Considering getting my mare tested - some questions


Jessica
 

Several years back my mare was very overweight and out of shape. It seemed like she was getting fat on air, and while she lost some of the weight with regular exercise we couldn't quite get her where we wanted. My vet ended up putting her on thyro-L, which she stayed on for several years. He suspected IR but felt the blood test had too high of a rate of inaccuracy to be worth it, and I declined the much more involved/more accurate test. She was on a very small dose (half scoop) and that seemed to level everything out. She also got grass hay 2-3x/day, 4 hours of grass time in the spring/summer/fall (drylot the rest of the time), and soaked beet pulp with a grass balancer.


This was all in Minnesota, where the grass can be very rich and we were feeding good quality grass hay, occasionally with a small percentage of alfalfa. When on round bales she seemed to self regulate fairly well.


We moved down to Texas last fall. She lost a little weight in the move and it's taken time figuring out how to put it back on. I ended up taking her off of the thyro-L about a month ago - no change in energy, and she's started to muscle back up a little.  She is on coastal hay, 2x/day, and is now getting the Nutrena low starch formula grain as the place I was getting grain from stopped carrying the grass balancer with any regularity. She is on pasture here as they don't have dry lots where I board, and out for 8 hours/day (stalled the rest of the time).


Now, I bought a muzzle for her for the spring grass, but she really hasn't gained much weight being on the grass all day so I haven't had them put it on for turnout.


I have been thinking about doing the IR test with the karo syrup (per my vet's recommendation), as he said this is considered pretty accurate? She doesn't seem to have any symptoms of IR any longer, but it has taken some time to put this weight back on and this is a horse that up until 6-12 months ago, I would have never imagined I'd be trying to put weight ON her. She is 13 this year and we've been battling fat kid status since she was 4-5.


Basically, I don't want to have her out on grass without a muzzle if we're risking laminitis. She's never had a laminitic episode and I would like to keep it that way!


From what I've read online a lot of places just recommend testing glucose, insulin, and leptin?


Thanks all,

Jessi




Sherry Morse
 

If she's had her teeth done on a regular basis and is suddenly no longer maintaining weight
I'd start with general bloodwork to make sure there's nothing else going on.  Since you moved and she then lost weight there's always the chance she's not getting enough nutrition from the Coastal/Texas grass as she was on the Minn hay/grass combination.

Has she had any definite indications of IR (fat pads, cresty neck) or was she always just 'an easy keeper' - without testing you really don't know for sure what you're dealing with.

I'm not sure where bloodwork would go for Texas but if you tested her for thyroid as well as glucose, insulin, leptin and ACTH (at Cornell that's one of the panels offered) you'd cover all the bases for PPID/IR and Thyroid.

Somebody else with more experience will probably have better advice :-)
Sherry in PA


From: "insidiousglamour@... [EquineCushings]"
To: EquineCushings@...
Sent: Wednesday, April 22, 2015 11:17 AM
Subject: [EquineCushings] Considering getting my mare tested - some questions

 
Several years back my mare was very overweight and out of shape. It seemed like she was getting fat on air, and while she lost some of the weight with regular exercise we couldn't quite get her where we wanted. My vet ended up putting her on thyro-L, which she stayed on for several years. He suspected IR but felt the blood test had too high of a rate of inaccuracy to be worth it, and I declined the much more involved/more accurate test. She was on a very small dose (half scoop) and that seemed to level everything out. She also got grass hay 2-3x/day, 4 hours of grass time in the spring/summer/fall (drylot the rest of the time), and soaked beet pulp with a grass balancer.

This was all in Minnesota, where the grass can be very rich and we were feeding good quality grass hay, occasionally with a small percentage of alfalfa. When on round bales she seemed to self regulate fairly well.

We moved down to Texas last fall. She lost a little weight in the move and it's taken time figuring out how to put it back on. I ended up taking her off of the thyro-L about a month ago - no change in energy, and she's started to muscle back up a little.  She is on coastal hay, 2x/day, and is now getting the Nutrena low starch formula grain as the place I was getting grain from stopped carrying the grass balancer with any regularity. She is on pasture here as they don't have dry lots where I board, and out for 8 hours/day (stalled the rest of the time).

Now, I bought a muzzle for her for the spring grass, but she really hasn't gained much weight being on the grass all day so I haven't had them put it on for turnout.

I have been thinking about doing the IR test with the karo syrup (per my vet's recommendation), as he said this is considered pretty accurate? She doesn't seem to have any symptoms of IR any longer, but it has taken some time to put this weight back on and this is a horse that up until 6-12 months ago, I would have never imagined I'd be trying to put weight ON her. She is 13 this year and we've been battling fat kid status since she was 4-5.

Basically, I don't want to have her out on grass without a muzzle if we're risking laminitis. She's never had a laminitic episode and I would like to keep it that way!

From what I've read online a lot of places just recommend testing glucose, insulin, and leptin?

Thanks all,
Jessi





Jessica
 

Thank you!


My initial thoughts were the nutrition in the grass/hay down here vs. Minnesota...but I want to make sure I cover my bases and don't overlook something like IR and pay for it with something more serious than a few extra pounds.


She has been slowly putting weight on...I've increased her grain some, but didn't want to make a huge jump (as she's already getting more than she's ever had in her life!) Another mare has only been here a few weeks and has really "fattened up" on the grass, but mine just hasn't.


She does have a cresty neck, but that's her breeding, too (both mom and dad had big necks - Friesian and Mustang). No fat pads or anything else, really.


Again, thanks for your input. She's having her teeth checked on Friday (as she does every spring and fall).


Nancy C
 

Hi Jesse

You will get a full welcome from one of the senior volunteers soon but want to comment on testing. 

I must disagree with your vet regarding his choices on testing.  You do not need the Karo syrup test  which is based on human medicine and not without risk.

What the group recommends is non-fasting blood drw of serum insulin, leptin and glucose.  The model for this testing and review of results are based on looking at ponies in a natural condition from the VA Poly Tech.


Your breeds are prediposed to IR so it is good that you are looking for diagnosis. While you are waiting for more guidance from us, go take a look at the diagnosis page of ecirhorse.org (link below) and download Dr Kellon's Diagnosing IR and PPID 2013 NO Lamintis! Proceeding. (link also below)

http://ecirhorse.org/index.php/ddt-overview/ddt-diagnosis
2013 Proceedings & Recordings Table of Contents

 


Both of these will be helpful not only for you but also for your vet.  The proceeding especially explains and weighs the benefits of all the current tests.


Lastly, its great you are in Texas. The 2015 NO Lamintis! Conference will take place in Georgetown on Nov 6-8.  See nolaminitis.org.


Nancy C in NH
ECIR Moderator 2003
FACT: The VA Polytechnic Pony Study is the only study to look at IR and laminitis under natural conditions. See  E. M. Kellon, VMD, Diagnosis of Insulin Resistance and PPID, 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 









---In EquineCushings@..., <insidiousglamour@...> wrote :

Thank you!


My initial thoughts were the nutrition in the grass/hay down here vs. Minnesota...but I want to make sure I cover my bases and don't overlook something like IR and pay for it with something more serious than a few extra pounds.



Maggie
 

Hi Jessi,

In addition to the information you've already gotten from Sherry and Nancy, I would like to add one more thing.  Since you first joined back in June 2003, we have a new and improved website that you may not be aware of.  It's a great place to get a lot of great information about the DDT/E philosophy that we follow and also a great place to send your vet for information about testing.  Here's a link to the site.  Just use the menu on the left in blue to navigate around and view all of the sections.  Your vet may be the most interested in the "Diagnosis" page.
Equine Cushing's and Insulin Resistance Group Inc.

 

Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response
ECHistory4 


 


Jessica
 

Thank you! I have looked over that site. I am assuming my vet did not prefer the blood draw, as insulin can give a normal reading while the horse is actually IR (as it states there). But from what I'm reading, it's the leptin draw that you rely on to pinpoint IR or not IR?


I am a little confused on the blood draw information - is this just one blood draw non-fasting?


She is fed hay right away in the morning (after not having any overnight) and turned out onto pasture between 7 and 8am. Should the blood draw be four hours after her AM hay?


I have read up on the karo syrup method and it says that it's safe and out of all of the studies they've conducted they haven't had issues. I haven't  read the actual papers as of yet, but it sounded like the vets who promoted this method and felt it was more accurate do not feel it imposes any risk of significance.


Thanks,

Jessi


Nancy C
 

Hi Jessi

If you vet uses "lab normals" as his or her way to review results he is correct in his assertion. The so-called "normal reading" does not mean the horse is not IR.  That is why we use the IR calculator as outlined in the diagnosis page on ecirhorse.org.

Leptin can be more exact but can be influenced by outside factors such as age, exercise, pergnancy.

You want one blood draw, non-fasting but eating a low ESC and Starch diet preferably hay or  something like ODTB Cubes all night. If they go longer than a few hours you will hvae a break int eh fast when you serve breakfast and need to hold off testing  for about four hours to avoid the spike in glucose and insulin once they resume eating in the morning.

I would not put her on pasture.

The question about karo syrup safety has been brought up here many times.  Yhe original researchers and others did say/have said there was minor risk.  It would be too much for my horse.

Speaking strictly on a personal level, I've not heard a good answer as to why using tests from human medicine is preferble to those derived through research on horses and their physiology, which is what ECIR recommends. 

by using a nonfasting blood draw after eating low esc and starch hay and using what is called "the proxies" developed by Va Poly Tech, you are mirror the most intensive testing available, called Minimal Model.

I referenced the 2013 NO Laminitis! Proceedings earlier.  Please take a look at the complete doc on Diagnosing IR and PPID. it reviews all the tests, why they are used, why ECIR Recommends what it does. Your vet can also find these proceedings on IVIS (International Veterinary Information Service)

Therefore, the ECIR Group recommends a simple blood draw for serum insulin, glucose and leptin. The horse should not be fasted prior to testing, but fed hay only the night before and day of testing. Understanding the conditions of the test and the use of proxies will determine IR status. To calculate the proxies, the ECIR Group Calculator is available to do the math: IR Calculator

 

Help us out too, Jessi when you post by giving us your name as you have done, but also adding your general location and when you joined the ECIR yahoo.


Many thanks.


Nancy C in NH
ECIR Moderator 2003
FACT:  The fall seasonal ACTH rise was first documented by an ECIR Group member and her veterinarian after noticing her horse had repeated bouts of fall laminitis. Fall laminitis is now recognized as an early sign of PPID.  See  E. M. Kellon, VMD, The Internet as an Epidemiological Tool, 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 




---In EquineCushings@..., <insidiousglamour@...> wrote :


I have read up on the karo syrup method and it says that it's safe and out of all of the studies they've conducted they haven't had issues. I haven't  read the actual papers as of yet, but it sounded like the vets who promoted this method and felt it was more accurate do not feel it imposes any risk of significance.


Thanks,

Jessi