Excessive protein


jonna.ahlberg
 

Hi! I have a question. I have read that its not a good idea to feed excessive protein to a IR/laminitis-horse. But how much i "excessive protein"? I have found a hay with lots of protein ( and I if I can use this hay I dont need to add anything else but minerals). When I use my calculator it tells me "excessive protein" 200 g. Is it to much? 
She got laminitis on one foot 2018 and 2020 but we dont know why but I treat her as an IR-horse. She has been thin since last year. 
She is a warmblood, about 500 kg. 
Thanks!


Candice Piraino
 

HI Jonna,

Welcome to the group! Pleas upload the hay analysis and your case history as soon as you can so we can provide better assistance for you and your horse.

Bottom line- yes too much protein will affect your horse in a negative manner.

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you.

--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Eleanor Kellon, VMD
 

I'm doing a segment on this very question for the Conference. There is some evidence it could be an issue but the controlled study used a 30% balancer type product fed at 4X the usual amount and it had 12.5% S+S. It may be that certain amino acids are an issue while others are not.

I could be a lot more specific with history details. Is she working? Any blood work? How old? Laminitis in one foot is highly unlikely unless there is an injury, a club foot or white line disease.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Cindy Q
 

Hi Jonna

To add on, most people are happy to find crude protein "as fed" in the 8-11% region. For imported hay where I am (imported from the US), I see 12%+ quite often and my estimate is above 13% would be high and 15% or more very high. One concern is high protein can indicate legumes (alfalfa) mixed into your hay which may not be tolerated well by IR horses. There is a concern if the protein is very high that it may indicate high nitrates. A few of our volunteers have shared posts on high protein and nitrates and soaking to reduce nitrates, I will list a few helpful links for you: 
https://ecir.groups.io/g/main/message/266620
https://ecir.groups.io/g/main/message/262058

I'm not sure what you entered into the calculator. Are you saying your hay gives 200g of crude protein per kg (20%)? That would be excessively high. I am not sure why you say if you use that hay you do not need to add anything else but minerals. Please look at the advice that Candice shared to you in the welcome letter on the recommended diet as well as the emergency diet which is linked.

Has your horse been tested for PPID and how old is she? You can read about our recommended testing protocols under the first section of the Welcome letter under diagnosis.

--
Cindy and Glow (over the rainbow bridge) - Sep 2017, Singapore
ECIR Primary Response





jonna.ahlberg
 

Thanks! I think I had a case history back in 2018 when she had laminitis but I dont find it :( Maybe I need to do a new one. 
--
Jonna Ahlberg in Sweden 2018


jonna.ahlberg
 

Thanks! I think I have to do i new "case history" but in short she got laminitis in January 2018. She couldnt walk and the x-rays told us the the coffin bone had rotation and the vet and farrier told me my horse probably had to put to sleep. But we managed to stay alive and in 2020 she had the same problem again (in May). You can see it on her foot (dont know what you call it in english, there is a "circle" on her foot). 
In 2018 my vet did some blood work (PPID) but it was ok. My mare is 11 now, a Swedish Warmblood (with an irish dam). She likes food and can be very fat very fast...
I just walk her right know but hopefully I can start to work her more soon. 
--
Jonna Ahlberg in Sweden 2018


jonna.ahlberg
 

Thanks! Here in Sweden we may have other analysis than the rest of the world :) No, I mean 200 g/day, crude protein is about 137 g, maybe you use % (we dont), so maybe it is 13,7% then?

I will try to do a new case history.
--
Jonna Ahlberg in Sweden 2018


 

Hi, Jonna.
Martha found your Case History for Anna. Your Case History folder is here: https://ecir.groups.io/g/CaseHistory/files/Jonna%20and%20Annie/ 
The next step is to update your automatic signature with the link to the folder. Go to your subscription page:
https://ecir.groups.io/g/main/editsub
Scroll down to the signature block near the bottom. Copy and paste the link to the folder under your signature. Add a space or return after the link to make it clickable.
Scroll to the bottom of the page and SAVE!
When you update your CH, you will upload it to your folder. You'll easily find the folder is because it will be in your automatic signature.
Let us know if you have any questions.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Sherry Morse
 

Hi Jonna,

When you update your signature you also have a photo album: https://ecir.groups.io/g/CaseHistory/album?id=64989 so you can post new pictures there and also add that link to your signature along with the Case History folder link.




jonna.ahlberg
 

Thanks, maybe it works now...or maybe I have done something wrong :D
--
Jonna Ahlberg in Sweden, 2018

CaseHistory@ECIR.groups.io | Files
 https://ecir.groups.io/g/CaseHistory/album?id=64989


Sherry Morse
 

Hi Jonna,

Perfect!  Do you have any current x-rays or hoof pictures to share?  The 2018 x-ray is bad, but we have seen worse here.



jonna.ahlberg
 

Yes, I found one from october 2018, it is added.
The first one is from the day after I found Annie very lame, in January 2018. She was ok in the morning but couldnt walk in the evening. I took her to my vet directly because I thought it was an abscess... but no :( Annie got bute but had colic 5 days later and the vet said "well, you have to choose, colic or laminitis". I chose laminitis so no more bute..and she was not lame anymore until 2020 again. 

We took x-rays in 2020 again (when she was lame again) but I cant find them, I remember the vet said that the coffin bone hadnt changed to the worse.  
--
Jonna Ahlberg in Sweden, 2018

CaseHistory@ECIR.groups.io | Files
 https://ecir.groups.io/g/CaseHistory/album?id=64989


jonna.ahlberg
 

I can take some pictures of the hoof tonight.
--
Jonna Ahlberg in Sweden, 2018

CaseHistory@ECIR.groups.io | Files
 https://ecir.groups.io/g/CaseHistory/album?id=64989