Diet/Supplement Questions for Cupcake (Alison) + recommended blood work + Prascend dose


 

Hello! We have finally gotten most of the info from the vets (other than most recent blood work (not that recent) - hopefully forthcoming) in Cupcake's case history file. We are working hard to get her stabilized and out of the repeated acute laminitic episodes, which seem to be worse this year than ever. We have a few questions about the emergency diet and supplements below.

Cupcake is around 300 lbs. She currently (as of 7-15-2021) gets fed 2x/day as follows:

AM
PM
  • 1/2 lb TC Timothy Cubes (soaked)
  • 1/2 lb soaked beet pulp without molasses
  • 0.5 mg Prascend tablet (1/2 pink tab)
  • 1 tsp OneAC
 
Questions

1) Without being able to test the timothy/orchard soaked hay, would it be better to feed soaked hay than the Safe Starch Forage? The Safe Starch tends to give her diarrhea when it's the only source of forage, but it wasn't a problem when she was getting hay as well in the past (although the hay was unsoaked before, and she's only getting soaked hay now). Is there another source for free choice forage?

2) Should we start the supplements one at a time or all at once? We have everything but the APF, but are unsure as to how to tell what is working if we start them all at once. Thoughts?

3) Dosages/amounts for a 300 lb mini mare... Do these look correct? Should they be split evenly between meals or all at once?

  • 1/2 lb TC Timothy Cubes (soaked) 2x/day
  • 1/2 lb soaked beet pulp without molasses 2x/day
  • 1 tbsp Iodized Salt
  • 1/3 tsp MagOx 58%
  • 800 IU Vitamin E (2 400 IU capsules)
  • 2 oz stabilized ground flax
  • 3/4 tsp (starting dose) Jiaogulan in water paste AM and PM - 20 min before feeding
  • 8 ml APF Solution? Would this be as needed or daily, indefinitely?
4) When the vet does come, what blood work would be advised, if any, right this time of year? 

5) We've discussed raising the Prascend dose with the vet from the current 0.5 mg, but the vet seems resistant to this idea. How can we work this, if a higher dose is recommended? It doesn't seem to be helping much at the current dose, but there are admittedly spotty feeding records up until the recent past. Should we work on the basic diet first (i.e. give it more time - and how long)?

Thanks in advance for your help!
Rebecca, Alison, & Cupcake in Wilmington, NC
 


 

Wanted to add: Cupcake will be getting trimmed tomorrow (Tuesday, 7/27) and I'll post photos and post-trim video for reference.

--
Rebecca Wyatt, PBHT III
Wilmington, NC - Member since 2007
https://naturespathhoof.com
https://facebook.com/naturespathhoof

Cupcake Case History: https://docs.google.com/document/d/1s_Z2ORfcL2JtlYeNBLKU6Ez6cxvtf0ubegFF66StUNM/edit?usp=sharing
Cupcake Photos: https://ecir.groups.io/g/CaseHistory/album?id=266055


Sherry Morse
 

Hi Rebecca,

First a bit of housekeeping:

Could you please add Cupcake's CH to the folder in the Case History group and then update your signature with the link to that folder?  https://ecir.groups.io/g/CaseHistory/files/Alison%20and%20Cupcake%20-%20Rebecca%20Wyatt,%20farrier

Second: As far as the current diet - When you say Triple Crown Timothy Cubes is that actually the Timothy Balance Cubes? Is the beet pulp rinsed/soaked/rinsed or just soaked? Is the hay actually being weighed or is this just a guess?  You have 2lbs in your email and 4lbs in the CH and that's a HUGE difference, particularly with a mini. 

Looking at Cupcake she could stand to lose some weight, although she's not as fat as many minis we see.  However, it's going to be a fine line on making sure she's eating enough but not too much. If she's really 300lbs now I'd guess that she should be closer to 280-290 for an ideal which would make her total intake a max of 5.6- 5.8lbs (hay and concentrates combined) and you need to consider the types of feed as well (more on that below).  If she's currently being fed 6 lbs a day of hay, beet pulp and cubes she's going to need something reduced right off the bat.

Simplifly is made in a base of wheat middlings and dehyrdated alfalfa meal so would be off my list of things I'd feed a pony with laminitis issues.  The treats which are made from alfalfa would be a no go either for the same reason.  As mentioned in the welcome letter while alfalfa is low in ESC+starch it is unsuitable for many IR hoses.  There are many members here who use Timothy Balance Cubes as a treat for their horses (and that of course is taken into account as part of the daily intake). They are fine to be put into a treat ball dry.

As far as your questions:

1 - Safe Starch isn't actually safe for an IR horse so I would not be feeding this to her at all.  As mentioned in the welcome letter you can soak hay that has not been tested.  We do not advocate free choice feeding of hay here.  If you want to feed multiple times a day that's fine, but the total fed (this includes forage and any supplements) should not exceed 2% of the equine's ideal body weight and some may need less to maintain their ideal weight.  This is also why knowing exactly how much hay she's currently eating is important.  Triple Crown Timothy Balance Cubes are fed at a 3:4 ratio (3lbs of cubes = 4lbs of hay) so that's also something to keep in mind.  1lb of cubes should be ok per day but if she starts gaining any weight or if her crest starts to get larger something needs to be cut back. 

2 - You can add in the necessary supplements (flax, Vitamin E, Mg and salt) at the same time.  If she's tolerating the .5mg Prascend dosage (how is this being administered?) she does not need APF.  Please note that the Vitamin E needs to be in oil to be effective.

3 - the dosages are fine to start for your supplements off the top of my head.

4 - you need to test for Insulin and glucose. You can test ACTH again as she's been on the Prascend since March, but it should be done ASAP as we're already going into the seasonal rise period and if her ACTH is elevated you may find yourself chasing the rise to try to get it under control.

Looking at the video from earlier this month Cupcake isn't really in a dry lot - if there's even a chance she's scavenging grass there should be an effort made to remove as much of it as possible from that area.  She may also need to be muzzled to keep her from eating while she's out, even though it doesn't appear that there's much to eat out there.  Stressed grass can be dangerous for an IR/PPID horse.

If she still has access to the Himalayan block please remove that - the color in the block comes from impurities in the salt (including iron) that can be bad for an IR horse.

A full set of current hoof pictures would be really helpful: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help




 

Hi again,

The most recent/updated info is in the case study PDF document now in the files. I measured and weighed everything this morning to be sure. The himalayan block has been removed. It is the TC Timothy Balance Forage cubes. The hay isn't really free choice; she eats the whole 2.5 lbs through a slow feed back over 24 hours. I feel like she would be too stressed physically and mentally only having meals with no constant source of some sort of forage -- can you explain the group's position on that?

A dry lot (literally) is being prepared, but not ready yet (the growth is being killed with an organic herbicide, but I'm not familiar with the brand). She's not very interested in the little sprigs that grow here and there in her current lot, but it's also 100% shaded, so not much would grow there anyway other than moss. 

So just ask the vet to test insulin and glucose, not ACTH (understand the seasonal rise)? She's "tolerating" the 0.5mg Prascend dose, and it's given by hand with a small amount of her feed at evening time. I just have not noticed any difference in her symptoms at all since she started it. The owner reports she has a bit of a haze in the evenings, but I haven't noticed it.

Just with the recent dietary changes alone, I am seeing drastic improvements in her energy level, demeanor, up-time, and soundness (although I've explained to the owner that it will be several months of *good* well-connected hoof growth before there are any remarkable soundness changes without padded boots). I posted some photos of her most recent trim, and my own personal critique includes trying to get those heels down more and toes further back. It's not a "pretty" trim (wiggly, sore-footed mini), but it helps her quite a bit. The 1-2 week schedule has been beneficial, but boy can she grow a ton of hoof in that amount of time. Her sole depth is unusually(!) thick for a founder, but I suppose that is a good thing.

...Side note, I also do web development and web-based applications/databases. I'd be more than happy to help simplify the case study database and entry process of photos, etc. - let me know who I should speak with!

Thanks again!

--
Rebecca Wyatt
https://naturespathhoof.com
https://facebook.com/naturespathhoof
Wilmington, NC ECIR Member since 2007

Cupcake (Alison, owner / Rebecca, farrier)
Case History: https://ecir.groups.io/g/CaseHistory/files/Alison%20and%20Cupcake%20-%20Rebecca%20Wyatt,%20farrier
Photos: https://ecir.groups.io/g/CaseHistory/album?id=266055


Sherry Morse
 

Hi Rebecca,

Normal horses do not eat 24/7 even if they have access to food at all times. However, one of the issues with many IR horses is that they have elevated Leptin so they don't have an off switch when it comes to eating.  Letting this sort of horse eat free choice will result in them remaining fat and continuing to have elevated insulin in a never ending cycle until something is changed (which is usually the amount of hay fed and restrictions in feeding). 

If Cupcake is taking a full 24 hours to eat her hay ration that's fine as long as the amount she's fed is still what she should be eating and not free choice.

If the vet is coming in the next few days you can test ACTH, you just need to be cognizant of the rise and that there is an adjustment to be made for that.  The fact that you're seeing positive improvements points to IR being the main issue and the diet changes helping with that.





 

Yes, to clarify, she is eating her ration throughout the day (not all she can eat but it's lasting that long). Insulin resistance is such a fascinating topic. I've always heard that horses need a steady supply of forage (albeit not in great amounts) to help prevent stress and ulcers. Is this no longer the consensus?

I'm looking forward to attending the No Laminitis! conference and absorbing every bit of knowledge I can while I recover from mastectomy surgery on the 12th (can't physically work for 6 weeks, but I can learn!).

--
Rebecca Wyatt
https://naturespathhoof.com
https://facebook.com/naturespathhoof
Wilmington, NC ECIR Member since 2007

Cupcake (Alison, owner / Rebecca, farrier)
Case History: https://ecir.groups.io/g/CaseHistory/files/Alison%20and%20Cupcake%20-%20Rebecca%20Wyatt,%20farrier
Photos: https://ecir.groups.io/g/CaseHistory/album?id=266055


 

On Fri, Jul 30, 2021 at 09:31 AM, Rebecca Wyatt ~ Nature's Path Hoof Care wrote:
I've always heard that horses need a steady supply of forage (albeit not in great amounts) to help prevent stress and ulcers. Is this no longer the consensus?
Hi, Rebecca.  It is true that horses need access to forage over a 24 hour day instead of being meal-fed two or three times in that time period. But it's obviously not true they need forage in their mouths 24 hours a day to avoid ulcers, or we couldn't ride or work them. We avoid long periods of empty stomachs, but that is not the same as steady consumption 24/7.

We suggest slow feed hay nets to extend the time that forage is available and to slow down consumption for our equines that lack an appetite off-switch. Following Dr Kellon's guidance, I aim for periods no longer than 2 hours without access to forage during the day and 6 hours over night. 
 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Eleanor Kellon, VMD
 

Here are some blogs on that topic:

https://wp.me/p2WBdh-1aH

https://wp.me/p2WBdh-ys

--
Eleanor in PA

www.drkellon.com 
EC Owner 2001