New Member -- Need Alternatives to Soaking Hay


hmmatthews2003@...
 

My IR boy, Remy, presently gets 1.5% ideal body weight (16 lbs) of soaked hay along with 2 lbs of Poulin E-Tec balancer per day. However, for a number of reasons, I need to find a sustainable alternative to soaking hay. My initial plan was to transition to a combination of TC Safe Starch, TC Timothy Balance Cubes, and Poulin Forage Extender Mini Bites. This offers a variety and, therefore, options in the event of supply chain delays. All three 'seem' to have appropriate levels of starch / sugars for an IR horse, and I like that the safe starch offers long stem forage. That said, this is all very new to me and, I admit, quite overwhelming. I'd love to tap into the collective wisdom here to get feedback on this combination, a suitable % of overall diet for each (e.g. 50% Safe Starch, 25% Balance Cubes, 25% Extender) or perhaps an even more creative solution for my ravenous, bored, but very adorable redhead.
--
~ Heidi
October 2021, New Hampshire
Remy Case History: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Remy


Eleanor Kellon, VMD
 

Why are you soaking the hay?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 
Edited

Hello Heidi,

Welcome to the ECIR group!  Your first post to the group triggers this welcome message.  There is lots of good information included.  After you’ve digested what you can, store it in a safe place for future re-reading - or just ask us to send you another one.

It’s fairly common for people to think their pets are bored with their diets and try to liven them up a bit.  My dog gets the same meal twice daily, day after day after day and not once has he complained about it.  The Triple Crown timothy balance cubes provide everything your horse needs with added salt, vitamin E and flax and they’re really the only safe product in that category.  I feed some Cavalor FiberForce as it seems to qualify as appropriate although we have not officially designated it as such.  The issue is that other products are not guaranteed to be consistently below 10% s/s.  Here’s a link to those products we have designated ‘safe’.  


The technique we use to set back your horse’s seemingly out of control leptin, is to slow down his access to food. With hay, you can put it in small holes nets and, if that isn’t sufficient, double the net.  With cubes, it’s a bit different.  I add water to my cubes until they ‘puff’ up and feed them like that which obviously isn’t suitable for a net.  At night, I add a dry cubes ball to their stall with a small number of cubes to keep the, busy overnight.  The cubes contain more nutrition than a similar weight in hay so you would replace 20# of hay with 15# of cubes.  My horses get hay/cubes for their main forage and I use a mix of Nuzu, Cavalor and cubes in a very small amount as a carrier for their supplements.

Going through his case history, I have a few comments.  First, thank you for posting it!  Now that you’ve done that, updates will be easier.  Next time you update, please add the approximate date that you took him off the 40 acres of pasture.  I didn’t notice any insulin numbers listed in your blood testing.  Do you have that value or how was he diagnosed IR?  You actually have two numbers for glucose and none for insulin so maybe you incorrectly entered one of the values.  Correcting that would be very helpful to us.  Here’s a link to a short easy user’s guide to metformin.  You mention the number of tablets Remy gets but not the mg value.  Is this given once or twice daily?  Metformin can result in mouth ulceration, depending on how it’s administered, so that’s worth reading about.  We don’t advise giving metformin and NSAIDs together due to the issue of ulcers but we actually don’t recommend NSAIDs  at all as they are not effective as control for laminitic pain, which is not inflammatory.  The primary means of controlling that pain is through eliminating its cause, through diet and/or trim and use of metformin or invokana for really difficult cases.


That seems like enough for now so the general welcome follows.  Please let us know if I’ve generated more questions than I’ve answered.

Welcome!

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 (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.

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


 
 


Lavinia Fiscaletti
 

Hi Heidi,

Thanks for filling out a case history form for Remy. I have a few questions for you so we can help you better.

It's almost a sure bet that the test results you have listed in Remy's case history as glucose are actually insulin results - the reference ranges are those for insulin, not glucose. Would you please double check that with your vet. His insulin has dropped enormously since the first test, so that's a great change in the right direction.

Have you had your hay analyzed? Once you have the analysis, you may find there is no reason to soak it, which would make things a lot easier. The Poulin balancer, TC Safe Starch and the Poulin Forage Extender Mini Bites are not suitable foods for an IR horse as none have a guaranteed ESC + starch that is below 10%. The TC Timothy Balance Cubes (the same as the Ontario Dehy Timothy Balanced Cubes) are definitely safe as they are batch tested and guaranteed to be below 10% ESC + starch. The Purina Carb Conscious treats are iffy at best as the starch is 4.9% + sugar at 4% (not guaranteed analysis).

Why is Remy on thyroid medication? Why is Remy on Equioxx? Is Remy still stall bound 24/7?

Hang in there, we'll help you get this sorted out.

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


hmmatthews2003@...
 

Hi Dr. Kellon,

I began soaking with the emergency diet, and have continued due to results from the hay analysis: WSC=17; ESC= 10.3 and subsequent recommendation to continue to soak. 
--
~ Heidi
October 2021, New Hampshire
Remy Case History: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Remy


hmmatthews2003@...
 

Thank you so much for your quick reply. Indeed the lab results I posted for glucose are meant to reflect insulin— I’ll be sure to make that change — and that’s how the diagnosis of IR was made.

Remy was pulled from his 40 acres on approximately 28-June-21, when he first came in sore on the left front (which was later confirmed to be IR-related laminitis) and has remained on stall rest since then. He has a daily 15-minute hand walk at this time and we’ll gradually start to increase that as he’s able  

His dose of metformin is 18 tabs twice each day, each tab = 1000 mg. I’m aware of the risk of mouth ulcers, so we’re watching very closely. 

The Levothyroxine is to help amp up, if you will, his metabolism in order to drop weight (he has approx. 200 lbs to lose and we’re about half way there). 

Hope this helps to provide clarity, and I’ll be sure to update our case history. 
--
~ Heidi
October 2021, New Hampshire
Remy Case History: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Remy


hmmatthews2003@...
 

Thank you so much! You’re correct, the lab results are insulin and not glucose. As you can see, he’s made great progress! 

I’ve had the current batch of hay analyzed and it shows WSC=17 and ESC=10.3, so I’ve continued to soak.

The Levothyroxine is to help boost metabolism in an effort to lose the extra 200 lbs he’s been carrying (we’re about half way there). 

He has been on daily Equiox for some time, for a history of kissing spine (now post-ISLD) and other chronic osteoarthritis issues. 

He remains on stall rest, with 15 minutes of hand walking once each day. We will hopefully be able to slowly increase that, as he’s able. 

I hope this helps to provide additional clarity, and thank you again for your kind words.


--
~ Heidi
October 2021, New Hampshire
Remy Case History: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Remy


Kirsten Rasmussen
 

Hi Heidi,

You've made great progress, and all 3 things (removing pasture, soaking hay, starting Metformin) are why.  If you remove 1 of these variables (ie soaking hay), I would retest insulin after 1-2 weeks to see how much of an effect it has.  Your hay is definitely risky at 10.3% ESC (what is the starch?), and I would not advise stopping soaking.  However, you don't know how much of an effect it will have if you don't try it and recheck insulin.

That said, many of us have figured out how to have hay soaked at a boarding barn, and/or through the winter...not sure what reasons you have for not bring able to soak, but maybe we can give more advise if you can specify them.  It's not necessarily easy, but it's easier than dealing with laminitis/founder.  You could also try buying your own low sugar hay if you can find some.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album


hmmatthews2003@...
 

Thanks so much for your feedback, Kirsten. To answer your questions:

Starch is 0.6.

As for soaking, it's simply a matter of time and logistics, and now winter coming. I work long hours and board about 30 minutes away, so it's sometimes difficult to get the barn every day and it takes quite a bit of time to pull everything together once I get there (weigh and fill x4 hay bags, soak for 60 minutes, drain for 15/20 minutes, grind and mix meds, etc.). The only way I've been able to make it work thus far is to prepare everything in the evening for the following day. (It makes me sick worrying about the soaked hay sitting for so long before feeding.) Now, with winter coming, I'm honestly not sure how I'm going to be able to continue to soak-- I won't have a suitable location to drain the water where it won't pose a freezing/safety hazard. But, to your point, the hay is just too risky not to. 

--
~ Heidi
October 2021, New Hampshire
Remy Case History: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Remy


 

Hi Heidi,
I know hay soaking is time consuming but I live in northern New England, soak once a day and never have any issues.  I never pack the bags tightly so they aren’t as likely to mold.  No one has rejected their hay for being frozen and crunchy.  I do have a barn to work in.  It’s not heated but out of the wind and, because it’s at my house, I installed a drain to a dry well.  Could you soak it at home?  Soaking in hot water decreases the soaking time by half.  While never quite as reliable as doing it yourself, can you pay another boarder to do it for you?  Maybe a Pony Club or 4H member who might make a learning project of it?
--
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


 
 


Kirsten Rasmussen
 

Oh I see, yes it is time consuming.  And exhausting if you have to be there every day after work.  Even though the hay only soaks for 1 hr, weighing it out into nets, filling the barrel, soaking, rinsing and draining takes closer to 2 hrs.  Definitely finding some paid help would be good, especially if there are days you can't be there.  Will the barn do it for a little more in boarding fees, or in exchange for a few hours of your labour 1 day a week?  Or can you hire some who is there every day, or maybe lives there like the barn owner's daughter/son if they have one?  When I am going to be away, I pre-measure each day of hay into garbage bags and split out the am and pm portions with a second smaller garbage bag inside the big one.  Others have used Rubbermaid bins or feed tubs and then stack them so they take up less space.  My horse-sitter just needs to transfer it into nets and get it soaking while she does the rest of the chores.  It does make it a lot quicker for the person soaking it when the weighing step is removed, and if you have room at the barn you can pre-measure a week's worth in advance.

Another option might be trying to source a low sugar hay and asking if you can store it at the barn.  Even if you can't store a year's supply there, even 20 bales could help if they are only fed on the days you are not there to soak hay.

Talk to your barn owner about where you might be able to drain water to.  Many of us run a pipe out to an area away from traffic and often where there are plants that like to be watered.  They might have a creative solution.

Like you and Martha, I soak 24 hrs of hay at a time.  Aside from freezing solid when temps drop below -15 C, the only time I've had an issue is warm AND humid weather where the hay starts to smell sour the next day.  This weather combination is rare where I live, and I still feed it to my horse when it's like that because it smells more like it's fermenting rather than molding, but I know it's less palatable to him.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album