Lavinia is there ever a right time for corrective shoes?

Jeanne Q

I have just given my farrier the go ahead on corrective metal shoes with pads for Glory's fronts.  I am really torn and am not sure this is the right move.  I have been dealing with her rotation and serious bone loss for over a year now.  To be honest I am surprised that she is still with us.  If you look at the latest rads you will see the RF P3 is basically gone.  However, this little mare has not once given up and only shows signs of increased zest for life.  I started her on PEA 3 weeks ago and she is walking so much freer in the last couple of days and I am encouraged.  The shoeing is scheduled for this Thursday.  My farrier has been researching trying to find an option to get her more comfortable.  The way her RF is growing out it does not allow for the frog to work properly.  There is no frog, groove, sole definition other than the 2 planes from trimming the heel and leaving sole.  Basically, what the farrier has in mind is to widen out the heel some to give the frog space to get the blood flowing.  A backwards shoe, rockered on the heel, open in front.  Banana shaped to keep her rocked back on heel.  Dental impression material and a thin pad in between.  He plans to use these super thin wire nails to cause the least trauma. 

I just kind of feel like we are at the "hail mary" point with Glory and am willing to try just about anything.  I have read everything there is to read and agree that barefoot is best in almost every laminitis case.  Glory has been barefoot through all of this and, granted, the trim was hardly ever perfect(thats a whole other story) P3 continued to rotate and lose bone. Is there a point that shoes might make sense?  Any thoughts would be appreciated!  I didnt sleep much last night for thinking about it. 

Jeanne Q MN 2020

Re: Help for laminitis


Durango CO
Check out FAQ :

Re: suggestions in getting insulin down

vicky monen

No I havent and my vet didnt feel he wanted to add that in just yet.  He wanted to add more prascend before adding other meds.  As Samson is also on  EPM meds too.  As the vet said he feels Samson is a very complicated case. As we have several issues at one time going on simultaneously. 

Do you think the metformin would be better than increasing the prascend? Or are you saying addition too increasing the prascend to add metformin? 
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

Re: Lyme Treatment

Sherry Morse

Thank you Dr. Kellon! With Lyme being endemic in this area and every horse we've ever tested at the farm being positive we usually only test/treat the ones that aren't quite right.  We have another one being tested today who was dead lame on Friday and was jogging/loping around again on Saturday like she never took a lame step - I'm curious to see what her results come back at.

Re: Hay - As Sampled Vs Dry Matter Question


Dr. Kellen,

Thanks for the reply and info.

One of the things we have on our square baler is a bale chamber mounted moisture meter.  It is a Agratronix BHT-2 model (for anyone who might wish to know) and gives us moisture readings as we bale.  For us, typically dry baling is 12% to 17%.  It is rare to get under 12%, but I do believe the bales “sweat” down to some equilibrium moisture.

If we see moisture heading for 18% or more, we either knock off until later or the next day.  If rain is on its way, we will apply buffered propionic acid hay preservative rather than loose the hay quality to rain.  This is rare for us to do, but have the option if needed.

I had not considered lower humidity levels for anything other than preventing dust and mold, so I appreciate the info.

In pursuit of quality hay and lower humidity levels, we use a mower conditioner.  Ours has impeller tines that take the hay and push it against a treadplate hood, as well as against the grass itself.  The scrubbing action removes the waxy coating on the grass stem (we do not raise any legumes - timothy, ocassionally Teff and as our fields age and see an influx of Orchard grass and fescue for a heavy timothy mix).  I liken this scrubbing action as taking the wrapper off a loaf of bread and setting it in the sun.  The hay dries out fast.

We also cut at a 4-5 inch stubble to get the grass off the ground to further assist curing/drying and use a tedder to turn the hay, again to help drying.  The higher stubble is also of benefit as less dirt/ash content comes into a bale and it’s just easier on our equipment not to be digging into the ground.

All of the above is driven to prevent dust, mold and retain hay quality.  I will consider next year the 12% moisture threshold.

Again, I’m reading and learning from this ECIR group.  I feel to know the mind of an informed horse owner is to better hone our haying.

I don’t have much to offer, but to the extent it would be helpful, I would be glad to discuss the haymaker side of haying with anyone.  Just take my thoughts and advice with a grain of salt.  We are still a work in progress.

Bill J. in VA 2020

Re: Lyme Treatment

Eleanor Kellon, VMD


I would double the vitamin E and add acetyl-l-carnitine, 9 g/day, for nerve support.  Not much point in using probiotics at this time because they won't survive the doxy but doxy is well absorbed in the small intestine in horses so there should be minimal effects in the cecum and colon. When treatment is over, use a  stomach/foregut formula like GUT .

Once Lyme is chronic it is difficult if not impossible to cure. The 30 days is often enough to effectively quiet it down. If not, I'm sure your vet will reconsider.
Eleanor in PA 
EC Owner 2001

Re: Use of Palmitoylethanolamide(PEA) for pain management

Jeanne Q

3 week update on Glory on PEA
Glory started PEA on 11/24 @ 3g. in evening feed.  Added another  3gr dose to morning feed on 12/4.  So it has been a total of 3 weeks.  As of yesterday there was considerable difference in her gait.  She literally burst out of her stall in the morning.  She is moving much much more freely and I think as normally as she can at this point.  My opinion is that the PEA has helped her immensely.  There is a definite difference in her movement and attitude.  I have seen no weird side effects.  She has gone off her morning feed the last two days.  I dont know if that is related.  Only other thing is, about a week in the dosing she started being more her old feisty self.

I will probably start reducing the dose to find her comfort zone.
Jeanne Q MN 2020

Re: suggestions in getting insulin down

Sherry Morse

Hi Vicky,

I may have missed this but have you tried him on Metformin to see if that helps with insulin numbers since his ACTH does seem well controlled right now?  That would probably be my first choice of things to try if everything else is tight as it can be.

Re: Looking for help reviewing Hay Analysis


Hello Stephen and Kelly,
Below you will find the detailed document for new ECIR members. The document has a structure to it that will guide you thru understanding how this "Main" group is organized and what steps we request our members take who request help/guidance for IR/EMS/Cushings horses. We  recommend that you also use our website link below. All clickable links are blue colored.

Starting with diet balancing is very important, and getting assistance with it is a wise decision. When I joined this group I dithered around about contacting a "Balancer" as I knew nothing about the people on the balancer list and I had no idea what it would cost me. In hindsight I realize that creating a correct and safe diet for my IR horse was THE most important thing that I could do for him. It was money well spent and far less expensive than a single set of horse shoes. I contacted Kathleen Gustafson about diet balancing and she provided me with a huge amount of How-To information about finding the products I needed, who to buy them from, how to measure and weigh the products, etc. I am sure the other balancers will also provide you with similar services.

Since you do have a Donkey with hoof issues (laminitis?) we do ask you to also get started on creating a Case History for him/her.
There is a lot to read below but don't be overwhelmed by it. If you have any questions please ask them. 

Welcome to the group! 

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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


Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album

Lyme Treatment

Sherry Morse

Hi All,

Since the vet was at the farm to do a castration and x-rays on two of the other horses I had her pull blood on Scutch to check his metabolics and I asked her to add in Lyme too - not because of anything specific he's doing consistently (a couple of trips at the canter here and there and some 'knuckling over' behind) but just the little voice in my head saying 'check it, just in case'....

Well, his metabolics are slightly improved from last year (glucose 117 and insulin 45.77) when he was checked but his OSPF Lyme titer is 6027 (he was 9000 last year when I had him tested and was spooky and didn't want to be touched). Doxy is on order for 30 days which the vet thinks is enough.  We did 60 days last year and I'm not so sure 30 is enough so any thoughts on that would be appreciated.

Anyway, I know that I should remember the answer for this but for extra support for Lyme treatment - last year I did 2500IU Vitamin E and probiotics.  I have a probiotic on order but anything else I should add in that I'm forgetting? 

Re: How Do I Know-Winter blanketing/leg wrapping

Jeanne Q

Re: suggestions in getting insulin down

vicky monen

"You currently have him at 1mg Prascend, but you could try increasing it"

Hi there,
Can anyone tell me how much I should increase the dose to??  What am I looking for once I reach the right dose? 

My new vet says to get him up to 2 pills a day.  He does have such an issue with various levels of the veil when increasing it.  He is not eagerly eating currently and sometimes has a nibble then leaves it.  Going off feed is the issue when increasing the meds.  He is on APF.   Will be increasing the Stabul 1 to see if he will be more interested,. 

I have him only up to 1 1/4 prascend as of today.  Increasing the dose this week to  get him up to 1 1/2 pill per day. 

How do we know what to increase it to? 
What am I looking for with the dose increase? 
Will the lameness stop when we get to the correct dose? 
Since the ACTH is always in normal range,  Do I just keep retesting the Insulin and once the correct dose is met the insulin will finally come down? 

How do you know if the dose is too much? What are the signs to look for if its too much? 

Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

Re: Case Hx folder is Empty

Eleanor Kellon, VMD

Pleased send the hay analysis to kellon "at" I'm having trouble reading it.
Eleanor in PA 
EC Owner 2001

Re: Recommendations for next steps? Can Prascend cause this weigh loss? maybe needs to be reduced?

Rhonda Turley

Will try to do that tomorrow



Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     

Re: Frog and hoof question


I posted some sole pics.  The LF frog was shedding in the middle so I removed it as was a big flap. But the tip remained as did the back half. I hope her frog is stretched as it kinda worries me that I am too close to her coffin bone if it isn’t. I sure hope I am ok!  No lateral
pics thought as too blooming cold out.  I need bring the break over back on the LF.  I see some balance inneed to fix as well tomorrow if I get a chance to do so and it warms up . As I type this it is -30C with the windchill.  Wow that is a big temp change from yesterday when it was -10c.  Put a 300 gram blanket on Rio just in case and made sure she had boots, socks and wraps on.  

August 5, 2017, Brandon, Manitoba, Canada



Case History


Re: IR and pregnancy

Maria Duran


María Durán Navarro 
Dec 2017
Madrid (Spain)

Plutón´s Case History
Plutón´s Photo Album

Re: IR and pregnancy

Nancy C

May I please add that pregnant mares are often the last ones to get a trim. I get that they may be in greater discomfort and harder to work on. Keeping the trim tight physiologically will also help reduce the impact of high(er) insulin.
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

Re: Case Hx folder is Empty


Dear Dr. Kellon,

My hay is posted in photos. (I tried to put them in a folder in case hx but it wouldn't accept photos there) I need to balance the Teff hay. I don't know how to do that and I hope that the labs I have on the hay are sufficient. The original supplier provides those labs to the person I buy hay from. Any notes are not mine. I can't get to the warehouse. She bought a bunch of Teff hay for me. I am getting a small load and I can retest if necessary. Candy can't typically eat more than 3# of grass hay without getting diarrhea. Unfortunately, Candy won't eat the TC Tim cubes fluffed up, not even overnight. I am currently increasing them as they are and phasing out the Safe Strch Forage.. She will no longer eat Stabul 1 pellets, so the vehicle I use for supplements currently is tested tim pellets (esc 4.6 + s .9). It takes a long time to get Candy to eat anything that has been doctored with supplements. Palatability is really an issue and I am struggling. How little tim pellets would I need to give that would not require additional balancing? My hay soaking days are over. The arthritis I have in my hands prevents me from doing this.

Candy is off of NSAIDS. She is on 2 scoops of phyto-quench. Her treading has decreased. Hopefully, when I run out of phyto-quench she won't need anything, but I will try the PEA if she does. I have Glycemic EQ here and laminox which I was going to start when done with NSAIDS, but I guess that will wait because of the PQ. If the Glycemic EQ works as a balancer for the hay I could use it even if the Jiaogulan will be blocked. I started the Mov-ease for arthritis pain/creaky joints. Of course she hates the taste of that. I'm guessing I will have to syringe that and the Jiaogulan into her if she needs additional J. I really do want to wean her off the thyro-L becausse I'm thinking she might be able to gain a little weight. So as soon as I get the right balancer for her hay I can start that process.

My vet said you all connected and she plans to move forward. I don't know if she mentioned it, but both parents have Covid and she may not be as responsive as she usually is.

Thank you,

Dec 2020, Santa Cruz, CA
Candy Case History:

Re: How Do I Know-Winter blanketing/leg wrapping

Deb Walker

Hey Sherry...thank you for that link on searching. I often cannot find things when I try to search for them as well, and so I often don't ask questions because everybody that responds here is so busy. Now I have some other tips to try :)
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:

Re: 2nd request Vaccinations


Thank you Dr K. 
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
Joined 2019

1601 - 1620 of 256748