Re: How to say "thank-you". Please help.

Cindy Giovanetti

Voted.  Can’t imagine where my horse would be without Dr. K’s expertise.




Cindy, Oden, and Eeyore, North Texas
On ECIR protocol since 2/19

Re: Flyte update

Lecia Martin

Got it.  Thanks so much.   
Lecia Flyte and Flame
Alberta, Canada

Re: Update on Isaac


Where are you in WI? Pulaski Warehouse carries TC Timothy balance cubes. I bought their last bags and waiting for the next shipment, but might be an option.

Also, seems silly but after trying to get my mare to eat beet pulp, I tried the picky eater protocol by giving her fresh beet pulp every night in her stall. Then when she wouldn't eat it I would set it out in front of her for my gelding to eat it. She decided then that it must be good since he was eating it and she kicked him out of her bucket. Maybe worth a try. 

I'm sure the moderators will have advice. But I've also mixed the supps in water and poured over her hay when she was being stubborn and would only eat hay (some ends up on the ground but I think it still gets them used to the taste) some people syringe it I've read on here, but haven't needed to try that myself.
Amber Lauer
September 2016, Black Creek, WI

Sunny Case History

Re: splits in heel bulbs; need help lavinia, dr kellon or someone who has experienced this

Daisy Shepherd

photos posted  for tiko focus on heels and bulbs.  thank you. daisy tiko whisper
Daisy, Tiko and Whisper
CO, April 2019
Case History: 
Photo Album:,,,20,2,0,0

Re: Peanut has stopped eating her hay

Eleanor Kellon, VMD

Did your vet examine her mouth carefully?

Try to observe how she is eating her Stabul 1.  Does she chew it carefully or bolt it down?

It doesn't sound like appetite is the issue here. Horses with ulcers classically go for hay over the concentrates but it wouldn't hurt to treat her for 3 days or so. I'd also try hay on the ground or in a bucket/trough rather than a net and see what she does with hay pellets or cubes.
Eleanor in PA 
EC Owner 2001

Peanut has stopped eating her hay



This is a wierd one. Hope you can help me.  About 2 weeks ago Peanut started not finishing her hay meals. She would eat most but not all. Prior to this she always ate everything I put in her hay net. So I tried a hay net with larger holes. But that didn't seem to make any difference. Then I tried feeding it free choice...but it only got worse. Finally last Thursday and Friday she didn't eat ANY of her hay!! She would eat her Stabul-1 with her minerals. And she would eat green grass if she could get to it. But totally refused to eat any hay. She also quit drinking but was licking her salt block a LOT. She had very reduced amounts of manure because nothing was going in. Note-This is the same hay she had been eating since April. I changed bales and fed the refused hay to the rest of the herd. They all gobbled it down. 

I took her to the vet on Saturday. All vitals were normal or near normal. CBC was also normal. Still waiting on results of chem panel. Vet gave her 10cc of banamine to see if it would help.  It did seem to encourage her to eat a bit more....but still hardly any. I did feed her 2# of Stabul-1 with some clay ( bentonite) in the am and 2# in the pm with her minerals. To encourage her to start eating I have allowed her to graze on very short dry grass for a hour each morning and evening which she readily does. She has started drinking again and her poop production is back to normal. But she still refuses to eat her hay!!  Vet is leaning toward ulcers. I am thinking it may be psychological. 

I am at a loss....has anyone else had this experience??  Any ideas on how to encourage her to eat her hay?? I do have a grazing muzzle that fits her but I haven't tried previously because the hay nets were working well.   TIA

Alice A
March 2021, Custer, SD 
Case history:   .
Peanut's photo album:  .

Re: New ACTH test results

Eleanor Kellon, VMD

That number is good but doesn't predict what it might be with the rise. If you have had fall laminitis issues I would increase it starting mid July.  Also be alert for crest changes, decreased movement, as we get closer.
Eleanor in PA 
EC Owner 2001

Re: Thoughts on Life Data Lab products for the IR horse and laminitis

Eleanor Kellon, VMD

The founder of Life Data Labs, Dr. Frank Gravlee, was a true visionary and Farrier's Formula addresses the key issues in hoof health but cannot substitute for supplementation based on an actual analysis. His son is running it now. I don't see anything in their lamina, adrenal, EMS, PPID formulas that would be of help.

Eleanor in PA 
EC Owner 2001

New ACTH test results

Joy V

Hi group,

The vet came out on 06/23/22 to test Willie's ACTH once more before the rise is in full force.  I've uploaded the results & updated his case history, but just wanted to see what the experts think.  ACTH was 22 pg/mL (lab ref range 15-40 pg/mL).  His previous test in April ACTH was 26 pg/mL.  Is this number okay?  Or should I go ahead and raise his pergolide to 2mg?  

Thank you in advance!

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

Case history:  Willie's Case History
Willie's photo album:  Willie's Photos

Re: need of advice

Eleanor Kellon, VMD

I agree with Bobbie's comments. Nothing more to add until we have more information.
Eleanor in PA 
EC Owner 2001

Thoughts on Life Data Lab products for the IR horse and laminitis


Recently I watched videos presented by Life Data Labs about IR and laminitis. 
They promote their products for each problem.
What are the thoughts on their products and their claims of them helping growing a healthy hoof from the inside, helping increase circulation, etc. 


Jean Hinrichsen WI 2022

Re: How to say "thank-you". Please help.



"Dr. Kellon helped me save my gelding Elko's Eye of Odin. He had a rather unique onset of winter laminitis, almost no other symptoms indicating he was EMS. Thanks to a referral to Dr. Kellon's ECIR groups (on Facebook and I had metabolic panels drawn for both of my BLM Mustangs - Bella, a 16yo mare, and Odin, a 12yo gelding. BOTH had sky high ACTH, high insulin, and leptin. She personally helped me determine that I could fly my gelding to our new home in Maryland so that his recuperation could continue, and she gives this time equally to so many of us who have very tricky questions. Thanks to Dr. Kellon's personal crusade to ensure that Cushings/PPID and EMS/IR are no longer by default death sentences that lead to crippling laminitis, pain, and eventual euthanasia, my mare Bella is now rideable, and my gelding Odin is recovering using the ECIR recommendations she put into place and volunteers in her groups share with horse owners like myself. I cannot emphasize this enough - no single equine vet practicing alive right now is doing more for the science of horse health than Dr. Eleanor Kellon. She deserves this award, and then some. Thank you for accepting this nomination on her behalf, from my horses, myself, and thousands more like us. "
Jen McCabe
Laytonsville, Maryland 
Joined 2022
+ Odin (2010 BLM Mustang - IR/EMS diagnosed after Winter Laminitis), Bella (2008 BLM Mustang - PPID/Cushings diagnosed in 2000)+ Fiki (2015 Arabian)
Odin and Bella Case Histories

Re: need of advice

Bobbie Day

Hello Darla and welcome!
We're glad you're here, we'll do our best to help you and Bailey get this sorted out. I am going to try to address your main concern and hopefully our other mods and possibly Dr.Kellon will chime in as well. Since this is your first post, I will be including your welcome message as well. It requires quite a bit of reading but take your time to process it all, but please keep it handy for future reference as it addresses a lot of the questions we get here.
First of all, can you tell us what Bailey's actual test results are? It may be that she very could need an increase in her dosage still. Please see these for more information. 
See Dr.Kellon's replies on this subject
And more reading here. 
The effects of hyperprolactinemia and its control on metabolic diseases (
We will be starting the seasonal rise soon so it's very important to have ACTH under control, we look for these numbers to be in the high teens or lower twenties at the most. Is there a reason why you can't exercise her? There are other forms of exercise if she's not comfortable right now, can you hand walk her?
I would stop the Remission as it's just an expensive form of magnesium which you can source yourself, and it will save you a lot of money doing so.
Have you balanced her diet to see what her mineral needs are? 
If you could do a case history with all her test results it would be very helpful to us. A lot of us have moody mares ourselves so we know what a challenge they can be, but we really need to know more about Bailey to give you more advice. 


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. 

Bobbie and Maggie 
Desi (over the rainbow bridge 7/21) 
Utah, Nov 2018
NRC Plus 2020, NAT, C&IR March 2021
ECIR Group Primary Response

Re: Heaves, Heat & Testing


Jennifer, I don't know if this will help Jack, but years ago I sold a horse to a breeder in southern France.
She told me in summer she had to hose all her horses down twice a day AND stall them with a running fan until late evening.  I don't know if Jack would tolerate that, or if it might exacerbate his RAO.  Since he's PPID, he may need a close clip as well.  
Beth Benard
Rome. NY

Re: Update on Isaac

Eleanor Kellon, VMD


You can order Stabul 1 from You could use high dose Jiaogulan or APF to counteract the appetite issue. How is his hoof comfort? His last insulin in the history is dangerously high. Are you soaking his hay?
Eleanor in PA 
EC Owner 2001

Update on Isaac


Isaac is still refusing to eat his supplements/timothy pellets since upping his Prascend does to the full dose of 1/2 tab. I lowered it back to 1/4 tab about two weeks ago and he still will not eat his supplements. He eats his hay as normal.  I have tried cinnamon, fenugreek, putting less supplements, adding 1/4 cup stabilized rice bran. I am checking the boxes on the picky eaters list and will continue working my way through the list. I have started leaving out Spirulina to start isolating. No luck yet. I am concerned that he is not getting his balanced supplements to grow a good hoof. He tends to get WLD, which has all since grown out, but still concerned. I thought I had added his Prascend to the CH under medicine but it is not there, I will update that with specific dates.
I know this will be a red flag but I have thought about going back to whole oats to get him eating again. The TC timothy cubes and Stabul 1 are not available at the local TSC and the feed mill will special order but the price doubles. It must not be in high demand in this area.
Thank you for your support.
Rene` in WI 2021 | Album

need of advice

Darla Procope

Hi, I am new to owning a horse and need some advice. I have a 14 year old Friesian/Welsh with Cushings named Bailey. As soon as we got her we had the vet out and they confirmed that she had Cushings and put her on 1mg of Prascend. I was also advised to put her on the supplement called Remission. We have noticed a difference in her coat and her nipples stopped leaking milk since we started. Bailey has a strong personality but has been getting worse since spring and needs exercise. We also have a gelding that just came off the track in January and he goes crazy when she is in heat. Wasn't sure if anyone had any advice on what to do to help with the moods. Right now with her mood she is running whenever she sees us coming and is pulling away when we do catch her, which is new.
-Darla Procope
 New Castle, DE 2022

Re: Flyte update

Eleanor Kellon, VMD

The hulls are similar to BP in that they ferment easily and are more calorie dense. If he will eat 1.5 lbs of 50:50 BP and hulls three times a day that would be my target. He will likely back off hay consumption but that's fine as long as his weight stays stable.
Eleanor in PA 
EC Owner 2001

Re: Seeking help on foot sore IR horse

Eleanor Kellon, VMD

Bobbie has already given you a ton of good advice and direction. I would like to address the issue of shoes. The rationale for shoes with sinking is they get the foot off the ground. However, by depriving the foot of the support from sole and frog you leave the coffin bone suspended from the weak laminae and predisposed to more sinking. Sinking causes the thin soles/poor ground clearance, usually complicated by overly long toes. Pour in pads may or may not help. To help, they would have to be level with the bottom of the shoe. Otherwise, boots and pads are a proven solution.

I don't want to overwhelm you but inflammation is not driving the laminitis, insulin is. When you get a chance, read the  2017 proceedings on Endocrinopathic Laminitis and Inflammation in EMS. They are free.
Eleanor in PA 
EC Owner 2001

Re: How to say "thank-you". Please help.


Nomination for Dr. K submitted! She deserves this award and I am honored to be able to do my part. Thank you so much for making us all aware of this nomination opportunity 
Sydney J in BC Canada 2020

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