Quarter Horses and IR


Jen Nordlund
 

Hello everyone,

I've been a member for a few years but I'm pretty sure this is my first post. 

I've noticed that every once in awhile members of this group will mention that quarter horses are not a breed that is susceptible to EMS/IR. I find this rather surprising, because at the barn where I board, almost all of the horses are quarter horses, half of them have had metabolic bloodwork done, and all but one of those have come back as having varying degrees of insulin resistance. We have always done non-fasting tests, always sent bloodwork to Cornell, and always interpreted results using the ECIR calculator as a few of us are avid followers of this group. Of the 16 quarter horses that are "regulars" here, 8 have confirmed IR. Two have had laminitis episodes with rotation that required careful rehab, and another 2 did not have any rotation but were quite lame and also went through lengthy careful rehab following protocols of this group. I'm happy to say that none of us are in crisis anymore and most of us are riding again, but we have learned that we have to be very careful in our management as some of these horses will start to show lameness after just a few days if they are not exercised as much, or if they get even one mouthful of grass.

I should also add that none of these horses have PPID, and the oldest one was 13 when first tested for IR and PPID.

Is it odd that we have so many IR quarter horses here? Or am I just misinterpreting what others mean when they explain that IR is not common for quarter horses? Could it be that it is more common than previously thought, and it's just unusual that so many people at my barn have bothered to test our quarter horses for it?

Curious to know the group's thoughts on this.
--
Jen Nordlund, Saskatchewan, Canada
Joined 2019
Billie's Case History: https://ecir.groups.io/g/CaseHistory/files/Jen%20and%20Billie 
Billie's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=276827 

Reba's Case History: https://ecir.groups.io/g/CaseHistory/files/Jen%20and%20Reba 
Reba's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=238471 


Cindy Q
 
Edited

Hello Jen

Welcome to the group! I wanted to say how great that you have a bunch of friends to support each other out with your horse management practices and share information on hay tests and balancing etc! While you may be familiar, I will be sharing our official welcome letter below. If a horse is on/off or borderline showing issues, always worth to reread the details of our recommendations. For example, you may be able to tighten up some area of the diet (your CH for Billie mentions blue salt block - not sure what that is).

I'm not able to answer your question on quarter horses predisposition or lack thereof. But great job that you can do bloodwork to check on each individual horse which we know to be the gold standard if done under recommended protocols! Lovely horses btw.

Based on your case histories, you seem to have spent a certain amount of energy constantly checking if your horse can be comfortable to go without boots as much as possible and only using boots when they look poor. My own thoughts are don't obsess so much over whether they can be barefoot. If they seem to be on and off and generally your records seem to say they go better in boots, just make boots the regular practice (save when you want to do a check for baseline).

This is a mindshift but give it a go for Billie because why keep them dancing around the borderline of comfort right. It may be this is enough to get them more firmly into the comfortable zone and hence more consistent. Indeed, it seemed to have benefitted Reba although her notes stop mid 2020. Having said that your pictures of Billie show Scoot Boots which I have used a lot and they are considered to be a lighter protective boot. If even with those boots on very regularly, you get the on and off thing, consider xrays and/or switch to a different boot with more substantial rubber sole/thickness such as Cavallo or Equine Fusion or seeing if you can fit some pad into your Scoots. I regularly help trim a friend's horse between farrier visits and although Scoots had served us well, we did switch to Cavallo this year and the horse seems more consistently comfortable than ever before (pros and cons - we get more rubbing and moisture).

Based on the one picture of Billie from the front, he is quite narrow in the pecs area and I am wondering if that's his conformation or is due to discomfort/compensation over time. Good to take more pictures and maybe after a more sustained period of boot/pad wearing that may change.

I'm not sure if you have current concerns for Reba and if so please let us know as well as update her case history.

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. 

--
Cindy and Glow (over the rainbow bridge) - Sep 2017, Singapore
ECIR Primary Response





Sherry Morse
 

Hi Jen,

In addition to the advice Cindy provided in her welcome message I would add that Billie's bloodwork is perfectly normal for a non-fasting horse in terms of his insulin results.  It would be helpful to see a full set of hoof pictures and any x-rays you have for him to see if there are issues with his trim that need to be addressed.  




Jen Nordlund
 

Thank you Cindy!

I had updated Reba's case history last fall but apparently forgot to upload that, so I updated it again and this time I also put it in the folder here for the group. I did sell her to a friend in January, the same time that I got Billie, so I'm no longer current on Reba's exact details but I do know she is still following a strict diet and riding lots, and I just watched her show at a reining show this weekend so safe to say she is doing really well. :)

I do plan on adding more pictures of Billie but I only had the one recent one when I was throwing together a case history for him last night. He was quite under-conditioned when I got him and still looked like a baby for being 6 years old, but he has already come quite a ways since then so I think he will fill out over time.

Thank you for the input about the boots! Billie seems to be doing well again but I could certainly try a more consistent booting strategy. He was not the only horse here who got sore for a couple weeks, there were quite a few who did all around the same time. We are pretty sure it was just because the weather has been going between extreme wet and extreme heat lately, because it wasn't only the IR horses that got sore either.

And thanks again for the welcome!

Looking forward to hear other's thoughts on the whole quarter horse thing. It would be really weird if we were just one isolated group who happens to be attracted to metabolic quarter horses, wouldn't it?

--
Jen Nordlund, Saskatchewan, Canada
Joined 2019
Billie's Case History: https://ecir.groups.io/g/CaseHistory/files/Jen%20and%20Billie 
Billie's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=276827 

Reba's Case History: https://ecir.groups.io/g/CaseHistory/files/Jen%20and%20Reba
Reba's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=238471 


Kirsten Rasmussen
 

Hi Jen,

Yes, it is odd to see so many QHs with EMS.  Maybe it's partly due to a lack of testing.  It is also possible that certain bloodlines are more likely to be prone to it, or that any cross-breeding with more susceptible breeds could increase the likelihood of EMS.  Dr Kellon would be the one to really comment on this, but from what I've seen in this group since I started volunteering the QHs here do not have elevated insulin without PPID.  I'm sure there are exceptions that don't come to mind, but not many.

I agree with Cindy that it's great you have a barn full of similar-minded horse owners to support each other!  That is probably more rare than QHs with EMS! 

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


Bobbie Day
 

Hi Jen
Just my two cents but I live in QH country and have lost three myself that were not properly diagnosed, two with laminitis and one with PPID. I can't tell you how I wish this information was available when I was pulling my hair out looking for answers. In my IR cases, (although I can't prove because no insulin tests were given) they were both fed rich alfalfa and at least one on pasture. I just wonder if maybe all the horses at the barn are being fed similar diets? Maybe it's too much for them and not enough work? I am just thinking of my experiences of course but here because we have more QH than anything else, and I think it happens more than you would think. Grass hay is in very short supply in my neck of the woods, although there are almost no pastures here anymore one of mine was on it at the time. 
I kick myself all the time wishing I had gotten good guidance then. Hindsight is 20/20 I guess, but the great thing is as others have said that you are aware and watching them, I think that's half the battle!
--

Bobbie and Maggie 
Desi (over the rainbow bridge 7/21) 
Utah, Nov 2018
NRC Plus 2020, NAT, C&IR March 2021
ECIR Group Primary Response 

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie
https://ecir.groups.io/g/CaseHistory/album?id=271156

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi 
https://ecir.groups.io/g/CaseHistory/album?id=78821


Eleanor Kellon, VMD
 

Bobbie,

How was the laminitis diagnosed in those two horses?

--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Bobbie Day
 
Edited

Dr. Kellon
One came down dead lame after a ride, she was the one on pasture, but they were all fed alfalfa. Took her to the vet here and he said arthritis and to let her on the pasture, so she could move around freely and gave me bute. I knew something was terribly wrong, she had never had a mis step before this episode. Took her back again, but she got progressively worse. We had taken my riding horse to a very good vet in CO for navicular treatment so I called him, and he told me what to do so she could make the trip to him (over 100 miles) he told me about the Styrofoam pads and thick bedding and limiting movement. But once he saw the x-rays, he didn't have any hope of her recovering, of course, now I would at least try to re-hab her, but this was in 1988, I think? But he didn't take any bloodwork either.
The paint was just before we got Desi, she had a cresty neck and constant swelling in her legs, ouchy when rode and started refusing to give her feet to the farrier. She would literally lay down with my husband every time we went out with her. Both of these mares were probably twelve or so if I am remembering correctly.  I didn't know better then either, had x-rays done on her and the vet said there was nothing wrong, she was just swelling from standing around, if there was rotation, he didn't see it. I think I stil have those x-rays. I'm just speculating about her being IR I guess because again he didn't do any blood work. But looking back she really looked metabolic, I wish I had known more.  Besides them all being QH that is the only thing my horses had in common. But sometimes I wonder if the only reason we don't have more of it here is because most QH's I know get a lot of exercise?  
--

Bobbie and Maggie 
Desi (over the rainbow bridge 7/21) 
Utah, Nov 2018
NRC Plus 2020, NAT, C&IR March 2021
ECIR Group Primary Response 

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie
https://ecir.groups.io/g/CaseHistory/album?id=271156

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi 
https://ecir.groups.io/g/CaseHistory/album?id=78821


Eleanor Kellon, VMD
 

Bobbie,

It's difficult to sort through this at this late date of course, especially with the first one, but Paints have Spanish blood and are definitely at risk of metabolic laminitis.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Kathy Hurd Hollister
 
Edited

I too am surprised that the Quarter Horse breed hasn't been identified as a breed more susceptible to IR. My Reg. Quarter Horse mare was diagnosed as a 4 year old and she is now 13. It has been a life-long struggle with her. She is extremely sensitive to anything that goes into her body. In the past she has been in ICU because of vaccine reactions. I'm currently soaking her hay but still am battling hoof abscess and a cresty neck. It's time again to send blood work to Cornell. So far she is not PPID.

--
Kathy-Joined 5-/2016
Mia Case History:  https://ecir.groups.io/g/CaseHistory/files/Kathy%20and%20Mia 
Florissant, Colorado


Kirsten Rasmussen
 

Hi Kathy,

My understanding is that some QH bloodlines are more prone to EMS.  We seem to get a lot more QHs here that don't have EMS but do have PPID, which obviously will bias my views.  Thanks for pointing out Mia's history, she is one of the exceptions in this group that I knew would be here but couldn't think of off the top of my head.  I'm sure there are more!  :)

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


Eleanor Kellon, VMD
 

Since the QH is normally very insulin sensitive, it may be that our "normals" are too high for QHs. That said, there are many QHs and QH families that are extremely easy keepers and have huge crests but perfectly normal insulin - same with drafts.

Mia is interesting because even though her insulins are consistently mildly elevated, her leptins are always normal. I don't know what this means but there is something different going on in the QH.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001