Normal insulin levels but clinical laminitis? Is this EMS or not?


talley_catherine@...
 
Edited

Hi everyone,
I posted about Saskia the other day and received some very helpful advice - thank you.

Her insulin/glucose were both normal after the Karo syrup challenge last Friday. (Insulin 5mU/L; glucose 6.1mmol/L RR 3.9-6.5 mmol/L) However, she exhibited a pain event for 2 days after this test.

We re-tested her on Wednesday after non-fasting - just hay and four hours after the first hay feed of the morning. Normal again. (Insulin 6 mU/L; glucose 5.1 mmol/L RR 3.9-6.5 mmol/L)


We also re-xrayed her on Wednesday (uploaded). No rotation, slight decrease of sole depth on one foot. Toes better aligned now after the trim but can still come back a tiny bit more (need to post my hoof photos but a couple were out of focus when I did them this morning so have to re-do them). Heels need to come down a little more. 

She has recovered from the acute event over the weekend and is super comfortable in therapy boots, although still painful to walk on stones in bare feet but is comfortable on grass.

What does this mean? EMS or not? We are continuing to manage her as if it were a laminitic event since the reaction to the Karo test seems to indicate a sugar sensitivity. The only other sign is the thin soles (it has also been very wet here which may not have helped the soles, but none of my other horses has this problem). She is also over fat.

Thanks!

--
Cathy
NSW Australia
Jan 2022

Saskia DOB 30/9/2013

https://ecir.groups.io/g/CaseHistory/files/Cathy%20and%20Saskia
https://ecir.groups.io/g/CaseHistory/album?id=271799


Tamara Gonsor
 

I am watching this discussion as we are having the same problem. 


--
Tamara G. in Cave Creek, Arizona 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Tamara%20and%20Malik
Malik Photos: https://ecir.groups.io/g/CaseHistory/album?id=252564


Eleanor Kellon, VMD
 

Definitely not EMS - and not laminitis either.  It's high insulin that causes laminitis, not high sugar.  Not all hoof pain is laminitis.  For example, her long toe, poor ground clearance, underrun heels, flat palmar angles combine to cause problems like pedal osteitis, navicular area/DDFT strain, sole bruising.

Further discussion of this horse should be on the Hoof group.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


talley_catherine@...
 

Thank you very much, Dr Kellon. I guess I can stop soaking hay now! I will head over to the Hoof group.
--
Cathy
NSW Australia
Jan 2022

Saskia DOB 30/9/2013

https://ecir.groups.io/g/CaseHistory/files/Cathy%20and%20Saskia
https://ecir.groups.io/g/CaseHistory/album?id=271799