EMS and IR- advice needed

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SamSar1

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Hi,
My pony had a bout of laminitis whilst on loan, over a year ago. She returned home lame and when this was investigated it was found that she had had a bout of laminitis causing rotation in both front feet with quite a bit of concussion. Blood tests showed she was IR and she was diagnosed with EMS. She was around 90kg overweight.
She came sound fairly quickly, has gradually lost all excess weight and is now in full work (ridden 4-5 times a week.) However, we cannot get her insulin levels under control so she remains at high risk of laminitis. She has had no further bouts, has stayed sound and does not appear foot sore. She has no excess weight to loose.
The farrier and vet are happy with her and her routine. She is turned out by day with a grazing muzzle on a pretty bare paddock. The muzzle will come off over winter. She is fed a full trickle net of soaked hay at night in her stable. She has a 400kg pony's ration of baileys lo-cal balancer with hi-fi molasses free added in over winter months. She is on a general joint supplement.
Can anyone with experience of the condition suggest anything else i could try or any supplement they have found to help?
I'm really anxious about the long term effects on her body if i cannot improve her levels. She has tested negative for cushings twice. She is only 11 years old. Any help/ suggestions appreciated,
Thanks!
 
Do you mean you're struggling to get her blood sugar levels under control? I think that's the issue rather than insulin.

Vet not suggested metformin? It helps to get the sugar out of the bloodstream and into the muscles.

Try adding cinnamon to her feed- it has positive benefits to diabetics and I've seen it in some horse supplements recently.

Not sure if the zinc levels in your balancer, but zinc is important for blood sugar control. Forage plus and Prog Earth both do balancers for laminitis so worth checking % against their brands.
 
Thanks for your response. Yes, that is what i mean regarding the levels.
I will look into those supplements and compare with what is in her balancer, thanks.
Vet is not recommending metformin atm but did say she would need it if she had another bout of laminitis to help her body get things under control as she would be unable to do so without it. I just feel like we've worked really hard with diet and exercise but to no avail and it is so frustrating.
There is an American supplement which i can get shipped here called Heiro which seems to incorporate lots of the things which may help. Has anyone experience of using this?
 
Be aware that just because your horse has tested negative for Cushings twice does not mean that she doesn't have Cushings. My horse was tested positive for EMS but twice had negative results for Cushings. In the end he was put on a trial dose of Prascend resulting in a much improved horse - energy levels up, coat improved etc.
 
I will bear that in mind, thankyou. Her coat looks ok and she feels pretty much the same to ride as she always has so hopefully she genuinely hasn't got cushings. Can i ask, what made them eventually decide to try the Prascend?
 
You could ask for a THR test rather than the usual ACTH test for Cushings. I wouldn't be happy with a vet who suggests waiting for the pony to get laminitis again before prescribing Metformin and would rather explore that further, either with him, or with a 2nd opinion than just wait.
 
If you are happy to pay for metformin it seems silly not to use it a second bout of lami might leave the pony more impaired or dead and you seriously out of pocket I think it's time for a second opinion .
Ideally you need to talk too a lami expert .
 
I don't think she is saying she won't prescribe atm but she is waiting to talk to a specialist to see if there is anything more i can try first. I think she knows i am hopeful not to medicate if it can be avoided. Obviously if it is the best thing i will go for it. I think she was more making the point that if she does have a laminitic episode she wouldn't be able to deal with it without the metformin because of the way things are atm. Sorry, i maybe didn't word that part very well. I will look into the options of the other cushings test though, thanks. To be honest, my vet has been fab and very supportive, when others haven't.
 
SamSar1 said:
Thanks for your response. Yes, that is what i mean regarding the levels.
I will look into those supplements and compare with what is in her balancer, thanks.
Vet is not recommending metformin atm but did say she would need it if she had another bout of laminitis to help her body get things under control as she would be unable to do so without it. I just feel like we've worked really hard with diet and exercise but to no avail and it is so frustrating.
There is an American supplement which i can get shipped here called Heiro which seems to incorporate lots of the things which may help. Has anyone experience of using this?
Click to expand...

I've just looked up that supplement and actually I think you'll find similar herbal / natural supplements here in the UK, although you might have to mix up your own.

Ginger and cinnamon are both in it and both are showing some positive outcomes in human trials at reducing blood sugar levels. They are believed to work by encouraging the muscles to take up the sugars rather than having them circulating in the blood stream. Fenugreek is similar.
Magnesium oxide you can buy cheaply in the UK and is also known to support blood sugar control.
Milk thistle supports the liver - I feed that as a supplement to both my metabolic horses.
Vitamin E - powerful antioxidant.
There's some other stuff in there such as kelp, which I imagine is for a variety of other vitamins etc.

BTW - I'm a diabetic so have an interest in this!
 
My horse was diagnosed with IR EMS after a near fatal bout of lami back in June. She weighed over 700kgs and is now down to 546kgs. She is turned out during day and in at night on 3kgs of soaked hay in a very small holed bet. She has 250mls of keep calm soaked for 10 mins along with 15mls lamiguard, 1 scoop NAF multi vits and mins, garlic, mint, biotin, and glucosamine and her dose of metformin and a handful of dengie molasses free. She had a vet check last week and vet is amazed at how well she is doing. Back to full work and no signs of any illness at moment. Balancers etc do contain a lot of sugar. Every horse is different but I was advised not to feed anything other than a small feed to get supliments and medicine into her. They don't need loads as horses are designed to graze scrubland. Just a good multi vit mixed with a token feed and no apples carrots etc and restricted hay. Lami horses unless underweight should not be fed adlib forage 1.5 to 2% of ideal body weight of forage per day is plenty. If being turned out half the above % as that is a full daily amount
 
Wow, well done on the weight loss front. I'm so glad your horse is doing so well. Yes, perhaps the balancer is not helping. My girl was 489kg and is now down to 398kg. Vet says 400 is about ideal for her. She has shown no sign of pain or lameness in over a year and is going well when ridden.
Can i ask, when did you start the metformin? Did u have her levels reassessed to see the improvement? I was under the impression (perhaps totally wrongly) that the metformin doesn't always work and is usually used to help horses who are still overweight which mine is not? I think i need to phone my vet and find out more about it.
I have also contacted a couple of places re vits/ minerals/ supplements etc and they also feel certain vits etc may be lacking in her diet since it is restricted so addressing this might help. Thanks for all the ideas and experiences so far!
 
I startwd using the metformin around end of July. Vet could not do glucose tests until she had recovered from the lami attack as the tests would be innacurate due to the strss her body was under. The metformin is designed to lower the glucose levels a secondary effect is the weight loss. Some vets will not prescribe it as it is not licences for use in horses do this may be why your vet is reluctant. If yours is now a good weight maybe cut out all feed and treats and just give a token feed of something approved by laminitis trust with a multi vit suppliment and see how he gets on. Good luck with everything. It's a never ending battle looking after a horse once it's had it's first lami episode :(
 
That sounds like a good idea but i'd have to move livery yards first. I'm already under fire for not feeding enough from the yard manager and i know the yard all think i am starving her. It has already been said that i'm cruel and my pony is like a welfare case. It is been a real uphill struggle to implement the necessary changes but i suspect other people may have experienced similar attitudes etc. Thankyou for all your advice, i will have another careful look at what she is fed and discuss the metformin with my vet. Thanks for your good wishes- i just wish i had never put her out on loan and maybe we wouldn't be in this situation now ��
 
Metformin saved my IR shetland, he had >0.5 adiponectin levels and was getting bouts of laminitis despite already being very restricted and very slim. I would re-consider the lo cal balancer, it's quite high in starch. I feed a spinkle of happy hoof with linseed and equinmins advance complete (and metformin of course). He is muzzled overnight and comes in during the day to ad-lib hay.
 
Zuzzie said:
Be aware that just because your horse has tested negative for Cushings twice does not mean that she doesn't have Cushings. My horse was tested positive for EMS but twice had negative results for Cushings. In the end he was put on a trial dose of Prascend resulting in a much improved horse - energy levels up, coat improved etc.
Click to expand...

Echo this... we had one we were certain had Cushings. ACTH test borderline... TRH test showed high readings and she went straight onto Prascend. Now, if I was surprised at an ACTH results I woudl definitely go for a TRH.
 
I will enquire about having it done, just to be on the safe side. She shows no other signs but i know sometimes the signs are not so obvious in one horse than another. I don't think the vet or myself were surprised by the cushings test. She was more surprised/ concerned that her adiponectin level is 1.1 and we can't work out why. As i say she appears otherwise sound and happy and has been in full work for almost a year now. I am going to take out the balancer and try the specialist one from Progressive earth or forage plus and add in a little micronised linseed. I will speak to the vet sbout getting this other test done for cushings and about trying the metformin. Thankyou so much for all this advice. I know feel i have a way forward!
 
SamSar1 said:
I will enquire about having it done, just to be on the safe side. She shows no other signs but i know sometimes the signs are not so obvious in one horse than another. I don't think the vet or myself were surprised by the cushings test. She was more surprised/ concerned that her adiponectin level is 1.1 and we can't work out why. As i say she appears otherwise sound and happy and has been in full work for almost a year now. I am going to take out the balancer and try the specialist one from Progressive earth or forage plus and add in a little micronised linseed. I will speak to the vet sbout getting this other test done for cushings and about trying the metformin. Thankyou so much for all this advice. I know feel i have a way forward!
Click to expand...

If she has no other signs then maybe it isnt Cushings... sounds like you have done incredibly well with the weight, I hope you find a way forward. Ponies are a worry :(
Pro Earth supplements are excellent and work out very good value.
 
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