Saraphina IR


CYNDI CARLSON
 

Hello!
I have a 20 yr old Hanoverian I rescued 4 years ago.
I have on going issues with her spiking! She is currently on 7 lbs soaked, low sugar low starch hay twice a day, one scoop heiro,insulin wise in a small amount of nutrena safe choice grain(1lb)in the morning. Evening she gets 1 lb safe choice with two scoops thyro L. I recently, after reading a post on your page have cut her down to one scoop as she is very thin.She is rotated( gets xrays every six weeks and is getting bute for pain,she is in easy boots and has had corrective shoeing in the past that has not helped. I am in desperate need of any advice at this point!
Thank you
Cyndi Carlson


--
Cyndi Carlson in Co. 2021


 
Edited

Hi Cyndi,

Welcome to the ECIR group!  This is a formal welcome which is sent upon your first post.  I’ll try to address some of your specific questions and pose some of my own.  Then I’ll include our welcome information which will bring you up to speed on what we do here as well as some ways to help your horse.

What do you mean by ‘spiking’?  I usually think of that in terms of temperature but you don’t mention that.

If you are feeding 14 pounds of hay and 2# of hard feed daily, that might not be enough.  Are her teeth adequate for the job?  These are questions we ask for the case history but I’ll ask them now - what are her height and weight?  It’s generally recommended feeding 1.5 to 2.0% of her weight, more if you want her to gain.  You are feeding the correct amount to maintain 800#.  I have a Hannoverian here which is 16.2hh and weighs about 1200#.  It’s also possible that she’s struggling to maintain her weight due to PPID.

Do you have hay testing documentation that you can share?  There are two types of testing - wet and near infrared - the wet being what we recommend as it’s more accurate. 

Have you tested her for PPID?  Warmbloods are more likely to have their insulin resistance driven by high ACTH levels than some other breeds.  If she’s quite small, she may be a mix of a Hannoverian and something more thrifty which would make her more likely to be insulin resistant without PPID.  At her age, I would definitely test for PPID and treat with pergolide if indicated.

Have you noted any changes in rotation with your frequent Xrays?  Provided she not in a continual state of laminitis, the farrier should be trimming in a manner to slowly reduce the rotational angle.  When you join the case history subgroup and submit your case history, you will have access to a photo album where we encourage you to post radiographs, photos of her feet (according to our directions) and body shots so we can get a better idea of her condition and suitability of trim.

Don’t expect bute to help her pain.  Bute is an anti inflammatory but laminitis is not an inflammatory process.  The only way to alleviate the pain is to remove the triggers which are causing it, by instituting a correct diagnosis, appropriate diet and trim.

What follows is all the good reading I mentioned earlier.  Please don’t hesitate to let us know if you have questions.

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


 
 


CYNDI CARLSON
 

Hi,
sorry I did not reply...a little confusion on my end!
so I should not have used the word”Spiking” She is having laminitis issues.
Saraphina is a Hanoverian/Andalusian,15.1 and weighs 893.Her teeth were checked this spring and are good.
i am just starting her on pergolide. Is there a good link to find Jiaogulan?

The hay I feed is from a company in Idaho named Standlee. They have their hay analyses on 
line.she is getting Timothy hay(soaked) NSC is 10
--
Cyndi Carlson in Co. 2021


Cindy Q
 

For jiaogulan, many of us use https://www.mybesthorse.com/index.html

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





Sherry Morse
 

Hi Cyndi,

Are you using the Standlee compressed bales?  For an 893lb horse the feed intake should be about 18lbs a day so Saraphina needs a bit more than she's been getting.  Do you have a link to the actual hay analysis?  I only see a listing for protein, fat and fiber on the Standlee website.  We look for ESC+starch to be under 10% but some horses do even better with less than that and Saraphina may end up being one of those.


You can order Jiaogulan from Uckele - https://uckele.com/jiaogulan-powder.html (there's a discount code "ECIR" for our members) or My Best Horse (https://www.mybesthorse.com/info_jiaogulan.html)




 

No problem, Cyndi.  I think there was some confusion on all of our parts.  

Here’s a link to APF.  You might be able to find it locally at a good tack shop or feed store.  You don’t need both APF and jiaogulan as they are both suitable for the purpose.  I’ve only had experience with APF and I start it a few days before starting or dramatically increasing a pergolide dose.
--

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


 
 


CYNDI CARLSON
 
Edited

Hi Sherry,
yes Standlee compressed Timothy hay.The only chart they can provide is a forage Nutrition chart on their website.shows 10% nsc. I have purchased tested low sugar and starch hay before and it tested higher than the hay farmer said. It’s hard to find anything lower than 10% around here.I am currently getting our hay tested but not hopeful it will be low.
--
Cyndi Carlson in Co.


CYNDI CARLSON
 


Cindy Q
 
Edited

Hi Cyndi

It seems like Philip Himanka a certified practitioner from Progressive Hoof Care Practitioners would be in your area so I would suggest you contact him for help on your pony. He is a mentor in the PHCP program as well so he would be very experienced with laminitis cases. His details are here: https://progressivehoofcare.org/directory/entry/603/ .

I don't know him myself but I have heard good things about him from other PHCP mentors/practitioners.

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





Candice Piraino
 

HI Cyndi!

I can attest for using both APF and J-herb from my Best horse. BOTH are fabulous in my opinion- so whichever you chose that would be a great benefit for your horse. I used APF on my gelding when he foundered a few years ago, and when he first started pergolide. And I currently have him on jherb now and he has been on j-herb for almost a year consistently. It has a lot of benefits, which is why i continue to feed it daily to him.

Also, I wanted to add that I have personally met and spoken to Philip Himanka, and he is a very nice guy and he is very well educated in podiatry care. If you have the chance to get him to come look at your horse, I would HIGHLY recommend you do so. He could be a great resource for you. If he doesn't get out your way, he could also maybe provide you with another contact to help you with hoofcare.
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


CYNDI CARLSON
 

Hi Candice,
Thank you for your advise.I ordered the J-herb from my best horse.I just started pergolide yesterday.I am getting ready to contact PhilipHimanka.I am getting rads tomorrow can’t wait cause she can’t walk. I wish I could get this moving faster for my girl but we’re getting there.I also will get all my hoof pics at that time.


--
Cyndi Carlson in Colorado 2021
https://ecir.groups.io/g/CaseHistory/files/Cyndi%20and%20Saraphina ( https://ecir.groups.io/g/CaseHistory/files/Cyndi%20and%20Saraphina )

https://ecir.groups.io/g/CaseHistory/album?id=266150 ( https://ecir.groups.io/g/CaseHistory/album?id=266150 )


CYNDI CARLSON
 

Hi thank you Cindy,
I was just looking for his info. I sent him a message,praying he gets back with as I am getting rads tomorrow.
--
Cyndi Carlson in Colorado 2021


Lavinia Fiscaletti
 
Edited

Hi Cyndi,

I corrected the dates and views on the rads in Saraphina's album. I also added the most recent rad of the RF.

When the vet provides copies of the rads from tomorrow, please ask if they can provide ones without any mark-ups on them. That way, it makes it easier to show what the trim needs to do without trying to work around a lot of text, lines and numbers that are already on the images. It would be helpful if the coronary bands could be marked, along with the tip of the frog. Have read here for more of an explanation:

https://ecir.groups.io/g/main/wiki/1571

Hang in there, although the trim needs a lot of work, it is fixable.

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


CYNDI CARLSON
 


-- Hi, thank you for getting my rads in order Lavinia.will do with the rads tomorrow 
I had a conversation with Phillip Himanka PHCP.He is coming to my place Saturday and will be looking at the rads tomorrow .
per our conversation he told me Saraphina needs probiotics, her manure is dark and semi hard.He suggested I ask the group about California Trace minerals.
Im assuming I need to get the Timothy hay compressed bales I buy from Standlee tested since they do not test for mineral values in their hay.Any leads/ links to buy these?
Cyndi Carlson in Colorado 2021


Sherry Morse
 

Hi Cyndi,

Information on hay testing is on the diet section of the website: https://www.ecirhorse.org/DDT+E-diet.php




CYNDI CARLSON
 

Hi Sherry,
I was looking for information on were to get California trace minerals, and what probiotic product I should get.
sorry about my confusion 
--
Cyndi Carlson in Colorado 2021


Candice Piraino
 

HI Cyndi,

This is GREAT news that Philip is able to come to you and SO QUICKLY! That's fabulous!

If he is recommending California Trace, here is the link. I always like to tell people, if you can spare it, try to go with California Trace Plus. It has way more bang for your buck and your horse will thank you! https://www.californiatrace.com/

Keep us posted!
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Cindy Q
 
Edited

Hi Cyndi

For probiotic, this post by Cass lists a few that Dr Kellon said suit https://ecir.groups.io/g/main/message/250704 . Among that list, I personally have used Bio-vet Equine Generator. It's a good price for the high number of CFUs of various probiotics especially if you are not getting the smallest pack. Jessicac Hempfling who distributes it sells direct with free shipping within US, here is her FB business page. I have found her quick to reply by facebook messenger when I had questions. If you do not have facebook, she has a simple website as well https://www.facebook.com/Bio-Vet-by-Jessica-Hempfling-107045054565117/ and https://hempflingbiovet.square.site/home
--
Cindy and Glow (over the rainbow bridge) - Sep 2017, Singapore
ECIR Primary Response





Lavinia Fiscaletti
 

Hi Cyndi,

For a probiotic try Uckele's Absorb-All or Quadra Fac:

https://uckele.com/quadra-fac-2000.html

https://uckele.com/absorb-all-4.html

Use the code ECIR at checkout for a 5% discount.

Make sure that Saraphina is drinking enough water as hard manure can be a symptom of dehydration.

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


CYNDI CARLSON
 

Hi
Thank you for the links! I’m excited about Philip coming!
I have been concerned about Saraphina drinking enough water that I put a bucket in her stall .She has a automatic waterer but I can’t tell how much she’s drinking.This way I can tell she is drinking.


--
Cyndi Carlson in Colorado 2021
https://ecir.groups.io/g/CaseHistory/files/Cyndi%20and%20Saraphina ( https://ecir.groups.io/g/CaseHistory/files/Cyndi%20and%20Saraphina )

https://ecir.groups.io/g/CaseHistory/album?id=266150 ( https://ecir.groups.io/g/CaseHistory/album?id=266150 )