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Update on founder case and question on how to proceed


Mara
 

Hi, everyone. My guy foundered at the end of June. He is outwardly doing great. Feet look awesome, happy with the last set of x-rays a few weeks ago, and moving well. We hand walk 20 minutes, and trot in-hand 10 minutes every day. He can only go in a 12x24 pen, as that is the extent of the dry lot situation. The issue is, his last bloodwork came back high insulin, again. I had tried him on Metformin, but he stopped eating it and the risk of oral ulcers concerns me. I need barn staff to give it.

Looking for help with the following:
- Does normal seasonal rise in ACTH cause increased insulin? I tested at the end of September. I only tested glucose and insulin. His ACTH was fine in June. Should I have tested ACTH? 
- Might ALCAR help him be more insulin sensitive?
- How long should he stay on J-herb? He started when he was in pain, but he has been pain free for a few months.
- Hard to get him to lose weight. Does he just need more time? Would a course of Thyro-L help kickstart the weight loss? Cons to that?

Thank you for your input.
--
Mara
NJ
2020
https://ecir.groups.io/g/CaseHistory/files/Mara%20and%20Enzo/?ord=dirname&d=asc


 

Yes, rising ACTH can cause rising Insulin levels which of course can lead to laminitis. I had to learn that it just makes sense to test Insulin, ACTH and Glucose every time. I think that some vets may not know that Insulin levels can rise during the seasonal rise of ACTH. 

Mara, do you have the barn hay analyzed? I know this can be hard at many boarding stables because they get multiple loads of hay during a given year. 
--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Mara
 

Thanks, Bonnie. I have the hay tested throughout the past 10 years. It always comes back low s/s. However, we get deliveries every 2-3 months, so I test here and there. Not ideal, but I board him.

My fault not to test ACTH. What would be the earliest to retest, if I want to pass seasonal rise time?

Try ALCAR during seasonal rise? Stay on J-herb if no longer in pain?

So many questions...lol

Best,
Mara


--
Mara
NJ
2020
https://ecir.groups.io/g/CaseHistory/files/Mara%20and%20Enzo/?ord=dirname&d=asc


Kirsten Rasmussen
 
Edited

Regarding the jiaogulan, it really does speed up hoof growth so as long as you can keep on top of that with more frequent trimming I think it's a good supplement to keep post-laminitic horses on.  It increases circulation in the hoof,  which in turn speeds healing (and growth!).

ACTH can be tested again after the winter solstice.  But it would be more useful for you to know how high ACTH is during the seasonal rise.  If it's more elevated than normal, you might have a case of early PPID that can be treated with pergolide during the rise in order to keep Enzo's insulin better controlled.

The Thyro-L should Kickstart weight loss.  I'd use it as a last resort because I don't like how it changes thyroid function over time, then they have to be weaned off of it slowly.  I think 17 lbs is a bit on the high side in hay considering how inactive he is now, so reducing that is where I would start.  You could try reducing it to 15 lbs/day (about 1.5% of current weight), or just by 1 lb/day and watch to see if you notice a change.  I know we generally advise feeding whichever is greater of 2% of ideal or 1.5% of current BW, but if I fed 2% of ideal my horse would be overweight.  I keep his hay at 1.5% of ideal, then adjust if needed when we are exercising more.

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


Mara
 

Thanks, Kristen. I will test blood again. I have not had leptin done on rechecks. Is that necessary?

Good to know on the thyo-l. Hard on the hay. I have tried many configurations and uses of hay nets. With basically no turnout, other than a tiny pen, he is angry and destructive. Slowing him down has been a challenge. I share his pain.
--
Mara
NJ
2020
https://ecir.groups.io/g/CaseHistory/files/Mara%20and%20Enzo/?ord=dirname&d=asc


Kirsten Rasmussen
 

Leptin is a "nice to know", but ECIR's official standpoint is that it is not diagnostic so you can save your money if you wish.

I hear you on the frustration he has.  Have you tried a Parallax treat ball?  I put about 2 cups of hay cubes in it and my horse gets most of it right away, the last 1 or 2 cubes can take hours to get out!  My horse often goes back to it to try it again and again when he's bored and has nothing left to eat.  Just one small thing you can do.  I'm sure there are lots of other ideas out there...

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


Candice
 

You have some great feedback Mara!

Wanted to add maybe something else to slow him down. Have you thought about or tried 2 slow feeding nets with hay- doubled I mean? He would have to really work at it if he had to go through 2 nets. Might be worth a shot? And make sure the holes of net are small 1 inch!

--

Candice 

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History: https://ecir.groups.io/g/CaseHistory/files/Candice%20and%20Shark

Shark's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71507 

PHCP Barefoot Trimmer @ www.arkhavenfarm.com