Date   

Acute laminitis

Jess
 

I have a horse with acute laminitis going on 9 days now. Responded well to 2 grams bute twice a day, 1 gram bute does not seem adequate to manage discomfort. Also put on thyroid medicine. Being fed 18 pounds soaked hay in 1.25 hole net bag split between multiple meals. Also eats 1 scoop loose himalayan salt and 1 cup wellsolve w/c with thyroid medicine. On matted stall rest with soft rides containing laminitic gel. So far no movement of coffin bone based on radiology but concerned horse is still experiencing discomfort after 9 days. Likely brought on by hock injury that resulted in a month off from exercise and other feed changes that sent this easykeeper over the edge. Most comcerned at this point with mitigating the acute laminitis. All advice is appreciated. Thank you.

--
Jessi-ra_Dakotas_2021


Re: WAS: Stabul 1 / NOW: Julanne and Oreo

Kirsten Rasmussen
 

I corrected what I wrote in my first post above...I have a bad habit of leaving out the decimal point when saying what percentage of BW in hay a horse is getting!  You are right and she is getting 1.9% (not 19%!) of her current weight.  I found I had to drop my boy down to 1.5% of his current weight to get the last 100 lbs off, and then start soaking that amount of hay to get the last 30lbs to go.

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


Re: WAS: Stabul 1 / NOW: Julanne and Oreo

Kirsten Rasmussen
 
Edited

Hi Julanne,

The April reference ranges are 9-35.  That's because ACTH goes up naturally in the fall so the November reference range goes higher.  Its a minor detail but you could correct the April reference range you gave in your Case History if you like.

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


Update: Relevante Goes Rodeo

Lynn
 

Dr. K's April 9 blog post on "Conditioning The Older Horse" was excellent and timely for me and the boy.  Last May radiographs showed severe broken HPAs in Relevante's hind feet. So much so, that Dr. K and Lavinia said to stop exercise and riding. We set about to biomechanically correct the problem with the right trim [from Lavinia of course...we need t-shirts that say "Feet By Lavinia"] and in October 2020 he was weaned out of his Easyboot Clouds (with wedges) and I started walking him and building up the time. [you can see his hoof evolution in his photo album] Last Saturday we were cleared to ride. [I had been building up weight starting with walking him saddled]. I rode him for the first time since this happened at a walk for 15 minutes. It was hard to hold him back because he wanted to GO, but I finally got him to walk on a loose rein. Today was his third medical massage in row [we did a series] and then I took him out to the arena for a walk/ride. [I'm using a knotted training halter with reins because I'll need it when he's ready to gait to help him balance and get his groove back. So I wanted to get him used to it.]
Well...today I became a star  - if I'd know I would have worn a flashy shirt with fringe. He was calling out to the other horses in the barn and as we neared the back of the arena in a flash he spun, threw his head down and started to full out buck. After I recovered from my initial shock - I stopped it by pulling one rein to my knee/foot. The gal who did the massage was watching him to see if she could detect any soreness anywhere and when she started to step outside the gate that's when he threw his little tantrum, one of THREE!!!!! I am proud to say that I did not come off once during this little drama. I am surmising [since he can't talk] that he didn't want to be in the arena alone - and to be fair - he knew his lunch hay was in his stall. I do try to avoid meals time at the barn but sometimes you can't.  I finally got him to be calm and just walk - if I saw him start to get anxious I immediately turned him back to the gate but I wouldn't let him stop there - I kept him moving....and we ended the ride on a positive note with me still aboard. We will continue to adhere to Dr. K's "long and slow" advice per her blog but I share this because despite his long road to recovery [which we are still traveling]- after his shenanigans today - he can't be hurting that much [and here I was afraid I was going to "break" him because I'm no expert at rehab] but secretly - though I would never tell him this - I am glad to see him be able to kick up his feet - just preferably not with me on him the next time.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: WAS: Stabul 1 / NOW: Julanne and Oreo

Lavinia Fiscaletti
 

Hi Julanne,

Was the testing just a plain ACTH (one draw) or a TRH stim test? The reference ranges for the stim test are 9-110pg/ml.

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


Cody's test results

Sherry with Dusty, Blue and Cody
 

Hi, Dr. Kellon and everyone else who so selflessly dedicates their time here.  I entered Cody's new test results in his case history (I think I got it right), and was wondering if someone could take a look and let me know how we're doing.   Please note that with the weight tape he weighed in at 915 but using the calculator he was a little over 1000.  He is a little thin so somewhere in the middle perhaps?  Thanks in advance.    
--
Sherry, Feb 2018, Gates, NC
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Cody  

https://ecir.groups.io/g/DustyHoof/album?id=38179 

https://ecir.groups.io/g/BlueHoof/album?id=38486

https://ecir.groups.io/g/CaseHistory/album?id=38227
 


locked Re: Equi-analytical 604 analysis on Timothy Balanced Cubes and Amino Trace +

Nancy C
 
Edited

You are welcome. I did this for the many people who are concerned about your reporting. I also wanted you to see you have options right now that will lower your iron intake, labeling not withstanding.
  I am actually a bit surprised that I have never seen information on the iron in the Timothy Balanced Cubes on ECIR, its bio availability and the decisions made with respect to what portion of that iron to balance on ECIR.
Actually, it has been. I highly recommend you learn how to search the message archives where you can read about the travails of labeling equine products. Dr Kellon answered your preliminary questions about iron in February. We have reported ECIR's current stand on bioavailability with you over the last few days. There are many, many conversations about not relying on labeling.  This group was started 21 years ago with a thirst for information that no one had. There's lots of historical info in the message archives of members going to bat with companies, seeking accurate reporting of "sugar" and starch, NSC, NFC, ESC, WSC., fructan, iron, and probably a host of others I am not remembering.

The battle continues over 20 years later.

You may have noticed -- or not -- that we've had at near a dozen members report with laminitis or other concerns in the last 24 hours. So that we may focus on their Case Histories (thank you all!), I am going to close this conversation. If Dr Kellon needs to she can open it back up.

Hope you can find a friend in the Canadian agency that rules on labeling. Also need it for the USDA.

Kristen, you are right about Manganese, but Sandra's is low. We don't know anything about her horse, so I was not going to report on it.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room


Re: WAS: Stabul 1 / NOW: Julanne and Oreo

Julanne Baker
 

Thanks Kirsten! I appreciate your help!
i just checked my finalized report for 11/20. The reference interval stated is 9-110. Maybe they have a typo? 35 is a far cry from 110!😂
Oreo has always been an air fern since she was 3. I’ve had trouble with various barns keeping her rations down because she gets so little ( and she’s such a big girl!). The only time her weight was easily managed at or below 1100# were the years she was on ThyroL. The small dosage quit working for her about 4 years in. The vet suggested we increase it, but she refuses it since beginning Prascend. I see the ECIR doesn’t recommend it anyway, so I guess that’s just as well.
Including her ration balancer, she gets 1.9% of what the vet would like her to weigh. (When she was hospitalized as a 4 year old at University of Florida Vet school, they suggested 1100# (taped) as her ideal weight. Until we used the Thyrol L, she was more consistently at 1149. That’s where she is now. It’s like her set point😂) For about 7 years after blowing up considerably, she was on pasture with a grazing muzzle. My current barn owner provided her with a dry lot, so we don’t use the muzzle anymore.
Her current boarding situation (since 2016) is more adaptable about her situation. Until 2013, my biggest problem was getting the stable to feed her what I asked them to. 

Thanks for your suggestions on diet and supplements. I will be working on transitioning her to the ECIR suggestions as well as testing her hay. Crossing my fingers that her ACTH and Insulin are down in the next labs!

--
Julanne in Florida 2020
CaseHistory
Https://ecir.groups.io/g/CaseHistory/files/Julanne%20and%20Oreo


locked Re: Equi-analytical 604 analysis on Timothy Balanced Cubes and Amino Trace +

kguest@...
 

Hi Sandra,

Because you are in BC I'll share something that may also be a factor, and that could also be influencing tight balancing for your horse: manganese. Apparently BC hay is very high in manganese (as a result of Mt St Helen eruption). I know that in my field, manganese is much higher than iron. If your hay is not balanced to this it will impact uptake of copper and zinc and may therefore be a piece of the puzzle you're trying to figure out in relation to your horse that could seem like an iron issue (since they interfere with balancing in similar ways). 
--


Kristen and Jasper, Prince George BC
December 2016
Case History: https://ecir.groups.io/g/CaseHistory/files/Kristen%20and%20Jasper .
Jasper Photos: https://ecir.groups.io/g/CaseHistory/album?id=3346 .


Free feeding tested hay

Pat
 

Hello,

My Canadian mare had laminitis August 2020. (See case history.) She has done well at new barn on your recommended diet and tested hay. 
 
She has been on a restricted diet before (in terms of % of preferred body weight) and lots of exercise and never really did lose much weight so I believe the weight loss is a result of low starch hay. Since being on weighed hay and your recommended diet, she has lost around 150 lbs.

But I am now worried she has ulcers (because of sudden on set of behaviour problems, like biting, which she has never done before).
She is fed 3x per day in hay nets but devours it quickly, leaving her with long windows without food.
Her blood work says she is not insulin resistant but your calculator says she is compensated IR, sensitive to food.

Would it be safe to at least try free feeding of tested hay for a week or two or longer, if I keep track of her weight? I would use a whole bale, small-hole net approach. I realize it could take some time for a full transition - but is it safe to just start and see where it goes in terms of health and weight. I am wiling to stop if her weight gain is too much or any other health issues arise.

Thanks!

--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: New case history files converted to pdf

Kirsten Rasmussen
 

Oh I didn't see you already started a new Topic.   Here is my input on your Case History:

https://ecir.groups.io/g/main/topic/was_stabul_1_now_julanne/81999090?p=,,,20,0,0,0::recentpostdate%2Fsticky,,,20,2,0,81999090

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


Re: Liz & Onyx - New Results 2021

Kirsten Rasmussen
 

Hi Elizabeth, 

It looks to me like he has a BSC of 4.5-5...  I think I can just barely see his ribs in one of the side profiles
https://ecir.groups.io/g/CaseHistory/photo/94258/3204270?p=Created,,,20,2,0,0
and if you can easily feel each rib that is consistent with a 5.  I like his current weight.  But I agree that 1000lbs would be near ideal for his size....  Maybe your measurements are off?  There is definitely a big discrepancy between your weight-tape and calculator estimates.  Can you get him scaled to give you an actual number?

His recent high insulin is concerning, but any and all of those factors you listed could have combined to elevate those results.  It's really up to you if you think it justifies a re-test.  Certainly a review of whether his diet is still tight is in order.  Did you start on some hay that looks different than previous bales?  Maybe it is higher in sugar/starch.  Also watch that he is not getting ANY fresh green stuff in his sand paddock now that spring is here.  Even the smallest amount under the fence or stray weeds/grass can affect them at this time of year.  I see some green closely cropped grass just inside the fence in this photo:
https://ecir.groups.io/g/CaseHistory/photo/94258/3204268?p=Created,,,20,2,0,0
I'm not picking on you, I just know from personal experience that this is a really hard time of year and this little bit of grass would put my horse into a laminitis flare-up.  I would heavily salt the grass patches, then wet it enough that the salt dissolves and soaks into the ground a little to kill it.  Then rake up the roots so it doesn't come back.  I buy the salt you use on sidewalks as it is much cheaper than food grade salt.  Or kill it by covering it with a light-blocking barrier,  like rubber mats.

Hope that helps a bit! 

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


Re: New case history files converted to pdf

Julanne Baker
 

Thanks Sherry. Will absolutely be changing out the supplements as you suggested. My original question was about changing the Nutrena to Stabul 1. I have samples coming but don’t know how much to give. 

Her hay is weighed but not soaked. Since her blood work I have increased her work as far as intensity. We were doing more walking under saddle than trotting. Now we are trotting for 30 minutes and then walking or doing other arena type work for 15-30 minutes more , on an average of 4 days per week. I strive for 5 but with rain and my other life it works out to about 4. (i keep records in a riding app)The barn is 45 minutes away from home. Luckily at 68 I have a less hectic schedule unless my grandkids are here.
 I am hoping her bloodwork will be better this time although her weight doesn’t indicate that. 
Thanks for the help!
--
Julanne in Florida 2020
CaseHistory
Https://ecir.groups.io/g/CaseHistory/files/Julanne%20and%20Oreo


Re: Recent bloodwork concerns

jennigrossi.jg@...
 

First of all I want to thank you both so much for your help. Sherry, you were so patient giving me all of those instructions and I've made the changes that you suggested to my images and signature. I really appreciate it as all of this is sort of overwhelming, including the technology. Thank you

I want to clarify that Firestorm is not on pasture. He's on a half acre that is mostly dirt. We're in Northern Michigan, which is new to us both, so I am getting used to the fact that, in this environment, green stuff still seems to find a way to grow. Since this stressed weeds and grass is likely even more dangerous, I will put a muzzle on him if I notice him grazing on anything.

One thing that is really got me confused is how well he seems to be doing with the numbers, especially ACTH, that he has. Since I have him down to 1 mg, I was prepared for him to possibly be at a higher ACTH than he was previously, but no where near where he is. He is currently shedding well and otherwise looking well. Is there any type of sample mishandling or other issue that could be confusing things? Kirsten mentioned the possibility of not all of the ACTH being active? I will definitely up his dose and will go with a whole other mg as recommended by Sherry (2mg total), but I'm just perplexed. When he was previously on 1.5 to 2 mg and his bloodwork looked good, he didn't look nearly this good symptomatically. I really appreciate the kick in the pants from you both. I got these results from my Vet on Thursday via email with a note that just said if I have any questions to give him a call. I was immediately freaking out, but his nonchalant email made me question myself. Thank you for taking this seriously and empowering me to up his dose to 2mg.

Do you guys think I should ask for some emergency Metformin to start immediately too? He hasn't needed it before, but this is by far the worst his numbers have ever been.

Also, Iron is a huge concern of mine. We have well water and it has a ton of iron. I have a horse hydrator filter that I put on the hose to fill the horses water tank and I get their water for soaking feed from their tank. I should probably do the bloodwork to KSU on him as well, right? I can't prove it, but I feel like this time of year, snow melt and rain cause our water to have even more iron, but as far as I can tell, the filter is doing a good job of removing it from his water. However, it's probably still a concern on and in his hay, right? If you can direct me to more iron info, I'd appreciate it. I've been struggling a bit to find it.

Finding a horse vet up here is very difficult, but I'm also working on getting some hoof rads asap. The ones I posted were taken 1.5 yrs ago just as a check up.

I'm ordering some APF right now. Firestorm has tolerated 2mg well in the past, but I've always increased him more gradually than I plan to this time since it's emergent. The APF won't be here for a week, even from Amazon. Is that still helpful? Should I do the APF or APF pro?

Lastly, Firestorm is a super busy horse. So, I usually keep a roundbale of 1st cutting (this is our stemmiest and least quality hay up here) in his pen at all times. It helps him to stay busy and fulfill his need to "graze". I plan to test it, but based on what grows up here, it should be mainly orchard with a bit of timothy and like i mentioned, it's very stemmy, not much leaves. He doesn't love it, but it's something to do. Neither him or his pen mate has ever gained weight on it without supplementation of other hay or concentrates. I'm concerned with removing the roundbale, because without it, he finds other things to do. He chews everything he can get his mouth on or tries to graze and our soil is very sandy and there's no grass to eat. So, I worry about what he's ingesting. Any advice on this front is super appreciated. I am working on getting him a large pasture to be turned out in with his friend and I'll muzzle him with the holes covered, this would be a bigger area he could wander and not be so bored he gets into mischief, but for now, we don't have access to it and it's still in process of being fenced. I will also have to thoroughly test his muzzle before i do this because if he gets it off there, that would be catastrophic. 

Thank you all again, I feel like my brain is spinning a million miles an hour. I'm sorry if my thoughts are all over the place.

Jennifer


--
Jennifer Grossi
Charlevoix, Michigan
2018


Re: Stabul 1

Kirsten Rasmussen
 

Hi Julanne, 

So that we don't hijack Sandy's thread, I have started a new one for you here with my suggestions based on Oreo's Case History:
https://ecir.groups.io/g/main/topic/was_stabul_1_now_julanne/81999090?p=,,,20,0,0,0::recentpostdate%2Fsticky,,,20,2,0,81999090

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


WAS: Stabul 1 / NOW: Julanne and Oreo

Kirsten Rasmussen
 
Edited

Hi Julanne,

Thanks for getting your Case History loaded.  One correction to note: the lab normals for your April 2020 ACTH value should be 9-35, not 9-110.

This is a good time to redo her bloodwork so I'm glad that is part of your plan.  You need to know if 1mg Prascend has brought her ACTH back into range.  If not you might need to steadily increase the dose until it does, ideally accomplishing this before the seasonal rise begins in August.  Please let us know when you have the new results.

In addition to PPID, given Oreo's breed, difficulty losing weight, high leptin, crest, and elevated insulin, she is likely also EMS at baseline.  I think you know this, and that it means her diet needs strict control.  Great that she is on a dry lot already!   But her hay should be soaked to reduce sugars until you can get it tested for ESC (sugar) and starch to ensure it is safe.

She--like all equines, but especially PPID and EMS equines--would also really benefit from a mineral supplementation program that matches her hay.  I highly recommend having her hay tested using the 603 "Trainer" package at Equi-Analytical (https://equi-analytical.com/feed-and-forage-analysis/analytical-service-packages/), then hiring one of our recommended diet balancers to determine how to adequately and safely (given her likely EMS) supplement her hay to encourage healthy hoof growth, increased insulin sensitivity, and a stronger immune system, all of which are compromised in PPID+EMS horses.

Minimizing body fat in EMS horses really helps control the elevated insulin and leptin: 
https://pubmed.ncbi.nlm.nih.gov/30520164/ 
To lose weight Oreo should be eating either 1.5% of her current body weight, or 2% of her ideal body weight (whichever is higher) in hay and including the weight of any other feeds.  If you are weighing her hay and she is actually getting 20lbs (+ 1lb of the Nutrena ration balancer), then she is getting 1.9% of her ideal weight and 1.8% of her current weight.  If you are following our recommended amounts but not seeing a result, you could cut the Nutrena out, then try dropping her hay ration by 0.5 lbs at a time and see how she does.  Slow and steady weight loss is best.  Don't feed less than 1.5% of current weight though because starving them is not helpful (it has the opposite effect and it can increase insulin) and can be dangerous, and ultimately aim for a BCS of 4.5...you want to just barely be able to see her ribs.  Soaking hay also reduces calories a bit without reducing volume and that is what got the last 30 lbs off my EMS horse, who was very difficult to get to a healthy weight.  I had to feed even less than we recommend because some horses are real air ferns and he was one of them!  I also didn't know what his true ideal weight was until I got him to BSC of 4.5. 

I'm not as good as Sherry at sussing out which supplements can be problematic, but I've yet to see anyone say any Nutrena, Platinum Performance, Smartpack, and MSM-containing supplements are safe for horses that have EMS.

Insulin-wise is not as effective as they lead you to believe, even the horses that respond to it (2/3, in their study) have what I consider too small of a drop in insulin to be worthwhile, in my opinion.  Soaking hay is much more effective and WAY cheaper.  Metformin is a better option but I personally would try soaking hay first because: a) having to give my horse a medication 2x a day that can be complicated to administer is not something I WANT to do, and b) the effects of Metformin are reduced with time so I'd rather save it for a critical situation (ie acute laminitis) when it is likely to be at its most effective and when it is most needed, as long my diet-control methods (including soaking hay) are working well in the meantime.  This is the first year I've soaked hay consistently and although I REALLY did NOT want to do it, especially thru winter, it became a part of my daily routine and I don't really mind it so much anymore, especially because I see the positive effect it has had on my horse every single time I look at him!

Hope that helps! 

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


locked Re: Equi-analytical 604 analysis on Timothy Balanced Cubes and Amino Trace +

Sandra Draibye
 

I appreciate you going to all this effort, and I think I have said that Scott agrees with you that my diet was balanced even at the 2020 ppm. But you have identified the basis of my concern for sure - I want to know the total amount of iron in everything my horse is ingesting so that I can choose the best option for my horses and keep the iron as low as possible.  You are correct,  I can lower iron by taking out the pelleted supplements and the cubes.  But to know I should even think about trying that I would have to have some idea that those are high in iron.  Based on the tags on the bags I would think there was 20 mg of iron in the amino trace +  negligible iron in the timothy balanced cubes.  Even a deep dive on the Ontario Dehydrated website would have found around 240 ppm in the cubes.   The 2020 ppm and 900 ppm were a bit of a shock to me.  No one can choose the best option for their particular horse without accurate information.  I am actually a bit surprised that I have never seen information on the iron in the Timothy Balanced Cubes on ECIR, its bio availability and the decisions made with respect to what portion of that iron to balance on ECIR.   But in any event, labelling regulations appear to be an issue.
--
Sandra on Vancouver Island, B.C.
December 2018


Re: Update on Vinnie- Post Hospitalization for Hypertriglyceridemia

Nancy & Vinnie & Summer
 

Hi all, with Vinnies insulin increasing my vet and I decided to add back Invokana at 1/8 of his previous dose and monitor. We don't want to risk another acute laminitis or any more damage to the laminae. 

Will update with results when I have them.

Thx Nancy 
--
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


Re: Recent bloodwork concerns

Kirsten Rasmussen
 

Ps.

If you redo rads, be sure to mark his hooves up as detailed here: https://ecir.groups.io/g/main/wiki/Getting-Good-X-rays

I also recommend taking a set of hoof photos to go with the rads, as detailed here: https://ecir.groups.io/g/main/wiki/Hoof-Related-Photo-Instructions

You might find the thrush battle is less of an issue when you get the diet balanced and low sugar.

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


Re: Vermont Blend

Nancy C
 

Hi Sandy

Way back in time when I bought the wrong kind of Vit E caps (not in oil) I asked if I needed to cut open the caps when I mixed with a table spoon of olive oil, I was told, yes, I should, because the  vitamin E needs to not get lost or separated from the oil in the vast acidic ocean of the hoses stomach.

Here is another response from Dr Kellon that is similar in a good thread about flax and E.

https://ecir.groups.io/g/main/topic/71821886#247599

I would add extra oil.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room

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