IR and n/p1 mare


eissagholian@...
 

Hello Group,

I am new to this group and would like help with putting together a proper diet for my IR n/p1 horse that has a history of laminitis. I have started her on the emergency diet today and will be mailing out my Equi-Analytical test tomorrow. I am currently boarding her at a boarding facility that feeds twice a day. They feed once at 5am and another at 3pm. I am able to have someone soak her hay bag and give it to her for her 3:00pm feeding but I'm not sure what to do about the 5am feeding. Am I able to soak her hay bag at night then empty the water and leave it for them to feed it to her at 5am? I need help with how to set up the soaking hay process as I work full-time. 

Also, my vet wants me to slowly transition her to Bermuda pellets within 7 days. However, I am a little worried that the pellets wont be enough for her. She is currently on three 6lb flakes of Timothy hay a day and she also gets a cup of Bermuda pellets, 1 scoop of Uckele magnesium, and 1/4 cup of chia seeds once in the evenings.  Based on her blood and insulin test results, her vitamin E is extremely high as well as her insulin levels. Therefore, my vet wants me to act fast and change her diet ASAP. Further, due to an unrelated joint injury, she has been out of work since January. I have been hand walking her for 20-25 mins a day to slowly be able to bring her back to work. She is also scheduled to get her shoes put back on in a week based on x-rays with the presence of her vet and farrier. 

I would greatly appreciate help with putting together a good property diet for her as I am new to all of this. Thank you in advance for your help!
--
Ani in CA 2022


Eleanor Kellon, VMD
 

Ani,

We REALLY need a full history to know where all of this is coming from.  Also, where was the n/p1 testing done?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Sherry Morse
 

Hi Ani,





Gymah
 

Just out of curiosity, I thought a horse with PSSM1 couldn’t also be IR? Or are there rare cases where a horse has both? 
--
Helene A. in BC 2021
Photo album:
https://ecir.groups.io/g/CaseHistory/album?id=271068
Case history:
https://ecir.groups.io/g/CaseHistory/files/Helene%20and%20Rosie


eissagholian@...
 

Hello,

I have PSSM test results from UC Davis and Animal genetics. They both came back with n/p1. 

My mare got laminitis in September of 2018 in both front feet but right front had more rotation than the left. With the help of a vet and farrier we got her feeT onto the the right track and I took  her off alfalfa and oat hay and switched her to Timothy hay only. From end of 2019 until January 8, 2022 I have not had any lameness issues with her. We were going on regular trail rides, shows, and even did cattle sorting.

On January 8, 2022 while we were coming back from our trail ride, we were coming down hill and she got excited and sprained her left front. After we got back to the ranch she was off. I contacted the local vet had x-rays on he LF but he couldn't find her injury so he referred her out for an MRI. I contacted her original vet that helped us with her 2018 laminitis episode and he said to take her to a hospital and they will give a second opinion as he was home ill and could not see her at that time. I took her to the hospital beginning of February the vet did another set of xrays and nerve blocks and determined that she had inflammation in her left front coffin joint and said that she has had a traumatic injury. He said she will benefit from a Pro-Stride joint injection. They gave her the Pro-Stride injection a week after and she came home. When I brought her back home I was told to start walking her for 15-20mins a day. I started walking her two days after her joint injection but noticed that something was not right with her hind end as she did not want to move forward or she would hold her left hind leg up as if her muscles got stuck/tied up. I slowly continued to walk her and she would walk out of her hind end soreness/stiffness. Therefore, I thought it was her PSSM kicking in due to her not getting any exercise due to her coffin joint injury. During this time, after consulting with vets, we decided to remove her two front shoes and transition her to barefoot. I was using cloud boots to walk her every time I would take her out of her 12 x 24 well bedded stall. She seemed like she was slowly getting better until April 22, 2022 when her original vet and a new barefoot trimmer came out and x-rayed her front feet again before trimming. Vet said her front left had rotated much more compared to her 2018 rotation and the last x-xrays from 2020 when she was in full work and he had fixed her hooves/rotation. He also X-rayed her hind hooves and saw that she had rotated in her left hind but no rotation at all on her right hind. He suggested to put shoes back on her as soon as possible as her soles were thing and had been cut short by her old farrier. After they carefully trimmed her a little that day, she started walking like how she was walking when I first brought her back home from the hospital. She got very still in her hind end and now she does not want to put weight on her right hind. Vet also tested her insulin on April 22, 2022 and informed me on 04/27/2022 that her insulin levels are extremely high and that she needs to be transitioned to Bermuda pellets only from her timothy hay and he also instructed me to stop any and all supplements she was on. 

However, after a little research I did that evening, I decided to start soaking her timothy hay bag in water for 60 mins and then feed it to her. I am also still feeding her chia seeds, Uckele magnesium and a cup of Bermuda pellets. We have an appointment with the vet a farrier that our vet works with, to put shoes back on her on Friday May 6th. 

At this point, I do not know what I need to do and do not know how to put together a proper diet for her. I am extremely stressed and have not been able to sleep since January. I need urgent help as my mare had never shows signs of PSSM until being on stall rest. Also, the vet said that it is very interesting that she only rotated on the left front and left hind. 

PLEASE HELP I DON'T KNOW HOW TO HELP HER AT THIS POINT! 

I don't know if I should leave her in her stall or if I should force her to walk until she walks out of her hind end stiffness like before. I don't know if I should follow the PSSM diet or her IR/laminitis diet. I really need help and would like someone experienced to look over my hay test results and her blood work and let me know what they think I can do to help her. 
--
Ani in CA 2022

Case History: 
https://ecir.groups.io/g/CaseHistory/files/Ani%20and%20Diamond


Sherry Morse
 

Hi Ani,

Great for getting your CH started, now here's what else we need:

Diamond's current weight, Diamond's ideal weight, dates of PSSM and all metabolic testing, and actual results for those tests.  When she had laminitis in 2018 were her insulin and glucose tested?  Do you have copies of the x-rays taken at that time?  Do you have copies of the current x-rays?  If you have those please start a photo album and post those images there along with current trim pictures (directions on how to take those can be found in the Wiki: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help).  Since she's a GV please wrap her legs before taking pictures so the coronary band is visible in all shots.  

Is there a reason you are wanting to put shoes back on her now instead of keeping her barefoot and booted?  In terms of growing more sole Diamond would probably benefit from more frequent trims to get her toes back under her (this is a guess based on how we see many trims) that do not touch the sole and that's going to be difficult with shoes on.  I know this is the exact opposite of what your vet has told you but putting shoes back on will not solve the problem, it's just putting a band aid on it.

If she's not actively laminitic exercise is the best insulin buster there is so walking her (with her boots on of course) should not be an issue.  Is she able to be out in a dry lot at all or are the only options the stall or walking?

As far as diet, my understanding is that a typical PSSM and IR diet are similar in that both are focused on limited sugar and starch intake and are forage based.  Our recommendation of less than 10% ESC+starch works for both PSSM and IR horses.  For both diets it's recommended you test hay (we use Equi-Analytical 603 Trainer which is run via Wet Chem and is more accurate for ESC+Starch than NIR) and balance to those results.  You can find a list of people who can help you balance your hay here: https://ecir.groups.io/g/main/files/6%20Diet%20Balancing/HAY%20BALANCING-1.pdf  If you need a vehicle for supplements rinsed/soaked/rinsed beet pulp is safe as is Stabul-1 (available through Chewy or through the Stabul-1 website) or Triple Crown Timothy Balanced Cubes.  All hard feeds DO need to be considered as part of the 2% she's fed daily and if you opt for the Triple Crown cubes they're fed at a 3:4 ratio to hay as they're more calorie dense.  

If you have your hay and blood test results as PDF files you can add them to your case history folder and let us know they are there, or if they are JPGs you can create a photo album and post them there.  

Most of all - keep breathing. You're doing the best you can with the information you have at hand and we're here to help you figure out things going forward.




On Saturday, April 30, 2022, 03:59:04 AM EDT, <eissagholian@...> wrote:


Hello,

I have PSSM test results from UC Davis and Animal genetics. They both came back with n/p1. 

My mare got laminitis in September of 2018 in both front feet but right front had more rotation than the left. With the help of a vet and farrier we got her feeT onto the the right track and I took  her off alfalfa and oat hay and switched her to Timothy hay only. From end of 2019 until January 8, 2022 I have not had any lameness issues with her. We were going on regular trail rides, shows, and even did cattle sorting.

On January 8, 2022 while we were coming back from our trail ride, we were coming down hill and she got excited and sprained her left front. After we got back to the ranch she was off. I contacted the local vet had x-rays on he LF but he couldn't find her injury so he referred her out for an MRI. I contacted her original vet that helped us with her 2018 laminitis episode and he said to take her to a hospital and they will give a second opinion as he was home ill and could not see her at that time. I took her to the hospital beginning of February the vet did another set of xrays and nerve blocks and determined that she had inflammation in her left front coffin joint and said that she has had a traumatic injury. He said she will benefit from a Pro-Stride joint injection. They gave her the Pro-Stride injection a week after and she came home. When I brought her back home I was told to start walking her for 15-20mins a day. I started walking her two days after her joint injection but noticed that something was not right with her hind end as she did not want to move forward or she would hold her left hind leg up as if her muscles got stuck/tied up. I slowly continued to walk her and she would walk out of her hind end soreness/stiffness. Therefore, I thought it was her PSSM kicking in due to her not getting any exercise due to her coffin joint injury. During this time, after consulting with vets, we decided to remove her two front shoes and transition her to barefoot. I was using cloud boots to walk her every time I would take her out of her 12 x 24 well bedded stall. She seemed like she was slowly getting better until April 22, 2022 when her original vet and a new barefoot trimmer came out and x-rayed her front feet again before trimming. Vet said her front left had rotated much more compared to her 2018 rotation and the last x-xrays from 2020 when she was in full work and he had fixed her hooves/rotation. He also X-rayed her hind hooves and saw that she had rotated in her left hind but no rotation at all on her right hind. He suggested to put shoes back on her as soon as possible as her soles were thing and had been cut short by her old farrier. After they carefully trimmed her a little that day, she started walking like how she was walking when I first brought her back home from the hospital. She got very still in her hind end and now she does not want to put weight on her right hind. Vet also tested her insulin on April 22, 2022 and informed me on 04/27/2022 that her insulin levels are extremely high and that she needs to be transitioned to Bermuda pellets only from her timothy hay and he also instructed me to stop any and all supplements she was on. 

However, after a little research I did that evening, I decided to start soaking her timothy hay bag in water for 60 mins and then feed it to her. I am also still feeding her chia seeds, Uckele magnesium and a cup of Bermuda pellets. We have an appointment with the vet a farrier that our vet works with, to put shoes back on her on Friday May 6th. 

At this point, I do not know what I need to do and do not know how to put together a proper diet for her. I am extremely stressed and have not been able to sleep since January. I need urgent help as my mare had never shows signs of PSSM until being on stall rest. Also, the vet said that it is very interesting that she only rotated on the left front and left hind. 

PLEASE HELP I DON'T KNOW HOW TO HELP HER AT THIS POINT! 

I don't know if I should leave her in her stall or if I should force her to walk until she walks out of her hind end stiffness like before. I don't know if I should follow the PSSM diet or her IR/laminitis diet. I really need help and would like someone experienced to look over my hay test results and her blood work and let me know what they think I can do to help her. 
--
Ani in CA 2022

Case History: 
https://ecir.groups.io/g/CaseHistory/files/Ani%20and%20Diamond


Eleanor Kellon, VMD
 

Helene,

Horses that are symptomatic of PSSM are very insulin sensitive, not resistant, but it's not clear any of the signs she is showing are from PSSM. Heterozygous individuals (only one abnormal gene) don't necessarily show signs.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

Ani,

When horses with high insulin and laminitis pain are confined to a stall they typically come out stiff because the circulation is poor.  Holding that left hind up was likely because of pain from the laminitis.  I would suggest getting her on LaminOx, 2 scoops https://uckele.com/laminox-3lbs.html . If you have never used your new customer discount, use coupon UHNWELCOME for 10% off and if you did use it use ECIR code for 5% off. Is she on any pain medications? Has she been tested for PPID?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


eissagholian@...
 

On Sat, Apr 30, 2022 at 09:59 AM, Eleanor Kellon, VMD wrote:
PPID
Dr. Kellon,

I have not tested her for PPID, however, she has been six panel tested through UC Davis (GBED, HERDA, HYPP, HYHM, MH, PSS1) they were all N/A except PSSM1 which she was N/PSS1. I ordered LaminOx a couple days ago and I received it today. However, I am giving her Magnesium from UCKELE. Do I stop that and just give her LaminOX now? As far as pain medications, I was giving her Equioxx but I stopped giving that to her Monday and I started giving her 1 scoop of bute to her today. She seems like she is doing a little better now and I feel like it's because her soles have grown out more now. 

Also, since her last farrier cut her soles short, my current vet is recommending putting shoes back on her to get her soles off the ground until she grows fore foot. 

I have tested her blood, insulin, and cushings. Would you like me to upload them for you? Her RBC was 6.4 (low), LDH 584 (high), and her Vitamin E 14.44 (high). Everything else is normal. Also, vet said her insulin is above 200, which i'm not sure what the normal range is. 
 
--
Ani in CA 2022

Case History: 
https://ecir.groups.io/g/CaseHistory/files/Ani%20and%20Diamond


Eleanor Kellon, VMD
 

PPID and Cushings are the same thing. Can you put those lab values in her case history.

Stop the bute. You can't use that with LaminOx. Do you have boots and pads? That's better than shoes. Insulin over 200 is very high. Ask your vet to prescribe metformin 30 mg/kg twice a day and test her after 5 to 7 days to make sure it is working. You can continue the magnesium.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


eissagholian@...
 

I put cloud boots on her front feet when I take her out of her stall. Does LaminOx have bute in it as well? Also, since LaminOx seems like it has magnesium in it, do I have to continue supplementing her with additional magnesium or it's just an option? 

Also, I will ask my vet to prescribe metformin. Thank you for your prompt responses and help. Do you by any chance know a farrier that specializes in corrective trimming for laminitis horses in or near Los Angeles California? 

Thank you,
--
Ani in CA 2022

Case History: 
https://ecir.groups.io/g/CaseHistory/files/Ani%20and%20Diamond


eissagholian@...
 

What are the artificial flavors in LaminOx? 
--
Ani in CA 2022

Case History: 
https://ecir.groups.io/g/CaseHistory/files/Ani%20and%20Diamond


Eleanor Kellon, VMD
 

I'll find out what the flavors are and post here. Once you get insulin, weight and trim under control you can stop it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

There is no bute in LaminOX and the magnesium silicate is a flow agent, not bioavailable. Look for a trimmer here https://progressivehoofcare.org/directory/ .
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

The artificial flavor is vanilla.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001