Hi all, my boy has been doing so well but it's winter and his usual time to just stop wanting to move. He had bloodwork showing IR with a note that it was most likely seasonal last winter about this same time. 

Here's what I have done:
He's on Equioxx, half tab once a day
He's on tested grass hay
He's on EquiPride
He has his boots on and is on shavings in his stall. He doesn't want to go out right now but is getting up and down and walking stiffly to his feed and water. He has laid down to sleep well in his stall.
We are on a 6 week trim schedule with a good farrier.

I just got some jiagolan. He wasted a whole bucket of the Ukele so I got some of the straight supplement. What dosage would you suggest for a 500-pound pony? 

What else would you do to make him more comfortable? 

Thanks so much,

Heidi

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Heidi M. in Colorado 2022 with the amazing Romeo, a 2004 model Shetland-type pony. 
Case history: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Romeo
Photos: https://ecir.groups.io/g/CaseHistory/album?id=278534

Also I have Metformin but haven't started it. 
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Heidi M. in Colorado 2022 with the amazing Romeo, a 2004 model Shetland-type pony. 
Case history: https://ecir.groups.io/g/CaseHistory/files/Heidi%20and%20Romeo
Photos: https://ecir.groups.io/g/CaseHistory/album?id=278534

There's a good chance he was abnormal on the initial blood work in 2018. Do you remember the number? Reference ranges are not normals.

There's no way he should weigh 500 lbs unless he is morbidly obese. Is he? The EquiOx dose is likely too high and isn't doing anything at all to help with foot pain. You have to stop it to use Jiaogulan. Wrap his legs and put socks and boots on his feet. Search the files for Jiaogulan for instructions. Also see https://wp.me/p2WBdh-Yy .

This article has a formula for estimating pony weight https://www.horsehealthproducts.com/horsemans-report/equine-health/how-to-weigh-your-horse .
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Eleanor in PA

www.drkellon.com  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
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Hi Heidi,

His current grass hay is probably still too high in starch (and protein) for Romey.  I would definitely be soaking it to help lower the sugar, but also looking for a lower protein and lower starch hay.  The problem with starch is that it has approx  twice the effect as ESC/sugar does, so a starch of 3+% is equivalent to an ESC of 6+% (and it does not soak out!).  Add that to your actual ESC /sugar on the hay test and you are well over 10%.  Keep in mind your sugar and starch analyses are also done by NIR, which it states on the report is only an approximation.  We have consistently found that NIR underestimate these values significantly, and NIR results for ESC and starch cannot be relied on.

The protein is also too high for a thrifty pony, or any horse with EMS unless they're in extreme work or are pregnant.  It's possible that the high protein is actually due to high nitrates, which can also promote hoof pain/laminitis.   Soaking the hay will also lower nitrates if they're high.  You can request that nitrates are added to your hay test.

I also suggest getting his insulin, glucose and ACTH tested now.  That will help you determine if the cause is high insulin, or if it's more likely to be due to cold temperatures (aka "winter laminitis").  In the meantime, warming him up, stopping the NSAIDS,  and adding jiaogulan will help him if it's related to cold weather.

I'm thinking that if he's maintaining good weight on 6 lbs hay/day, his actual weight is between 300-400 lbs.

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Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019
Kitimat, BC, Canada
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In addition, shorten the trim cycle. Even two week intervals can be too  long,

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Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President 2021-2022

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Hi Heidi,
The only insulin value I saw was in Feb of last year.  It was high enough to cause him to be sore.  Cold temperatures can elevate insulin but I suspect it was already quite high by then.  I would suggest doing a TRH stim test for ACTH fairly soon.  It will detect early stages of PPID, where the ACTH is only elevated, and markedly so, during the fall rise.  You should test insulin/glucose at the same time.  If that’s the case, you can treat with pergolide during the fall months, which would prevent an ACTH related increase in insulin.  I would also suggest testing insulin more frequently than you are now - once in the early spring after the weather is warmer and again late July/early August along with ACTH, just as the rise begins.  
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