity, etc. It makes a difference for older, fixed income folks.
Ann Conn and Azeem
Central Texas. 2016


Re: Donkey possibly IR

Trisha DePietro
 

https://ecir.groups.io/g/main/files/Donkey%20and%20Mule%20Specific%20Information
 :) 
Hi Pam... the link to the donkey file is listed above. Sorry...I didn't do the link correctly in your first response. --
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Donkey possibly IR

Trisha DePietro
 

Hi Pam. Welcome to the group. I have included our welcome letter for you to review. It contains alot of information regarding Insulin Resistance. I have also included a link to our file on donkeys and mules...This is all baseline reading and good information to save for future reference. If you have any specific questions after reading through or at any time, please feel free to post here, on the main forum. I am sure, our donkey experts will chime in and offer any information they have as well. It would be really helpful if you would complete a case history for your donkey. It helps us see all pertinent information together in one place, so we can see the "big picture"....link to donkey file:     https://ecir.groups.io/g/main/files/Donkey%20and%20Mule%20Specific%20InformationHello       

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


Donkey possibly IR

Pamlevy94@...
 

Three-year-old male donkey slowly developing a cresty neck although quite thin.  Is currently on forage of 60% Barley straw that’s been tested (low starch and sugar) with the balance being Coastal Bermuda (not tested).  No grain just a vitamin/mineral with added salt.  Hay is weighed based on his weight.  Spine and ribs are easily felt.  Just received more Bermuda that I will be testing.  
--
Pam L. CA 2022













Pam L. CA 2022







 


Re: Hoof pain

Lisa
 

Hi everyone, 

Thank you for taking the time to respond. I will try to answer questions and give an update.

Nira has been getting weighed soaked hay since 2/10/22. While this was about 12 days after symptoms started, we at first thought she was sore from being cast. She has lost weight since starting the weighed soaked hay. 

I do add salt to her meals. I have done this since October 2020. She is maybe drinking a gallon of water during the day. She is inside and it hasn't been warm out at all until this week. I drain her hay but it is pretty wet when I feed her, it's been too cold to get it well drained without it freezing.

The most current x-rays I have of her feet are in her photos. These X-rays were taken before the farrier trimmed her toes back. I will try to take some hoof pictures and get them posted. She has been in boots with gaiters and leg wraps since mid-February. I will add socks tonight. Temps have gone up above freezing at night and into the 40's and 50's F during the day now. I'm hoping that will start to help, but the socks might also help if she is getting rubbed. I bought some different boots today to try. They should arrive in a few days.

The vet was here this morning. I was worried about her colicing. He gave her some fluids and did a blood draw to confirm her kidneys are okay and they are. Our plan is to do blood testing again in a couple of weeks (after the temperatures are hopefully a little more consistently warmer at night) and also X-ray her hooves again. Dr. Kellon, I will check into the information on the blood tests you recommended and see what my vet says about metformin. 

Thank you!

Lisa L
August 2020 Milaca Minnesota
Case History: https://ecir.groups.io/g/CaseHistory/files/Lisa%20and%20Nira
Nira Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=273134


Re: Lost too Much Weight

Eleanor Kellon, VMD
 

Vaccine reaction from November is highly unlikely - and autoimmune even more unlikely. Did you look into getting the Ontario Dehy cubes either from one of their distributors or Triple Crown?  You may need to replace all his hay with softened cubes.

Agree with pergolide increase. The insulin isn't normal but it's not in acute laminitis range either.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Haystack Low Carb/Low Fat pellets not "fluffing"

Eleanor Kellon, VMD
 

The safe list only refers to sugar and starch content. These are things you would feed in the smallest amount possible to get supplements into the horse. Rice bran has the wrong omega fats profile - but so does hay. Alfalfa in small amounts is usually tolerated.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Lost too Much Weight

Liz7033@...
 

Update:
New test results from Cornell: ACTH 33.6 pg/mL, Insulin 39.0 uIU/mL and Glucose 109 mg/dL.  The ACTH and insulin are still high per ECIR group standards. Dante's pergolide was increase the day after the blood draw from 1.1 mg to 1.5mg.  Awaiting Vit E and Selenium test results.
Also awaiting various muscle disease tests from UCDavis.

The vet (who did his teeth in January) was sure it wasn't a tooth, gum etc. problem and didn't recheck his mouth. The vet was leaning toward autoimmune event related to 6 way vaccine given at the end of November.

The soonest I could get a chiro is next Thursday. 

Dante is now eating about 8 lbs of grain daily, made mostly of Haystack low/low (waiting for ESC/Starch test results) LMF- low NSC, timothy pellets and RSR beet pellets.  He also gets 4 lbs of alfalfa and 5 lbs of local grass hay which he still doesn't eat completely.

Per tape measure his weight has stayed constant for the last 2 weeks and is his usual perky self.  

Any comments or additional thoughts?






--


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


Re: Haystack Low Carb/Low Fat pellets not "fluffing"

Lara Domaszewicz
 

Hi, I'm a little confused and hopefully someone can clarify. The Haystack low carb/low fat have alfalfa and rice bran pellets in the ingredients and are listed on the safe list. I thought we were not suppost to give our IR/metabolic easy keeper horses alfalfa or rice bran? 
--
Lara Ca 2019


Re: Hoof pain

Sherry Morse
 

Hi Lisa,

Can you please post current hoof pictures following the directions in the Wiki: https://ecir.groups.io/g/main/wiki/1482#Photos-and-Hoof-Evaluation-Help

If she's more comfortable in the boots, leave them on.  If she's biting at them check to see if they're rubbing.

Insulinwise should provide your money back if you send it to them.  If you decide to stop the Thyro-L you will need to wean off of it.

Thryo-L taper: https://ecir.groups.io/g/main/message/265797


How long has she been on weighed hay? 




Re: Stupid questions I am too embarrassed to ask or go against the status quo

Eleanor Kellon, VMD
 

LJ,

No mystery here. The leftovers is the reason.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: New-ish Member questions

Sherry Morse
 

Hi Rene,

You definitely want to check both this Spring then.  If he's still elevated you would then need to decide if you want to treat now or start treating him prior to the rise as you do not want to have a laminitic episode that could have been prevented.  He may only need medicating during the rise for now but how long that would continue is variable for each horse.




Re: Stupid questions I am too embarrassed to ask or go against the status quo

LJ Friedman
 

i suffered keeping ,my freisian black with custom supplements.. after i switched to ca trace plus..  voila.. all black.. cant say why and dont care now.. plus he eats all of this supplement where the customs were always left over..  
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Re: Acetyl-L-Carnitine

Eleanor Kellon, VMD
 

Give 1 g/100 lbs of body weight.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Hoof pain

Eleanor Kellon, VMD
 

Lisa,

Her toes needed to come back more in both sets of films and she has a thickened horn-lamellar zone which indicates chronic low level damage but there's no real rotation and sole depth is better than most.

Are you wrapping her legs and putting socks under those boots? Cold could be playing a big role.

When they bite at the boots it usually means they are being rubbed by them. Check heels especially.

How much is she drinking? Horses with stomach pain sometimes drink more. It doesn't sound like there is a problem and no danger of interactions or toxicities.

Yes on the vet coming back to repeat insulin and consider TRH stimulation for ACTH.  You could also ask the vet to prescribe metformin, start that at 30 mg/kg twice a day, then wait to do blood work for 3 to 7 days.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Hoof pain

Rita Chavez
 

Hi Lisa,

I'm no expert and I know the professionals here will chime in. But I wanted to ask, are you adding salt to her meals? I never used to before, but once I started the emergency diet for Stetson and started giving him loose iodized salt with each meal he really increased his water intake. Still is. 
--
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: Requesting advice about Fizzie's trim

Eleanor Kellon, VMD
 

You can recheck 3 weeks after your dose change. If you wait until you are well into the seasonal rise it will be too late. DEFINITELY check insulin. Only about half of IR horses are overweight. Laminitis in both IR and PPID is caused by high insulin.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Acetyl-L-Carnitine

Yvonne
 

how much would i give to my horse?  Thank you
--
Yvonne
Rego Terrace BC 2022


Re: Compounding Pharmacies - Avrio

Shawn Gould
 

The compounding pharmacy saga is exhausting. My 5mg pergolide base in oil for 30 day supply went up $48 at Avrio. Mixlab was even more. So I tried Thriving Pets, after some discussion with Ian decided to switch to capsules and got a great price, $103 for 2 months supply of 6.5 pergolide mesylate!! I was elated. Called my new vet to inform her I needed to switch and why. Next thing I know she is quite upset because some pharmacy (college) called her and who the heck is that?! Made worse because I told her Thriving Pets would be calling her. Got a lecture on how bad compounding pharmacies are and there are only 2 in the nation that she trusts, Precision and Wedgewood. (I stopped using Wedgewood years ago as I felt they had a good reputation with vets but have very poor customer service and price gouge. I used them for dogs, cats and horses.) Ok, so I call Precision in Bakersfield. I talk to the pharmacist, Phu. He is GREAT, super patient, listened, had good ideas AND THEY PRICE MATCH to the best of their ability. He said let’s stick with the liquid and get 2 mos at once. So we compared to Avrio which was going to be $117 a month. Precision will do  2 mos. for $140! Thank you very much! So now I would recommend Precision. He let me know that I am getting a very special price. Again, very appreciative. Out of curiosity I called back to do a price check and their regular price for my Rx would be $240. Whew, so whatever you’ve got going on give them a call and ask to talk to Phu, tell him you are thinking of changing pharmacies because of huge jump in price and see if you can get a better deal. This is all so frightening and frustrating. 
--
Shawn and Candy
Dec 2020, Santa Cruz, CA
Candy Case History:  https://ecir.groups.io/g/CaseHistory/files/Shawn%20and%20Candy
Candy Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=258140

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