I am preplexed


I am sure it has happened, but I don't remember seeing a post regarding an IR/cushings horse with stretched lamanie and brusing on the hind feet at the toe?
No known back feet issues 6 weeks ago or ever until the farrier was here today.   She came  today for a regular trim and lo and behold, the brusing and stretched lamanie on the hind toes.
I need to update my case history but here are the updates.
2 different types of hay: 1 is 7.1 sugar and starch and the other is 7.3.  
Xrays 2-22 and they are in the case history. 
June 2022 ACTH 20.1
June 2022 insulin 191.47 (lower than most times,  unfortunately)
I have no idea how or what to do.  No new damage on the front but he is foot sore and has been for a few weeks. 
He also has DSLD as well.
I spoke to the vet today and he is going to do some research.   He and my farrier already know this guy is a tough case and has been for years.  Nothing and I mean nothing can get bis insulin down.  No pulses, no rocking back, no heat, he has a big tolerance for pain which isn't always the best thing.  He is eating, standing, walking (not enough to ride or exercise), drinking and pooping.  Except for the stiffness in his walk, one wouldn't know that he feels like crap unless you know him.  

Any ideas? Help?
Thanks in advance!
- Amy 10-2016

Mooresville, Indiana 

Stormy, Case History, Photo Album



I wanted to also update he is usually on 2.5 mg pergilode.   I did increase to 3 during the seasonal rise.  
- Amy 10-2016

Mooresville, Indiana 

Stormy, Case History, Photo Album


Maxine McArthur

Amy, it would be helpful if you could take some recent photos of his feet and upload them to your photo album. Otherwise we are speculating in the dark. Once you’ve uploaded the photos, please refresh the link to your photo album  in your signature as per the Wiki instructions, so that we can click on the link and see your photos. 

If he has DSLD, is it possible his fetlocks have dropped a bit, putting a strain on his toes as his angles lower? DSLD horses usually need a very tight short trim on the toes and frequent meticulous balancing. 6 weeks might be too long for him now. 
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response



Lesley Bludworth

My mare has very brusied hind feet. She is recovering from severe lamitis in all 4 feet that started this last June.
She was toe landing on the outside of her right hind severely after a trim and developed a purple bruise on the outer wall.
She was in easycare gloves with pads in the back and clouds in front but I got clouds on the hinds and that bruise is growing out..
She is still not heel landing on her hind feet ( hard to tell to watch but the pads in the boots are hardly flattened at the frog/heel contact, the toe area is flattened) and the toe/frog is still stretched forward where the front frog is moving back some
She has separated lamina on the hinds visible on x ray.
I just got the 5 degree wedge for the cloud boots to ease the breakover in the back and they seems to really help. I could hardly keep up with her on our walk.
I don't know if that helps at all ;)
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare IR/EMS, PPID?


I will do some research here to see what angles to take the pictures.   I don't normally have much luck searching here but I will do my best. 
I still don't know what to do with his insulin.   Even when he was exercised it was still high.  He is truly a hard case.  
- Amy 10-2016

Mooresville, Indiana 

Stormy, Case History, Photo Album


Lorna Cane

Amy,go here for photos help:

I found it by going to Wiki:

Lorna in Eastern Ontario

Kirsten Rasmussen

Hi Amy,

Instructions on photo taking, naming, and uploading are here:

There is a new line of medications called SGLT 2 inhibitors that has been very successful at lowering insulin in intractable cases.  But we don't recommend it until it's clear that nothing else is working for that horse because it is new and there are potentially serious side effects.  If you feel you are at that point, you can email Dr Kellon with your vet's email and she will send you both what you need to know if you want to try it.  Their management has to change drastically from what we typically do for horses with metabolic issues.  Email drkellon "at" gmail "dot" com

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

Snickers' Case History
Snickers' Photo Album