Unexpected very high insulin on low carb feeds—Dr. Kellon


Mary T
 

I have not posted in a very long time.  I apologize for not have a case file any more—we were at a rehab center 10 years ago & it went by the wayside.  Briefly—Ally is an Arabian mare, now 26, diagnosed PPID/IR in 2006, saved by following this program.  Very well controlled with diet & Cabergoline.  Labs have always been mid normal—until now.  We ran out of lower carb hay, which we also soaked.
Ally is extra carb sensitive.  For example, she cannot tolerate ODTBC—she gets elevated digital pulses.  I have to keep her carbs below 8-8.5%, total NSC.
So since I cannot source a safe hay, I decided to feed a complete feed, & have been mixing ODTBC with Zero.
I feed 1.6# OTDBC & 3.3# Zero in a soaked mash three times/day, plus one feeding of what’s left of her low carb soaked hay.  We began 4/17/22 & slowly worked up.  We drew labs 5/11/22.  Just got the results back.  ACTH 15.  Insulin 114.  Glucose 127.  I am upset & in shock.  The highest Ally’s insulin has ever been is 23–when someone was sneaking her grass.  Her care is impeccable.  There is NO grass, no cheating with her diet.  Ally has lived with her IR/PPID since 2006 with NO rotation or sinking.
I am aware the group is not crazy about Zero—but it’s the only way I can get her carbs low enough.  I realize there is too much iron.  My plan was to have Dr. Kellon do mineral balancing once I had her switched over.  I don’t like the canola meal—but I increased her ground flax to 4 oz/day.
Could the legumes in the Zero be an issue?
I am afraid Ally is going to founder because we do not have safe food for her.
What can I do?!?!

Thank you!
--
Mara & Ally
2006 PNW


Sherry Morse
 

Hi Mara,

You already know we really need a case history for a complete picture.  Just some basic info that would be helpful though - what is Ally's current weight? What is her height?  Is she in work?   How much hay is she being fed?  Is that being soaked?  Is there a reason you aren't using rinsed/soaked/rinsed beet pulp? We look at ESC+Starch, not NSC so you need to know that total, not just an NSC number.  

Are you feeding Hygain Zero or something else?   Based on her numbers she can't tolerate "Zero" which if it is Hygain, has Rice Bran as well as Canola Meal so that would point to it needing to be stopped now.




Mary T
 
Edited

I’m sorry—this just happened & I am in shock & an emergency — nothing safe to feed Ally.  I am 16 years behind as my history was lost.  I am frantically looking on line for something safe to feed Ally while I wait for my vet to call.  I think that’s the best use of my time ATM.  If that means you can’t help me, I’m sorry.

As you read in my message, I cannot feed 100% ODTBC either.  I still have a little lower carb hay left, which we soak, but not enough to feed more than one 5# meal/day.  When on soaked hay, Ally ate total of 20#/day in four feedings.  She is 14-2, weighs about 850#.  In a few days, I have nothing left to feed her.  The barn’s hay (I had my own) is higher carb & first cutting w/ many seeds.  

I will have to put Ally down rather than allow her to founder or starve.  She cannot tolerate the levels of carbs that most metabolic horses do.  She will founder, if she isn’t starting to already.  She is an exquisitely sensitive mare, whom my vets over the years consistently tell me I know very well.

I hadn’t started the R/S/R BP as she gets some BP in the ODTBC & I wanted to see where we were.  She historically bloats/colics if I feed more than about a cup/meal, so it’s not a panacea.  She cannot live on it.

I understand you look at ESC + starch, but you need to be aware there are some horses who are more carb sensitive—as I stated in my message.  If I go by your guidelines, she will have trouble, which we learned from hard experience.  Ally is an outlier.  Please reread my message.  I’ve been at this 16+ years, with excellent results until today.

I am not trying to be difficult—only to save my mare.

--
Mara & Ally
2006 PNW


Mary T
 
Edited

Well, I think I figured it out.  Teff hay pellets w/ R/S/S BP.
Will need to test the teff pellets, try to find Haystack, as they have flax & BP added.  Will need to find mineral balancing for the high iron.
There is no way I can recall the level of detail to properly recover my lost history of 16 years with the degree of detail & accuracy required.  I’m sorry.  I have a PPID Ir horse who has done amazingly well using this program… 
2006 on our signature is for real.

--
Mara & Ally
2006 PNW


Trisha DePietro
 

Hi Mary.  If I were you, I would still start a case history from where you are today and get it uploaded. Especially now that you have found a possible food source. If things change dramatically again and other issues pop up, your case history will be here, with current information and your new feeding regemin outlined. I don't doubt your horse is an outlier....all the more reason to get his/her current  case history established. I don't think any of us volunteers want you to remember or agonize over 16 years of success!!! But current state is important to record, track and trend. 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


quatzie_baby@...
 

Mara --

I have extra low carb hay, I lost my Cushing horse in February. I hay extra hay tested to be under 10% sugar and starch. If your in the Salem, Oregon area/or near please contact me.
I am more that willing to sell you a some to get you by. It's Valley Grass Mix. You can e-mail me @ quatzie_baby@... if your interested. 
Beet pulp and Haystack Low carb low fat pellets are also very helpful. Wishing you the best 
--


Jeannie 
2010 Oregon
NRC +, CIR0813, NAT0413

Case History   https://ecir.groups.io/g/CaseHistory/files/Jeannie%20and%20Zena
Photo  
https://ecir.groups.io/g/CaseHistory/album?id=57253&p=pcreated,,,20,2,0,0

 

 


Sherry Morse
 

Hi Mara,

You don't need to go back to 2006 but doing a current history from now going forward will help us help you.




Ronelle
 

Mary- Have you called Haystack directly about the Teff pellets?  If not, their phone number is on their website.  One of the owners is a vet.  They've been very helpful with me.  If you've already tried this, I apologize for being redundant.  Also, where in the PNW are you?  
--
Ronelle and Yoyo
2015 Bend, Or, US


Eleanor Kellon, VMD
 

Regarding the sweet lupin in Hygain Zero, see table 1 on page 2 here: https://www.foodstandards.gov.au/science/monitoringnutrients/afcd/Documents/Industry%20Report%20-%20Australian%20Sweet%20Lupin.pdf . "Carbohydrate" is starch and the inulin is a fructan so NSC 15%, ESC+starch 10%.  Did you have it analyzxed? They don't guarantee any levels, just say it's low."Roughage products" could be anything from alfalfa to corn cobs. It has about 2% rice bran oil, minimum. The information on Chewy doesn't list Canola meal.

Yes, Ally is very sensitive but WSC cannot affect her insulin beyond sugar component. Fructan is not a dietary carb any more than wood is.

The numbers for the latest batch of the cubes is ESC 5.5 and starch 0.4 [WSC 7.6 just FYI] from the raw materials. You could soak your cubes inside a lingerie bag then submit a dried sample for minerals also to see what you need to supplement.

IR does become more difficult to control as they get older and you could have a component of that here. You could try metformin 30 mg/kg twice daily.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Mary T
 
Edited

Thank you!  I’m sure it’s the Zero, as we have recent insulin levels.  Earlier this Winter, insulin 8 (!) then 15 in March.  That was on soaked lower carb hay.  We’ve used Zero as a carrier with no issues, but in very small amounts.

I think we’re going to use the Standlee teff, with some ODTBC mixed in.  I hear you about the ESC/WSC issue.  I’m no doubt much more correct to say Ally is simply very carb sensitive & I need to keep her carbs as very low as possible.  Very, very sensitive mare in all things—even for an Arabian :).

I spoke with Ontario Dehy & gave them the lot number of our product.  It was higher.  They told me about the numbers you have, but ours were higher, totals, including WSC, ESC, & starch about 10.7.  Our lot was distributed through Triple Crown.  Again, I understand about the WSC/ESC issue, but if I don’t manage this tightly, even though I may have the specific issue described inaccurately, Ally develops digital pulses.  So we strive to get her total carb numbers below 8% if we can, 9% if that’s the best I can do.
Insulin earlier this Winter 8-15 with a 26 year old Arabian mare with 16 year history PPID/IR….the good news is ACTH 15 on Cabergoline.

Do you still do hay/feed mineral balancing?  Ally will need it for any teff pellets she gets.

Thanks again!
--
Mara & Ally
2006 PNW


Mary T
 

I did a few minutes ago.  I also called Standlee.  I thought Haystack would be better, but Standlee had better numbers when I spoke to them.  I then reviewed tests in the files here.  Standlee has lower iron, higher protein, slightly better carbs—but I will send my own sample for each lot I buy from.
--
Mara & Ally
2006 PNW


Mary T
 

Thank you!  I will keep you very generous offer in mind.
I’m in PDX.  I will see how much storage we have left in the hay barn.

Thanks again!!!
--
Mara & Ally
2006 PNW


Mary T
 

Also, just thought of this—in my broken laptop are years of labs.  I’ve tested multiple times yearly or if concerned.  Ally’s insulin levels consistently support my cautious approach to feeding & carbs.  Her insulin will pop up into the low 20’s if we are not extremely vigilant & cautious.  I wish I had access to those labs.  I’ve kept in touch with Ally’s breeder.  She is very well respected horsewomen in the Polish Arabian world & a vet tech.  She told me Ally & her dam are the most sensitive horses she’s ever met.  Mainly, that’s great & lots of fun.  But there is always a flip side to everything.  
With this insulin level of 114, she is also guzzling water as of this AM, so with the digital pulses, I don’t think a fluke or lab error.
--
Mara & Ally
2006 PNW


Chris Hanson
 

Hi Mary,
Hang in there, I recently tested the Standlee Timothy pellets and they came back well. Sorry I haven’t posted the results yet s but it was recent.
someone else tested the Standlee Teff pellets and timothy and I know those results are on the website here somewhere.
the Standlee Timothy consistently tested lower than their Teff pellets which I had been feeding my horse Woody. The difference I noticed with Woody is that though he happily eats these timothy pellets he doesn’t look forward to them with the same enthusiasm as the Teff. For him too much enthusiasm has usually indicated a reason to double check what he’s getting in a food.
Good luck!
Chris
--
Chris H in CA 2021
https://ecir.groups.io/g/CaseHistory/files/Woody%20and%20Chris


Sherry Morse
 


quatzie_baby@...
 

Mara 
I found you some low carb hay tested that would be closer to you. 
North Valley Ag  has compressed Orchard Grass tested 7.8 simple sugar and .4 starch
below is the test results see link. it's not cheap hay. 

North Valley Ag  503-537-0815, they will deliver to your location 
http://www.northvalleyagllc.com/
hay test below : 
http://www.northvalleyagllc.com/uploads/1/1/5/9/115966461/eq147595.pdf

That would give you another option ..
Good Luck 



--


Jeannie 
2010 Oregon
NRC +, CIR0813, NAT0413

Case History   https://ecir.groups.io/g/CaseHistory/files/Jeannie%20and%20Zena
Photo  
https://ecir.groups.io/g/CaseHistory/album?id=57253&p=pcreated,,,20,2,0,0

 

 


Eleanor Kellon, VMD
 

If she is guzzling water that's a sign of uncontrolled PPID, not IR.  ACTH doesn't tell the whole story in many horses. She may need a TRH stimulation test.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Hi, Mara. You can probably access everything on your broken laptop using a disk recovery or hard drive recovery service. If you laptop is a Mac, Apple provides the same service. I've done this myself when my computer died unexpectedly and my backup routine was not so great. I haven't priced it in years.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
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