Need help with long term diet
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I didn’t think I needed to do an emergency diet.. until I found new numbers on Teff grass which says it could go as high as 22% nsc!! I board Jadon, so I only buy a few bales at a time and no one here tests what they sale. So, now I need to find someone here who can and will test what I have. He’s on 1/2 lb of McCauly’s 30 which the nutritionist with that company tells me total is 15. So with his computed numbers so close to IR, I really need some help here. I live in KY (Horse Capital of the World) unless of course you own a horse :/
-- Nina and Jadon Kentucky 2020 https://ecir.groups.io/g/CaseHistory/files/Nina%20and%20Jadon
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Nina,
Please forget about NSC. It contains fractions that are not of concern to insulin response. https://wp.me/p2WBdh-Kf . You need to make sure your analysis includes sugar and starch fractions; also need a complete mineral profile for balancing. -- Eleanor in PA www.drkellon.com
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Sherry Morse
Hi Nina, The only way to be sure what the numbers are for the hay you feed is to have it tested. Again, we ae not interested in NSC, we are looking at ESC + starch. Information on the difference in a very simple version can be found in this message - https://ecir.groups.io/g/main/message/197217. If you can't test your hay (information on doing that is on the ECIR Diet page: https://www.ecirhorse.org/DDT+E-diet.php) you can soak it as per the directions on that page or you can look at substituting tested cubes for all or part of his diet. We recommend OBTC as they have a guaranteed analysis and can be fed at the rate of 3lbs of cubes to 4lbs of hay if used as a substitute. Here in the US they are sold by Triple Crown as Naturals Timothy Balance Cubes. Again, unless you can confirm that the McCauley's is below 10% ESC + starch it's probably not acceptable for Jadon. The fact that it has added iron in it would make me very wary of it as that's something we try to avoid with IR horses. Ultimately you want to mineral balance his diet to match whatever his main source of forage is - whether that's hay or the OBTC or a combination of both. Most commercial ration balancers may or may not be correct for the area of the country you're in or for the deficiencies found in the diet so your best bet is to use actual numbers and balance to that. You can find a list of balancers (people who will help you balance Jadon's diet once you decide on a forage source) here - https://ecir.groups.io/g/main/files/6%20Diet%20Balancing. If you click on the first file in that folder you'll find a list of acceptable commercial balancers if you aren't able to do a hay analysis. Looking at your CH there are a couple of things that jump out at me - weight of hay being fed is really important to know with a horse that's overweight. Jadon should be eating no more than 24lbs a day TOTAL - that includes hay, grain and pasture. Without knowing how much hay he's actually eating it's difficult to say if he should be eating less to encourage continued weight loss or if he's at a good amount right now. MSM is a no go for IR horses as is the Himalayan salt (among the other impurities in it which give it the pink color is iron which is again a no go for IR horses). My suggestion would be to replace that and the Smartsalt pellets with just an ounce a day of regular salt added to his feed. You may find it cheaper to source the chasteberry and vitamin E (in oil) by themselves versus using the Smartpak version. Those things at least can be mixed together and put in containers for the barn to dump in to the carrier as needed. For a carrier we recommend Stabul-1 (http://stabul1.com/) which can now be ordered off Chewy.com if your local TSC doesn't carry it or can't be talked into carrying it. You've done a good job so far in managing Jadon so I'm sure you'll continue doing well for him.
Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891
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As an addendum to Sherry's detailed post, if you feed only ODTB cubes you will not need balancing minerals since they are already added based on analysis of each batch of hay. If Triple Crown is not available in your area you can contact Ontario Dehy directly as they also have direct dealers in the US.
-- Eleanor in PA www.drkellon.com
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lvbnazgrl@...
I am new to this group and find it interesting. While I am deep in confusion over the nutritionist's suggestions vs the Vet (MUCH more about that later), I do want to make one comment/question re some info I see in this reply. I researched the Triple Crown Timothy cubes (as suggested by nutritionist) and found the iron to be quite high. My horse is not IR, so I don't want to confuse things, but did have a question about that. Again, I will post the "story" of my Buster at a later time and see if I can, with all your help, get unconfused about what/how to feed him.
Thank you. -- S Day in AZ 2020
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Sherry Morse
Hello and Welcome to the group! While we generally suggest horses that are not IR/PPID be discussed on the Horsekeeping group (https://ecir.groups.io/g/Horsekeeping) I am leaving your message here for the moment so you can get the full orientation email and so Dr. Kellon and/or Auerlio from Onatrio Dehy will be able to address your question with regard to the amount of iron in the OBTC. For starters though I will direct you to this relatively recent discussion chain on the subject: https://ecir.groups.io/g/main/topic/69752730#245817 and add that we would not be recommending this product if we thought the iron level was a danger to the many IR horses who are eating it. With that said, here is the rest of our standard welcome message. You may want to save this for your reference as it has a LOT of important information in it. The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time. Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck. Orienting information, such as how the different ECIR sections relate to each other, message etiquette, what goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.
DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each. PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. *Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols. *Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions. No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:
We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse. *Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it). The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers. There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals. We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult. TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment. Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs. EXERCISE: The best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.
There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better. If you have any technical difficulties, please let us know so we can help you.
Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891
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are you referencing the
Timothy cubes, or the Timothy BALANCE cubes ??
-- Ellen Pal & Savvy N. Alabama Aug 2013 Case History
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I called all over the area and no can or is currently testing hay. I did remove salt pellets and msm pellets from his supplements. He exercises in the round pen daily for 10-15 minutes a day. Having been out of any work for years, it is a process. I can give him his supplements without grain. For now he will remain on approximately 8 lbs (Max) in a slow feeder, his Teff and Orchard. He goes out in a muzzle even though his paddock has not had much grass return yet. I have the APF ordered and will give Pergolide another try. He gets hooves done Tuesday and I will post hoof picks after. For now I did add body pics and one hoof pic to the folder.
-- Nina and Jadon Kentucky 2020 https://ecir.groups.io/g/CaseHistory/files/Nina%20and%20Jadon
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Hi Nina,
I think this is the link to Nadon's photos. But I don't see any photos. https://ecir.groups.io/g/CaseHistory/album?id=244202 Could you have forgotten to hit Save somewhere? Or ? -- Lorna in Eastern Ontario
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They finally uploaded but I’m not sure I connected it to his case history? I followed directions but I may have missed something:/
-- Nina and Jadon Kentucky 2020 https://ecir.groups.io/g/CaseHistory/files/Nina%20and%20Jadon
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Hi Nina,
You got it! He's handsome. Now ,can you go back to the signature box ,in Subscription and add the Photo link.....https://ecir.groups.io/g/CaseHistory/album?id=244202 to your signature.......remembering to hit Save. In your other post ,did you mean he is only being fed 8 pounds a day of hay, or did I misunderstand? -- Lorna in Eastern Ontario
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lvbnazgrl@...
There is a question/answer page "from their nutrition experts" on the Triple Crown site. I called them to confirm.
In a conversation with a nutritionist who studied with you, it was suggested that I offer my PPID horse Triple Crown Lite if I was unable to find Mountain Sunrise Timothy Pellets. I also had the iron content confirmed by TC in a telecon. Some of the labels also show the iron content..I believe TC Lite is one of them. -- S Day in AZ 2020
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On Fri, Apr 3, 2020 at 10:03 PM Lorna in Ontario <windybriars@...> wrote: Hi Nina, -- Nina and Jadon Kentucky 2020 https://ecir.groups.io/g/CaseHistory/files/Nina%20and%20Jadon
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Thanks Lorna! I think I did it :)
-- Nina and Jadon Kentucky 2020 https://ecir.groups.io/g/CaseHistory/files/Nina%20and%20Jadon
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Hi Nina,
Did you remember to hit Save ? -- Lorna in Eastern Ontario
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Hi Nina,
As Sherry said, until we know how much he is being fed, by weight, we can't know what is needed. I worry about a 15hh horse being fed only 8 lbs. of hay,nothing else to speak of. Good idea about getting a luggage scale. Then you will know how to proceed. Let us know,when you do,ok? -- Lorna in Eastern Ontario
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The TC product we were talking about here is the Naturals Timothy Balance Cubes.
-- Eleanor in PA www.drkellon.com
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Bobbie Day
Nina
I bought a fish weighing scale from amazon, I think it was around fifteen bucks. I put the hay in a hay net to soak. Pretty boy, I must say though that twelve pounds is the same amount I give my little RM mare, she’s only about twelve hands and eight hundred pounds. My big horses eat twice that, I bet once you weigh your hay you’ll be surprised. -- Bobbie and Desi Utah, Nov 2018 https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi https://ecir.groups.io/g/CaseHistory/album?id=78821
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Hi Nina,
First let's go back to "he's Compensated IR". That was before you made any changes. So there is no emergency right now. It's good to remove the things Sherry suggested removing because they might not be all that helpful, and they could be harmful. But when Jadon's blood was drawn he was actually doing quite good, aside from ACTH. Because he is a quarter horse, he is genetically less likely to be IR....his insulin is likely being driven up by his ACTH. So get that under control and you should see his insulin come down. Once he's on his full dose of pergolide (which will be the dose that brings his ACTH into the middle of the normal range), instead of "compensated IR" you might see "not IR" in the calculator. If he only has PPID and it is well-controlled year-round and not causing insulin to rise, he might be fine on some pasture if you keep his weight and ACTH under control. If insulin does not improve but he remains "compensated" then he is still doing good, although to keep him there he might need to stay off pasture +/- have soaked hay instead. If he gets into the "uncompensated" range, but his ACTH is well controlled, he is IR and you will need to aggressively work to reduce his dietary sugars, first by by soaking his hay and second by looking for a longer term source of low sugar+starch hay, and no pasture at all... Is there any way he can be completely muzzled (closed/sealed muzzle) during turn out? Not only is it is impossible to know how much grass he is eating, it's easy to overestimate it if there's not much pasture (although you will see a ravenous horse when he comes in if that's the case) and really easy to underestimate it even if muzzled. Plus you'll never know how much sugar he is actually getting from his pasture as this varies by hour, day, season, weather, nutrients, etc. I think it would be best to feed him 2% of his ideal weight in hay (or 1.5% of his current weight, if it's higher), and eliminate the pasture completely until his weight is controlled and you see his insulin is normalized. Can he be brought in halfway through his turnout for an hour to eat a meal of hay so he doesn't go more than 4-6 hours without eating? Definitely get a DIGITAL scale and weigh his hay. I use a 10$ digital luggage scale I bought off Amazon. Subtract the weight of the net you are weighing it in (these can be a couple lbs), or hang a big plastic bucket from it, zero out the scale, and then weigh out your hay in portions. Finally, if there is absolutely no way for you to buy and store enough hay at a time to make testing it feasible, consider feeding a mineral balancer that covers the general deficiencies common to all hays as well as deficiencies you might have in the area your hay is grown. Others in this group in your area might know what works best...I would rely on the advice here, with Dr Kellon's oversight, over a feed company representative. But it would be better for Jadon's health in the long run if you can figure out a way to buy a 6-month supply of the same hay (same field!), test it, and supplement the deficiencies appropriately. And then you'll know the sugar+starch and can decide if it needs to be soaked. A small shed or a tarp with pallets on the ground can store a pretty decent supply of hay for 1 horse...plus then you'll have a secure source of hay in the event of quarantine (our new normal?) or hay shortages. I'm never comfortable with anything less than a 1 year supply of hay on my property, but that's partly because it is hard to get good hay in my region. You are doing a good job! Focus on getting him up to his full pergolide dose, and then re-test to make sure it's adequate and see how his insulin and glucose are then. -- Kirsten and Shaku (IR) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album
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