New Member - Shetland with acute laminitis and cushings

Lorna Cane

On Tue, May 4, 2021 at 08:47 AM, Kirsten Rasmussen wrote:
In my experiments with soy hull pellets, they turn into gummy paste if they sit too long soaking, which some horses (mine included) do not care for. 
Hi Kirsten,

This is interesting. I've never experienced this,in all the years I've fed soy hull pellets to my herd.

Lorna  in Eastern  Ontario
Check out FAQ :

Kirsten Rasmussen

Hi Karen,

The soy hull pellets or RSR beet pulp make up the mash for the supplements.  Most horses like beet pulp but sometimes they need to adjust to it.  Adding salt can make it more palatable.  Because it is fed RSR (ie wet), the supplements stick to it and are eaten as well.  In my experiments with soy hull pellets, they turn into gummy paste if they sit too long soaking, which some horses (mine included) do not care for.  Just dampening soy hull pellets with a bit of water so supplements stick, and feeding right away keeps them more solid and less gummy, so the texture might be more appealing.  That works for my horse.

Not knowing your pony's weight, I'll give you the amounts for a 1000 lb horse, and you can reduce accordingly depending on his actual weight, so fir example a 500 lb pony would need half of these amounts.  We recommend the minimum daily salt ration 1-2 Tbsp for a 1000 lb horse (it depends on the Na and Cl in your hay, and more is needed if sweating) to be fed with minerals, plus free choice loose salt.  Unless your horse uses his teeth on it, a block does not provide enough salt.  1600-2000 IU vit E, in capsules containing oil or as a powder mixed with a tiny bit of oil to make a paste.  2-3 oz fresh ground flax seed. 

I feed pergolide in a small handful (1/4 cup or less), of extruded feed that is "safer" for EMS horses.  Others put it in an empty peanut shell, or the core of a small slice of carrot or a hole drilled into a hay cube.  If your pony is actively laminitic though, I'd avoid extruded feeds and carrots, and consider syringing it in (dissolve tablet in warm water in a medication syringe).

Getting the diet as tight as possible is the best thing you can do right now to reduce hoof pain.  After 24-48 hrs you should see improvement in comfort.  If not, then the trim is likely contributing to the pain and needs to be dealt with.

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


Thanks Lorna, used to have Maxisoy years ago for our dear deceased now mini/shetland cross. Will see if I can track some down tomorrow. We did mix beet pulp with his Zero pellets and chaff and he managed to sift everything out and left the beet pulp behind every feed, so have given up on that.
Karen Bevis in Tas Australia, 2021

Lorna Cane

Hi Karen,

Did you see Maxine's suggestion? Maybe just the soy hull pellets ,as a carrier, would pass inspection,if he won't touch beet pulp ?

Maxine said, "Can you get Energreen Maxisoy? It's soyhull pellets, nutritionally similar to beet pulp and a safer feed than the chaffs. You can mix it with beet pulp as well (that's what I do) after rinse/soak/rinsing the beet pulp."

Loose salt ( rather than salt block ) can be included in the mix .


Lorna  in Eastern  Ontario
Check out FAQ :


Thank you all. It will take us a few days to get our heads around all of this information. We can take some photos later this week when we have more time. What is your advice for giving him his medication and the suggested supplements - vitamin E, flax meal, salt - without a mash to hide it in? I know we can get a salt lick, but how to get the other items into him? And what would the quantity of vitamin E and flax meal?

Thank you!
Karen Bevis in Tas Australia, 2021

Maxine McArthur

Hi Karen
Can you get Energreen Maxisoy? It's soyhull pellets, nutritionally similar to beet pulp and a safer feed than the chaffs. You can mix it with beet pulp as well (that's what I do) after rinse/soak/rinsing the beet pulp. Zero is generally a safe feed but if he's actively laminitic I would stop it for now. 
As the welcome message above says, make sure there's no grass anywhere he can reach, even if it looks dead. I have a friend who moved to Tassie from Canberra (she's in Dover) and was appalled at the lushness of the grass there. Even her young, active Arabian riding horse is on a track system and dry-lotted at night. 

Let us know what his blood test results are, and if you can get the case history done we can help you further.

Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response


Sherry Morse

Hi Karen,

Fat deposits are usually an indication of IR, not PPID.  Since you haven't done any bloodwork yet I would suggest that after 3 weeks of being on the full tab of pergolide (should be 1mg dose?) that you have blood pulled for insulin, glucose and ACTH.  That will let you know if you need to increase the dosage of pergolide and if his current diet is controlling the IR or it needs to be tightened up even more.  Hopefully at this point he's been totally removed from grass.  As Bonnie already mentioned lucerne is an issue for many IR and PPID equines so that needs to be cut out completely and just use grass hay for him. 

If this is a laminitis due to IR or PPID you might as well stop the bute using the taper outline here:  The reason he's probably appearing to go backwards when you ease off it may be related to a rebound effect and not really because his feet are any more sore without it than with it.

As already mentioned, pictures of the current trim and any x-rays you have will help us help you.  Also having a case history done so we know how much he weighs, how much he should weigh and how much he's currently eating (not just what he's eating) will all be very helpful as well.


Welcome to the group Karen!
I am attaching our new member information packet below. It is chock full of information. There are blue colored words which are clickable links. As you read thru the document you can click on links that will open /expand more in-depth information.

Do get started on your pony's case history. This health history is important. Our experienced moderators need details about your pony in order to give you safe, relevant advice. I know the case history document is long and may seem daunting. I found it easier to actually print a copy of it and begin filling it in with pencil notes as I gather the details.

Reading what your pony is being fed I would advise you just feed soaked GRASS hay, salt, vitamin E and ground flax seed only. NO lucerne  in any form as it is quite commonly a trigger for laminitis.  All the details about the safe emergency diet is in ate DIET paragraph below.

Bute doesn't help laminitic feet but if you are using it be sure to taper off  when stopping, do not withdraw it abruptly. 

We do recommend having blood tests done but do use the ECIR protocols for the day of the blood draw.

We have members in Australia who can give you further advice about safe feeds, blood tests, etc. I am glad you found this group, it has helped so many equines and owners.

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/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 etiquettewhat 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 Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/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 EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*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: EMS 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:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

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 EMS/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 EMS/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 EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR 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.

EXERCISEThe 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.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 


Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album Deceased


Hello. Hoping for some advice as we have been trying a few things to help our shetland pony and every time he seems to be improving he goes downhill again. We have had experience dealing with a previous shetland who foundered and knew how to get a handle on it quickly and get it under control. We are having no luck at all here.

We moved to a new property 12 month ago, and he experienced a bit of trouble from the richer grass here (had never foundered previously) so we had some fenced off areas where he could be near our other equines but with a mostly hay diet. It was a cold summer and we didn't really notice that he hadn't fully moulted until the end of summer when he got really sweaty and had a bad bout of laminitis that has not really ended. After trying all our usual tricks (no grass, soaking hay, regular gentle walks), and getting his feet trimmed by someone other than ourselves, we had the vet visit.

He diagnosed Cushings because of his long coat and laminitis and fatty deposits above his eyes. No actual tests were done, diagnosis was on the basis of symptoms. That was about 6 weeks ago. Since then he has been on Pergolide 1/2 tab per day day, increasing to 1 tab per day when 1/2 didn't change anything, and since that hasn't made much difference, some Periactin as well (4 tabs per day). We are still soaking hay. We had also been feeding him a mash of lucerne chaff, oaten chaff and 'zero' pellets (Australian brand suitable for founder ponies). We found out that Oaten Chaff is high in sugar, and lucerne isn't so we cut the oaten right back, he seemed to improve, but now back here we started. We tried throwing beet pulp in the mix, but he didn't like that. He has been on Bute most days - just when we start easing it off he goes backwards again. His feet are still very sore, particularly his front feet.

All advice appreciated. We don't know what else to do to help him and hate to see him like this.
Karen Bevis in Tas Australia, 2021