Topics

Acute Laminitis / Hay Analysis / Bloodwork

 

Last Saturday my 9yr Dutch Wb mare Schimpie developed acute laminitis from being started on Dex then Oral Prednisolone 1 week prior for allergies/severely itchy skin. We immediately started icing , did 3 days of IV DMSO, started Metformin, Pentoxifylline , acepromazine, bute, and increased her Thyro L from 1 scoop/day to 2 scoops per day...within 3 days her comfort greatly improved and we have decreased her bute to 2 grams /day. Monday we xrayed and they showed what my vet called mild/2 degrees rotation ...she said that this was from prior not what was actively happening ...my mare is a bit overweight from having lived out all winter and spring while my barn got rebuilt..hence the weight gain and our winter in pa was unusual in that the grass never fully went away. Bloodwork came back showing high insulin ..acth and cortisol normal and lyme negative. We switched her to this tested low sugar Timothy hay and are feeding it since Monday....she has been eating 2lbs/day Buckeye Gro N Win ...I’m planning to take her off that if it’s whats recommended -although New Bolten Center said she can remain on it?? Anyhow could you please take a look at this hay analysis and tell me if you think Vermont Blend or California Trace Plus would be a better choice than the Gro N Win? My Vet said she should lose at least 200 lbs...can I safely use Speedibeet as a carrier for the meds and balancer? And anything else I should add or take Away?  
Any suggestions greatly appreciated.

Thank you
Michele Goldberg 
215-692-4397
Bernville, Pa 






 

Forgot to add supplements she has been on: Smart Digest Ultra , Tractgard,Kinetic Vet SA Powder, Elevate Vitamin E, Select Mega MSM pellets, Kauffman’s Integrihoof, was on Metaboleeze just now switched to Insulin Wise, Purina Outlast Ulcer Supplement.

Sherry Morse
 

Hi Michele,

The group does not accept attachments so you would need to post the Hay Analysis in a Case History folder and it does not look like you have one set up yet.  You should have received the Case History email explaining how to set this up now but if you have any questions, please let us know.

Since it's been a long time since you've posted I'm going to include our welcome letter which should answer many of the questions that you have.

From your email it sounds like your mare is IR.  I'm not sure how long she's been on Thryo-L but while it can help with weight loss, it has not been found to reduce insulin levels.  Buckeye Gro N Win has been tested to be 14.99% sugar+starch so is well over the level we consider safe for an IR horse.  You can see those results here: Buckeye and other feed test results

While some of our members can give general recommendations on mineral balancer products, it's really best to have somebody mineral balance the hay you're feeding.  You can find a full list of balancers here: Diet Balancing (scroll down to the Hay Balancers.pdf file).

To encourage weight loss we expect that you know both your mare's current weight as well as her ideal weight and recommend that she be fed a TOTAL (that includes hay and any sort of hard feed) of 1.5% of her current weight or 2% of her ideal weight until her ideal weight is reached.  More on that in the Diet section below as well as on the ECIR website at https://www.ecirhorse.org/DDT+E-diet.php.  Speedibeet has been discussed here before and you can do a search in the messages for more information on it, but it can be used as a carrier.  If you decide to use regular beet pulp we recommend Rinse/Soak/Rinse for the beet pulp to make sure it's as clean as possible.  Depending on the test results for your hay you may still need to soak that as well (again directions in the Diet section below). 

As far as your list of supplements - Insulinwise has had mixed results among our members - again, you can do a search of the archives to see that.  The Smartdigest Ultra and the Outlast both have an alfalfa base which can be an issue with some IR horses so you may want to consider removing those from her diet until you get her IR under control.  Elevate has dextrose in it and no oil which is needed for Vitamin E to work effectively so that's another supplement I would suggest stopping in lieu of straight vitamin E in oil which you can buy in any drugstore.  The Equishield contains rice bran which is another no go for most IR horses, so again you may want to consider stopping that.  For many IR/PPID horses getting their diets tightened up and their numbers under control can help with their allergy symptoms so just something to keep in mind with regard to that.  There's nothing in the Tractguard that raises red flags for me but somebody else might have a comment on that.

From the sound of that supplement list your girl has had issues with ulcers, is that correct?

With all of that being said, what follows is the official welcome letter which has a lot of information in it so grab a cup of your favorite beverage, take notes and let us know what you have questions on.



 

Thank you for all the info ...I will look over everything more thoroughly later on and answer questions better later as well...I will stop the Gro an Win and remove some of those supplements ..however what should I feed in the mean time as her”meals/feed” to carry the supplements ? I know Dr Kellon mentioned Glycocemic Eq which I don’t have -I’d have to order it ...on hand I do have Ontario Dehy Timothy Balance cubes ...would that be better in the mean time until I figure out what to feed her ?? I’m so confused and overwhelmed 😔


--
Michele Goldberg
Bernville, Pa
joined 5/19/2016

Sherry Morse
 

Hi Michele,

The Ontario Dehy Timothy Balance Cubes (ODTBC) can be used for her supplements or even to substitute for her hay as their ESC+starch value is always within ECIR guidelines and is mineral balanced.  I would suggest you put her on the emergency diet (outlined on the diet page at http://www.ecirhorse.org) for now.


 

Ok thank you ...I stopped the Gro n win and am replacing that with small amount Ontario Dehy Timothy Balance cubes as her “feed” and to carry her supplements until I’m able to pick up some speedibeet (which I think she will like better -she’s not crazy about the Balance cubes ...and mix with Glycocemic Eq or the Vermont Blend ...she’s being picky about eating because of all the meds lately so I’ve got to find something tasty ...anyone have experience if either of those 2 are picky eater approved ?? Also she’s now developed mouth sores from the Metformin ...does anyone know if I got that compounded if it would cause that issue?? I’m having to syringe it into her mouth because she’s refusing her food with it. Thanks I advance ...I plan to try and work on the case history today ...wanted to add that her low sugar Timothy hay is 6% nsc, 8.8% ESC and 1.8% starch


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Michele Goldberg
Bernville, Pa
joined 5/19/2016

Sherry Morse
 

Hi Michele,

Ugh on the mouth sores.  That's not an uncommon problem with metformin being syringed.  It's very likely that she's not being picky about eating because of the meds but because her mouth is bothering her. 

More reading for you -
Metformin and mouth sores:

metformin is highly alkaline There are oral formulations for human use but they are pH adjusted with hydrochloric acid.

It might help to mix it into oil instead of water and make sure the outside of the syringe is wiped clean.


Many people find their horses won't readily take the Metformin. Grind it up (cheap coffee bean grinder works well), mix with some oil and syringe it in. Check that the dose is correct - 30mg/kg, twice per day.

Finally - that hay is over our 10% ESC+starch cut-off so I would recommend you soak it before feeding.  I know it might not seem like a big deal since it's just a bit over but many of these horses are so sensitive that even at lower levels they need their hay soaked. You can do 30 minutes in hot water or 1 hour in cold water and then dump the water someplace where she can't get to it. 



Bobbie Day
 

Michele
A lot of us have went to stabul one, it’s like crack for my girl. All my horses love it.
You can look in the files for more information but you can get free samples, many flavors and very small easy to eat pieces. Good thing is you can order them from Chewy. I don’t think you would find a horse here that has refused them, not that I’ve heard anyway.


--
Bobbie and Desi
NRC March 2020
Utah, Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi

https://ecir.groups.io/g/CaseHistory/album?id=78821

 

Michele, two things.
Metformin. If you syringe metformin -- in addition to wiping off the outside of the syringe before you touch your horse's mouth--after you syringe it, be sure to rinse the mouth with clean water. It took me several syringes of water, like syringing to irrigate a horse's mouth after a dental procedure.  Also, carefully wash the outside of the mouth, too, to remove even a dot of metformin solution.  I'm a metformin drop-out because of swollen lips.

Carrier for your mineral supplements. If you choose Speedibeet, don't forget it will have to be rinsed, soaked, and rinsed again, like any beet pulp. I analyzed Speedibeet dry, out of the package, and found iron at almost 500 ppm. Read how to soak BP here: https://ecir.groups.io/g/main/files/5%20Core%20Diet/Beet%20Pulp/Beet%20Pulp%20Basics%20–%20How%20to%20use%20BP%20in%20Your%20Equine’s%20Ration.pdf

I personally use about half a cup of Nuzu Stabul1 (delivered to my door by Chewy.com) as a taste tempter in softened  ODTBC that were softened with just enough water to cover. I weigh the cubes,  200-300 grams or 7 - 11 ounces, depending on the horse. I feed supplements in the late afternoon, so anything left uneaten is available to nibble overnight. 

--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 

 

Hello everyone and thank you so much for the responses! I started rinsing/flushing her mouth with water after syringing the Metformin ...hoping this starts to help...question ...what type of oil is safe to give ?? I have Animed CoMega with hemp oil in the feed room..would that be ok??


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Michele Goldberg
Bernville, Pa
joined 5/19/2016

 

The Stabul One looks like a good choice ...more questions ...are you guys giving this just to carry minerals/supplements ? or is this used as “feed” ? I’m giving my mare a small amount of the Ontario Dehy Timothy Balance cubes for now as I happen to have it on hand because it’s what I feed my Cushings/IR pony ...figuring its better than the Gro N Win she was on ...or can I give some Stabul one mixed with the balance cubes or should it be one or the other?? Now that she’s been put on a diet because she needs to lose weight I want to make sure she’s still getting the proper amount of nutrition ...with the Gro N Win it was simple ...you fed a certain amount based on horses weight /amount of work....I guess I’m just unsure because I’ve taken that away and there’s no instruction on how much balance cubes to feed ?? ...I thought the Vermont Blend looked like a good choice for minerals to balance her hay ...but will it provide enough or the proper amounts of protein , vitamins and amino acids beings that she’s a performance horse?? Sorry for all the questions and if they seem redundant ...I’m just so overwhelmed and want to make sure I’m doing everything I can for her.
Thanks in advance
Michele & Schimpie


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Michele Goldberg
Bernville, Pa
joined 5/19/2016

Lavinia Fiscaletti
 

Hi Michele,

You can use the ODTB cubes, the Stabul 1 or mix them as a carrier. If your horse needs to lose weight, I'd stay away from a grain. You are correct that the ODTB cubes are a better choice than the Gro N Win. ODTB cubes can be used as a virtually complete feed IF that is all the horse is fed - just need to add ground flax, vit E and salt. Otherwise, you need to balance minerals intake to whatever else is being fed.

In order to be able to give you specific answers to your questions, we need to have more specific information. We can't suggest which supplement would be a better match to your hay without seeing the analysis for the hay. In a performance horse, the best match is a custom supplement based on the hay analysis.

This is why we ask you to fill out a case history - so that all the needed information to help you and your horse is readily available for the volunteers to access as needed to answer your questions.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR

 

Ok ...so do you still add stuff like minerals or a forage Balencer to your Ontario Dehy Timothy Balance Cubes/Stabul One mixture?? I’m guessing I would still need to add something like a balancer to my ODTB cubes since I’m only feeding a small amount of it to achieve proper nutritional requirements ?? I was considering trying the Vermont Blend and mixing with the ODTB cubes ??
Thanks in advance
Michele & Schimpie

--
Michele Goldberg
Bernville, Pa
joined 5/19/2016

Kirsten Rasmussen
 

The ODTB cubes are balanced to themselves so that if they were the only source of feed then only salt, flax and vit E need to be added.  If they are not the only feed in your horse's diet, the additional hay or feed will require mineral balancing and supplementation.  The ODTB cubes will not add any minerals that you need to balance your hay.  So yes, if you are also feeding hay you will need to add minerals.  If you have a hay test with major and trace minerals, it's well worth paying a balancer to find the most appropriate mineral mix out there, or have them design a custom supplement for your hay.


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

 

Even with careful rinsing and flushing the Metformin is still irritating the crap out of her poor mouth ...for those of you have gotten it compounded ...did that make a difference Vs the tablets ground up and syringed?We inquired with Wedgewood and it’s insanely expensive ...did anyone else that got compounded find it to be a lot more money?? I’m wondering how important the Metformin actually is and if it’s completely necessary with all the irritation it’s causing ...the Pentoxifylline is also a big pain in the but too as it forms a sticky thick gel almost immediately when mixed with water ...I’m just having a tough time with all these meds. I’m wondering if I should just stop the Metformin until her mouth heals up ...it looks like a swollen chemical burn. I got some Stabul One today ...I’m gonna try to see if she will eat the tablets mixed with some if that?
Michele & Schimpie


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Michele Goldberg
Bernville, Pa
joined 5/19/2016

Sherry Morse
 

Hi Michele,

Most people here have had their horses on Metformin because their insulin was not responding to changes in diet alone.  As you're just starting to institute diet changes you may want to discuss with your vet seeing how those go while forgoing the Metformin so her mouth can heal.  You might also want to check on how long the vet wants you to administer the Pentoxifylline as well as the Ace and the Bute. From our experience if she is IR the bute will not help with the laminitis and I'm not sure what the purpose of the other drugs is supposed to be at this point so you may want to clarify that with your vet as well.



Eleanor Kellon, VMD
 

Michele,

Compounding won't help.  Are you feeding immediately after giving it?  That should help. You could also try mixing it in Milk of Magnesia to reduce irritation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

 

I’m stopping the Metformin because her mouth is so inflamed and irritated ...the bute was to help with her immediate discomfort from her laminitis which was triggered by the steroids...we are weaning off the bute and are down to just 1 gram once per day for 1 more day ...the Pentoxifylline and the Ace were also given initially all to help reduce pain...I’ve stopped the Ace and I’m contemplating stopping the Pentoxifylline because she is so over having anything syringed into her sore mouth at this point...her bloodwork revealed high insulin (63) cortisol and acth normal ...she’s been off pasture , on stall rest , now eating tested low sugar Timothy, and I’ve stopped feeding the Gro N Win...so I’m hoping with just those diet changes alone her insulin will come down.
Michele & Schimpie


--
Michele Goldberg
Bernville, Pa
joined 5/19/2016