Re: Sparkles, Trying to Make sense of this case ... Tick disease, IR, Laminitis

Sherry Morse

Hi Jen,

Not Dr. Kellon but some quick answers for you:

1- TRH Stim - if you do it in early June you should get a good answer on whether you need to start pergolide or not.  Once we're past the solstice ACTH naturally starts creeping up but not to the extent that it will go up in the fall.  That just leaves you less time to try to get it down through medication prior to the full seasonal rise.

2 - Laminox should be fine to use with VT Blend.  Don't think there have ever been any studies on how effective it is but Dr. Kellon would know more on that.

3 - do you have actual numbers for Sparkle's "weak positive" test.  As you know, Lyme effects all horses differently - my gelding's titer was 9000 the first time I treated him and was 6000 to start the 2nd time.  He was definitely showing very subtle signs at 6000 but not as bad as the first time.  His ACTH was also elevated with the first round of Lyme but was normal after treatment.  

4 - if you feel the need to use a pain killer many of our members use Devil's Claw instead of NSAIDs (which both Bute and Banamine are).

5 - a full set of hoof pictures following the directions in the Wiki ( would be helpful.  

6 - turnout in boots if that's what she needs to be comfortable.  She'll let you know what pads work for her and which ones don't.  She may prefer the flat pads to ones that have a set wedge to them and that's fine.

Re: New member with puzzling case - update 3/24

Sherry Morse

Hi Heather,

Your x-rays show toes that are still too long on both feet. If you'd like help with trimming please take and post a full set of hoof photos as outlined in the Wiki ( and then post a message that says something like "Lavinia, markups needed" and make sure you do that at least a week before the next trim is scheduled (although she needs one ASAP based on the photos and x-rays you've already shared).

Re: Dr. Kellon Please Review- New Test Results

Sherry Morse

Hi Chris,

Perhaps you missed my answer from yesterday: Re: Please Review- New Test Results ( but 1000% agree with Maxine that 1 - your vet is wrong, 2 - lowering the dose when he's not controlled on 2mg is asking for more trouble and 3 - given the lower than normal glucose I'd wonder about sample mishandling issues which are more of an indication that Prascend needs to be increased and then everything rechecked in 4 weeks or so.  

You want to make sure he's well controlled going into the seasonal rise (which means upper teens/low 20s for most PPID horses) and looking at your case history he actually has never really been well controlled.

Re: Suspensory Injury now - please advise


Hi Dr. Kellon,

Actually I would greatly appreciate any advice you can provide on trim. Sorry if my previous note implied I will not do what needs to be done to provide the best case for Callisto. Of course I will. Rehab in our situation, and with our the wet session is challenging, and I was just expressing that, probably not useful.

Regarding diet, I am confident that his diet has been mineral balanced for the past year now. I feel my next steps are to continue to treat PPID with Prascend based on symptoms and work with my farrier on trim. Again, I would appreciate any advice on trim and thank you for all the advice to date.

Lara W. in Victoria, BC 2021
Callisto Case History
Photo Album

locked Re: Urgent Advice Required (Part II)

LJ Friedman

is there a reason you use this in paste and not tablets ?? how? why ?  steglatro??
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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


Re: Laminitis Charlie

LJ Friedman

I remember cool stance as not the best product for IR.. but not sure why  . was years ago... I  use  hygain zero instead
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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


Taking hay sample without a hay probe?


What's the best way to take a hay sample without a hay probe? I'd rather not have to completely cut open the bales to do it. Just wondering what other people have done?
Helene A. in BC 2021
Photo album:
Case history:

Re: Help with Hay


Hi Ed,
If you’re going to test your pasture, you should do it now while the horses are ‘eating’ it.  Your sample won’t be green and lush, but most likely brown and full of roots.  That’s okay because that’s what they’re eating out there and those pieces of plant life have much more sugar than a long stalk of green grass.  We suggest cutting hay in the early morning because the sugars head back to the roots without sunshine.  That happens whenever they’re stressed, including in winter.
The gist of this is that we don’t recommend putting IR horses out on grass, whether or not there are green shoots appearing.
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: Chicy New Lateral Rads 2022-03-21

Lesley Fraser

Even 20 minutes sounds a bit rushed to me, never mind 10….

I remember politely asking one farrier if he could take a bit more off Omar’s toes - they still looked too long to me. He said he would, no problem, and would I just stand Omar next to a drain. When I looked bemused and said, “Pardon?”, he said it was for all the blood to run into, ha ha ha. I politely fired him.

By the way, I’m so glad to hear that Chicy’s had her baby and they’re both doing well.

Lesley and over the bridge Omar,
11-2012, Cambridge, UK

Omar - Case History

Re: Sparkles, Trying to Make sense of this case ... Tick disease, IR, Laminitis


Thank you, Dr Kellon for your reply.

"Only about 50% of IR animals fit the overweight profile. I agree with doing a TRH stimulation."

We planned to do the TRH test in June as that is when our herd has their annual. Should the TRH be done sooner than that .... or are we headed into a "safer" period?

"High insulin causes vasoconstriction and cold on top of that only makes it worse. Cold can also make insulin readings erratic but it can't be the sole cause here. Gabapentin is used when nothing else is left but it doesn't seem to do much of anything. Try Laminox 1/2 scoop twice a day and use coupon code ECIR for 5% off."
Just looked at the Laminox ingredients. I see that there are some of ingredients used in the "mito cocktail" used in people. This is something I have been wondering about since I have been caring for these ponies. I will ask more about this another time. What percentage of horses w/ PPID and or IR respond well to Laminox? And is it ok if the horse is on something like Vermont Blend?

"I'm not aware of Anaplasmosis causing laminitis. All chronic illness comes with some IR but not to this degree. I'd repeat the testing to see what's going on. Maybe you were lucky and caught Lyme early."
Lyme test was repeated with the Metabolic panel in Dec and was the same ... a weak pos. I am from CT and have dealt with LD issues since the early 90s ... part of the "issues" were doctors (including infection disease from two different states) having varying opinions on tests and results and to treat or not treat. I don't know if a weak pos in a horse means anything or not. What are your thoughts on the fact Sparkles had significant improvement on Doxy ... enough so that she wanted to be back on the track with the herd but declined once the course of Doxy was done. I know Doxy has some anti-inflammatory properties ... but does it have that much? More effective than Bute ... or Banamine? Incidentally, I never thought bute was that effective ... I foolishly continued to give out of guilt and needing to do something. On days she was more uncomfortable I would give Banamine instead ... this seemed more helpful. I only tried this a handful of times though.

"It's because her heels are too high. The palmar angle - angle the coffin bone makes with the ground - should be no more than 5 degrees. Her toes should be backed up a bit too but don't disturb the sole in the front half of the foot."
Does it look like the toes were "disturbed" in the Feb pictures? We noticed heel was high after the rads and farrier trimmed more than she had been ... Sparkles was quite sore after this for about five days whereas previous trims Sparkles always felt better afterwards. Farrier is coming this afternoon.

You can put her out for as long as you like as long as she can't get any grass (winter or not).
RE putting her out. Boots or not boots? And speaking of boots, We had to try 3 different kinds before we found boots that fit her well which were the soft rides. We tried the clouds too. Both Clouds and SR came with wedged pads. Prior to that I was making pads including pads from Easycare which are not wedged. We wopted to continue making our own as we were not sure if the wedge would bother her. After realizing she is creating a wedge with pads I am wondering if she should be using the wedged pads that came with the Softrides as it might be more comfortable .... OR if we should continue using the flat pads as we can analyze how they are wearing?

Jen and Sparkles in New England 2022 | Album
Sparkles Case History

Re: Help with Hay

Trisha DePietro

Hi Ed. I found this interesting extension article regarding Tifton 85. It looks like a good option hay for Cushings/IR horses- Just adding this here so you can review it and have more information to make a decision  
Trisha DePietro
Aug 2018
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder

Re: Stopping hoof boots from smelling?


"Amazingly rank" odor might indicate a thrush infection, maybe check for deep cracks in the back of the heels?
Bonnie and Lad
North Ontario
Dec 2008

Re: New member with puzzling case - update 3/24


Lateral rads were taken today and Ava has a few more degrees of rotation in both of her fronts.   I updated my photo album.   An ultrasound of her ovaries was performed, the vet said her ovaries were larger than to be expected (left was 6cm and right was 5.5cm, CL indicated she was not in heat) , but did not have the honeycomb appearance often seen in GTC tumors.  Blood was taken for a definitive diagnosis. It will be sent to UC Davis and I should have results in one week.  Invokana has been ordered, but it won't arrive for 3-4 weeks.  

Next week we are re-testing her ACTH levels.  
Heather W in WI 2022

Re: cookies trim photos uploaded

Julie Allen

Dr K ..
define out of control ? 
too long ? Too much ? 

I left them alone as instructed . In my opinion they looked  way better before I was instructed to let them grow out .. 
so here we are -- 

to be fair I did ask and post and beg for help .before I trimmed .

and as soon as I pay my last vet bill from November --  I will get more rads . Until then it's a big nope .
Thanks for the heads up ..

Re: Dr. Kellon Please Review- New Test Results

Maxine McArthur

Hi Chris
I'm not Dr Kellon, but I've been a member of this group for over a decade and speaking from what I have learned here . . .  with all due respect to your vet, he's wrong. There are so many horses on this group who are happy and living long, productive (whether ridden or retired) lives on much greater doses of pergolide than 2mg. My mare, for example, is on 4mg of pergolide and I will continue to raise her dose should her symptoms and blood test suggest the need. 
Our well-controlled PPID horses do of course die eventually--but they usually die WITH Cushings, not FROM it. PPID is a progressive disease; it does not have to be "terminal". 
Please ask your vet to provide proof for the assertion that pergolide eventually stops working (spoiler alert, there is none). 

If Monte were mine, and his ACTH was at 63 in what should be the lowest time of the year, plus he has clear symptoms, I would not hesitate for one millisecond to increase his dose, APF or no APF. Also, do you have the lab reference ranges? I'm wondering if the glucose is a bit low--which can possibly indicate mishandling/degradation of the sample. 

Sorry if I sound a bit militant, but it's something I feel strongly about as I have seen horses genuinely die from uncontrolled Cushings due to owners following misguided veterinary advice, and I want to try to help prevent that ever happening again. 
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response


Re: Bute and Devil's Claw


Thank you again for all the help and encouragement! 
I stopped isoxuprine following Dr. Kellon's recommendation and figured out a way to feed the double dose of PQ so he's been getting 4 scoops a day for two weeks now.
He has been off NSAIDs for 3 weeks.
He has been on LaminOx for almost 3 weeks (since March 5)
I forgot to mention Quadra Fac (double the recommended dose) in my list of supplements I keep feeding.
I tried espom salt poultice compresses (poutice under the cling wrap) to help with abscesses if he has them - he started tearing up his boots so apparently the poultice was somehow causing itch or irritation.
Then I switched to nightly epsom salt soaking.
Then someone recommended animalintex hoof pads and I am now trying them instead of the soaks (for 4 days as of now). They don't seem to bother him like the poultice did.
No abscesses drained.
He's not improving.
I trimmed him again 3 days ago (about 10 days between the trims). It didn't seem to make him worse this time.
He habituated the pain but he is getting increasingly depressed from the combination of pain and solitary confinement. My other horse comes to see him time to time but waking up pastures are too enticing to spend too much time around the barn. He has not been confined since he came into my care 9 years ago as a 10-month-old colt and they have been inseparable since then as well. I spend 5-6 hours with him a day but I have to work.
I still cannot habituate his pain but at least it's no longer an active, sleepless panic but more like a gripping sense of helplessness to help him. I don't know what else I can try.
Help from this group has been a godsend.
Ed P in TX 2022

Re: Dr. Kellon Please Review- New Test Results

Chris Pennbo

Ok, I just got off the phone with my vet.  I am not sure what to think.  I would love it if Dr. Kellon could take a look at these results AND at what my vet is recommending. I like my vet but he has nowhere near the experience with PPID that Dr. Kellon does!

Monte is on 2mg of Prascend, given once daily.  Our vet is cautious about raising the dose, and in fact wants to lower the dose. His reasoning is that there are only so many mg of pergolide that you can give and once it stops working well there is nothing more to be done.  He would like us to lower Monte's dose to 1.5 mg daily. I asked him about the super low Insulin and Glucose numbers. His thinking is that pergolide/Prascend CAN also lower those levels and that APF can also lower those levels. Monte is on 6cc of APF daily. He would like us to keep him at that dose. We will recheck blood levels in 2 months.

I am concerned.  If Monte is already at PPID levels of ACTH, then aren't we putting him at risk for negative effects of Cushings by reducing his levels? Is there any truth to the idea that lowering his Prascend levels but keeping his APF the same can lower his ACTH levels over time? Our vet also stated that since Cushings is terminal we are just prolonging the inevitable at this point and at some point we will no longer be able to manage it as the Prascend will no longer be effective and there isn't anything else.

Monte's main visible symptoms of PPID are coarse and thin hair coat, occasional swollen sheath, reoccurring thrush and abscesses, soft tissue issues with hip, and lack of strength in his jaw. His weight is good. Monte is 28.


ACTH   63 pg/mL
Glucose 61 mg/dL
Insulin   9   uU/mL

May, 2019  Big Bear Lake, California  

locked Re: Urgent Advice Required (Part II)


Hi, Rebecca.
Cass here. I need to ask you, please, to post only from one single identity/email address. You and I spent some effort  getting your information in place for Rebecca.speed@.... If you look earlier in the thread you're posting to, you can see that your case history and photo album all show up perfectly under your signature with that log-in information. 

We volunteers can follow your progress from December of 2021. But our jobs as volunteers are much harder if we need to track your posts as Rebecca.fowles@... too!

The next time you post, please be certain that you have logged out of ECIR as Rebecca.fowles@... and logged back in as Rebecca.speed@....  Maybe you can put this information in your Address Book so you can find it easily in the future.

Many thanks and good luck with Emme.
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Re: Fat and Insulin Resistance

Nancy C

Hi Maria

I think the problem is that the safety of high fat feeding has not been studied. The ECIR recommendation for 4% fat or less in the diet comes from analysis of the equine's evolutionary diet. based primarily on forage would not be more than 4% fat.

More comments from Dr Kellon:

High fat diet safety in EMS has never been tested and is contraindicated in other species.

Also, there are studies showing high fat worsens insulin response such as this one in our files.

This post is Dr Kellon's explanation of the above study

The fat data though is very significant. For years it has been claimed that high fat is good for IR in horses, despite solid data from other species to the contrary. This study shows that's not the case. We still need studies to determine the minimum level to have this effect, in both normal and IR horses.

Eleanor in PA

More comments concerning fat and IR here

Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022

locked Re: Urgent Advice Required (Part II)


Thank you Eleanor - 5mg per ml

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