Hi "jorey50",

Welcome to the group!  Please tell us your first name so we know what to call you.  To give you more specific answers, we need more details about your 9 yo Arab.  We ask all members to fill out a case history on their horse.  To do that you need to join our sister site ECH8, but it shouldn't take long to get approved.  Then just follow the directions on the main page to fill out a CH.  Here's a link to that:  

In the meantime, let me explain our philosophy to you.  It's called DDT/E which stands for Diagnosis, Diet, Trim and Exercise.  To answer your question, yes their is a preferred method to get a diagnosis.  Insulin resistance (IR) and Cushing's disease (PPID) are two conditions that have some overlapping and similar symptoms.  At the age of 9, your Arab is unlikely to have PPID, though it's not unheard of in a 9 yo horse.  Arabs, though, along with several other breeds could be the "poster child" for IR!  The 4 tests that we recommend to get a complete diagnosis are: ACTH, insulin, glucose and leptin, drawn on a NON-fasting horse, preferably sent to Cornell.  The labs require special handling so have a read on our website for the details.  http://ecirhorse.org/index.php/ddt-overview/ddt-diagnosis   You'll find a link to Cornell's website on that page which shows the costs of the testing.  Since adding an ACTH (to test for PPID) to the insulin, glucose and leptin, (which tests for IR), doesn't cost that much more, I would definitely do that.  If it comes back normal, you will have established a baseline.  If not, then it will be $25 well spent.  PPID is treated with medicine (pergolide) and IR is treated with Diet

So that takes me on to the next very important part of the DDT/E, Diet.  The diet is low sugar starch grass hay (tested to be under 10% sugar + starch), and low fat (under 4%) with minerals to balance the excesses and deficiencies in the hay.  And to replace the fragile ingredients that are lost in the hay curing process we add Vitamin E and ground flax seed.  Details about amounts can be found on the Diet part of our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diet  Until you can have your hay tested we recommend that you start the emergency diet, which involves soaking you hay for an hour in cold water or 30 minutes in hot water which removes up to ~30% of the sugar content. Make sure you dump the water where the horse(s) cannot get it.   Also, very important as what you DO feed is what you DON'T feed!  No pasture, grain, molasses, sugary treats, including apples and carrots, no brown/ed salt blocks.  You should be feeding 1.5-2% of your horse's BW in grass hay.  We like to use small mesh hay nets with the total hay for the day divided into several small portions.  You can get a fish scale at Walmart for about $10 for weighing your hay.  Getting rid of that lunchtime alfalfa was a wise thing to do!  It can be high in starch, which converts 100% to glucose and can cause an insulin spike, and can also cause some horses to be foot sore.  Here's where we like to send our hay for analysis.  As for the #603 trainer's package for $54:  http://equi-analytical.com/ 

Trim:  Toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  You are welcome to post pictures of your horse's feet so that one of our hoof specialists can see if your trim is optimal.  The pictures would go in the PHOTOS section of ECH8, the group where you join to do your CH.  Here's a site that shows how to take great hoof photos: http://www.all-natural-horse-care.com/good-hoof-photos.html 

Exercise:  The best IR buster there is!  But a laminitic horse should never be forced to move!  You didn't mention if your Arab is footsore or not, but if so, boots and pads may be in order for comfort.  Why did your Arab need to have his SI joint injected?  Just curious, as low grade laminitis can cause a horse to shift their weight and stand in unusual positions and become sore.  This is often mistaken for arthritis and/or other joint problems.  Not saying this is what is going on with your horse, but just something to think about.

So, "jorey50" lots to think about!  We have a TON of information in our files and old messages, and also on our website.  Please take some time to read that information, using the index in blue on the left side to maneuver around.  But don't hesitate to ask any further questions that you have!  We ask all members to sign their name (first is fine), date of joining and general location each time they post.  Also, once you get your CH done, please add a link to it in your signature as well. It really helps us to find it faster and answer your questions faster!  Thanks!

March 2011
EC Primary Response
http://groups.yahoo.com/group/ECHistory4/files/maggie%20in%20virginia/

Hi "jorey50"

I forgot the link to ECH8.  Here it is:  https://groups.yahoo.com/neo/groups/echistory8/info  If you have any trouble joining, just let us know and we can send you an invite.

March 2011
EC Primary Response
http://groups.yahoo.com/group/ECHistory4/files/maggie%20in%20virginia/

Jodi and "Tango" in Scottsdale, AZ