Diabetic horse? Confused by lab work


Maggie
 

Posted on behalf of Kathie (with Libby):

Is it possible for a horse to be diabetic? My vet diagnosed him as IR 2 years ago and I have been treating him for that. He has lost weight and muscle and has a big belly and no top. I don’t see any fat deposits anywhere. He is 21 yrs, 14-3 hands and weighs 878 lbs, and a purebred Arabian.  His glucose is 14.9 and insulin 90.3 His cloride is 94 (normal range 96.6-104.0)  After the last blood work came back my vet said he is probably diabetic, and just chuckled about it.  I don’t know if he is or what to do about it. Any thoughts?

My response:

Hi Kathie, 

This is a great question for the forum as it doesn't come up too very often. 

Yes, absolutely it is possible for a horse to become diabetic.  Usually IR horses have elevated insulin levels but normal blood sugars.  When the blood sugar is also elevated, you can consider them to be diabetic.  Not sure why your vet is chuckling about it.  Can you tell me the units of measure for your insulin and glucose, please?  Once you know that, you can enter your info into the IR calculator and see what comes up. 

All that said, did you do an ACTH when you did that lab work?  You're describing perfectly a horse that has PPID--21 years old, lost weight and muscle, no topline.  Go to the website and look over the info there on PPID.  An elevated ACTH can drive the insulin up on top of it being elevated due to IR. Once you get a PPID horse on pergolde it can really help with getting the insulin under control.  You'll still need to maintain a really tight diet since he's IR at baseline.  

So....if you didn't get an ACTH with those labs, that would be the first order of business.  You need complete diagnosis to know how to proceed. 

Kathie's response:

His glucose is 14.9 (normal range 3.6-5.7) and his insulin is 90.3 (normal range 28-390) That was Oct. blood work and in Aug his insulin was 33.2 and glucose 14.9 I don’ see any results for the ACTH. Isn’t his insulin in the low range and the glucose is in the high range. In the calculator he comes back as not IR. I’m just not sure how to proceed in order to help him. He is different from Libby. I also have Libby’s mother who is IR and two other horses with PPID, both are on pergolide and doing ok so far. Libby is doing fine, being ridden 6 days a week, not sore and happy to be working again. She went through a bad time with not wanting to work at all and pinning her ears when tacked up and refusing to go when in the ring. Even kicking the fence boards. She is happy to go to work now, for the last 2 months. Before I would have maybe 3 or 4 good rides and then off again. This is the longest time that she has been so good while being ridden. I am planning some clinics this fall and maybe showing her dressage next year. Libby’s mother Target is IR and has been having problems with sore feet since Jan this year. Her glucose is 5.0 and her insulin is 725 in Oct. In Aug is was glucose 4.9 and insulin 2019! I don’t understand why so many of my horses are not normal. thanks for your help.

Hi Kathie,

I'm so happy to hear that Libby is doing so well!  I did look over her CH and see that she was getting alfalfa hay and pellets, whole oats, Hoffman's crunch. Hopefully getting her diet cleaned up has helped her to feel better.  Those symptoms you describe (not wanting to go, pinning her ears when tacked up, refusing to go in the ring, kicking the fence boards) could have been her trying to tell you that her feet hurt.  Low grade laminitis can present with subtle symptoms such as you described.  

The next important step for Libby (and all of your horses) would be to get them on a mineral balanced diet.  I see that you've tested your hay, so you're ahead of the game!  If you contact one of the balancers they can help you to get the minerals balanced.  You'll be amazed, really what being on a proper mineral balanced diet can do for your horses!  Meanwhile you might consider adding one of the 2 decent balancers available in Canada.  From Jaini's post #226908

Right now, in Canada, there are only two suitable off-the-shelf ration balancers available (fortunately, both of them are excellent):  I will say that my custom mix from Mad Barn is quite inexpensive,  especially compared to other (completely unsuitable, or not very useful) balancers like Farrier's Formula.   

VifArgen Le Cheval au Naturel http://lechevalaunaturel.blogspot.com/p/blog-page_13.html  

Mad Barn AminoTrace+  https://www.madbarn.com/ca/product/aminotrace-pellet/   


Need to get one of the vets to chime in here wrt the lab work for your gelding.  It would be ohsohelpful if you could fill out a case history on him as well!  Let us know if you need any help with that!  

This post might help answer your question about why so many of your horses are "not normal".  You have Arabians and Arabian crosses, yes?  They are genetically prone to being IR.
https://ecir.groups.io/g/main/message/206640

PPID is age related (horses over 10 years at more risk), and there is some debate about long term IR increasing the risk for the development of PPID.  Here's some posts by Dr Kellon: 
https://ecir.groups.io/g/main/message/177964 
https://ecir.groups.io/g/main/message/131880 
https://ecir.groups.io/g/main/message/174387 

Hang in there Kathie!  
 

--
Maggie, Chancey and Spiral in VA
March 2011
ECIR Moderator/Primary Response


Eleanor Kellon, VMD
 

Yes, he's diabetic by definition with a glucose that high.  "Pancreatic exhaustion" with insufficient insulin is rare in horses but has been reported.  I agree he is likely PPID as well.  Would get ACTH tested and start pergolide the same day.  In addition to IR diet, I would also start him on metformin.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


bokayarabians@...
 

I need help with my four horses who are either insulin resistant or cushings. Addy and Cherokee are on pergolide and the diet. Addy still has very goopy eyes, and Cherokee has very high insulin. I don't know what else to do for them. Target  has very high insulin, is wearing clouds and so far is comfortable. She has very thin soles but is only careful when turning  tightly. We hand walk her 3 times a week and she seems fine. She still has a huge crest and fat on the shoulders but a big belly and ribs. I have all the horses on a hay balancer developed for horses on Vancouver Island, but it was low in copper, lysine, methionine and biotin, according to Jaini. I went to the feed mill here and asked them to provide the missing ingredients and amounts I would need to add. The horses are all looking better and have soft shinny coats, but I am so worried about the high insulin levels and don't know what to do about that. I have 8 horses total and can't understand why half of them are not well.
--
Kathie with Libby and Sweet P
Cobble Hill, BC, Canada
Aug 2018
Case Histories
Ω


Lorna Cane
 

Hi Kathie,

Welcome!

I haven't had a chance to look at your CH yet, but just wanted to tell you something,in case it gives hope.

You said," I have 8 horses total and can't understand why half of them are not well."

I had a herd of 10 , years ago......  of them were Cushing's and IR ! At the same time, more or less.
After several false starts,I found this group. Lucky for my ponies.

Hang in, keep breathing.

--

Lorna in Eastern Ontario, Canada
ECIR Moderator 2002
https://ecir.groups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf

 


 

Kathie, what exactly is that balancer? I looked at the Shar Kare site, and couldn't figure it out.  In your next post, could you please list everything that the horses are being fed?   It looks like the cranberry experiment was a bit of a bust, since the horses still have very high insulin, glucose, and triglycerides.  Something is driving those numbers, and it must be something in the diet.  In the case of the PPID horses, it could also be that their pergolide dose isn't high enough.

Dr. Kellon has given you very good advice about starting pergolide and metformin.
--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711


bokayarabians@...
 


-- The balancer is called LifeLine MD Balancer and to that I add 1/4 tsp biotin, 2tsp methionine 1 1/2 tblsp lysine and 1/2 tsp copper. 2tblsp salt, 1 cup ground flax 1/2 tsp biochrome. This is mixed into 1 cup soy and 2 cup beet pulp (rinsed for the IR and PPID horses) Target and Libby also get 2 tsp cinnamon and 2 tsp bovine colostrum. Target and Libby also get 12 lbs grass and teff hay in slow feed nets, and at the last feed of the night they get a mush of 2 lbs alfalfa timothy cubes and 1 lb of soy pellets.This is the only soy these two get. I am having the trimmer out on Fri and would like to make sure he is on the right track for Target's feet. The others are all ok right now, have had no issues with them except Libby in 2016 when she had laminitis very bad and it was suggested that I put her down. She has been good since then and I am riding her 6 days a week. I am just concerned about the high blood levels in all their tests. I have ordered the metformin but it is not here yet, maybe Mondy or Tues this week.
Kathie with Libby and Sweet P
Cobble Hill, BC, Canada
Aug 2018
Case Histories
Ω


 

Well, right off the bat, please stop the Lifeline = Matrix MV balancer. I have done a lot of looking for feeds and balancers in the past, and I did have some starch and sugar results from the Lifeline and Matrix feeds; I have lost those numbers, but I can tell you for certain that there is nothing in those feed lines that can be safely fed to IR horses. Also, given the fact that the information on the website is so very inadequate: https://ottercoop.com/_customelements/uploadedResources/2017MatrixProductGuide.pdf   you have no idea how much of any minerals they are getting with that balancer.

I am unable to find nutritional information about how much sugar and starch is in cranberry powder. Could you ask your vet if she has that information?  And also, ask what the cranberry powder is supposed to be doing.
--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
DDT+E = effective treatment for PPID and EMS/IR equines: https://bit.ly/2J4ZgYT

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193.
https://ecir.groups.io/g/CaseHistory/album?id=39711


Eleanor Kellon, VMD
 

 For starters, see if you can source soyhull pellets instead of soy for your protein supplement. Use as much as you need combined with hay and beet pulp (well rinsed and soaked) to get protein up where it needs to be.

Stop ALL other supplements and get body shots of the horses posted ASAP as well as hoof photos.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001