Date   

Re: Responding to instructions

Maggie
 

Hi Linda,

Welcome to the group!  Did you have any specific questions for us?  Below is a rundown of our philosophy with lots of helpful links.  Take some time to read and absorb the information and let us know if you have any questions.  We're here to help!
 

The ECIR 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 font) for more information/instructions that will save you time.

In order to help you and your equine quickly and effectively, we need you to explain your equine's situation by following the instructions you were sent upon joining. Your completed case history form and ECIR Signature will save days of back and forth questions. If you haven't done so yet, please join our case history sub-group. Follow the uploading instructions so your folder is properly set up and then upload your case history. If you have any trouble, just post a message or email the case history group explaining specifically 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 Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may have 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 APFThe 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 spikeMake 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.

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.

We ask all members to sign their first name, general location, date of joining and link to the case history and photo album every time they post. It helps us to find your info faster to answer your questions better. You can set up an automatic signature so you don't have to remember to do it. 

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. 

--
Maggie, Chancey and Spiral in VA 
March 2011 
EC moderator/Primary Response


Responding to instructions

L Bond <ljbond@...>
 

Hello,

My name is Linda, and I am in Irvine, CA 92602


Re: Struggling to get a diagnosis

Jo Ellis
 

Vet did not bring TRH! Took a blood draw to retest ACTH, Insulin and glucose. Plain tubes used this time (not for ACTH) Chilled immediately in ice bath (not ACTH as vet said this would not degrade en route. True?) and transported in fridge in vets car. On site glocometer reading was 6.2mmol/l. Probably slightly high since I had given fresh hay a little over an hour previously. The horses had some leftovers but would rather starve than eat off the floor!!! Ha Ha got to love 'em :) Hopefully results on Friday
--
- Jo - May 2016 Wales, UK
Devon Case History https://ecir.groups.io/g/CaseHistory/files/Jo%20and%20Devon

 


Message Posting Etiquette - Keeping ECIR User Friendly, Wed, 11/15/17 #cal-notice

main@ECIR.groups.io Calendar <noreply@...>
 

Message Posting Etiquette - Keeping ECIR User Friendly

When:
Wednesday, 15 November 2017

Description:
Message Posting Etiquette

This is a high volume group that can be difficult to follow. Help make it easier for everyone by following the Message Posting Guidelines below:
1) Sign your posts. This is a very large group.  Whenever posting a message, identify yourself and your equine by using your full ECIR Signature with your first name, location, the date you joined and the links to your Case History folder and Photo Album. The volunteers need all this information to provide quality responses and suggestions for local support, vendors, vets, hoof care, etc. 
 
2) Be clear in your posts. If you need to quote a line this is most easily done using the web to reply (not from email). Once you have the message you want to reply to on your screen, copy the text you want quoted, then paste it into the reply message composer.  Highlight the text you are quoting and then click on the quotation marks in the toolbar.  
3) Be considerate of the Support Team. They volunteer to help members in their spare time. Many have full time jobs. Unless you are in an emergency read the Start Here Files and check the archives to see if your question has been answered before.  Many new member's questions are answered there.
4) Discussion should always take place on the forums so all members can learn from the conversation and the support team can help clear up confusion.  
5)  Try not to hijack threads.  Start a New Message or change the subject line to discuss issues not covered by the subject line.
6) Don't immediately re-post.  Give “missing” posts a few hours before reposting. For unanswered messages, be patient. A lack of response is not personal or a reflection on you in any way. With so many posts some do get missed. Unless in an emergency situation, wait roughly 48 hours before re-posting and edit the subject line with "2nd Try". 
7) Off-topic but horse-related discussions: ECIR Horsekeeping Forum provides a place to discuss issues involving non-PPID/IR horses, general horse keeping practices, other equine health issues, alternative therapies and any equine related philosophical debates.
8) All discussion about horses with PPID and IR - including their hooves, boots etc - takes place in the ECIR Forum. Hoof related discussion for horses that do not have PPID/IR takes place in the ECIR Hoof Forum
 Thank you for your cooperation.
 
- Owners, Moderators & Primary Response Team of the ECIR Group
 
 


How much magnesium for non PPID horse

 

For my PPID horse, I have his hay analyzed and balanced to tell me if magnesium is needed and if so, how much. I have a new horse that is non PPID. The previous owner fed magnesium in the form of Quessence, a magnesium based supplement. I have magnesium Oxide hat I use with my PPID horse already and wondered if I could use the same magnesium for my non PPID horse. If so, how much? The one I use is from HorseTech 60%.

Cynthia from CA
Tucker 10/10


Re: Struggling to get a diagnosis

Jo Ellis
 

Hi Karen
This from Dr Clougher in response to my first post. I hope I can get a good test so I can help Devon with his symptoms.
"The TRH stim test can often tease out the actual PPID horses, but this test can't be performed between mid-July and mid-November"
--
- Jo - May 2016 Wales, UK
Devon Case History https://ecir.groups.io/g/CaseHistory/files/Jo%20and%20Devon

 


Re: Struggling to get a diagnosis

 

The ideal is to do both a stall-side glucose test, and also request the glucose along with the insulin, glucose, leptin (or adinopectin) and ACTH. Then, if the glucose from the lab is wildly different from the stall-side glucose from the glucometer, you know there is a blood handling issue, and a suspicion that the other values are not accurate. If you do the stall-side test (which is pretty accurate), but then there is avblood handling issue, you still have no clue whether the insulin etc are accurate.  Adding the glucose to the insulin etc tests is generally only 6 to 10 dollars more, and well worth the cost, in my opinion, even when using a stall-side blood glucose test.   Weirdly, in our clinic, we have found that our Accu-Chek blood glucose tester usually reads lower than what the lab sends us on the same blood sample (but not by much - not enough to have to change insulin doses on diabetic cats and dogs).  
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Re: Still confused about deworming

 

Hi Maxine, 
We pick up manure all day. The property owners do morning and evening pick up and my pasture mate and/or I do pick up while we are on the property. One or both of us is on  the property every day. There is grass and weeds in some of the pasture paddocks and sand and dirt in the paddocks where my IR horse lives in (although I am starting to see little green seedlings popping up). Anyway, the property is mucked all the time and the muck is put in a covered bin after pick up.
--
Robyn & Toons
North Bay, CA

April 2016

https://ecir.groups.io/g/CaseHistory/files/Robyn%20and%20Toons

https://ecir.groups.io/g/CaseHistory/album?id=9117

 


Re: Glow - Severe IR and Suspected Cushings

Cindy Q
 

Hi Lavinia

Saw your response to Ellen - so it sounds like I can (and should) go ahead to rasp the edges all round the quarters and toe hoof wall to make take it in further. I definitely want to try this but I'm not sure how far to go and would err on the side of less. Can I just understand on the new sole photo - it shows a long trenches both sides and this bumpy ridge near the toe. Are you actually saying I should take it as far in as reaching the trenches (that go from the quarters up closer to the toe)? 

The october pics didn't have all these raised ridges or trenches so I'm not sure if something negative is going on there in the newer photo. I would be worried I do something wrong and cause harm by accident. Thank you for the time as always.

I feel this weekend would be a good/safe time to try as it's a good in between time (between farrier visits).

Ellen - thanks for your kind thoughts/encouragement. I also am following others' threads to learn from Lavinia's advice and markups there!

--
Cindy - Sep 2017, Singapore


Re: 2nd attempt - Riosa's X-rays uploaded and trim suggestions requested

hdavis
 

Thanks Lavinia.  That most definitely helps me understand better.  Very helpful!   


From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Lavinia Fiscaletti <shilohmom@...>
Sent: Tuesday, November 14, 2017 8:09:27 PM
To: main@ECIR.groups.io
Subject: Re: [ECIR] 2nd attempt - Riosa's X-rays uploaded and trim suggestions requested
 

[Edited Message Follows]

The faint, closely spaced horizontal lines are growth rings - like those on a tree. In a healthy, tightly balanced hoof, they are level and evenly spaced all the way around. You can't actually feel them when you run your fingers over the surface of the wall. Uneven distance between parallel rings indicate a change in growth rate for some reason (good/bad/neutral). Dips and/or bulges (like the smile effect you mentioned) indicate there is different pressure being placed on those areas vs. the ones to either side. For example, if you back the toe but don't also bring the areas in the pillars inward proportionally, you'll start to see bulges that correspond to the horn tubules in the pillars because they are longer than the ones in the center of the toe.

When there are actual horizontal ridges, they indicate some sort of "event/change" took place when that growth ring was being formed. It could be laminitis/founder, excess pressure from imbalances in the trim, illness, nutritional changes (both better and worse), abscess blowout, etc.

Does that help?

--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team


--
Heather
August 5, 2017, Brandon, Manitoba, Canada

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

 Photos
https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .



Re: Triple Crown being bought by Purina

Aurelio Henriques
 

Lin,
    I would expect this would be the case, but another source for the cubes in the North East is Cooperative Feed Dealers.  
(This, in addition to Cargill Nutrena)
Both distribute these in the Ontario Dehy bag.


Aurelio, in cold Goderich Ontario Canada



------ Original Message ------
From: "Lin Reuther" <LSReuther@...>
Sent: 11/14/2017 10:03:30 AM
Subject: Re: [ECIR] Triple Crown being bought by Purina

Does anyone here in the NE know if Blue Seal will still be carrying the Ontario Dehy cubes from Triple Crown?

Lin in cold Vermont and Charlie, the old guy Cushings Haflinger


Re: 2nd attempt - Riosa's X-rays uploaded and trim suggestions requested

Lavinia Fiscaletti
 
Edited

The faint, closely spaced horizontal lines are growth rings - like those on a tree. In a healthy, tightly balanced hoof, they are level and evenly spaced all the way around. You can't actually feel them when you run your fingers over the surface of the wall. Uneven distance between parallel rings indicate a change in growth rate for some reason (good/bad/neutral). Dips and/or bulges (like the smile effect you mentioned) indicate there is different pressure being placed on those areas vs. the ones to either side. For example, if you back the toe but don't also bring the areas in the pillars inward proportionally, you'll start to see bulges that correspond to the horn tubules in the pillars because they are longer than the ones in the center of the toe.

When there are actual horizontal ridges, they indicate some sort of "event/change" took place when that growth ring was being formed. It could be laminitis/founder, excess pressure from imbalances in the trim, illness, nutritional changes (both better and worse), abscess blowout, etc.

Does that help?

--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team


Re: Triple Crown being bought by Purina

Aurelio Henriques
 

Thank you, Tracy.



Aurelio
 Ontario Dehy
Goderich ON Canada


------ Original Message ------
From: "ironic_acres via Groups.Io" <ironic_acres@...>
Sent: 11/14/2017 6:40:20 AM
Subject: Re: [ECIR] Triple Crown being bought by Purina

Triple Crown Naturals.



Sent from Yahoo Mail for iPad

On Monday, November 13, 2017, 11:49 PM, Aurelio Henriques <ahenriques@...> wrote:

Hi, Tracy,
    Just curious if you get these in the Ontario Dehy bag or if in the Triple Crown Naturals bag...?


Aurelio
Ontario Dehy
Goderich ON Canada



------ Original Message ------
From: "ironic_acres via Groups.Io" <ironic_acres@...>
Sent: 11/13/2017 7:56:45 PM
Subject: Re: [ECIR] Triple Crown being bought by Purina

Regina,
I tried to send this through the group but it was blocked.
There is a group of us that get the balanced cubes in Dayton, Ohio. We order two times a year. If you'd like in on this it wouldn't be a problem. May be worth the drive two times a year.
Tracy
Jamestown, Ohio


Sent from Yahoo Mail for iPad

On Monday, November 13, 2017, 6:56 PM, regina bruno <rleb32@...> wrote:

Deb,
That has me thinking the 5 ton minimum is true.  That's 200 50# bags!!!  i don't have access to any feed store around here that could carry that much of one brand of feed.  it makes me think it's more an effort to eliminate the competition, but that might be giving them too much credit.  perhaps things are just a little bumpy right now.  i don't understand it but this is the first thing i haven't flipped out over!!!  Good idea to find other options.  Seminole is a pretty good feed, isn't it?

Regina and Smokey
June 26, 2017
Laurelville,  Ohio

 https://ecir.groups.io/g/CaseHistory/files/Regina%20and%20Smokey  .
https://ecir.groups.io/g/CaseHistory/album?id=8316  .


Re: New hoof photos

Jane Fletcher
 

After I had pressed send I thought what was I doing hijacking your post for my rant! Anyway best wishes. It's hard when the professionals aren't on board. Hope it went well!

Sent from my iPad

--
Jane, South East Western Australia
Nov 2016
Garnet and Bill


Re: Glow - Severe IR and Suspected Cushings

 

Thanks Lavinia! 

Yes, that make sense.   

It will definitely change the size and shape of her hoof and her boots as well.

Ellen
N. Alabama
08/10/13


Re: 2nd attempt - Riosa's X-rays uploaded and trim suggestions requested

hdavis
 

Hi Lavinia,
 
Just to double check the lines that dip down on the hoof are no relation to sinking is that what you are saying?  And they just mean uneven wall lengths?  As in a medial/Lateral imbalance?  Or can you explain more?

Also do the horizontal lines or ridges suggest the hoof has suffered trauma such as a laminitis episode?  Just curious as was told this years ago.

Thanks again!!


--
Heather
August 5, 2017, Brandon, Manitoba, Canada

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

 Photos
https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .



Re: 2nd attempt - Riosa's X-rays uploaded and trim suggestions requested

hdavis
 

Oh ok good to know as I was worried that she had sunk in all 4 hooves!  Thanks so much!!!

Heather Davis

On Nov 14, 2017, at 5:08 PM, Lavinia Fiscaletti <shilohmom@...> wrote:

Hi Heather,

OK, now I understand.

That is an indication that there are uneven wall lengths. It is not related to sinking.
--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team



Re: 2nd attempt - Riosa's X-rays uploaded and trim suggestions requested

Lavinia Fiscaletti
 

Hi Heather,

OK, now I understand.

That is an indication that there are uneven wall lengths. It is not related to sinking.
--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team


Re: Glow - Severe IR and Suspected Cushings

Lavinia Fiscaletti
 

Hi Ellen,

Yes, all of the hashed-area could/should have been removed at once. With the amount that needed to go, you could start a rough-cut using nippers, then finish off with a rasp.

I agree, it looks like most of the work that was done involved backing the center of the toe (which is a good start) plus possibly some overall height reduction. The hoof capsule now appears to be shooting further forward - but this may be an illusion if there was significant heel height removed.

Either way, the toe needs to come back more and the adjacent areas need to be brought inward proportionally so the end result remains in a hoof-shape rather than a square.

Does that make sense?

--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team


Re: Struggling to get a diagnosis

jayjrobins@...
 

I also would like to know if a glucometer can be used. How does one get a blood sample? What is the normal range. In short, how does one go about doing the test in order to get meaningful results?
Jayj and Jingles



--
Jayj and Jingles
Central Alberta
Mar 2017
Case History: https://ecir.groups.io/g/CaseHistory/files/Jayj%20and%20Jingles ( https://ecir.groups.io/g/CaseHistory/files/Jayj%20and%20Jingles ) .
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=6937 ( https://ecir.groups.io/g/CaseHistory/album?id=6937 ) .