Date   

Re: Olaf Check-In

Cecile Johnson
 

Thank you.  My expectation with Olaf has been to slow the progression and make him more comfortable using Diagnose, Diet and Trim.  

I ordered the acety-l-carnitine.  I also ordered capsicum cream.  I want to confirm I can use the acety-l-carnitine with Laminox as he is getting 1/2 scoop of Laminox per day.  

If this is neuropathic pain, wouldn’t Gabapentin help him?  
--
Cecile J in OK 2022
Olaf Case History:  https://ecir.groups.io/g/CaseHistory/files/Cecile%20and%20Olaf
Olaf Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=272407


Re: Using large cooler to soak hay - ? for Nancy C.

Joy V
 

Thank you all, Dr. Kellon, Cass and Nancy!  I am going to have to buy feed store hay (which I'll have tested) but great to know I can remove more sugar if I need to.  

Joy


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

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


Re: Jijis TRH Stim and Lyme Multiplex Results

 

The vet who did her x-rays acknowledged pedal osteitis, but no navicular. I am in agreement with you though, I will be on the search for a vet in my area who can run better quality radiographs, with a more comprehensive lameness exam.
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


Lyme test results

Bonnie Eddy
 

My vet said Cornell no longer does a complete tick disease panel, only Lymes. 
This is the report I got. What in the world does this mean? Vet said, "basically it means almost positive, but could be a false positive"

OSPA: 311Negative
OSPC: 646 Equivocal
OSPF: 146 Negative

So what should I do?  She said, "We can ignore it, retest in a month, or treat"

This horse has something going on, while her ACTH stem test showed baseline pre was 45.1, the post was only 85.4. She has been started on Prascend, and up to .75mg right now as she kept hitting the veil at anything above .5mg
I've split the dose which she seems to be tolerating better.
Thank you so much,
--
Bonnie with Allie and Racham(over the rainbow) from Southern California, Nov/2016

https://ecir.groups.io/g/CaseHistory/files/Bonnie%20and%20Allie
https://ecir.groups.io/g/CaseHistory/files/Bonnie%20and%20Racham


Re: Solar Penetration

Bobbie Day
 

Hello Nicolle,
Thanks for reaching out and welcome to the group, I will be sending along your official welcome message which can be quite daunting at first but please give it a read and keep it for future reference, its full of great information that can, and will come in handy.
I'm assuming you have an IR/EMS, PPID horse or maybe both, since your here.
You are asking about solar penetration, are you experiencing that now with your horse? Could you possibly provide us with more information so our hoof experts as well as Dr.Kellon can advise? It would help us to help you with more details, if you're in an emergency situation please give us as much background as you can while you complete a case history, any x-rays and test results would help our team to better help you.
Now on to your message, please let us know if you have any additional questions. 

Hello 

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine (look under the Hay Balancing file if you want professional help balancing). If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 

 


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 

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie
https://ecir.groups.io/g/CaseHistory/album?id=271156

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi 
https://ecir.groups.io/g/CaseHistory/album?id=78821


Re: Using large cooler to soak hay - ? for Nancy C.

Nancy C
 

Hi Joy.

I think you have your answer: more water.

Wanted to also add that the number of 30% reduction of sugar often mentioned is really an average. Mine was significantly higher at 50% reduction.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Solar Penetration

Nicolle Dupont
 

Good morning,

I am seeking advice on treating solar penetration, what protocols have been successful.

Thank you.  
--
Nicolle D in BC Canada 2022


New hay analysis for Yankee

jmc
 

Received my 603 hay analysis for this year - first time for two years in a row from the same supplier (yay!).. 

Surprisingly, it's nearly identical to last year's, except WSC is higher, and ESC + Starch is 11.1%... but iron is nearly half of last year's. I'll watch them both carefully, but even though ESC+Starch is over 10% I think he should be ok. I'm hoping the lower iron will mean it's mostly a wash :)  I'll get a new feed analysis from Mad Barn since he's still on AminoTrace+, but appreciate any comments on the hay analysis.

Yankee is doing well PPID-wise (I updated the CHR in April after his yearly bloods), except his topline still isn't great, and nothing seems to improve it.
--
Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386


Re: Using large cooler to soak hay - ? for Nancy C.

 

More water will also work. So using a larger container for soaking will leach out more sugars. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Avrio...again

 

I also use Mixlab and have been happy with them.  I was a Pet Health Pharmacy customer and had planned to move on to Avrio but they aren’t licensed for Vermont either.  So far, it has worked out well.
--
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: Using large cooler to soak hay - ? for Nancy C.

Eleanor Kellon, VMD
 

  Yes, new water will remove more sugar.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Hay Analysis: 603 Trainer or 604 Equine Complete?

Eleanor Kellon, VMD
 

Yes, that sounds right. Sulfur is a critical nutrient for plants as detailed in the link I posted. It used to be routinely added but since pollution greatly increases sulfur from the environment it wasn't needed. With current pollution controls, it's needed again.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Zahr Update: Insulin and glucose results

Mikaela Tapuska
 

Oh that's good, I'm glad to know that. Thank you Cheryl :)
Maybe I just need to take a deep breath and realize I can't control all the variables in this situation, but am doing what I can otherwise. It's difficult not to overthink it and start stressing, though!

--
Mikaela Tapuska in Calgary AB, 2021

Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr

Photo Album : https://ecir.groups.io/g/CaseHistory/album?id=274255


Re: Using large cooler to soak hay - ? for Nancy C.

Joy V
 

Question for Nancy C in NH -

Hey Nancy, do you know if soaking the hay again for another hour (in new water) after it's already been soaked for an hour,, would result in further reduction of ESC/starch?  Or do you think it gets to a point where all the sugar that can be soaked out is out?  

Thank you!
Joy


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

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


Re: Hay Analysis: 603 Trainer or 604 Equine Complete?

 

I think a hay grower near Susanville CA may have told me that she dresses her orchard grass hay fields with something that increases the sulphur levels in the soil.  Does tat sound right?  Several list members in Sonoma County purchase her hay, known to me as "Sharon's Hay."  It seems to test well, and my EMS Fjord horse who was formerly very fat and with very high leptin and insulin levels tests in mid ranges of those values while eating Sharon's hay from 2021 plus California Trace Plus.  

--
Gail Russell 8/30/2008

 

 https://ecir.groups.io/g/CaseHistory/files/Gail%20and%20Brother%20-%20Odin%20-%20Decaffe%20%20-Gunthar .


Re: Avrio...again

Nancy C
 

Totally agree with illegality, Dr Kellon.

Deb, I'm using MixLab and have been happy with them. Pricing will need to be checked.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Re: Emmy's RISQI numbers

Eleanor Kellon, VMD
 

Joy,

This isn't the time of year to do it but if she needs extremely high doses of pergolide it might be better to switch to injectable cabergoline https://betpharm.com/product/cabergoline-5-mg-ml/ . One bottle will last 50 days at the average dose.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Avrio...again

Eleanor Kellon, VMD
 

LJ,

I'm not a lawyer but that kind of interstate commerce could be illegal. The worst case scenario with Chewy would be she has to open more than one capsule.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Using large cooler to soak hay

Nancy C
 
Edited

Just to add a bit more to my N=1 experiment in soaking over night and all day: I did check water temp in the cooler before emptying. My water continuously stayed well into the cool/cold range in the "extreme" Coleman cooler. I have that water temp recorded somewhere but it will take me a bit to find it. My well is also treated so pH/aciditiy was not an issue.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Re: Shetlandpony 13 year laminites and Cushings

Eleanor Kellon, VMD
 

Hilde,

There are some cases that are so longstanding they cannot be made comfortable but that is a very small number in our experience. If you follow the DDT protocol exactly and get some radiographs for us to evaluate we can try to help you further.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

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