diet


nancygilliam56
 

Hi,

My 23 yr old TB was diagnosed with Cushings [NOT IR]. His glucose and insulin levels are fine; just higher ACTH [279]. He is sound just depressed, long coat. Do I need to go to low NSC diet with glucose and insulin levels ok?
Thanks,
Nancy


Linda <PapBallou@...>
 

Do I need to go to low NSC diet with glucose and insulin levels ok?


Hi Nancy -

Do you have your insulin and glucose values posted somewhere on the list? If not, please post them. Unfortunately, many labs use very generous normal values, values that can be problematic. The IR diagnosis is frequently missed.

If the insulin and glucose are indeed normal, I would still modify the diet, at least until the ACTH is controlled. An ACTH as high as 279 typically causes some degree of IR.

Linda
EC Primary Response
West Coast
May 2004


nancygilliam56
 

Hi Linda,
Glucose: 102 [range is 60-120]; insulin 17.3 [range 10-30]and my vet says he is not IR and does not need lo carb diet.
thanks,
Nancy

--- In EquineCushings@..., "Linda" <PapBallou@...> wrote:

Do I need to go to low NSC diet with glucose and insulin levels ok?


Hi Nancy -

Do you have your insulin and glucose values posted somewhere on the list? If not, please post them. Unfortunately, many labs use very generous normal values, values that can be problematic. The IR diagnosis is frequently missed.

If the insulin and glucose are indeed normal, I would still modify the diet, at least until the ACTH is controlled. An ACTH as high as 279 typically causes some degree of IR.

Linda
EC Primary Response
West Coast
May 2004


Linda <PapBallou@...>
 

Glucose: 102 [range is 60-120]; insulin 17.3 [range 10-30]and my vet says he is not IR and does not need lo carb diet.
Hi Nancy -

He is what we call compensated IR. His insulin and glucose levels are such that he is not in the range of severe risk of laminitis, but needs attention to avoid high sugar/starch/fat foods.

As said before, ***until you get the PPID controlled***, the threat of IR is hovering...and sadly, we never know just what might be the trigger for any given horse.

Linda
EC Primary Response
West Coast
May 2004


Lisa S
 

Nancy,

I had a hard time convincing my vet/husband that our gelding was IR based on what he called 'numbers magic.' He was not wild about the idea of looking at glucose and insulin in relation to each other, or calculating the RISQI--he calls it my 'diagnostic sleight of hand'!

I had to remind him that he was always telling his small animal clients that those 'normal' values are not really 'normal,' but rather 'reference' ranges, based on collecting data from lots and lots of tests, and arriving at a range that approximately 95% of the normal population falls into.

My personal suspicion is that there have historically been a fair number of IR horses out there that were considered 'normal' when they really were insulin resistant. If samples from these horses were considered 'normal' when calculating a reference range, it would certainly skew the range!

The bottom line is that he finally became convinced after nine months or so of reading our gelding's signs and observing the relationship between his diet and his comfort level. It was pretty dramatic!

If your vet winds up being skeptical, try what I did with my husband--ask him to humor you and treat him as an IR horse, and assess the results every few months.

Good luck!

Lisa in TX
Pookey Bear
June 2010

--- In EquineCushings@..., "Nancy Gilliam" <ngilliam@...> wrote:

Glucose: 102 [range is 60-120]; insulin 17.3 [range 10-30]and my vet says he is not IR and does not need lo carb diet. >>


nancygilliam56
 

Morning, Linda,
So Dr. Steve Duren, well known nutritionist recommended to me from WA State Univ. Vet school internist, "go to LMF Lo Carb feed, Stage 1, gradually moving from current oats to that fee over a week." "top dress 1 cup oil if weight loss an issue." I took him off Legacy, supplement that has Yucca per this list recommendation. We started him yesterday on .25 mg pergolide moving up to 1 mg by Friday, liquid suspension.

He is boarded for 6 more weeks and then I bring him home. I will anyalyze my hay, soak it, keep him off grass except with a muzzle. He has arthirtis and needs to keep movng.Retest in May.
Care to respond to my plan? Is there any danger in going to Lo Carb? I am not clear about how to create a case history for this group. Thank you!
Nancy and Cedar in Idaho
Feb 2011



Glucose: 102 [range is 60-120]; insulin 17.3 [range 10-30]and my vet says he is not IR and does not need lo carb diet.


nancygilliam56
 

HI Lisa,
Thanks ...did the lo carb diet help your horse or was it the pergolide? How do you know which steps made a difference?
Nancy and Cedar in Idaho
Feb 2011

--- In EquineCushings@..., "lonestarquarterh" <mostlyaggies@...> wrote:

Nancy,

I had a hard time convincing my vet/husband that our gelding was IR based on what he called 'numbers magic.' >

--- In EquineCushings@..., "Nancy Gilliam" <ngilliam@> wrote:

Glucose: 102 [range is 60-120]; insulin 17.3 [range 10-30]and my vet says he is not IR and does not need lo carb diet. >>


Lisa S
 

Nancy,

In the case of my IR gelding, we believe that what helped him the most was fixing his diet.

However, to be fair, because he was in the midst of life-threatening laminitis when he was diagnosed we also started him on a healthy dose of Thyro-L that we have gradually (over eight months) reduced to almost nothing.

When we have had 'slip-ups' with either--once he broke out of his stall and ate some grass, once hubby fed him unsoaked high NSC hay, once we quit giving the Thyro-L--he has had a return of some of his tell-tale IR signs: increased pain in his feet, swelling of his prepuce and icky secretions, hardening of the neck crest, and puffiness over his eyes.

My husband had to see these signs wax and wane with his own eyes to become convinced that the EC team members were on to something!

Now he is as careful with his diet as I am.

He went from being a 24/7 pasture horse on fertilized bermuda and lush alfalfa and Equine Senior and Oreos and peppermints to eating fewer carbs than...well, than me!

But his improved health has been worth it: more than 200 pounds lighter, no more inflammation in his feet, and a fabulous attitude.

In his case, no pergolide (since he is not Cushings...yet...) just diet and a little bit of Thyro-L. (And of course a skilled farrier/trimmer)

I would never have made so many radical changes all at once with Pookey Bear if he had not been staring euthanasia right in the face. It made me bold enough to be drastic with his diet--thank goodness!

I am confident that the closer you can get to the EC group's dietary recommendations, the better off your horse will be.

Lisa in TX
Pookey Bear
June 2010

HI Lisa,
Thanks ...did the lo carb diet help your horse or was it the pergolide? How do you know which steps made a difference?
Nancy and Cedar in Idaho
Feb 2011


Linda <PapBallou@...>
 

Hi Nancy -

"top dress 1 cup oil if weight loss an issue."

Oil is definitely not recommended. It can induce or worsen IR.

<http://pets.groups.yahoo.com/group/EquineCushings/message/120961>

<http://pets.groups.yahoo.com/group/EquineCushings/message/106608>

I always have to smile when I read the recommendation of oil for weight gain. Not certain humans are given recommendations to eat fat to gain weight when needed...and we actually have quite a bit of fat naturally in our diet.

Horses consume perhaps 4% of their diet as fat, mostly omega3 essential fatty acids (anti-inflammatory - that's the flax we recommend). Oils are virtually all omega6 EFAs - pro-inflammatory. IR/PPID horses to not need anything more to add to their inflammation caused by these health problems.

Weight gain, if needed, is best achieved with additional forage (free-choice even) and/or addition of protein. Protein is more readily processed by the horse, especially an older horse, if fed as whey protein, or amino acids. Hopefully weight gain won't be an issue, but if it is, we can discuss that later.

Or perhaps he was referring while being on the LMF? I would add rinsed/soaked/rinsed beet pulp to the diet - and the LMF will help as a taste tempter if Cedar should think BP is a poison ;-))

.25 mg pergolide moving up to 1 mg by Friday, liquid suspension.
Hope you read the discussions over the past few days about the efficacy of various types of pergolide. Ask to change to capsules with your next refill.


He is boarded for 6 more weeks and then I bring him home. I will anyalyze my hay, soak it (hopefully you won't have to!!)
keep him off grass except with a muzzle. He has arthirtis and needs to keep movng.Retest in May.
Sounds like a plan to me!

RE the LMF Low Carb - there was concern about this product having a lot of additional iron, yet another thing to avoid with IR/PPID. I recall, but can't get search to bring it up, that someone posted from the company that they are not adding iron to this particular product. I recall reading it because the LMF is all I can get here and I was pleased to see the change. Gosh - hope I didn't dream it!

I am not clear about how to create a case history for this group. Thank you!
Hey - learning the ins and outs of Yahoo groups is challenging! I'll send you an invite to join our history group *file cabinet*. You will find a file there with instructions on how to put together a case history of Cedar.

Linda
EC Primary Response
West Coast
May 2004


nancygilliam56
 

Thank you, Linda.
Nancy
2011 Feb


nancygilliam56
 

Lisa,
thanks~ Nancy

Idaho
feb 2011