Understanding BW


Hi, thank you all for all of your help.

Bucky has been tapered off the bute and seems to be doing well! I am waiting on my hay analysis kit to come through the mail.

I was able to get his bloodwork and have posted it in his Case History file. I am having trouble interpreting what I am seeing. His bloodwork was done fasting as directed by my vet, this was before I had any clue about fasting vs non-fasting. Any help? Thanks!

Kinsey in GA 2020


I plugged it in to the EMS calculator. Here are the results:

G/I Ratio   9.48     Interpretation: Compensated IR
RISQI   0.31         Interpretation: Compensated IR
MIRG   4.8

I understand that the fasting probably skewed the results, but someone mentioned that they still may be interpretable.

Kinsey in GA 2020

Eleanor Kellon, VMD

Hi Kinsey,

The proxies in the calculator are not for fasted insulins. A recent study showed upper limit for fasting should be around 5.2. Lab ranges do not apply to fasted horses. Your result is at least suspicious. It's not unusual for horses with clearly abnormal insulins when not fasted, on hay or pasture only, will test "normal" by lab ranges when fasted.

 On the other hand, not all overweight horses have EMS and many QHs are easy keepers but rarely have EMS. There are many reasons why a horse can be foot sore.
Eleanor in PA 
EC Owner 2001

Kirsten Rasmussen

Hi Kinsey, I think if you want to rule out EMS you would want to re-test insulin and glucose unfastened.  Also notable is that fasting will reduce ACTH, although even accounting for that Bucky's result would still be well within normal for the time of year.  His symptoms and the timing of his laminitis (if that was the cause of his hoof pain and pulses) are still suspicious for PPID, so another test you could run is a TRH Stimulation Test after December to see if he has an abnormal response.  You can do this with insulin and glucose at the same time if you want to better eliminate EMS and PPID as the cause of his problems.  None of these tests need to be fasting.

He also has very thin soles, so without shoes or boots he is going to be tender on all but the softest surfaces.  Make sure your farrier doesn't remove anything from his soles, no scraping to make them look pretty or anything.  You can also see in his rads that his toes are being left too long so his trim could be improved, too.  If he's throwing shoes because of poor attachment, you can also help him grow better hooves.  To help with hoof growth I would see about having his hay tested and getting some help with customizing a mineral mix (or picking the best commercially available mineral match) for your hay.

It's ok if he wears boots in his stall, too, so don't fuss about pulling them off and on.  But do make sure they come off at least 1x a day for an hour so his feet get some oxygen, especially if he still has thrush.  To boot, I prefer to sprinkle a generous amount of medicated foot powder powder into the boot, then put a cut-off foot from an old athletic sock over the hoof and just over the hairline (this prevents rubs and also keeps the foot powder off the hoof, which can get gunky, plus the sock absorbs some of the moisture that you get when the hoof is in a rubber boot with foam pads).  These socks get changed 1x a day, or 2x a day if it's really raining and damp here.  I don't have problems with thrush in boots anymore, but if Bucky still has thrush you can treat it daily with Pete's goo before booting, and do a weekly anti-thrush soak where you also give his hoof a good scrub out with a wire brush.  This was very effective for my horse.  Minerals balanced to hay can help with thrush, too.

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