Date   

Re: Farrier for Northern MN /East ND -near fargo ND

 

Her name is Amanda. I believe her Facebook is Bare Your Sole
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


Re: JIAOGULAN POWDER

eissagholian@...
 

Hello everyone, 

Firstly, I would like to know where I can purchase Jiaogulan Powder from as Uckele is on backorder.

Second, how much do I feed and how often? 

I have an IR horse that we are working on growing her soles.  
--
Ani in CA 2022

Case History: 
https://ecir.groups.io/g/CaseHistory/files/Ani%20and%20Diamond


Re: Update on Isaac

ferne fedeli
 

Interesting that TSC only carries on website...  I would certainly recommend ordering Stabul 1 from CHEWY.  They are MUCH easier to deal with than TSC (at least that has been my experience).  Don't know about pricing, but they should be similar, I would think.
--

Ferne Fedeli  Magic & Jack   2007

Point Arena, Mendocino County, California
Case History

 

 


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

Karolina Grad NRC+ 01/2017
 

Voted!

 

I am so amazed with dr Kellon's knowledge about horses welfare and nutrition. For every question she has an answer.  I have learned so much from her and appreciate the patience and willingness to spread good knowledge based on facts and science. Thanks to dr Kellon my horse feels much better and I was able to help so may horses in Poland thru proper nutrition.

Thank you dr Kellon!
Your input in horses health and comfort all over the worls is absolutely exceptional!
You are exceptional <3


--
Karolina
Grad NRC+ 01/2017
, NAT 05/2018, MPG 11/2018, UBW 2020
Poland, Europe


Re: Help for Mare following extreme over-trimming to sole

Sherry Morse
 

Hi Makendra,

If she's on Metformin you want to retest insulin 7  - 10 days after starting to see if it's effective.  Retesting ACTH is done 3 weeks after reaching the target dose of Prascend.




Insulin under control, but now significant remodeling of the spine

fullcirclefarmhorses@...
 

Last week I celebrated that Ava's rads showed correction of rotation in both fronts and another blood test showed her insulin remains in "normal' reference range.  Yesterday, the vet did rads of her back which showed her back arthritis has worsened and spread. She said she has significant remodeling and although she doesn't like to say it, she said basically Ava has kissing spine.  Her back pain was under control with Equioxx in the past, but she is now on Invokana and can't use NSAIDs.  I tried DC this past week and was gradually increasing her dose, yesterday she had hives (which is what happened when I used DC Plus years ago).  Now it could be hives from bug bites, but she was the only horse here to have them so I think it was a reaction to DC.  What else can I try to give her some relief?

The game plan is to try PRP and possibly shock wave since we can't do steroid injections.  Has anyone use PRP for kissing spine?  Any other success stories of providing relief when traditional therapies can not be used?   She does receive chiro, PEMF, and body work.  Would the Equicore system be worthwhile to buy?  I do plan to do ground work/rehab with her, but the vet wants me to wait two weeks after she receives PRP.  

The vet made it clear to me that PRP may not provide relief but she thinks its worth a shot.  I am looking for hope that I can give my girl a happy, comfortable life.  
--
Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564


Re: BOT flies - deworm again?

Ditte
 

  I read somewhere that wiping the BOT fly eggs with ethanol will destroy them by drying them out (easier than removing them). Does it kill them or is it a waste of time? And if it works how often would you need to do it? My horses haven't been dewormed for 10 years! You can't get dewormers in Denmark without a fecal egg count. I just had them tested and as usual numbers were low (0 and below 50). 
--
   Ditte
   Denmark
   June 2019


Re: Source for small bales of hay in south central area of Wisconsin

fullcirclefarmhorses@...
 

Hi Karen,
I am in SE WI.  A friend who lives in Richfield has small bales that tested around 7%.  I can ask if she has any left.  They are quite small though, only around 26 pounds, but it is beautiful, safe hay.  If there is a way you can feed round bales, I have another source of safe hay.  I don't know how practical it would be for you to drive a distance, but if you are interested I can reach out to both.

Oh, I just thought of another source of small bales, but his hay has not been tested this year.   I could reach out to him and get the ball rolling to test it.
--
Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564


Re: Source for small bales of hay in south central area of Wisconsin

Sunkawakan
 

I live in rural Watertown. I know the various folks who make hay in the vicinity because I drove up their driveways and knocked on their doors! Since Tuck’s EMS diagnosis, of necessity I have learned to be more discerning. That entailed a hay probe purchase, learning how to use it properly & cultivating a relationship with the folks at EquiAnalytical labs. Every grower I have asked has allowed me to sample their hay. I provide them with a copy of the results-at my expense, of course. I have had to decline to purchase some & move on to others based on results. I always offer an explanation. I am gregarious by nature so this is easy for me to do! What will you accept as “safe”? I still soak year round, because around here, my sources with the lowest NSC values are right at/around 10…


--
*Kim F
* WI
2021


Re: Help for Mare following extreme over-trimming to sole

Makendra Silverman - NS
 

Thank you, Dr. Kellon so very much. That is extremely helpful and the horse's owner may also be posting a reply (she was having some technical difficulties last we talked). I believe a new vet (whom I recommended and seems more well-educated on EMS) came out today and also did an acupuncture treatment. Hoping that the Metformin will soon be on board too and Thyro-L out. 

It is helpful to keep at front of mind that we don't know if this is mechanical and/or acute laminitis - but addressing both seems to be the best game plan. We're going to see if perhaps custom firm DIM pads with soft DIM at the rim of P3 may be helpful. I had originally made her a sort of medicine shoe with EasyCare 12mm soft and firm pads but I think they weren't enough for her weight. She's a large mare with Cloud boot size 5 draft hooves. 

The radiographs were indeed pre-trim.

Is there a recommended time frame for which you would re-test insulin, glucose and ACTH or just see how she is doing and judge from there?

THANK YOU. This is excruciating for this wonderful horse and her owner so especially grateful to you and the ECIR for your advice. 

All best, Makendra



--
Makendra and Arrow
Denver Colorado, 2021
Arrow's Case History: https://ecir.groups.io/g/CaseHistory/files/Makendra%20and%20Arrow
Arrow's  Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=262625


Re: Update on Isaac

Lavinia Fiscaletti
 

TSC only carries the Stabul 1 on their website, not in stores. You can order it directly from the website.

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


Re: Signs of IR

 

Hi Sherichka,

Welcome to the ECIR group.  You have got this all figured out!  You knew the signs of IR, recognized and acknowledged them in your horse and changed her management all without any signs of hoof pain.  Congratulations!

As a new ECIR group member making the first post, you are sent a formal welcome which contains lots of good information.  We focus on diagnosis, diet, trim and exercise in both resolving and preventing IR related issues.  It would be helpful for us to know the actual values on the blood tests.  Genetics predisposes horses to be IR and Arabs are high on the list.  As she reached maturity, she began to show symptoms of IR so it’s quite likely she is IR.  Her blood tests might say otherwise because she is well enough managed with diet and exercise.  As she ages, that balance will be more difficult to maintain.  The fact that you’re seeing fat pads is an indication she should not be getting grass - unless you intend to add a lot more exercise.  I think taking her off grass was a smart decision.  We never advocate pasture for IR horses unless fully muzzled.

If you would like us to comment on your mare’s trim, we can do that.  Horses with appropriate trims are less likely to suffer laminitis damage than others.

What follows is our lengthy informational welcome.  A lot of it will be familiar to you, I’m sure.

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. 

--
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: Update on Isaac

Mialisa@...
 

No problem Sherry!

I went to the Stabul 1 website and ordered the samples to try. They say TSC has this product but every time I check I do not find it. TSC tells me the manager will call me about ordering Stabul 1, but I still have not received a call and it has been 2-3 weeks. TSC would be so much more convenient as I visit them frequently.
Thanks everyone for your suggestions.
--
Rene` in WI 2021
CaseHistory@ECIR.groups.io | Album
https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac
https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua


Signs of IR

sherichka14@...
 

My 7 yr old Arab mare is showing many signs of IR. She is overweight despite regular exercise, she has fatty pads near her tail and has recently developed a cresty neck. She has an insatiable appetite as well. During the winter, she is turned out for 8-10 hrs and has access to hay in slow feed nets. All hay has been tested and is under 10% starches/sugars. She comes in and has another 2-3 flakes in the evening in an extra slow feed net. In the spring-fall, she is turned out on grass for 10+ hours and gets 2 flakes of hay in her net. Twice a day (all year) she gets approx 1/2 cup Nutrena Topline to carry the following: Quiessence (magnesium), ground flax, salt, probios, Equinity amino acids and vitamin E. She is exercised 4-6 days per week for 30 min +. We trail ride 1-4 hours several days per week in the summer. I had blood work done in the fall and the spring and everything was within normal levels except her Leptin was high. She had x-rays in the fall and there was no indication of laminitis. My vet didn't recommend pulling her off grass bc it isn't a lush mix and everything was within "range". But I've decided to put her on the dry lot starting tomorrow because there are too many red flags. What am I doing wrong? Any recommendations?
--
Sherichka in NY 2022


Re: Insulin resistant horse

Maxine McArthur
 

Michele, it might be worth checking your Spam folder as occasionally I’ve had messages from the group end up there. 
--
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: Insulin resistant horse

 

Hi, Michele. You apparently aren't receiving or reading messages sent to this new email address. I'll repeat what I told you a week ago. I found your old messages posted under the email noonehorsegal at yahoo.com. The moderator who helped you then, Maggie, has retired as a volunteer. I hope one of current crew of volunteers can help you out. Your case history folder is: https://ecir.groups.io/g/CaseHistory/files/Michele%20and%20Mac

To find a hay balancer, contact anyone on this list: https://ecir.groups.io/g/main/files/6%20Diet%20Balancing/HAY%20BALANCING-1.pdf

The first order of business is to finish your automatic signature. It's only 3 steps. 

1) To set up your auto signature, go to your subscription link on the main ECIR page: https://ecir.groups.io/g/main/editsub 

2) Scroll near the bottom of that page for the signature window to type in your name, general location, and year of joining, like: Michele L in CA, 2015  We caution against disclosing full names or addresses out of concern for online security, but the choice is yours.

3) IMPORTANT: Scroll to the bottom of the page and hit SAVE! 


We volunteers appreciate your help with this.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Insulin resistant horse

Michele Lane
 

Hello, about five years ago I had a person through your group that helped me analyze my hay and balance it for my insulin resistant horse. Is there anyway that you can look up on record and see who was helping me? Its been five years but my horse it has some metabolic upset and I am testing my new hay. 

My name is Michele Lane and horse is Big Mac
--
Michele lane


Re: Farrier for Northern MN /East ND -near fargo ND

Lori Ricigliano
 

Oh THANK YOU SO MUCH ! I have the write ups and digital suggestions from the laminitis site in Great Britain I could give her - if I could save this mare … she is metabolic & I feed her for insulin resistant  - I will be getting my profile with her photos & rads . 

What is her name ? I can’t find her in the directory ? 
Thank you 
Lori 


On Jun 30, 2022, at 9:09 PM, Olivia <estey.olivia@...> wrote:

Hello, I’m about 2 hours northeast of Fargo. There’s a trimmer out in Crookston who could possibly help you, a member of Progressive Hoof Care Practitioners. If she’s all booked, she might still be able to help you with finding someone local to you?
https://progressivehoofcare.org/directory/
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album

--
Lori R in MN - 2022 


Re: Farrier for Northern MN /East ND -near fargo ND

 

Hello, I’m about 2 hours northeast of Fargo. There’s a trimmer out in Crookston who could possibly help you, a member of Progressive Hoof Care Practitioners. If she’s all booked, she might still be able to help you with finding someone local to you?
https://progressivehoofcare.org/directory/
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


Re: Farrier for Northern MN /East ND -near fargo ND

 
Edited

Hi Lori,

Welcome to the ECIR group.  I’m sorry you’re having difficulties with your mare’s management but we have lots of experience helping others in similar situations.  You’re receiving this message as a response to your first post here.  The formal welcome letter I’m attaching serves as an introduction to the group and what we do to support your care of an IR/PPID horse.  It includes lots of useful information as well as links to much more.

While you stated your interest is in finding a suitable farrier, I’d like to start a bit earlier in her metabolic event.  The basis of our guidance revolves around what we call DDT&E, which stands for Diagnosis, Diet, Trim and Exercise as appropriate.  

In terms of her diagnosis, can you please provide blood test results for insulin, glucose and ACTH so we can see what her situation was two years ago, when this began, and now, where you still seem to be having difficulty. 

Her diet is most important in terms of her management.  The welcome letter describes an emergency diet which consists of soaked hay and a small number of supplements - flax seed, magnesium, iodized salt and vitamin E.  We recommend hay which is wet chemistry tested to have an ESC + starch of less than 10%.  Some horses need it even lower.  It sounds like she is on low NSC hay but how low, how that was determined and what the starch is are also important pieces of information.  Until that is all figured out, it would be best to soak and rinse her hay.  Keeping her off grass is also necessary.

Her trim is likewise crucial as you understand.  If you post your X-rays in an album in your Case History photo section along with photos of her feet as directed here, we can give you input about what needs to be done.  Finding a good farrier is important but finding one who can interpret X-rays adds to that challenge.  With markups we provide, your present farrier may be able to do the job.  I realize you have trimming directions from another source.  They may well be just fine but it’s hard to know until we see photos.  There are many of us here who have picked up a rasp to do the work ourselves.  There was someone on the group in the past year or so from Fargo who was having similar farrier issues.  How she solved it I’m not sure but I will rummage around in the messages, which you can do as well, and see if I can find her files.  Someone else here may have that information closer to hand. 

We discourage people from using NSAIDs because they interfere with healing and cause other issues.  Laminitis is not an inflammatory condition so NSAIDs don’t help the pain.  Many here have had good luck with Devils Claw.  Do not stop the bute abruptly - it needs to be tapered off slowly.  Thyroxine is used to jump start weight loss.  If she’s been on it awhile, it probably isn’t doing much but if you discontinue it, there needs to be a slow taper.  If she’s overweight, we recommend feeding an appropriate weighed amount of hay from a hay bag to slowly decrease her weight.

Exercise is great for lowering insulin values but should never be forced.  It doesn’t sound like she’s ready for that yet.

What follows is our lengthy informational welcome.  We’re looking forward to reviewing your mare’s case history files and helping you to increase your mare’s comfort.  Let us know as questions arise.  I’m sure others will post with more detailed information but I thought this would be enough to get you started without overwhelming you.

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. 

--
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


 
 

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