Started Emergency Diet with Splenda & June - need guidance please


First time posting ...
I'm very recently diving into holistic equine nutrition and have a desire to heal and prevent anything possible with the right diet, movement, etc for our horses. As a functional medicine health coach (for people), it was only natural for me to start thinking - wouldn't horses benefit from eating the right things and heal with the right nutrition, movement, therapies, etc.

We have recently started the Emergency Diet with two mares - Splenda and June (both 18yo)
We are using the soaked Timothy forage balancer cubes because we are currently out of hay and following the ED recommendations for vitamins/minerals

Splenda is overweight/obese, has inflammation, and has ringbone and scratches - we work with her in the round pen and she is pleasure ridden at least a couple times each week. She can be pretty grumpy and is a former lesson horse.

June is overweight, prone to laminitis, has inflammation, a cresty neck, a swollen and painful fetlock (to the point of keeping weight off of it at times and not wanting to go out of her stall), is overweight and in pretty consistent pain so exercise is not possible at this time

Wednesday last week, we started the Emergency Diet with both of them. They were previously on pasture with grazing muzzles during the day. Of course, on pasture, nothing was improving and in fact, only getting worse - but we didn't know until we knew. They were also fed grain twice a day.

After less than a week on the Emergency Diet, we notice the following improvements: *we will weigh again at weekly increments
Looks slimmer, swollen glands seems a bit smaller, seems happier, seems content, scratches are improved because she's on a dry lot
Fetlock is visibly smaller, not puffy and she doesn't seem to have any pain there, cresty neck seems to be softer and maybe even smaller, she doesn't seem as "touchy" (it is very regular for her to shy away from her face being touched, almost like she was blind or something - she isn't)

I could really use some help from you experienced, generous people.
I have so many questions - we kind of just jumped in and went for it with the Emergency Diet. And by the way, phew that's a lot more work than dumping a bit of grain in a feed bucket a couple times a day! Every day I think of something that might streamline this process a little bit more. So any tips you'd like to share in that regard would be greatly appreciated.
I know we are looking for obvious symptoms to alleviate or disappear - like the painful fetlock, cresty neck, etc. but I'm wondering if there's anything else we should be on the lookout for?
Could June's cresty neck completely heal or is that impossible?
Will these girls ever be able to be on pasture again or is that unlikely?
Both of these girls currently have shoes on their front feet. Splenda because of the ringbone and June's front feet are splayed like a duck's bill. Will it ever be possible for them to be barefoot or is that even advised?
How do we know when to transition from the Emergency Diet to a simple forage based protocol?
*For reference, we are waiting to bale some hay so we do not have hay analysis atm. We will have hay tested once it's in our barn so we can dial in the nutrition properly.

This is a lot of information and I feel so green and needy. Thank you for your time and consideration - I know monitoring these threads and answering questions and meeting needs is not a paid position for any of you. And if I'm posting incorrectly here, please forgive my ignorance - happy to correct anything that needs it. I appreciate you wholeheartedly.

Angela D in TN 2022

Cindy Q

Hello Angela

Welcome to the group! 

If you are using only the Triple Crown Timothy Balance Forage Cubes (I assume you meant this and not the TC BalanceR), you do not need to add minerals as that particular product is already balanced for minerals and the analysis is guaranteed. You do still need to feed the vitamin E, salt and a small amount of flax. You only need to add enough water to the cubes in advance to soften them so they break up. There is no need to soak them in excess water and drain them like you would untested hay as they are also below 10% ESC and starch. 
If you are feeding only the Balance Cubes, you are actually feeding a mineral balanced hay (in the form of cubes) instead of the emergency diet.

Have any of these mares been tested before for IR or PPID? You didn't mention their age. I'll be sharing with you our official welcome letter below. There's a lot of information there for you including Diagnosis and blood tests you can run to check if the mares are IR or PPID. These details should go into your case history. 

You can get trim advice from our resident hoof advisor Lavinia if you make a photo album, take hoof photos (we have specific recommended views and tips on how to take good ones and upload them. If you have xrays they can also be uploaded to your album. One advantage of the horses not being shod is having excess to their feet for regular trims and adjustments, however many compromised horses would need boots and pads for comfort in the interim at least. It would be hard to comment anything specific without good hoof photos and even xrays.

Here is the welcome letter. Take your time to go through all the the sections and 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. 

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


Thanks so much, Cindy! 
We are currently only using the TC Timothy Balance Forage Cubes because we are out of hay and about to cut some fields - so our hay is about 6 weeks out. We will do a hay analysis at that point. I was thinking the Balance Forage Cubes would be a good replacement for the hay - but if there's a better option, I'm all ears.

We are also using soaked and rinsed beet pulp - is that unnecessary?

In fact, we are transitioning our entire herd (3 additional horses with no evident metabolic issues - pasture grazing all day and night) from grain twice a day to a small bit of soaked cubes, beet pulp and added Vit E, ground flaxseed, salt and magnesium) and already noticing decreased inflammation and nicer coats. But now that I understand the cubes already contain magnesium, I'll drop that for all.

No testing has been done on the mares - they are each 19 years old. I'd like to do testing in the near future, but it's not my call since they aren't my horses.

I appreciate your help and will join the case history sub-group and start a Case History for each as soon as I can. So glad I found this group!

Angela D in TN 2022

Sherry Morse

Hello Angela,

As you don't own either of the horses you mentioned please make sure you read our Terms of Use carefully, particularly 4.d regarding posting about horses that you do not own.  


Hi Angela,
The beet pulp is not necessary if the balance cubes are working for your horses.  The cubes have a bit of beet pulp in them as a binder.  I find the cubes easier to work with as a carrier than beet pulp, which requires more prep in terms of rinsing and soaking.

Keep in mind that we’ve found the balance cubes to be a better source of calories than hay so feeding 4 pounds of cubes is equivalent to 5 pounds of hay.  

Looking forward to your case history!

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



Thank you for pointing that out - I do have permission to present health/case history 👍 
Angela D in TN 2022