New results, advise going forward
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Hi all, Both horses were fed their usual 1/2 lb Stabul 1/ 3oz Flax / 2500 IU Vit E / SimpliFly / 1 tbsp iodized salt at 6:45 am and grass hay left in front of them until Vet arrived at 11:30 am. All tests run by Cornell. MAX Max’s CH is completely up to date, and there are photos. Ginger is undiagnosed at this point so she does not have a CH but has photos also. I would greatly appreciate it if someone could look at their albums and help me determine BSC and or any trouble spots that I am not knowledgeable enough to see such as crestiness etc. Not sure about their feet … photos are 3-4 weeks out from last farrier visit.
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The crests on both horses are very slight. It looks like Max has some fat deposits at his tail base. The published literature on seasonal insulin changes in contradictory - some say yes, some no. With specific reference to your horses, If no change in diet or exercise, you obviously have an unexplained seasonal change.
Ginger may well be an early PPID case. I would consider TRH stimulation test after December. Agree with your Prascend plan for Max. Both of these insulins are considerably below the apparent threshold for acute laminitis We would need detailed hoof photos (instructions in the Wiki) to comment on the feet. -- Eleanor in PA www.drkellon.com |
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Lynda, your Sept 26 insulin values are identical for both horses. Is that a typo?
Ginger's insulin in April was high enough to diagnose her with well-controlled EMS. It should be no higher than ~13 uIU/ml in a non-EMS horse. If their exercise has decreased since April, that could contribute to the higher insulin in Sept. The only way to know for sure if it's ok to lower the pergolide dose is to lower it first, then retest 3 weeks later. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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On Wed, Oct 5, 2022 at 07:12 AM, Kirsten Rasmussen wrote:
Lynda, your Sept 26 insulin values are identical for both horses. Is that a typo? Kristen, Thank you so much for noticing that I duplicated Ginger’s number for Max! His correct Sept 2022 Insulin value was 20.33 ul/U Dr. K,
Thank you for your input. I was going to schedule an Oral Sugar test for Ginger in the spring, but I’m generally feeding/managing all my horses as if they are IR already, should I not bother with that and just schedule the TRH Stim test to check for PPID? I’m actually very uncertain what the correct weight for either should be, but Max and Ginger are being fed just a bit more than 1.5% of their (guesstimated) target weights of @1025 lbs for Max who gets 16 lbs grass hay, and @975 lbs for Ginger who gets 15lbs grass hay. Both get 1/2 lb Stabul 1 with their supps in the AM. Hay fed 3 times daily in slow feeders. I know that’s the low end of recommended amounts, and I worry that I’m contributing to insulin issues by not feeding more, but with so little exercise the last 5 months they’ve both gained weight over the summer. Max recently scaled at 1100 lbs and Ginger at 1080. With health and life issues calming down I'm working them in the round pen more often and hope to get back on trail soon. This group is amazing, and I’m in awe of the heroic efforts it’s founder, moderators, and members go to for their horses. Lynda Northern CA Jan 2022 https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max Max Photos - https://ecir.groups.io/g/CaseHistory/album?id=277238 Ginger Photos - https://ecir.groups.io/g/CaseHistory/album?id=278091 |
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Hi All, Dr. K, Kristin, Thank you so much for noticing that I copied Ginger’s number for Max! His correct Sept 2022 Insulin value was 20.33 ul/U Question re: their diets. I guesstimate Max should weigh @1000-1020 lbs and Ginger @975-1000lbs. Both are easy keepers who’ve gained weight over the summer while being fed just a bit more than 1.5% of those target weights. Daily, Max gets 16 lbs grass hay, and Ginger gets 15lbs grass hay. Hay is fed 3 times daily in slow feeders and under 10% ESC/starch.. Both also get 1/2 lb Stabul 1 with their supps in the AM. I know that’s the low end of recommended amounts, and I worry I may be contributing to insulin issues even though neither have yet been confirmed as IR, Both have gained weight over the summer… Max scaled at 1100 lbs and Ginger at 1080 not too long ago but they’ve had very little exercise. With health and life issues calming down I'm working them in the round pen more often and hope to be able get back in the saddle and on trail soon. Any input as to whether their current diet is appropriate or might be exacerbating any of their borderline IR issues? Thanks in advance for your always valued input. Lynda -- Lynda MNorthern CA Jan 2022 https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max Max Photos - https://ecir.groups.io/g/CaseHistory/album?id=277238 Ginger Photos - https://ecir.groups.io/g/CaseHistory/album?id=278091 -- Lynda M Northern CA Jan 2022 https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max Max Photos - https://ecir.groups.io/g/CaseHistory/album?id=277238 Ginger Photos - https://ecir.groups.io/g/CaseHistory/album?id=278091 |
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HI Linda
You did receive responses from Kirsten and Dr Kellon. Have a look here via this lilnk to the thread on the web. https://ecir.groups.io/g/main/topic/94124438#284225 It reads with your newest message first so scroll to the bottom and scroll up as you read. -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President 2021-2022 |
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Lynda,
If your hay is the one in Max's folder, it's on the high end for calories but low for protein. I would cut Max back to 15 and Ginger 14 lbs. I would give each of them 75 grams of casein https://canadianprotein.com/products/micellar-casein . No need to do a sugar test on Ginger, just get a baseline insulin and glucose. BTW, an insulin of 20 on this diet is too high. -- Eleanor in PA www.drkellon.com |
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Hi all, Thank you! -- |
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Hi Lynda,
An insulin of 40 for Ginger on a hay only diet is a strong positive for EMS-related IR. It would be no high than about 12-13 in a 'normal' horse. It's not high enough to cause laminitis, but it is high enough to affect the quality of her lamellar connections. Tightening up the diet (ie soaking hay) or increasing exercise will help lower Ginger's insulin. For Max, it could be diet, lack of exercise, or due to his PPID, but I would be happy with his insulin where it is. Keep in mind that the desire to eat all the time or the appearance of hunger in a horse with EMS getting adequate calories, is controlled by the hormone leptin, which is strongly correlated to weight. Being overweight makes them less sensitive to leptin so they don't realize they are full and they have an insatiable desire to eat more. So while getting the weight off can be difficult for them at first, as they become more leptin sensitive they will start to feel better and less hungry all the time. They also get used to their new normal. We are not advocating starving them, which worsens IR. We are advocating slow and steady weight loss to a BCS of 4.5/9. I suspect your target weights are too high if you're feeding 1.5% of target weight and they are not losing. For my horse, I thought his ideal weight was 1000 lbs so I fed 1.5% of that to get him to lose weight (he was a VERY easy keeper) but when he got to 1000 lbs he was still overweight. I have since got him to 900 lbs, his perfect weight, and the 15 lbs I had to feed to get him there and stay there works out to 1.7% of body weight. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Hi all, Kristen, Thanks for sharing your experiences, it’s so helpful and makes perfect sense. I worry most about Ginger, who’s always been a very leisurely eater… munching for awhile then walking away and coming back when she wants more. Over the last several months, she’s become the epitome of ravenous …aggressive around food, gobbling every tiny bit, then getting down on her knees for remnants under the trough, then eating leaves and twigs in the dry lot nonstop until her next meal. Dr. K’s recommendation to reduce their daily amount will be hard for them going into winter, but I did just start doing that and fingers crossed they lose some fat without losing their minds :) As always, thanks for your guidance. |
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Lynda,
Your best tool for keeping them from losing their minds is small hole hay nets - 1 inch - and double net the hay if you have to. -- Eleanor in PA www.drkellon.com |
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My husband modified their troughs with grates long ago, but even with 2” holes they chow through it pretty quickly. I’ve used nets only rarely because I know it’s healthier for a horse to eat with their head down and it seemed like a low net could be a hazard for horses wearing shoes…y’all know they’ll get into trouble if at all possible. So many folks on this site use nets … any favorite ways to attach? Do you attach at both top and bottom? Hang them over a trough to catch the waste? |
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Lynda, 'yes' to both hay net methods, but you'll find lots more answers to your hay net questions on Horsekeeping, which is the best place to ask about slow feeding practices. I would also caution against using metal grates in trough feeders. An aggressive eater will damage their teeth on them. I made that mistake my first year of horse ownership.
-- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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Sorry, should’ve realized that. Will go to Horsekeeping.
Thanks -- Lynda M Northern CA Jan 2022 https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max Max Photos - https://ecir.groups.io/g/CaseHistory/album?id=277238 Ginger Photos - https://ecir.groups.io/g/CaseHistory/album?id=278091 |
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Dr. Kellon,
I did look up the micellar Casein that you suggested I include due to my hay’s low protein, but with three horses (Max PPID/ borderline IR, Ginger possibly PPID/ signs of IR,, and Ari, 5 yo Rocky) eating that hay, the cost to add it to all of their diets is a bit out of my price range right now. With no indication of laminitis or foot soreness ever, and my farrier saying there are no stretched white lines or indications of sub clinical laminitis, would switching out part of the hay for alfalfa add the necessary protein? If so, what % of their current hay could or should be substituted? Max currently 15 lbs hay, Ginger 14 lbs, Ari 13 lbs. All get 1/2 lb Stabul 1 as carrier for supps. While alfalfa has never been a part of their regular diet, they have all munched it happily in my trailer on the way to rides with no adverse reactions. Thanks for your input. -- Lynda M Northern CA Jan 2022 https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max Max Photos - https://ecir.groups.io/g/CaseHistory/album?id=277238 Ginger Photos - https://ecir.groups.io/g/CaseHistory/album?id=278091 |
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