Date   

Re: Starting Case history

Sherry Morse
 

Hi Tracie,

Where in PA are you?  That may be a start for us helping you find a vet but many, many vets don't know as much as what we collectively know on this group.  The key a lot of the time is finding one who is willing to listen and work with you when you advocate for your horse.  Why is your vet advocating tendon cutting for your mini?  As you've probably already read our goal here is no laminitis and that means identifying and eliminating triggers - unless there's something related to the tendon that caused the laminitis (not very likely) doing that surgery isn't going to actually solve anything or prevent a future issue.

You've already been sent our detailed welcome letter and Kirsten's added some more information about filling out the Case History and photos, but do start with what they're currently eating and their current turnout/weight/etc.  You can always add other details in the notes section at the end but since you have your Excel chart you can also add that information in as you have time.





Re: contaminated feed

Sherry Morse
 

Hi Caroline,

Let's assume that the linseed was the culprit and it wasn't the grass he was getting into or it was a combination of both.  Now that both have been removed as a possible source of his issues you're down to managing his current pain and monitoring him for further issues.  With that in mind - how long ago did you stop the grain and get rid of his grass access?  Has he been checked with hoof testers to see if he is sore in a specific spot (which could indicate an abscess and the grass/linseed was just a coincidence of bad timing?  It's good that he's still happy on rubber and in the arena so you may be fortunate and nothing further will develop, but definitely keep an eye on him.




Re: contaminated feed

Lorna Cane
 

And also......

Contamination happens ,too, when corn,for example, was processed through the equipment,even if not for cleaning purposes. Just as a bulk order,or for mixing.

--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: Starting Case history

Kirsten Rasmussen
 

I'll just add: focus on posting the most current hoof photos, rads, and body shots.  There's no harm in posting older stuff though, especially rads or photos that tie in to changes noted in your case histories.

As far as finding knowledgeable vets in your area, I think you'll see here that most of us are working with health and hoof care professionals that are not experts on treatment of Cushings or IR.  You will have to share what you learn here with your vet and trimmer, and hopefully they will be open to learning more along the way, especially if they see how your horse's are responding to our recommendations.  We also welcome them to join our group and ask us the hard questions (not you!).  Dr Kellon is a font of knowledge and can share with them the science to back up what we recommend.

I'm glad you found us, via Cindy!!!

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Re: Lastest test results -- Insulin over 200 again

Liz7033@...
 

I'll run Metformin and Invokana by the vet.  Need to try metformin before invokana?

Her current hay, has iron level of 318 PPM  at approximately 18 lbs a day that is 2592 mg.  Is this high enough to warrant an iron test?   (If no rain, will have local hay to test next week  to see if I can switch hay. And then do a professional diet balancing)

Thanks
--


Liz
SW Washington
January 25, 2020

Tasha photo album
Case History


Couple of Questions

sunygirl06@...
 

I have 2 quick questions.

QUESTION #1
Sunny has been dx PPID/IR for 4 years now. Every year I feel like I am more on top of her symptoms, I feel like I am crazy/obsessively observant. 

-I have noticed last year and now again this year, around this time of year she starts standing in the mud. (I've seen her lay down a few times too, not sure if she just feels like laying down, but I think she may tender-footed.)
-She runs and flags her tail, but she not the nutty horse, she was in early spring.
-The gelding is pushing her around a little bit.
-She is eating well (she lost her appetite and weight slowly last summer, before I increased her pergolide in August)
-She is trimmed every 6 weeks by myself, (self educated by Pete's DVD series, for the past 5 years), and she was super-sound this winter and spring, and her trim hasn't changed

I am assuming the seasonal rise is causing this should I:

-recheck labs? (I was going to wait till July)
-increase her pergolide now?
-something else?

Is she going to feel "doggy" (as in mildly tender footed) every year at this time, even if her ACTH does come back controlled.

I've been increasing her pergolide by 1 mg (prasend equivalent) every year so far. I was kind of hoping to keep the same dose for longer than a year at a time! But she is my horse for giving lessons, so I'd prefer to keep her sound!!

QUESTION #2
Since taking the NRC plus course I would like to give her electrolytes on these hot, humid days we've had in WI. What do you give your horses, how much, and how do you decide when to give?

Thank you for your input.

--
Amber Lauer
September 2016, Black Creek, WI

Sunny Case History https://ecir.groups.io/g/CaseHistory/files/Amber%20and%20Sunny/Sunny%20Case%20History.pdf


Re: Starting Case history

Kirsten Rasmussen
 

Hello Tracie,

Welcome to the group!  It sounds like you are already on the right track and things are improving!  If you haven't already, make sure your IR mini has zero access to green growing things (grass and weeds).  Even a small amount can negate all the positive changes you've made.

You mentioned not knowing how much detail to put in your Case Histories....  Start with their current conditions, then work your way back to the time you first started seeing signs of Cushings or IR.  Don't delay posting your Case Histories with current conditions....you can always work on updating your computer file with more background while allowing us to see what you've posted online.  Focus on the current conditions and what is triggering those ongoing abscesses though.  All lab work is helpful, too.  You can add lines in the .doc or .pages file anywhere you need to add more info.  Just right click on the left side of a line that is formatted how you'd like your new line to look, and then from the list of options choose to add a line either above or below.  Let us know if that doesn't work.

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and 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/grey font) for more information/instructions that will save you time.

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 Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or 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 IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*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: IR 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 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. 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 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 IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID 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.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Re: Updated CH - Scotty Labs

Eleanor Kellon, VMD
 

Deb,

Metformin is actually very well tolerated as a rule. Cost would be about $1.50/day US prices.

As for test false positives, Proinsulin could react with some tests but I already checked with Cornell about that and their assay does not crossreact.  One thing I have wondered about, especially in horses with high insulin that are not actively laminitic, is insulin dimers. A dimer is two insulins bound together. Insulin spontaneously binds with other insulin molecules and it is know that both the active single insulin form and the inactive dimers are found in the blood. The test will pick up both. If for some reason a horse had higher than normal levels of the dimeric form, the signs could be less.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: contaminated feed

Lorna Cane
 

Thanks.

Sometimes corn,or other stuff,is used to clean machinery over here.I frequently find whole corn in the Soy Hull Pellets. Annoying, but no amount of questioning seems to help.That's what they do. Some companies are more careful than others.
Can you buy whole flax and grind it yourself,if the company identifies this as the situation?

Sounds suspicious ,for sure.

--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Starting Case history

Tracie W
 

Hello
I am a new member and I currently have 2 senior horses, one is 25 yrs old mare with suspected Cushings and Osteoarthritis  and the other is a 26 yr old miniature gelding with both Cushings and is IR, that I am desperately trying to help recover from another bad heel and coronary band abscess (second one in less than 1 year!) and laminitis.  I have owned both horses since they were very young (3 1/2 and 2 yrs old respectively) so I have a detailed history on both.

When filling out case histories for both, what information do you need to assist? A current long time member told me about this group, thru her suggestions and a lot of reading on your site, I immediately stopped feeding BOTH horses the grain I had them on and slowly introduced all the other emergency mineral/supplements suggested (now both are on the full recommended amounts with out any issues). They have both been on this currently 2 weeks and I have started to see some improvement with my Mini and both have good appetites eating most of their hay and all their BP with the minerals and supplements, thanks to the APF plus they are getting.

I did have my Timothy/Orchard 2nd cutting hay tested recently by Equi-Analytical with the protein at 12.7, starch at .1 and ESC sugars at 7.2. Your history chart doesn't allow for alot of detailed diet changes over time (which they have had especially my Mini with Vet and feed store owners recommendation! Which in hind sight I feel made things worse!)

Do I start with what they are currently getting (Cushings/IR Diet with Beet Pulp with minerals and supplements and hay)? Or do I start with what they were on before I switched over to what they are eating now?  When I did my own excel chart since moving here, I started to notice patterns and when episodes happened with both horses having abscesses (which neither has ever had prior to moving here) directly related to diets and soil conditions.

I have a good farrier that has now been coming out every two weeks to trim and is trying to help realign my mini which I think is helping some but I am not sure what else to do for him.

My current Vet, keeps recommending to have his tendon cut to release the tightness, which I have told her I am totally against this extreme measure and want to stick to basics - diagnosis, diet, trim and exercise. 

Your site doesn't have any recommendations for vets in my area.  How can I find someone that is knowledgeable about Cushings, IR and especially Miniature horses, their diet and care since I am new to this area/state and live in a rural area?

I have reached out to one of your balancers for suggestions with my hay analysis for a response on what nutrients/minerals amounts they actually need to make sure I am on target with the amounts they are currently getting.

I am so grateful to Cindy Broady, for all her assistance and for telling me about your organization as I was almost at the point that I might have to make a tough decision with my mini since I was not seeing any signs of improvements and he was just miserable!

I am working on all the body and foot photos and have lots of X rays recently and from the past on my mini, which is another question on what to upload as well.

Sorry for such a long email but I want to make sure I do things right so that your group can help me and my horses.

Thank you for your time and I hope you have a nice day.

Tracie Wang, PA, May 2020


Re: contaminated feed

Caroline
 

Sorry, I should have been clearer!

It's micronised linseed, I can see yellow flecks throughout the bag and the puzzle dropped into place when I found a bit of what looks like maize. It might be 25% yellow.   He has been getting this bag for about a fortnight and I noted that he was not quite right about 10 days ago, nothing much, just a bit less willing to go faster.  Put that down to him eating weeds under the fence - they are now removed / fenced off better.  Then a windy weekend left leaves all over and he was very sore yesterday, but he didn't improve with the removal of the weeds and the response to the leaves seemed out of proportion.
--
Caroline
Spalding, Lincolnshire, UK
September 2019
https://ecir.groups.io/g/CaseHistory/files/Caroline%20and%20Evan
https://ecir.groups.io/g/CaseHistory/album?id=231916


Re: contaminated feed

Lorna Cane
 

Hi Caroline,

Why do you suspect this? Can you see grain....whole linseed, or ground ?
If you can see grain, how much would you guess is in there? 50% ? 25%? Less?
How long have you been feeding this batch? And how long has Evan been sore?
Is there any way there is anything else that could be the culprit?

Sorry to be a question box, but obviously something is going on. Just need to figure out if it's actually contaminated linseed.

-- 

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: Vet suggesting euthanasia, any suggestions welcome...

Bonnie
 

It's good that this vet is in favour of peer-reviewed research. Can you direct him to the Proceedings from ECIR's conferences?
--
Bonnie and Lad
North Ontario
Dec 2008
 


contaminated feed

Caroline
 

I have just realised that the linseed I've been feeding is probably contaminated with grain.  Pony is now grumpy and unwilling to work, but looks sound on arena surface and rubber mats (normal habitat)  I've spoken to the shop, sales rep and  quality control and they are getting back to me but is there anything I can do for Evan, except wait for the effects to wear off?  He has no access to grass and have now weeded fencelines.  I've stopped riding and will update his case history now
--
Caroline
Spalding, Lincolnshire, UK
September 2019
https://ecir.groups.io/g/CaseHistory/files/Caroline%20and%20Evan
https://ecir.groups.io/g/CaseHistory/album?id=231916


Re: Working out Hay Amounts for Mini's Diet

 

Lynn it sounds like you are doing the right things for your little herd. They just need to lose weight. The nets with the tiny holes will help. I have an IR 1/2 Arab. I let him get overweight one winter and that triggered his first laminitis episode. Luckily I met a barefoot trimmer who sent me to this group. After his feet recovered I figured out to use the "Mini" hay nets and I hung several around the edges of his two dry lots so he had to walk around to find them. I even put small handfuls here and there to increase the walking. 

Best of luck,
--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Re: Updated CH - Scotty Labs

Lorna Cane
 

Hi Victoria,

If you go to our Files, click on Start Here, and scroll down to Commonly Used Abbreviations, you'll find it listrd there....along with lots of other short forms we use frequently.

But it stands for Advanced Protection Formula, called APF by the company. It's an adaptogen.
Auburn Labs makes it,so if you go to their site you'll find out lots more about it.

--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: Updated CH - Scotty Labs

yodatoto@att.net
 

What does APF stand for, spelled out? 
Just wondering, since I have seen posts mentioning it, when horses get lethargic or lose appetitie while on pergolide.  My horse was like that on and off, not eating well, while on the same dose of pergolide. Where he is boarded, they switched from one low carb feed  brand to another, then  back  to the original one , which seemed to help. Now I realize it may have been the pergoilide...

Thanks, VH

--
Victoria , Maryland, joined March 2020


Re: Vet suggesting euthanasia, any suggestions welcome...

Alicia Harlov
 

Thanks! 
And no, I don't think you guys make stuff up haha! Every time I see him I tell him ECIR has case histories on horses for decades etc. He's a skeptical guy in general and admits that
--
-Alicia Harlov in South Hamilton, MA 
PHCP hoofcare provider, The Humble Hoof podcast


Re: Updated CH - Scotty Labs

gypsylassie
 

Hi Deb, APF is an adaptogenic herb blend made by Auburn Labs.   If you go to Auburn Labs website you can read about it.   It can help with all kinds of stress, including adapting to pergolide.   The best price I've found is Thriving Pets and although there are varying reviews of their prescription dept., they have been a good source of APF for years.   
Laura K Chappie & Beau over the bridge
2011 N IL


Re: Working out Hay Amounts for Mini's Diet

lynnc66
 

Thank you Bonnie,

Sure, I will work on moving the photo album to the photos section in the Case History group, and look over all this information.

Thanks for telling me about the Shires Greedy Feeder hay nets, and I'll check them out.  Currently I'm using slow feeders, including several PortaGrazers, mini size.  Right now the donks and minis eat in feeders spread out over 1 acre.  I can look into separating them.  What I have noticed, though, is that the donks seem to naturally eat less and take more breaks from eating than the minis.  This is by choice, as there are plenty of feeders and hay available.

Thanks again,

Lynn Cox
Kern County, CA

May, 2007 

Bella Case History
https://ecir.groups.io/g/CaseHistory/files/Lynn%20and%20Bella

Meadow Grass Hay Analysis
https://ecir.groups.io/g/CaseHistory/files/MeadowGrass20200225_19255425a.pdf

37321 - 37340 of 284216