Kirsten - oh! Thank you very much for that clarity! I would have missed that (although am saddened by the news). I thought EMS was a condition that could lead to IR if mismanaged. Any threads I should search for to better help explain this progression? I’m quite sad as I retired my older guy with hopes of being able to ride/explore with a younger horse. I have no desire to get rid of him (he’s family now), but it seems we’re in for a long, troubled road ... at 7. He seemed to really fall apart this fall, where a year earlier he seemed fine and on his way (or I just wasn’t educated). 

Because of ~30 insulin I’ll keep soaking his hay (despite the ESC + starch in my current hay being under 10). Makes me nervous about new loads of hay as they aren’t always low. 

Thanks for note on a follow-up test and timing. I’ll plan for June as a better annual timeframe. Just wanted to get some data finally and be out of the seasonal rise timing. 

Any other advice other than to get him back moving as he can? Is it just a matter of time before he’ll need medication (metformin or ?) assuming all else stays the same? 

--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album

One more question Lavinia.  When do you think I could start some mounted work with her based on her xrays and hoof pics. Has she almost grown out a new hoof capsule?  She is being exercised via long lining, lunging and in hand 4-5 times a week and so far no sign of any issues regarding her hooves. Thoughts on when I could start some saddle work?
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Hi Joanne

Here's the most recent message from Dr Kellon on this supplement.

https://ecir.groups.io/g/main/message/249832

Here's a .pdf on resveratrol, used in other supplements.

https://ecir.groups.io/g/main/files/8%20Commercial%20Items%20Targeting%20IR%20and%20PPID/Resveratrol.pdf

This may not answer all your questions.  Let us know if not.

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2021 NO Laminitis! Conference, August 12-15, Harrisburg, PA

That was my concern too Lavinia. Just waiting for markups from you so I can book my trimmer in again and get the feet sorted. I really would like to just start walking him for 5 or 10 minutes a day to start with and try and get him moving again but won't until I hear back from you and get the flairs off his feet.
--
Debbie Rainbow
Western Australia
2021
https://ecir.groups.io/g/CaseHistory/files/Debbie%20and%20Kody
https://ecir.groups.io/g/CaseHistory/album?id=259494

Thank you for your feedback.

Getting the hay tested is difficult as it comes from various places and in reality I am limited even if the test results come back high. I don't think weighing his hay at the moment is a priority although I will get scales and start getting an idea but at the moment he just has 2 haynets I refill a.m and p.m and they are never empty when I refill them. I don't think he's still losing weight but I do feel he is a bit underweight but that could also be from a loss of muscles from laying down and not really moving for 4 months. I would really like to start hand walking him as I think he is very bored as well as getting sore muscles from being confined. Just waiting on markups from Lavinnia to get his feed trimmed again. Hopefully better than the last trim so maybe I can start walking him just for 5 minutes a day. But I will start trying to get an idea of how much hay he is getting. Thank you
--
Debbie Rainbow
Western Australia
2021
https://ecir.groups.io/g/CaseHistory/files/Debbie%20and%20Kody
https://ecir.groups.io/g/CaseHistory/album?id=259494

Great questions that I would like clarification on. I too took the deworming course and did not come away with a clear understanding of a good worming protocol. My take away was fecal testing is ineffectual and it seemed sensible to assume my horse will always have some kind of worm infestation but how to treat him was unclear. Tests apparently cannot detect tapeworms and treating those has it's own protocol from other discussions on this site. I would appreciate knowing exactly what to do and when. Also what dosage is safe for a 280 lb  mini. Is it OK to use the 500 lb. dose on a wormer syringe? And is there any reason to test?

Thanks, Valeree.  The vet in my family could not.  There are quite a few equine vets locally and I don’t recall any of them advertising that certification.  I’m sure I could research it further on Google but I was curious about why using one might be indicated.

For those who are curious, this thread began when I asked what a veterinary osteopath was.
--

Hi Lindsay,
I’m sure you know what I’m going to say but, if he were mine, I would increase his pergolide.  He still looks kind of ‘rough’ to me.  It can be decreased if there’s no apparent improvement.  I’m not a vet but I seem to gravitate toward vets who are willing to partner to me and I’ve generally had free rein making decisions regarding pergolide.  I was cautious about increasing the dose because of the expense but I always wanted to see what more would do.
The trim will still need attention as well.
--

Thank you Dr Kellon. I admit, the Equiox didn't seem to make a difference. I wondered about the cold at night and have a sheet or blanket on depending on temp, but his coat is so heavy I have discovered sometimes he is sweating under it. We have been following ECIR protocals, DDET. I am praying he will improve, but also dont know if some minis just dont make it through the laminitic episode. We are also having a body worker help him as well. Is there something else we can do or is it just time? Do they eventually recover? I've never had any of my horses get laminitis, so it is all new for me. Thank you and your moderators for the work you all do. The group is fantastic and hopefully will lead to the end of laminitis!

--
Marsha and Dame - Buzzy TN 2019

https://ecir.groups.io/g/CaseHistory/files/Marsha%20and%20Dame%20-%20Buzzy
https://ecir.groups.io/g/CaseHistory/album?id=258797

--
Cindy, Oden, and Eeyore, North Texas
On ECIR protocol since 2/19
https://www.facebook.com/LifeWithOden/
History: https://ecir.groups.io/g/CaseHistory/files/Cindy%20and%20Oden
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=91125

On Sun, Jan 24, 2021 at 07:32 AM, Kirsten Rasmussen wrote:

in a dish set into an empty water tank?

Kirsten this intrigued me—do you have a photo? Rubber mats are impractical for me but I hate wastage of feed.
 
--
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

 

We feed three way hay (oat/wheat/barley) grown in the Imperial River Valley - as far south in California as you can get before becoming Mexico. It has consistenty over the last 3 years tested extremely well with no additives needed!  This last load is the first time we've had any issues. We are waiting for the test results but it is very very stemmy to look at and Monte just chews it and spits out quids.  My point is if you find someone up your way whose hay is from the Imperial Valley you might like it.
--
-Chris
May, 2019  Big Bear Lake, California
https://ecir.groups.io/g/CaseHistory/files/Chris%20and%20Monte 
https://ecir.groups.io/g/CaseHistory/album?id=95892  

Hi Julie. You are so lucky you can take that deworming class with Dr. Kellon! 
Ivermectin is safe for our Cushings/IR  horses.  Here is some extra info on fecal egg counts by Dr. K.  https://ecir.groups.io/g/main/files/Deworming/SHORTCOMINGS%20OF%20FECAL%20EGG%20COUNTS.pdf  


--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder

Forgot to add-  He is also still on 1 lb of flax per day.  Should I keep him at that amount even after adding in the extra aminos/protein and psyllium?

--
Lindsay in TX 2020

Audi Case History:  https://ecir.groups.io/g/CaseHistory/files/Lindsay%20and%20Audi

Audi Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=248156 

Hi Cass,

I stopped feeding the orchard/timotjy to Vinnie when I got the test back on the orchard from Finta. That is the orchard with just about 8 esc+ starch and 222 iron (depending on the test in my folder ...I tested this hay 3 times :) )

Summer is eating half orchard/tim and half orchard from Finta.

I am pulling a new iron test on the two Vaca hays and sifted them because I didn't on the first test to see  what the iron looked like unsifted for reference sine I know we have really high iron out here. 

I have 23 bales of the finta orchard left and I can buy 48 of the Vaca premium orchard if the iron comes back reasonable to balance. There is a good amount of the Finta orchard timothy available. So that is why I am playing around with options to carry me.

I am hoping that I can buy enough hay to carry me through July to start the process over again with the second cutting orchard that may be available:)  ideally I would buy a years worth of hay if I could find it.

Thanks so much for your guidance!! I have learned so much!!
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Thanks, Dr. Kellon, for your advice and also the links!  

To answer your questions, yes, he is still on jiaogulan @ 1 tbsp twice a day and also half a serving of Tri-Amino.  To be honest,  I figured the current diet provided more than ample crude protein and aminos, but I was just trying to run out my supply of Tri-Amino.  I can certainly bump that up to a full scoop if you think it’s worthwhile?

So that I’m clear on all the supplements you’re recommending, as well as what he’s already on, they will be:

hay balancer
iodized salt, 3 oz
selenium yeast, 1 serving
PQ, 1 serving
Get-Away, 1 serving
Tri-Amino, 1 serving
Jiaogulan, 2 tbsp
Absorb-All, as above
Psyllium husk, as above
Whey protein isolate, 50 g

I’m finishing out my supply of Mov-Ease, but I hope to be able to discontinue that in order to simplify things a bit.  His daily care is geting quite complicated.  

With the whey protein, should I discontinue after the first 20 days if it fails to improve his eyes and/or weight?  And if it does seem to help, should I keep him on it indefintely?  

We have been trying to address the long toe/underrun heel issue.  Are you still seeing reason for significant concern on his most recent trim photos?  If so, what do you recommend we need to change? Lisa removed a considerable amount of material the past couple times she was out, and she took the walls out of weight bearing, as recommended.

Looking at the big picture, I get the impression you believe his various issues are not actually PPID signs but rather are symptoms of a combination of other factors.  Am I understanding that correctly?  If so, do you mind helping me understand your reasoning?  I really thought we were doing a good job controlling other factors, especially with regard to his diet.  And going forward, what sort of testing schedule would you suggest to help us stay on top of everything?  Finally, should we order ACTH, insulin, and glucose every time, or is ACTH alone good enough?  


--
Lindsay in TX 2020

Audi Case History:  https://ecir.groups.io/g/CaseHistory/files/Lindsay%20and%20Audi

Audi Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=248156 

Hi, Nancy,
That combination of hays may work for Vinnie in addressing ESC, especially since he's been eating the Finta Orchard/timothy for a while if I understand correctly. As you know, I am equally obsessed with the iron in these hays.

For those following this hay search, high iron intake can be harmful both to EMS as iron is deposited in the liver and other organs and to the immune system.
Iron overload is associated with metabolic syndrome. https://ecir.groups.io/g/main/files/Iron,%20Iron%20Testing,%20Iron%20Overload/Iron%20and%20Insulin%20Resistance.pdf 
Resources discussing suppression of the immune system from high iron. https://ecir.groups.io/g/main/files/Iron,%20Iron%20Testing,%20Iron%20Overload/Iron%20and%20the%20Immune%20System.pdf 

The method ECIR recommends to address the effects of high iron in the diet is diet balancing; however, once iron intake reaches a certain level, balancing adds such high levels of copper and zinc that supplements become less palatable. 

Iron can sneak into the diet from tested hay with high iron and from untested sources such as pasture. It takes little high iron winter pasture to undo all our hard work balancing the diet. One example of  high levels of iron in rain-saturated pasture at 2170 ppm iron as dry matter:
https://ecir.groups.io/g/CaseHistory/files/Cass%20and%20Satra%20-%20Cayuse%20-%20Diamond/Hay&%20Pasture%20Analysis/2012-02-WinterPastureGrasses.pdf

Take home message: we seek moderate ESC for our EMS horses, and moderate iron content may be just as important in the long term. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

--
Valeree Smith
Southern CA
2003