WAS: Metabolic test results back; seeking interpretation of results. / NOW: Kandace - to soak or not to soak hay


Kirsten Rasmussen
 
Edited

Hi Kandace,

I did say your hay was safe for most EMS horses but more sensitive ones need ESC+starch below 7%.
https://ecir.groups.io/g/main/message/257449
My horse is one of them.   :(  On unsoaked 7% hay, his insulin was around 41 uIU/ml this summer....not terrible but still very much in the sub-clinical laminitis zone (meaning his lamellar integrity is being compromised) .  But a month later he did have an acute laminitis flare-up and I had to start soaking his hay to bring it down to 4%.  That has stabilized him and brought his insulin down to a much healthier 15 uIU/ml.  When we got our freezing temps in November I tried to stop soaking and unfortunately he had another acute laminitis flare-up.  So now I soak his hay every day regardless of weather.

If K is doing well on unsoaked hay, no need to soak.  However while an insulin of 46 uIU/ml is a huge improvement for her, it is not great.  Even if she's not symptomatic the lamellae in the hoof are still being compromised.  You really want to see her insulin below 20 uIU/ml.  Likely the dietary changes you made and coming out of the seasonal rise for PPID are what helped, and its hard to say if the WIRX was also a factor because of these other simultaneous changes that we know are proven to help.  The cold weather might also be keeping insulin higher at 46, which means colder weather can put her at even higher risk of insulin peaks, which is why you want to get it down as low as you can.  Once she had her December set-back, though, that would have been a good time to start soaking her hay and see if it helped.  Your description of what was happening really sounded more like an abscess, which is probably why soaking her hay wasn't suggested to you, but remember it is something you can always try when she seems to be starting to get sore again.  Unfortunately winter it is the hardest time weather-wise to be dealing with water!  While it may not be practical to soak her hay this winter, you CAN start thinking about how you can set things up for next winter IF she needs soaked hay.  :)

There is a lot of trial and error in learning how to best manage these horses, and it can take years to get everything right for any given horse because they are all different.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album


Kandace Krause
 

Kirsten, Thank you for clearing up a few more questions.
Frankly, I cannot keep this horse if there is a next time.  This winter is a one off and due to Covid it is possible for me to be doing all the work.  I have accepted that I may not be riding her for more than a year, that she may never be a competitive horse again (but I hope), but the expense about  $8000 in vet bills and more to come and hundreds on vitiamins and minerals that she won't even eat, stall bound for another 15 years of her life?  It is not something I can do.  She is not in my backyard and I can't even exercise my other horse for fear that she will hurt her feet when J is taken away.
There has been no sigh of an abcess so far, tho with the NANRIC boots, I cannot see her feet in between trims.
The fact that she won't eat BP the addition of the things she should be being supplemented with scare me, I can't soak out the minerals her hays are providing.
I feel like I am beating my head against a wall, and that it isn't helping either of us.
Sorry, I need to rant and cry.

--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K
https://ecir.groups.io/g/CaseHistory/album?id=259062


Lorna Cane
 

Hi Kandace,

Ranting and crying go with the territory, I'm sorry to say.
Hang on.

I went to your CH because ,especially at this point in the nightmare,I wanted to see if there were areas that could be fine-tuned.
But I'm having trouble getting an accurate/current picture, based on what your messages have said....could be me.
Not sure how much hay she is getting,for example. And wonder if she is getting loose , iodized salt? And flax?
Not sure of her pergolide dose ? With 151 pg/ml results at this time of year I would be zeroing in on this big time,if she were mine.
And boots? Shoes? What is the current situation here?
I have more questions,but wonder, if it is not just me, if you could find a minute to update any details that need updating?

Especially when things are so difficult, it's been my experience (having had 7 IR/PPID boys) that getting every detail totally nailed down is so beneficial.
Every penny counts,so it is trés important to be sure to feed only what is known to help. The years and years of on-the-ground experiences of this group are a valuable go-to for this info.
This also applies, of course, to what is being looked at in the hoof area. 
And environmental area.Temperature can be a huge factor.
Even the tiniest detail, seemingly unimportant at first glance, can make a world of difference wrt the horse's quality of life,and therefore the owner's.....not to mention the financial savings, coming from getting value from everything that goes down the hatch.So to speak.

Sorry.Off soap box.
I just remember being in the same place you are now years ago ( the room is nodding), and what a miserable place that is to be. Wanting to help somehow.....to pay forward what I have been taught here.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Nancy C
 

Hi Kandace

I'd like to add my experience with high insulin and longevity.

Beau's was never controlled and in later years was 50-100 uIU.  Kept his ACTH in the teens.  Worked to reverse his tissue iron overload. Squeaky tight trim.  He was always on the verge of another potential event with insulin this high but we were on alert and adjusted when needed.   Nevertheless, he was able to work on the ground for all but the last years, with a bit of riding.

I get it that soaking hay is not fun.

Wanted you to know what can be possible.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2021 NO Laminitis! Conference, August 12-15, Harrisburg, PA


Lorna Cane
 

P.S.  Kandace......about beet pulp...have you tried soy hull pellets?
Just add water to moisten, or make soppy, whichever horse prefers.
No rinsing. Add supplements. Others may disagree,but I've never had a horse refuse these.

If supplements are a problem, start back at no supplements.Then start adding back in,teeny,tiny bits at a time. Allow several days from one increase to the next ( I do this ,anyway).
It's time consuming , and everso tedious. But usually it works ( until it doesn't).
And the minerals are going down.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Kandace Krause
 

Back in a better frame of mind, I am thankful and grateful for your help and hope you can keep your horse well.
--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K
https://ecir.groups.io/g/CaseHistory/album?id=259062


Kandace Krause
 

Hello Lorna,
I will try to get to CH but everything changes every day or everyweek and it's hard to keep up.
Hay 18 lbs divided 7lbs am, 11 lbs pm.
Now ODTB cubes 4 oz, soaked twice daily
Now 1 oz or maybe 2 dry BP then r/s/r
as you suggested am back to minute changes and having to pick my battles so far she will eat above if I add 1 tsp flax oil with 1000IU vit. E, nothing else
If she continues to happily eat this I will add something but not sure where to start and my questions on things she needs (I think) are unanswered.
Pergolide increase over last three weeks to now 1.5 tablets Prascend one day, next day2 tablets, then repeat.  She is starting to reject them, in treats and syringing one more thing is not acceptable.  She is becoming a bit dangerous with all this (inroduced mint flavoued milk of magnesia with metformin and she is starting to be a bit less reactive now, progress.)
My vet wants to get insulin down.  I don't know if he is aware of insulin spikes and cold but "K" is on stall rest, which for me is a 12 x 20 run in shed with a panel in front of it.
Her feet are in NANRIC Ultimate boots, which can be seen in xrays.  These are a therapeutic appliance.  Lavina mentioned not liking angles.  I forwarded that coment to vet and asked him to review with farrier.  no answer.
These are direct questions you asked.
--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K
https://ecir.groups.io/g/CaseHistory/album?id=259062


Sherry Morse
 

Hi Kandace,

I meant to ask you about this when I saw it mentioned and then got pulled into something else, but what is the reason between alternating the Prascend dosage?  IF she needs to the 2mg I'd stick with the 2mg every day as getting her ACTH controlled may help bring her insulin down as elevated ACTH can drive up insulin.  I don't believe there's a reason you can't put the Prascend in the same syringe with the metformin so that's one less time to be going at her with another syringe.




Lorna Cane
 

Hi Kandace,

Yes thanks. But may I make another suggestion......if you had taken the time needed to write this post,and used it to update your CH,we could all go there and see everything in one place.
Virtually impossible to go back and review messages because even though they give updates,they don't show what has gone on before.Very important details in order to see a pattern.
Then just one message here to say that CH is updated,and 'Bob's your Uncle'.

Why different doses of pergolide?

What do you mean "dangerous"?
You can feed cubes dry, at least I've never had an issue doing this.You can add them to whatever you're hiding the minerals in as a taste tempter.Just thoughts.
Iodized salt?

Not sure what you mean by not knowing what she needs.
Have you reread everyone's messages to you? Answers could be there,but anxiety may have hidden them from you? It happens.

Or please ask exactly what you are wondering about,ok?

But if you're CH is UTD and clear, people will have a much better chance of seeing what is missing and what is not needed.
Details,details,details.

Keep breathing.
In AND out .


--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Lorna Cane
 

PS again,sigh.
If Lavinia says the hoof angles are not appropriate,be sure to take note.

One of the problems with the appliances being used now is that the trim can't be addressed as often as is usually needed with these horses.
But I'll leave that to others more educated than I am wrt  hooves.
--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Trisha DePietro
 

Hi Kandace. It is a whirlwind of knowledge assimilation....It can be confusing and just when you think you got it nailed down, the horse refuses their medications...ask me how I know....In any event, I understand how you feel. It is a big lift sometimes to get these horses where they need to be. But, a Case history is really helpful in pulling it all together for you. I sometimes can solve my own issues by working on my case history. I see things that I forgot about, or that I am thinking I want to try, but I see by my case history, I've already tried it and it didn't work, or it did work....So, just rooting for you to do your case history :) 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Kandace Krause
 

Sorry Sherry I too distracted from reply.  I have updated CH, but I believe the alternating dose is about keeping Prascend at lowest possible level.  Her ACTH had dropped from 151 to 65 on 1.5 tablets, so adding another half tab per day to continue dropping.
--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K
https://ecir.groups.io/g/CaseHistory/album?id=259062


Lorna Cane
 

Hi Kandace ,

I was asking about this ,too.
The idea is to get those numbers down, especially at this time of the year, which does not involve the seasonal rise where you are.
If she were mine I would be adding a mg at a time, now that she has been on it for a while. It's your call, of course, and others will offer advice here.
But 65 is too high. 

Lots of horses here have been on mgs. in the teens and 20's,with no ill effects. Mine were among that group.
We dose according to what is needed to control the PPID.

Love that you are making feeding progress.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Sherry Morse
 

Hi Kandace,

Were she mine and she was at 65 on 1.5mg of pergolide I would not be alternating 1.5 and 2mg doses but keeping her at 2mg and then rechecking to see if that was enough to keep her controlled.  If she's till elevated on 2mg then she needs more on a daily basis, not an alternating basis.