Topics

Insulinwise & Alcar

Katherine Reid
 

My vet wants me to try Insulinwise for a couple months for my PPID gelding, and I have agreed to do this.  I asked her if I should stop using Alcar while he is on Insulinwise (he’s been on Alcar since forever, and it’s never made a difference that I could tell).  She said she would ask the people at KER.  I am wondering if anyone here has an opinion

Katie Reid
Ramona, CA
Member since 2005(?)

Lorna in Ontario
 

Hi Katie,

Just arm yourself with knowledge about Insulinwise,by doing an archive search. Lots of info in previous messages.
Also,be sure to record months during which you use it. And current insulin lab.levels.....no CH so not sure where you are in that regard.
Also,record clinical sign,size of crest,etc.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php

Nancy & Vinnie & Summer
 

In my humble opinion Glycocemic EQ was more effective than insulinwise.  I have used insulinwise for 2 years now and i didnt see reduction in crest.

I added Glycocemic Eq by uckele about 3 months ago and immediately saw a positive change in crest and pads over the lumbar region.

Thx Nan
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

 

Hi Katie,

While I have used Alcar quite a bit, I have never used Insulinwise so I have nothing to report on combining them.  I have understood that refunds might be available if Insulinwise doesn’t work so you might want to check to see if there are limiting conditions which could affect the refund.

In an effort to keep our long time members updated, we are sending them all the most recent ECIR welcome when they post.  It may or may not look familiar as we are not sure you ever received one and it is updated regularly.

We are also hoping that you will post a Case History for your horse so that we can respond more appropriately.  The instructions for doing so are found in the welcome letter.

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and 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 Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or 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 IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*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: IR 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 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 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 IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID 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. 

 

--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 

 

Katie, I wanted to add that my use of Alcar was for a horse that was PPID but not IR.  It’s use was not related to PPID.  The interaction or lack thereof you are asking about might well depend on the reason your horse is given Alcar.  Could you fill us in there, please?
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 

Shevawn Romine
 

Does anyone know if Platinum Performance Metabolic supplement is comparable to Insulinwise, Alcar or Uckele Glycocemic?     I started it,   Thyroid L,   and hay change all at the same time.    Have full hoof regrowth now , no pain,   and weight loss.   (Was already on a track ,  with muzzle for 5 hours in pasture)  So not sure which of these additions was really helping.   Not wanting to change ,  but if something is better…    Haven’t retested insulin yet,   as each month has been a breathe holding exercise .   


--
Cassie and Shevawn
03/2015   Gordon, TX
CH folder:  https://ecir.groups.io/g/CaseHistory/files/Shevawn%20and%20Cassie 
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=76832 

Sherry Morse
 

Hi Shevawn,

Thyro-L won't help lower insulin although it may help with weight loss.  Not sure if you've looked at the archived emails about Insulinwise but many here have found it not to be helpful at all either.  As far as the Platinum Product vs. Uckele - you'd have to feed 3.5 scoops of Platinum to get the same amount of Magnesium as in Glycocemic and that serving would give you 8.75mg of Chromium which is more than the Uckele product so there's that perspective as far as cost, but there's also more to the Uckele product than what it is the Platinum one. 

Without rechecking insulin and glucose you don't really know if Cassie is in a safe zone so you may want to consider doing that rather than holding your breath every month.


LJ Friedman
 

Insulin wise is refundable  if it doesn’t work. Imagine getting a refund for two years worth of insulin wise?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 

 

I had no change using Insulinwise and my girl was on Thyro L with increasing doses and it never helped in her weight loss. Tightening the diet and increased exercise were the only tools in the tool chest that worked for us. Balancing our hay is the only "supplement" she gets along with turmeric and spirulina with salt and flax. 

--
Nancy and Akira
3/20/2018  Burkesville KY

Case History: https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Akira

Katherine Reid
 

Thank you for all the feedback.  Appreciate the thought that went into them.  Still no idea whether it’s OK to combine with Alcar, so I guess I won’t worry about it.  

Diet is tight, ACTH under control, and exercise is as much as possible - vet says she’s seen it work in other clients so whee....off we go!  I’ll report back after a retest in two months.

Katie Reid
Ramona, CA
Member since 2005(?)

Lavinia Fiscaletti
 

I seriously doubt the company would refund 2 years worth of purchases of their product. They might refund the cost of one bucket.

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

Lorna in Ontario
 

I guess, it depends,too, on what your vet means by seeing  it "work".
Devil- in- the- details time again.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php