New member


Hello -

I joined to get help with my 19 year old thoroughbred gelding Valentino.

About three weeks ago (October 15) he came up with digital pulses in both hinds. Bounding so that I could actually see them.
No heat in feet, (body) temperature normal, pulse normal, slight lameness which has since resolved. We have a vet appointment on Nov 19.
I would love advice on which tests to get and whether to do x-rays. Thinking PPID, insulin...

Started soaking his hay immediately  - 1.5% of body weight (1100) of medium quality orchard split between morning and evening.
Replaced 1lb of Triple Crown senior with 1lb of Blue Seal Sentinel Performance fed in a.m. He gets a daily mash of 1.25 lb of beet pulp, 2 oz wheat bran,
and 1lb alfalfa cubes, top dressed with magnesium citrate, salt (iodized), vitamin E, U-7 and Ester C p.m. (am re-evaluating supplement measurements -
presently using package recommendations by weight, and 3-4 Tbs salt depending on weather)

Val is housed on a mostly dry lot (sand) but was getting 30 minutes daily of grazing on (sparse centipede) grass in a separate paddock.
No access to grazing after finding pulses.

I transitioned him to barefoot 13 years ago. The trim cycle varies, unfortunately - mostly 6 weeks but occasionally longer. This is out of my control
as we live on a remote barrier island off the NC coast. Val has thin soles and feet that like to flare. We have battled with chronic white line/separation.
Val has a history of abscesses for the last 3 or 4 years - twice or three times annually that I know of - usually following rainy periods, spring /fall.
Since the beginning of this summer he has had a persistent crack in one of the fronts coinciding with the farrier stretching our cycle to 8 weeks several times.
There are no event lines as of last farrier visit 2 weeks ago. I have learned to trim under my farrier's instruction, and have increased my touch-up frequency to weekly.

Val started with respiratory allergies last spring which have been well controlled with cetirizine. That same summer (2020) he also became anhidrotic for the first time -
controlled well with ONE AC. The anhidrosis returned this summer as soon as it got really humid.

The only other things I can think of are until 3 years ago Val's water source was an iron-rich well point, and I mistakenly was feeding loose un-iodized salt until
mid-summer this year when I switched to ionized.

Thank you in advance. I am looking forward to learning about improving my horse's health with your help.

Deanna Avery

Thank you for the response to my question! I have the same philosophy as this group regarding caring for both conditions. This is my husband‘s horse and the vet suggested Metformin straight away. This really has bothered me a lot. The side effects when reading the insert to metformin include G.I. disturbances and kidney side effects. I share this with my husband and he continues to use the Metformin . I will forward the answer you sent and hopefully he will read it and reconsider

Davery ; Southwest Washington; 2021


Hi Deanna -

So sorry to be confusing. I was not responding to your question - but probably putting my first post in the wrong spot.
Joined today and learning where everything is. Good luck with your husband's horse.

Sherry Morse


Hi Sherry -

Thank you for your response. I did join ECIR a long time ago while caring for a friend's horse who was showing some alarming symptoms.
(It ended up he was IR) My friend was computer illiterate so I shared ECIR info with her to help convince her to seek treatment. I am enrolled in the current
Cushing's/IR course, and the February NCR Plus.

Our vet appointment is next Friday (19th.) The wealth of information here can be overwhelming - especially without all the pertinent data.
I've decided to wait to post Val's history and hoof photos until after we get the radiographs next week.

I'm a little concerned about the accuracy of the PPID results, as I don't believe my vet uses Cornell, and I'm not sure how the sample will be handled
until it is shipped. I'm figuring if the results are super high despite time of year etc we can assume he is positive, but if they are borderline then the interpretation will be trickier.

At the moment (and for the last week) Val's hind pulses are negligible and he is sound, comfortable and energetic. This makes me lean toward his trims as a potential issue.
Because of our remote location - there is literally no other choice of farrier. Everyone on the island has to use the same practitioner, as no farrier will travel at least seven hours round trip for one or two horses. We all have to use the same farrier and be on the same schedule. Lots of repercussions to think about.
Outer Banks NC

Sherry Morse

Hi Christian,

I would suggest you confirm with your vet what facility he/she is planning on using for testing and if not Cornell, why not.  At the end of the day you are the one paying for the testing so you want to have the most accurate results possible.

Kirsten Rasmussen

Hi Christian,

We are coming out of the seasonal rise for ACTH so often early PPID horses start to improve around this time.  I still think you need a PPID test: baseline ACTH.  Add glucose if you want to see whether the blood was handled correctly, because it degrades easily and is more obvious.  Insulin is always good to get any time you test ACTH because it us what informs us of laminitis risk.  My concern given your island location would be can the vet keep the blood chilled (on ice), and centrifuge it within 4 hours of pulling the blood?  Remember, the blood needs to be pulled before any other procedures are done and before any sedatives etc are given, so it's at the beginning of the vet's visit.  You may want to confirm that will be possible.  If not, the results could be unreliable, unless ACTH is sky-high to begin with.  Since my vet travels to me, too, what I do after my vet pulls the blood first is immediately take the sample to a small animal clinic where they process it as per the instructions Cornell provides, then freeze it overnight and ship it out overnight by courier to the lab.  Perhaps you can have a friend or family member take the sample to the mainland for processing right away, if your vet won't be able to deal with it within 4 hours?

If your horse is kept barefoot and you are already trimming between appointments, you might be able to take on more of the trimming with time, especially if your farrier disagrees with the markups showing how to trim Val.  Many of us have done just that.

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