Further Insulin Resistant Woes

I worked at a barn a couple years ago that had a young mare who was IR. Woke up one day to find her foundered on all 4 feet. Severely foundered. With significant rotation in both front feet...over 15%...as well as rotation behind. She almost lost one front hoof. It was terrible. She was promptly taken off grain & alfalfa - the increased protein and calories in it result in increased glucose production in the liver...which is detrimental to IR horses. Excellent, frequent (every 4 weeks) trimming and diet saved this mare.

I've found this to be very helpful with the one gelding who foundered very badly several years ago: jiaogulan. Be warned, it's bitter. I got the fine powder and made a slurry out of it with a *whisper* of orange juice. Orange juice won out because he didn't hate it quite as much. But I still wore funny-smelling slurry on the back of my shirts. It reminded me of being a parent to a newborn. Spit cloths aren't accessories, they're must-haves.

Laminasaver will do it too, but it's a LOT more expensive. Even accounting for the "wearing of the green".

Obviously, whatever you do, do it in concert with your veterinarian and farrier. Good luck!

Oh, that gelding is sound enough to be ridden for 1.5 hours with no more than 200#. Admittedly, we do try to keep him off of particularly hard or rocky surfaces because he is barefoot. If we wanted to go somewhere more rugged, we'd invest in easyboots/old macs/etc.

LOTS of IR horses are on Thyro-L. It is actually shown to increase insulin sensitivity in horses so it can be quite helpful - besides the weight loss factor of it. Thyroid problems are usually caused by Insulin Resistance.

Alfalfa is a main ingredient in almost all of the feeds geared towards Metabolic, Cushings, IR, etc horses. Such as Wellsolve LS & LMF Low Carb. But, some do seem to have a sensitivity to it.

If your horse is sore on all 4 feet, I'd be worried she is acutely laminetic and would be taking more action other than bute/banamine - although that is helpful due to anti-inflammatory effects.

Is she on any pasture or grass? Have you tested your hay? There's a hundred things that can set them off.

Here's some reading on feeding - also addresses the alfalfa issue some
http://www.holistich...r-ir-horse.html
http://www.southerns...-resistant.aspx

Agree on the Thyro-L. It helps them tremendously. Also, do you have any Ace? You can call your vet on this, but we gave 1 CC orally to horses with laminitic episodes. And I would be soaking her feet in ice water.

Ace is thought to possibly be helpful because it's a vasodialator - meaning the thought is it may help increase blood flow to the feet. Poor blood circulation is thought to be an issue in laminetic horses.

Icing would produce a vaso-constictive effect, but icing is thought to be helpful also.

They (researchers) just don't know enough "for sure" facts about either one to make a concrete judgement on if they are helpful.

IME, when my mare foundered, icing seems to help tremendously. She seemed to feel better afterwards. It was definitely convienent that the barn had a professional grade ice machine though - otherwise that would've been difficult to do.

Mary -

I was also just wondering - what is the breeding on your mare? From the OFW, I think I can guess the sire line at least. It's interesting to me because I swear I hear of so many Insilin Resistant horses of Bey Shah breeding (mine included).

My mare is by RSD Dark Victory, by Bey Shah. I have also noticed that line tends to carry insulin resistance. I've heard of lots of those horses having laminitis problems.

My mare foundered on alfalfa two years ago, before I realzied she was IR. She had not had a laminitic episode since then, even during an impaction colic bout, until just now when I had added a bit of alfalfa back into her diet a month ago.Guess she is one of the lucky ones that are sensitive to it. She is currently on bermuda hay; I haven't tested it. Now and then she is let out for a couple of hours on old dead desert pasture. I don't let her out to graze when the grass is still green.

I have ace. Will give her a cc in the morning and see how she does. Icing her feet would not be easily done, I don't have an icemaker or quick access to bagged ice. i can hose her for a while with really cold water, though. Will pick up some ice tomorrow in town. Brrrr.

A good friend of mine also has an IR mare, she is adamant that thyroid meds are to be avoided. She has studied this condition for quite a while and is a member of the Yahoo group led by Dr. Eleanor Kellon. So, I am conflicted here. Guess I will go with what my vet recommends.

I am going to try jiaogulan as soon as it gets here; I made an herbal formula for Carrie that includes vitex, red raspberry leaves, yarrow, hawthorne, and several other anti-inflammatory and healing plants. Surely she won't notice one more smelly addition. The cinnamon i feed her seems to cover up just about anything.

Thanks so much to all of you who are posting here!!

When my little girl Gai Marchessa foundered, 15 degrees rotated in both fronts and she looked IR at the time etc. my vet came out and while she was rotated enough to have her put down for insurance reasons of course I did not want to do that without trying.

She is now 100% fine and no more IR. He really would get frustrated with me when I would talk about IR. He said "Everyone tells me their horse is IR and I most of them are not IR. " He continued "People go on the internet and read up on how to care for IR and instead of calling me and doing as I say they take advice of friends, farrier, internet gurus and 'experts' " He told me it makes his job so much harder.

He then proceeded to tell me if I did not do exactly as I was told (by him) he would not sign off on her insurance for my major medical to pay her expenses. He told me that he has to say that as otherwise people do what everyone else says. etc.

Well in the end, he saved her life and she is fine and no more signs of IR .....I did what he said.

The meds were not any you mentioned, one was bute (and in heavy doses so she had to be on renitidine too) and then one was pentoxifiline (spelled close to that) and then one other drug too. Was a real pain as it HAD to be given 2x a day and she was hard to medicate and would not eat it in her food but he made it clear this HAD to be done.

Cut her toes WAY back and put on backwards horse shoes (he does not believe in the heart bars as he said most farriers are not that good with them, if you have a farrier who is and you do a lot of xraying they can be fine) Anyway, kept her in those backwards shoes for a good year.

She is really and truly doing well now. I caught her with a little belly the other day so cutting her back but no signs other than she gets fat easy.

I hope you can figure out the right mix of things to get your mare back on track. Listen to your vet though and let him dictate to your farrier not the other way around (well if your vet is any good......)

On hay, she gets bermuda but also gets alfalfa as a treat, this has not caused any set backs. The only thing that would cause a set back in my opinion is if we don't keep the toes back.
Her feet tend to spread which was part of her issue in the first place.

(I tried joining the yahoo list but it really was conflicting with my vet and because he was so adamant already that the internet lists were causing some clients problems i did go ahead and avoid it after that ) Too much info can be confusing, pick one source and stick with it.

I was going to say, how about for a treat some safe starch forage by Triple Crown instead of alfalfa if she seems to flare up over alfalfa? Perhaps she really does have a conflict with alfalfa.

I really believe my farrier saved Carrie from having to be put down in 2010. He is very good and is the main farrier used by two different vet clinics when they have problem horses. My vet did x-rays and he built Carrie's shoes based on them. I don't remember the degrees of her rotation but they did look bad. Her left front coffin bone was back to normal and her right was only slightly off last time she was checked. He does keep her toes very short.
My vet has done post-doctoral research in the effects of anti-inflammatory drugs so I do trust her judgement. And the older vet she consults with is a lameness expert, he has clients from all over the country.
I'm of the opinion that the root cause of this episode is the alfalfa I was feeding her, I must have given her too much.
Funny that her former bad founder and this flareup occured at exactly the same TIME of year. Wonder why that is?

My mare is by RSD Dark Victory, by Bey Shah. I have also noticed that line tends to carry insulin resistance. I've heard of lots of those horses having laminitis problems.

My mare foundered on alfalfa two years ago, before I realzied she was IR. She had not had a laminitic episode since then, even during an impaction colic bout, until just now when I had added a bit of alfalfa back into her diet a month ago.Guess she is one of the lucky ones that are sensitive to it. She is currently on bermuda hay; I haven't tested it. Now and then she is let out for a couple of hours on old dead desert pasture. I don't let her out to graze when the grass is still green.

I have ace. Will give her a cc in the morning and see how she does. Icing her feet would not be easily done, I don't have an icemaker or quick access to bagged ice. i can hose her for a while with really cold water, though. Will pick up some ice tomorrow in town. Brrrr.

A good friend of mine also has an IR mare, she is adamant that thyroid meds are to be avoided. She has studied this condition for quite a while and is a member of the Yahoo group led by Dr. Eleanor Kellon. So, I am conflicted here. Guess I will go with what my vet recommends.

I am going to try jiaogulan as soon as it gets here; I made an herbal formula for Carrie that includes vitex, red raspberry leaves, yarrow, hawthorne, and several other anti-inflammatory and healing plants. Surely she won't notice one more smelly addition. The cinnamon i feed her seems to cover up just about anything.

Thanks so much to all of you who are posting here!!

Hi Mary,

Don't have much advice to offer other than also trying holistic stuff for laminitis. I am stull having issues with Jazz's feet and my new farrier told me he has had quite a few mild episodes in the past year. I wish you the best

Yea my vet says heart bars in the right farrier/vet combo's hands are great, he just does not trust most the farriers in our area and most owners don't want to do the xrays it takes to do it correctly (as you would need it more than one time).

It sounds like you have a great vet. I would stick with what works with your farrier and vet and be careful to get too much info elsewhere since it seems to conflict sometimes with what our vet/farrier would do.

Just my 2 cents after how I got that lecture from my vet and then once I just settled down and ONLY focused on him all went well. Before that I was trying to listen way too much to others' do this ' 'don't do that'.


But yea, if she shows a decline on alfalfa just do away with it, why not take that factor out of the mix then if she still does it you will know it was NOT the alfalfa. Kind of like a process of elimination.

Also.....if you want her to have some variety they make some good timothy pellets and such which could be a treat. There is a product called remission...now that is one thing I feel helped her, she is no longer on it but it was good stuff and my vet rolled his eyes at me but let me do it LOL.

You are lucky to have a good vet!

Mary, do you tend to give her more alfalfa or heavier feeds at this time of year or does she gain more weight? I know Marchessa has to stay light, but not thin and in some clients that has to be hard !!

Yes, I am guilty of feeding her too much when it is colder! And she is plumper than she really needs to be, as a result. Mea culpa, mea culpa!!!
I have used Remission on her as well, tried it after her first founder episode and I do think it helped. The Su-per LaminAid has the same ingredients plus other stuff, though, so I switched to that. She has done well on it. I took her off of it a few months ago since she seemed pretty much back to normal. Guess I will keep her on it all the time now, maybe it will help prevent issues.
Funny you mentioned the timothy pellets, that is on my list of stuff to get in town tomorrow! Thank heavens we now have Tractor Supply stores in our area, before they came in there was NO source of grass pellets unless you special-ordered them ( a half ton at a time!).

Regarding the Thyro-L...the horses we put them on had been prescribed it by our vet, and those horses did 180's after a few months. It was amazing.

Michaela, did they just start them on the Thyro-L or did they do a dex suppression test first? I'm told that the dex suppression test will cause an IR horse to founder, while it has no effect on a Cushings horse.

I have a mare that had a bout of laminitis so bad that the vet couldn't even pick up one front foot without the poor baby going to her knees. She was put on thyroid meds and started on a product called Remission, eventually when she was able she was given a low starch/low sugar pellet ,she is fed grass hay ,that was over 5 years ago and today you would never know there was a problem .

Mary, I am sorry she is doing poorly. I am in a similar situation, not as emergent as your but there are sooooooooooo many differing views on all of this! Ugh! My vet will not do the dex test just for the reason you stated. The ACTH test needs to be done when the days are getting longer, not shorter as most horses will test positive in the fall but only the true IR horses will test positive in the spring. I hate drugs! and prefer to use vitamins, minerals, herbs and diet to fix problems verses pharmaceuticals. Do you have a picture of your girl? I am curious as I have looked at so many pictures of IR, Cushing's and what not pictures and I am NOT seeing my horse in these pics. Ya he could stand to lose a bit of weight....so could I. He does not have a crest like I am seeing on these horses. He does not have the fat pockets above the eyes or above the tail. The only thing I see is a thicker coat then most horses, but could this be because he was born and raised in Houston, Texas and his body says this is MUCH colder here so it over compensates? He has a ticker neck then most geldings (not a huge difference but slightly) could this be because he was cut late or just genetics? He has always been this way even in his prime.

are you or have you been on the IR/Cushings email list that Dr. Kellon and other experts are a part of? If not I'd highly recommend it, they will be able to help you set up a diet plan for your girl as well as offer other info and support. Look up IR/Cushings on yahoo groups and you should be able to find the list to join.

That list is the one that drives my vet nuts. He said that IR/Cushings is currently the 'catch disease' for everything and anything. People see a fat or cresty horse now and immediately assign it IR/Cushings.

The best thing to do is have your vet check the list out first and make sure she/he agrees with its philosophy.

If my vet had not 'fixed' my mare the way he did though, I'd have been the first one there. But I really believe in veterinarians knowing their stuff and though the list is run by a Doc, she can't examine each horse .

the list doesn't diagnose anything as IR/Cushings without tests that prove it. And regardless of the diagnosis, the people are knowledgeable about the diet needed to keep an IR horse ( which the OPs horse is)as healthy and sound as possible. There are no magic cures or guarantees but any bit of knowledge helps. I have been able to help many horses through knowledge based on IR/cushings studies. Even if horses aren't confirmed IR, horses aren't meant to eat high carb diets, lush pastures, grains, sugars etc, so knowing what feeds are best to keep our horses from developing diseases like this is even better. Since my job is working with hooves, I have to be aware of the diet that is going into the horses I am trimming or else I can be chasing pathologies that can be cured with a simple diet change, and being aware or current studies and using a resource like this list, which keeps record of feeds that have been tested, and where they are available really helps when you are in emergency situations like with the OP's horse.

Michaela, did they just start them on the Thyro-L or did they do a dex suppression test first? I'm told that the dex suppression test will cause an IR horse to founder, while it has no effect on a Cushings horse.

No, we did not do a Dex suppression on the horses I knew...reason being was their age. They were all under 7...Cushings (at the time in 2007) hadn't been diagnosed in any horse under 7 years of age, so we were able to rule that out. It's known as a disease of "older" horses.

Dex or any other steroid (think joint injections) should never be given to a suspect IR horse. We did have another horse, a stallion who foundered the day after he had his coffins injected. He was always an easy keeper and had a bit of a cresty neck...attributed his neck to him being a stud...but maybe it was IR. He was young too so we didn't do a Dex/Supp test on him either.

I would be interested to know what information your friend has been using regarding NOT using Levothyroxine in IR horses. As an Equine vet tech for several years working in Internal Medicine with one of the best Internists in the world (no exaggeration), this was commonly prescribed for horses that were dealing with increased insulin...which translates into glucose intolerance. The drug impacted insulin sensitivity (allowing glucose tolerance) and helped many horses lose weight, lose cresty necks and gave increased quality of life. We did not have one horse adversely affected by treatment with Levothyroxine. It was actually quite the "miracle" drug for many of them who suffered recurrent laminitic bouts and obesity.

I hope you guys can figure out a solution for your girl.

I'm coming in a little late here, so bear with me as I try to address what I've seen on the discussion thus far. My own opinion is that IR is a completely man-made condition and if people would go back to feeding horses how they're supposed to be fed, we'd be seeing a lot fewer problems. I would agree that IR is a current "hot diagnosis". Just like how about 10 years ago, anything remotely neurologic was EPM....I think the Equine Cushing's group has its place, but I've stopped going there simply because of the fanatical, over-the-top individuals that tend to be involved. You are *never* going to get a perfectly 100% correct diet for any individual. I mean, how many HUMAN Type 2 diabetics are going through the lengths that some of these horse owners are? Same thing here folks! Don't feed X because the chromium is too much. Don't find Y because the iron & copper are off. Test every single bale of hay and adjust accordingly. But I digress....

These horses need to get back to a more "natural" diet. I.e. Grass hay, protein source, vitamin & mineral supplement and that's it. I LOVE LOVE LOVE forage balancers for these horses; use the product of your choice for that purpose. Mine is Purina's Enrich 32. The Don't-Use-Throid-Replacement has come from the Pete Ramey philosophy of managing these animals "naturally" and that you have to detox them. Don't vaccinate or deworm them either.....All I know for sure is that when I put suspected IR horses on Thyro-L, they lose weight and stop foundering. When its discontinued, they gain weight and start foundering again. I don't believe they are truly hypothyroid, but as mentioned (the research was done by Nicholas Frank for those interested....) increasing thyroid increases insulin sensitivity and will help get these horses out of their metabolic crisis so to speak. They may not need to stay on it all their life--and really shouldn't!--but I think its a great tool to get weight off them until they are sound enough to be exercised again. I think regular exercise and activity is critical as well.

I'd give caution to the "first I tried Equioxx, then bute, then Banamine". Lot of NSAID use there and piggy-backing NSAIDs will increase your chances of ulcers. There truly needs to be a wash-out period between NSAID use.

Uhhhhhhh....what else? I'm a firm believer in sole support for the acutely laminitic horse. Whether its in the form of composite acryllics or foam board, I think these horses are profoundly more comfortable with some sort of support. This can be in the form of deep sand bedding as well. There's been quite a bit of discussion within the veterinary community about the use of Easy Rider (I think that's right.....) boots that have varying density gels/rubber/foam whatever in the pad that slips into the boots. One of the top veterinary podiatrists Dr. Steve O'Grady presented a lecture at the latest AAEP meeting that these are not the cure-all they are made out to be. Of course, he is in the wooden clog camp, which is a whole separate discussion. I haven't used the clogs, but they screw on into the hoof, so you avoid percussion of driving nails and are designed to let the horse rock into the most comfortable position. Kind of a step back from the Redden Rocker shoes that were hot about 10 years ago as well.

great post CVM ( I almost completely agree LOL!) I agree that the IR/cushings list has some pretty over the top people ( doesn't ever group?) but I figured they might be able to help the OP find suitable feed products for her horse. I think a huge issue is that we want horses to live everywhere that we live, and many of those environments are not meant for horses. My area (and probably for the most part, yours) is a rainforest.... not a natural habitat for horses! Also, the soil here is deficient of certain very important things, like selenium. We get tons of mud, and way too much grass, and our hay is way too high in sugar ( usually) for many horses to live on and be healthy. I am glad the trend is now to finally get away from the carbs, and using minimal concentrates. I however am from the "Pete Ramey" camp.. and I have never heard him say anything about detoxing, no vaccinations or no worming. I know that there have been some interesting findings for some horses who have reactions to vaccines and worming and end up with cases of laminitis, but I've never heard him advocate not using them at all.

My barefoot trimmer is in the Pete camp (She only does my senior girls) and I am having a really hard time convincing her to worm her horse........she feels the diatamicous (oh boy bad spelling) earth worms them...maybe cvm can weigh in on that .

I am happy to hear what you said about the one product CVM as I am fostering a very very very obese mare....I will ask my vet about that....though he will probably roll his eyes at me lol. But can't hurt to ask!

He is just going to say "Put her on a diet" But he is also very old school....and does backwards shoes with drug therapy for founder. (it did work though and she was 15 degrees in both fronts)

I have seen the backwards shoe numerous times in recent years...it may be "old school" but it sure works!

I don't really think it's a "Pete" thing not to worm horses... more a "holistic" thing, that many "natural" trimmers like to follow because I guess they feel there should be holistic ways of worming without using chemical wormers, but it's certainly not something all "barefoot" trimmers or people who follow methods that Pete and other trimmers advocate believe or do.

Diatramtious (sp) works well for killing worms in a horse's gut. If the fecal tests come back with no worms or eggs then why use wormer? It also kills fleas and ticks and slugs oh my!