HELP Kat new blood work and signs of sore RF possible early laminitis


Hey team.  Just landed out of the country and got a call that kat is not doing well.  I also just checked my email and the blood work I had done late last week was finally returned.  Looking for advice on what next.  Will update my CH when I get to my final destination hopefully,  but only have my ipad.

Some history:

kat is now on 1.5 mg of prascend.  Only eats Timothy hay cubes by naturals  and some beet pulp am/pm.  I previously tested the hay and its below 10% Sugar/Starch.

Dec 31st he started to show signs of sore RF.  We pulled the shoe, iced etc.  thought it was another abscess so poltice etc.  off and on good days and did xrays again Jan 17th and no changes.  Put him in a soft ride boot and all good until today.

got his blood work results pulled last week and just now got them back. 

Glucose 117 mg/dl Reference 71-122  (same as nov 2022 text)
insulin baseline 64.08 ulU/ml reference 10-40  (was 31.5 in nov)
leptin - pending
TRH pre 15.2 pg/ml  reference 2-30  (was a 20.9 in nov)
acth post 229 pg/ml reference 2-110 (was 829 in nov)

So current IR calculator results:
G/I reatio 1.83
RISQI 0.12
MIRG 8.5

Clearly at high risk for laminitis with the continued IR calculators.  Since I am out of the country my girlfriend is in charge until I can get back sunday night.  She feels some heat so starting to ice 3x a day.  No change to diet.  

What else should we be doing?
Carolyn, SC, oct 2022

Sherry Morse

Hi Carolyn,

1- there's a chance this is winter laminitis in which case icing is the LAST thing you want to be doing.  What are the current temperatures?  Is he in socks/leg wraps or just the boot?

2 - as we've mentioned before there's no real research on a good post-TRH number while on pergolide. It could be a bump up is warranted but hard to say for sure.

3 - what were the weather conditions when the last bloodwork was done?  How long after feeding as I'm guessing he's not free choice with hay cubes.

An insulin level of 64 is not usually enough to cause obvious foot issues which is why I would treat this as a winter laminitis episode first.  How is his current weight? 


Hey Sherry. Thanks for the quick response.  Thank goodness for wifi on airplanes now.

wondered about the icing but was suggested by the vet.
weather conditions were lovely last week.  But over all the weather has been up and down and definitely colder now
he actually does get free choice hay but he is over 17 hands so I supplement with hay cubes and beet pulp.  He is perfect weight now (but was actually quite overweight for the first time in his life in sept before his fall laminitis episode (first time I’ve had experience any laminitis).  Been a big learning curve since thanks to this group.
Carolyn, SC, oct 2022


Forgot to answer - only in the boot.  Temps have been in the 60’s, 50’s today
Carolyn, SC, oct 2022

Eleanor Kellon, VMD


Since only one foot and with heat I'd be suspecting abscess. Icing is contraindicated. Warm Epsom salt soaks and poulticing would be good.
Eleanor in PA  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
The first step to wisdom is "I don't know."