IR feed and advice/HELP! Please
20 y.o. mare newly diagnosed IR with intermittent and becoming more frequent lameness. Her IR #: 143. Vit E and Selenium are also HIGH. ACTH was negative. . Xrays are negative. Vet recommended diet, exercise and InsulinWise. We have seen several vets without much guidance - more xrays and injections is their default and I am not interested.
My mare gets Stabul1, tested Orchard hay and GutX. I'd like to "balance" her minerals, but so much has vit E and Se. She 's showing dandruff on chest and neck for a couple weeks, along with a more watery fecal matter than usual as of last 2 days - she had none of this prior to starting the Stabul1. I bought a sample of VB Se free, started at 1 TBLS and she won't eat it - tried that for 1wk.
I am at a loss with no idea where to go for help. I've spent hours researching and can't try it all or its not available in my area or to be shipped. I am debating on trying OmegaFields HorseShine - thinking of the Omega 3's and her hooves need help too! I know amino acids are important too. I suffer from analysis paralysis but I can't have my beloved horse being the subject of a weird science project. I love this horse dearly.
Husband thinks it the Stabul1 that is the issue. He wants to discontinue but to what use in it place? soaking BP in morning hrs isnt really an option - as I considered changing to that too. Looking for something safe and budget friendly.
Appreciate any guidance. Seriously at a point of I don't know what to do. I'm the damsel in distress.
Oh, almost forgot, ACTH pre was 14.9 post was 59.4
Natalie S. in CO, 2022
Natalie S. in CO, 2022
Hello Natalie, welcome to the group.
We know how hard and stressful this can be but try to take a deep breath, you're in the right place for help.
I will be sending along your welcome message which will cover a lot of information, please notice that there are blue hyperlinks that will take you even deeper into the subject. We ask that you read this over, we know it's a lot to absorb but keep it handy to refer to if you would.
The cornerstone of the group's philosophy is DDT/E, which stands for Diagnosis, Diet, Trim and exercise. PPID is diagnosed with the ACTH test and is a progressive disease which can only be controlled with Pergolide or Prascend. IR/EMS is diagnosed with a non-fasting test of Insulin, glucose and is metabolic in nature which we keep in check with a tight diet and management plan. You say her IR was 143, was that insulin? Do you have a glucose reading?
When was she tested for ACTH, was it in the last month or so? We're currently in the rise so we expect higher numbers now, but we also don't recommend fasting or hauling a horse for testing so any of those scenarios can skew results.
If she was tested before august, her numbers could possibly be suspect of PPID, please read this.
Laboratory Reference Ranges are NOT the Same as Normal | Dr. K's Horse Sense (wordpress.com)
This is where a case history really helps the volunteers, information as is the lab reference ranges, dates, her weight and copies of all tests are all important. We know you're a "damsel in distress" but we can help you through this.
A balanced diet is very important for all horses but especially for metabolically challenged and or PPID equines.
The first step is to get your hay balanced, but in the meantime, you can start the emergency diet as outlined below.
You say your hay has been tested, can you give us those details? We want wet chemistry test results. We have balancers that can help you with that.
HAY BALANCING (groups.io)
Below is your message and rest assured, our mods and volunteers will reach out to help.
Welcome to the group!
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 etiquette, what 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.
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.
No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:
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 (look under the Hay Balancing file if you want professional help balancing). 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.
EXERCISE: The 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.
If you have any technical difficulties, please let us know so we can help you.
Bobbie and Maggie
Desi (over the rainbow bridge 7/21)
Utah, Nov 2018
ECIR Group Primary Response
Glad to see you made it over here. Please take your time reading through all the information in the Welcome email from Bobbie as it's a LOT to take in. We realize that but we like to think of it as a cornerstone document that everybody can easily find and refer back to which is why everybody gets a copy of their own sent to them.
We as a group have not found Insulin Wise to be effective. The best thing we can say is that they appear to offer a money back guarantee so you might want to take advantage of that.
If you think the Stabul-1 created an issue with digestion by all means stop it and see if that clears up. It's extremely unlikely that dandruff is related to a feed started 2 days prior, but of course anything is possible with horses :-) You can rinse/soak/rinse beet pulp in large quantities and then refrigerate or freeze it - many people do that at once so it's done for the week (or if they're going on vacation).
Short version of everything:
Get her on the emergency diet - rinse/soaked/rinsed beet pulp & hay with vitamin E, flax and Mg added
Fill out a case history
Post body/hoof pictures when you have a chance