Weight gain question


 

I didn’t expect to come back after receiving negative results for Jiji’s insulin and TRH stim test, but I’m worried.

She seems to be gaining weight despite being on the low starch and sugar diet. Including fat in her eye hollows/puffy eyes. No bounding pulses or noticeable heat from her hooves.

Is the bulging eye fat normal for a non-ECIR horse that’s just overweight? Or should I be more concerned with this?
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-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


Sherry Morse
 

Hi Olivia,

Define "negative" please - do you have actual test results?  What were the circumstances of the test (trailered/not trailered/fasted/non-fasted).  Your last test results pointed to her being IR at baseline and the test from June only shows the TRH stim test results.




 

I don’t have the actual test results, but I will ask for them. She was not trailered or fasted. This time it was done at baseline.

I’m not so sure if the OST done in 2021 was accurate because the vet did a non-fasting Karo syrup test. In other words Jiji had hay up until administering the Karo and then had nothing until the next blood draw.
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


 

Got the report on that baseline insulin test today. It’s in the photo album because I don’t have my PC with me.

The bulges in her eye hollows are firm, not super soft and squishy like before. Very puzzling to me.

Been checking for heat or bounding pulses twice daily, and so far nothing…
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-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


 

It’s looks fine to me, Olivia, especially since QHs are not generally IR at baseline, although we’ve had reports to the contrary.  I don’t know what to say about the bulging eye hollows.  That’s not something I’ve ever seen in my IR ponies so I can’t comment.  I was administering eye ointment to my most likely to be problematic IR pony and was very grateful for those hollows providing a place to steady my hand.
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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
 


Kirsten Rasmussen
 

Bulging eye fat can be normal for overweight horses.  But we can see her ribs, so she's not overweight.  The hard fat bulges above her eyes are puzzling and I would not dismiss that observation.  It could be just due to weight gain, but I would expect the weight gain to show up around her ribs, too.  Coukd the weight gain you observe be only in areas with fat pads? 

Her insulin is slightly elevated but nowhere near the point of causing laminitis.  She does not have endocrinopathic laminitis.  The lack of heat and the bounding pulses are consistent with that, although they are not always present with laminitis either.  I'm still a little suspicious of PPID despite the negative TRH Stim result, based on her somewhat sagging topline, the visible ribs despite you saying she's gaining weight, and the fat pads above her eyes, and the time of year.

Could she be standing that way due to pain from ulcers or flank pain?  Sometimes you'll see a laminitis-like stance when their gastrointestinal system is painful.  I see her Lyme test was negative, too, but I believe false negatives are common and do not entirely preclude Lyme.  Since Lyme is a systematic infection, you would not necessarily see high insulin as a cause of laminitis.

Hopefully other volunteers or Dr Kellon can add their thoughts.

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


Eleanor Kellon, VMD
 

I feel like I'm missing something here. An insulin of 36+ is clearly abnormal so she is IR. Do you have labs past the ones from 2021 in her file? The bulging eye fat is characteristic of EMS but not necessarily exclusive to it.

You are certainly in a high risk Lyme area and the history says she was diagnosed as Lyme positive. How?

It's true that QHs are rarely, if ever IR when not PPID but apparently she is a paint. Is that correct? Paints are definitely prone to EMS, probably from the Spanish influence.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


 

Jiji was diagnosed with Lyme in 2020 with the assay from Cornell. It was apparently a chronic case, my vet said. I wasn’t keeping track of her records then, so I dont have bloodwork results from before 2021.

We did the SNAP/rapid test this year after her laminitis event, and it was negative. My vet gave her the Lyme vaccine after that.

Seeing that her baseline insulin is elevated even after being dry lotted for months is very concerning to me. But she was exercised prior to taking it for her lameness exam, if that has any effect on insulin.
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-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


 

Sent too soon. My apologies.

She is grade and of unknown background. If it helps, we also elected for a basic blood test (like a CBC?) when we did her insulin at baseline. I can add that to my photo album in a minute here.
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


Sherry Morse
 

Hi Olivia,

Her current insulin level is not in the danger zone but I would definitely keep her on a tightly controlled diet and exercise her as you can.