new blood work


millionairess1989
 

Hi,
This is Mill's latest blood work from Cornell which now puts her as IR.

ACTH 22.4 pg/ml (9-35) previously on 7-9-11 40.3
Insulin 20 uIU/ml (10-40) 12.58
Glucose 83 mg/dl (71-113) 88
Free T4 1.49 ng/dl (1.2-1.8) 1.35

She has been on 1.5 mg Pergolide since the end of Dec. and gets approx. 16 pounds of an orchard/bermuda grass mix. The hay is almost gone and I do not have a lab report on it. I am still working on finding new hay. Mill gets 1 1/2 pounds of Wellsolve LS, 2 cups of beet pulp r/s/r plus salt and supplements. When stabled due to weather she also gets 2-3 pounds of TC Safe Starch forage and 1 1/2 pounds of TC Lite pellets.

Any suggestions on where we go from here?

Jennifer & Mill
Jan 2010
http://pets.groups.yahoo.com/group/ECHistory3/files/Millionairess


merlin5clougher <janieclougher@...>
 

Hi, Jennifer -

Well, the ACTH is looking good! It is a little disappointing about the IR status, though - still, better to be forewarned.

Looks like you are going to have to soak your hay for now, until you can get tested low sugar/low starch hay. Dang. Soak 1 hour in cold water, or 30 minutes in hot, and drain where the horses can't get at it. When I soak, I drain the water into my gardens, and the plants don't seem to mind.

The Purina WellSolve has less than 11% ESC+starch, but the starch can be as high as 5 or 6%; similarly, the TC Lite has about 5% sugar and 4.5% starch. If it were me, I would be tempted to reduce those two feeds to less than 1/2 pound each, just to tempt her to eat her supps. Does she like her rinsed/soaked/rinsed beet pulp? That is always a safe carrier for minerals. The TC Safe Starch Forage is just fine, at 4.3% sugar and 1.8% starch.

Thanks for the link to your case history - makes life much easier!

Hugs to Mill.

Jaini,Merlin,Maggie,Gypsy
BC09
EC Support

http://pets.groups.yahoo.com/group/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

--- In EquineCushings@..., "millionairess1989" <millionairess1989@...> wrote:

Hi,
This is Mill's latest blood work from Cornell which now puts her as IR.

ACTH 22.4 pg/ml (9-35) previously on 7-9-11 40.3
Insulin 20 uIU/ml (10-40) 12.58
Glucose 83 mg/dl (71-113) 88
Free T4 1.49 ng/dl (1.2-1.8) 1.35

She has been on 1.5 mg Pergolide since the end of Dec. and gets approx. 16 pounds of an orchard/bermuda grass mix. The hay is almost gone and I do not have a lab report on it. I am still working on finding new hay. Mill gets 1 1/2 pounds of Wellsolve LS, 2 cups of beet pulp r/s/r plus salt and supplements. When stabled due to weather she also gets 2-3 pounds of TC Safe Starch forage and 1 1/2 pounds of TC Lite pellets.

Any suggestions on where we go from here?

Jennifer & Mill
Jan 2010
http://pets.groups.yahoo.com/group/ECHistory3/files/Millionairess


millionairess1989
 

Hi Jaini,
I appreciate the suggestions but am concerned about Mill's weight. She has lost some already this winter and worry if I cut back on the Wellsolve LS it will drop further. Is beet pulp going to give her enough calories and how much would I have to feed? The sheer volume of it might become a problem. Do you suggest I do anything about her Pergolide dose?
Thanks,
Jennifer & Mill
Jan 2011


Lavinia <dnlf@...>
 

concerned about Mill's weight. She has lost some already this winter and worry if I cut back on the Wellsolve LS it will drop further.
Is beet pulp going to give her enough calories and how much would I have to feed?
Do you suggest I do anything about her Pergolide dose?
Hi Jennifer,
Beet pulp has 1.5 times the calories of hay so is a great way to add safe calories when needed. You can replace the Wellsolve L/S amount with bp. Same for the TC Lite. The Wellsove LS has very high starch(7% by Purina's analysis)which converts 100% to glucose. Plus it adds oil and alfalfa meal which are not good choices for an IR horse. The TC Safe Starch forage also has added oils even though the ESC+Starch numbers aren't bad. All of these are things that could actually make keeping/adding weight on Mill more difficult because her body can't utilize these ingredients properly. You can get the Ontario Dehy Balanced Timothy Cubes anywhere TC products are sold, although you may need to ask for them to be brought in. That would be another safe way to add extra calories.Testing hay/mineral balancing will also help you with getting things tightened up(realize you need to find new hay at this time).
Her ACTH is at a really good number right now so I would not alter the perg at this time. Plus, as her insulin jumped a bit(which may only be weather related), I wouldn't want to risk driving it higher by dropping perg dose at this time. If Mill were mine, I would wait until April to re-evaluate.

Lavinia, Dante, George Too and Peanut
Nappi and george over the Bridge
Jan 05, RI
EC Support team


millionairess1989
 

Hi Lavinia,

Her ACTH is at a really good number right now so I would not alter the perg at this time. Plus, as her insulin jumped a bit(which may only be weather related), I wouldn't want to risk driving it higher by dropping perg dose at this time. If Mill were mine, I would wait until April to re-evaluate.
Do you think that the weather could effect Mill's insulin level? How does that work? When I tested last July she grazed for a few hours then was stabled for 4 more with hay. This year she had hay for a few hours then was stabled with TC Safe Starch Forage, TC Lite and more hay. Can hay have a greater effect on isulin than fresh grass? I am having trouble understanding the increase in insulin level when she has been on lower sugar & starch foods.

Jennifer & Mill
Jan 2011


Eleanor Kellon, VMD
 

With sudden weather changes, like cold snaps, there is a transient (24 hours or so) increase in cortisol. Long term adaptation to cold involves higher levels of thyroid hormones, which disrupt energy generation in the cell so that more energy is "wasted" as heat and also worsen IR.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Lavinia <dnlf@...>
 

Do you think that the weather could effect Mill's insulin level? How does that work?
When I tested last July she grazed for a few hours then was stabled for 4 more with hay. This year she had hay for a few hours then was stabled with TC Safe Starch Forage, TC Lite and more hay. Can hay have a greater effect on isulin than fresh grass?
Hi Jennifer,
Yes, weather does affect insulin values. See Dr. Kellon's answwer for the "how it works".
If the hay is higher in sugar/starch than the grass then it could drive insulin numbers higher. The trouble with grass is that you just never know what the s/s values are at any given time and that those values change constantly. Sometimes it is OK, sometimes not. Hay has a definite s/s amount that doesn't change and when you test you know what that is. It may be safe or it may not. Was the hay tested? Soaked?
Although the TC products are better than most in the s/s/fat dept, they are not ideal and may still be too high for a sensitive horse. When doing bloodwork, feeding only hay would be preferred. The TC Lite is a concentrate/grain and that does produce more of an insulin response than forages.
Clear as mud?
Would you please add your general location to your signature. It allows us to pinpoint help for you better. Thanks.

Lavinia, Dante, George Too and Peanut
Nappi and George over the Bridge
Jan 05, RI
EC Support Team


millionairess1989
 

Hi Lavinia,

Although the TC products are better than most in the s/s/fat dept, they are not ideal and may still be too high for a sensitive horse. When doing bloodwork, feeding only hay would be preferred. The TC Lite is a concentrate/grain and that does produce more of an insulin response than forages.
I hadn't realized that TC Lite conatined grain. I will leave it out next time. What is the advantage of the Ontario Dehydrated pellets over the TC Safe Starch? What about alfalfa as hay or pellets? I read in some places that it is okay to feed and others not.
Thanks,
Jennifer & Mill in TN
Jan 2011


Linda <PapBallou@...>
 

What is the advantage of the Ontario Dehydrated pellets over the TC Safe Starch? What about alfalfa as hay or pellets? I read in some places that it is okay to feed and others not.


Hi Jennifer -

ODTBC are safe as far as s/s and are mineral balanced to each batch produced.

TCSSF has a larger amount of fat added than what we'd prefer to see. It is also mostly the Omega 6 type of fat - which is often referred to at the *inflammatory* type of fat. Omega 3s are the non-flammatory fats.

Fat can induce or worsen IR. There are a number of reports here that horses became laminitic when TCSSF was introduced to the diet. I have a personal experience with this.

Alfalfa - usually low in s/s, but has the ability to produce high levels of starch. Starch is more of a concern than sugars since it coverts to glucose 100%

There is also some other aspect of alfalfa, not understood but thought to be related to the protein, that can cause laminitis in certain horses.

It's a risk that I would not take when trying to get a horse's IR and/or PPID sorted out.

Linda
EC Primary Response
West Coast
May 2004


Lavinia <dnlf@...>
 

What is the advantage of the Ontario Dehydrated pellets over the TC Safe Starch? What about alfalfa as hay or pellets?
Hi Jennifer,
The ODTB are hay cubes not pellets. They are guaranteed to be below 10% s/s every batch. The don't contain any added fat or grains. Each batch is mineral balanced so all you need to add are ground flax(to provide needed omega 3's), vit E gelcaps and iodized salt. Can be fed dry or wet depending on your needs. They can be used as the entire diet or as a part. The only downside to them is that being cubes they don't provide as much chew time. Cost is higher than straight hay but the testing and mineral balancing are already done for you.
TC Safe Starch Forage has added oil which skews the omega 3/omega 6 balance toward the pro-inflammatory omega 6 side and raises the fat level to 6 %. Also has added iron. Not a monstrous baddie but not the ideal choice. Some horses do fine with it, some have foot issues.
The TC Lite contains wheat middlings, alfalfa, oil and added iron. All of these are contraindicated for IR horses although using a small amount to flavor a supplement carrier like beet pulp or soy hulls is usually ok. Meaning a handful - it is very concentrated and designed to be fed in place of traditional grains at a pound or two per day.
Alfalfa hay is iffy for IR horses - some do fine on it, many do not. Although the s/s is generally below 10%, something else in it (we don't know what for sure)causes laminitis issues for many. It is also a very difficult hay to mineral balance when used in quantity.

Lavinia, Dante, George Too and Peanut
Nappi and George over the Bridge
Jan 05, RI
EC Support Team