EMS management support/solidarity thread?

The advice about sugar levels in grass in interesting as there was a page going round facebook a few weeks ago that said levels were higher at night as the levels built up during the day. That said early morning was the best time to take a muzzle off. It's so confusing.
 
Trying to kill basically anything green and growing after so long trying to diversify the land and look after the soil health feels very wrong. This is one of the 'worse' (ie greener patches) that was 'done ' today, cos my horse still has really puffy eyes 😮‍💨😮‍💨
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Hermosa did 14k today and went over a boardwalk I was putting off until I thought she was ready to deal with it (bridges have been an issue ever since she nearly decked it on a slippery one as a baby). If they can go over the boardwalk in question, you can go wild. Took the boardwalk in stride, so we have far more possibilities to do big distances.
 
Hi all,

The last 3-4 weeks my boy hasn’t been ‘right’. Shortness in stride and lack of forwardness. Looks uncomfortable on both hard and soft.
He is: 12 year old 13,2 cob x

Today he hwe been diagnosed with Lami and EMS today. Also classed as ‘equivocal’ for PPID. Barely any pedal none rotation shown on the x-rays which we're really glad about but still concerned.
His bloods came back: PPID - 26.3 and insulin - 15.4.

He is now on soaked weighed hay and in a small paddock which is predominately dirt. He is also on bute for 14 days.
He is currently bare foot and always has been but will be shoeing him asap.

Would love to hear your experiences with lami and EMS and getting back into ridden work. I am fully aware this could take a long time and am in no rush to do so, want him happy and healthy foremost :)
 
Why are you shoeing out of interest?

I'd do a prascend trial, though we are in the seasonal rise currently. Did you do acth test or trh stim?
Once no longer actively laminitic the best thing to do is get him moving asap and (I'm presuming) weight off....weigh his hay as well, it should be no more than 2.5% of his body weight, if he eats quickly straw can be given (or a straw chaff like topspec zero/dengie light and healthy).
 
Why are you shoeing out of interest?

I'd do a prascend trial, though we are in the seasonal rise currently. Did you do acth test or trh stim?
Once no longer actively laminitic the best thing to do is get him moving asap and (I'm presuming) weight off....weigh his hay as well, it should be no more than 2.5% of his body weight, if he eats quickly straw can be given (or a straw chaff like topspec zero/dengie light and healthy).
Hi,
I am a full Lami novice so I am going to sound slightly naive!!
Was advised shoeing would provide him with more support.
What is a pracsend trail? We have. Or done that.
He is having 6KG hay a day now socked and into small hole nets. He does it quickly so will look into straw chaff etc as not heard of that before
 
I’d read that it’s a good idea to give EMS horses extra vitamin E and have had my mare on 3000iu per day.

I read a thing on a random vet’s website recommending 8000-10,000iu per day. What? That seems like a f- ton. Then I read some old threads on here where people were giving circa 5000iu per day to EMS horses.

What do you guys give?
 
Please don’t shoe him if he’s barefoot, boots with padding can be so much more comfortable for laminitics. I have one who as an ex show pony was as wide as he was tall when I got him and taking his shoes off when he was in pain was the best thing I ever did. If you must shoe consider glue on composites rather than nailing to already sore feet.

As far as supplements go milk thistle powder is a good for detoxing the liver. It cleanses the toxins in the body especially if he’s on Bute.
 
Does anyone feed ad lib hay with good results . Have been having problems soaking hay in this weather at moment I’m currently not living near yard so only am and pm visits, finding my pony has been bullying and harassing the other pony he lives with, that one is restricted also.

Been talking to a friend who has a horse who has had better results with ad lib as her horse was scoffing before , now regulates as nearly always got constant hay . Bloods are a lot lower than when she soaked and weighed out .
 
Hi,
I am a full Lami novice so I am going to sound slightly naive!!
Was advised shoeing would provide him with more support.
What is a pracsend trail? We have. Or done that.
He is having 6KG hay a day now socked and into small hole nets. He does it quickly so will look into straw chaff etc as not heard of that before
Shoeing restricts blood flow to the hoof capsule and though can provide instant pain relief, it slows healing and isn't best in the long run, particularly if there is rotation.
Boots, pads and a deep shavings bed alongside adequate analgesia (paracetamol has been shown to be very useful for laminitis) are better.

A prascend trial means giving some of the drug prascend (also called pergolide, peroquin etc) as an equivocal serum cortisol result means there could be PPID that is just not advanced yet. This is especially true if it was measured with the ACTH test, which is not as sensitive as TRH stim.

You could drop the hay and give straw alongside (though I'm presuming he's overweight of course in suggesting this); the 'general' rule is they should go no more than 4 hours without eating.
 
I’d read that it’s a good idea to give EMS horses extra vitamin E and have had my mare on 3000iu per day.

I read a thing on a random vet’s website recommending 8000-10,000iu per day. What? That seems like a f- ton. Then I read some old threads on here where people were giving circa 5000iu per day to EMS horses.

What do you guys give?
4k plus whatever is in his balancer. I don't give it because he is EMS but because he is off grass. I also feed a supplement because off grass. As mine lost sufficient weight he moved from equimins AC to spillers lite and lean.
I think Dr K suggested PPID got 5000iu vit e.

8 - 10k I believe is for horses found to be very low in vit e, you would cut back after a while.
 
Not related to the VitE supplements but those struggling with weight loss/condition/poor feet in their EMS horses because of having to soak hay and a restricted diet Mark Johnson my farrier on seeing DP’s feet last week suggested a mix of pea and potato protein. He said it seems to work better than just the pea protein alone and while he thought it would take two bags to see a result he was confident it would help. I would advise caution with quantities though as in overweight EMS horses protein can add to weight but in moderation it should help.

@Follysmum i think it depends on your turnout situation. My boys go out together at night and are in during the day so I do soak hay for my EMS pony at night when cool and he has it during the day but no longer do for my ex laminitic. He’s skinny and the vet is really happy with him but for DP a muzzle and 12 hour soaked hay is the only way I can keep his insulin levels down.
 
Hi all,

The last 3-4 weeks my boy hasn’t been ‘right’. Shortness in stride and lack of forwardness. Looks uncomfortable on both hard and soft.
He is: 12 year old 13,2 cob x

Today he hwe been diagnosed with Lami and EMS today. Also classed as ‘equivocal’ for PPID. Barely any pedal none rotation shown on the x-rays which we're really glad about but still concerned.
His bloods came back: PPID - 26.3 and insulin - 15.4.

He is now on soaked weighed hay and in a small paddock which is predominately dirt. He is also on bute for 14 days.
He is currently bare foot and always has been but will be shoeing him asap.

Would love to hear your experiences with lami and EMS and getting back into ridden work. I am fully aware this could take a long time and am in no rush to do so, want him happy and healthy foremost :)
re PPID do you have symptoms? if you look at the this is laminitis site (link in yr original post) it will give you symptoms. Before doing anything I would go through all the symptoms and see if your horse has any or lots. Some vets will trial prascend, some won't. If you have several symptoms then you could ask for a trial if not you could leave it for a while and retest. I found the ACTH test to be extremely unreliable and I think others have as well.

I would never shoe a laminitic horse (mine are all barefoot anyway) if the horse is barefoot you can see instantly what is happening ie if he relapses, if he has sore feet, or if he is walking happily. Vets seem pretty keen on shoeing laminitics for some reason. Mine was barefoot and I used padded boots.
Mine I guess was pretty similar to yours, I used padded boots 24/7 then reduced them to using them to ride in and when the horse was out but he is on a hard grass free track so boots kept him comfy.

As for riding mine didn't suffer too much footwise and could basically walk in boots sound. For a couple of weeks he was yarded then we started walking in hand for an hour a day for 2 months. Then he was ridden, booted at a walk for an hour every day. It took exactly 8 months to grow an entire new hoof and I restricted riding to a walk until the new hoof had all come down.

having sorted the diet ie no grass, no hay and we moved onto timothy haylage from which I got good weightloss then next thing to consider was trimming the feet to the x rays. The toe came back a little but not very much, I also got a farrier friend to check them and he took the toe back a little more, then I trimmed the toe every 2/3 days to renew the good bevel. I don't think you need shoes but more likely your trimmer/farrier or even vet to make sure they are correctly trimmed in conjunction with the x rays.
 
Not related to the VitE supplements but those struggling with weight loss/condition/poor feet in their EMS horses because of having to soak hay and a restricted diet Mark Johnson my farrier on seeing DP’s feet last week suggested a mix of pea and potato protein. He said it seems to work better than just the pea protein alone and while he thought it would take two bags to see a result he was confident it would help. I would advise caution with quantities though as in overweight EMS horses protein can add to weight but in moderation it should help.

@Follysmum i think it depends on your turnout situation. My boys go out together at night and are in during the day so I do soak hay for my EMS pony at night when cool and he has it during the day but no longer do for my ex laminitic. He’s skinny and the vet is really happy with him but for DP a muzzle and 12 hour soaked hay is the only way I can keep his insulin levels down.
I had a problem with protein (PPID and most likely EMS) To get weight loss I used late cut soaked hay. Whilst it was low in sugar it was also low in protein. I tried what I had thought was ordinary hay soaked but it was too high sugar for him. OK for the others but my horse can apparently act as a hay tester (at least he saves money on testing) higher sugar and he is very difficult to lead, low sugar and he is a dope on a rope.

I was already using pea protein which I found to be insufficient. It was difficult to get sufficient protein in that was under 10% s & s and he was starting to look in poor condition but losing weight. I moved to spillers lite and lean balancer which was the best thing I did. Realised it could produce weight gain but it hasn't it has just improved condition. Spiller told me it would take a month to see an improvement and they were right. If it does produce more weight gain I will cut back a little on something else. Alfalfa would have been great for protein but less than a kg and a horse that was happily walking barefoot over a stony yard was hobbling.

It took a long time to get the diet correct to get weight loss, keep him happy, keep him in good condition.
We settled on timothy or native grass with herb haylage, thunderbrook herbal chaff. If anyone wants a very happy horse thunderbrook chaff is the answer. Everyone loves it. Not sure my bank balance does :D:D
and unmolassed sugar beet, lite and lean, salt and vit E. No grass. I doubt mine will be able to have grass again.

For mine that seems to be as good as it gets and the horse after 8 months of this is now considerably improved, his coat no longer resembles a yak thanks to pergoquin but I had several sleepless nights and a lot of struggle to get there.
 
@paddy555 it is such a trial and error isn’t it. No two are the same and it does take a bit of experimenting until you find the right combination. I’m just thankful DP is still with me after his sister was PTS due to uncontrollable EMS, laminitis and full penetration of the sole ☹️

If no grass is the solution then so be it and educating owners is the best option out there. I am very appreciative of this thread as none of us know everything so every post is a bonus.
 
@paddy555 it is such a trial and error isn’t it. No two are the same and it does take a bit of experimenting until you find the right combination. I’m just thankful DP is still with me after his sister was PTS due to uncontrollable EMS, laminitis and full penetration of the sole ☹️

If no grass is the solution then so be it and educating owners is the best option out there. I am very appreciative of this thread as none of us know everything so every post is a bonus.
total total trial and error. I found it hard and I am very interested in feet, PPID and EMS and had a fair amount of background info. To someone who lands in this nightmare situation with little knowledge it must be very daunting. You were lucky to have Mark. :D

I'm so sorry about DP' sister. That must have been hard and I had an out of control laminitic a few years ago also PTS. With some once it starts there seems to be no way to stop. It has a mind of it's own.

hopefully lots of others will join in on this thread. Every snippet of info is valuable and may help someone's horse.
 
Cool. She has five hours of grass per day with a muzzle. Grass tests at 3-4 on a refractometer. So far, no relapses. I am riding… a lot. Averaging two hours per day, a mix of schooling and hacking. I need to make sure I’m feeding her enough for the work, but still getting the weight off.
 
Does anyone feed ad lib hay with good results . Have been having problems soaking hay in this weather at moment I’m currently not living near yard so only am and pm visits, finding my pony has been bullying and harassing the other pony he lives with, that one is restricted also.

Been talking to a friend who has a horse who has had better results with ad lib as her horse was scoffing before , now regulates as nearly always got constant hay . Bloods are a lot lower than when she soaked and weighed out .
I feed as lib (in a hay net. As much as I can shove in there and if he’s eating it all down I would add a second but it’s a huge hay net) my guy is also on a big lush pasture (we’re talking 20-30 acres) in the state of Kentucky. Think grass as rich as Ireland. (We’re moving to the UK soon. Like end of this month so that’s why I’m here) now he is in a grazing muzzle until the grass dies and I wear yellow tinted sunglasses cause I find it easier to spot the hints of green when it’s coming back alive and immediately muzzle again. My guy also gets a flake of orchard/alfalfa with his farm hay. I find the grazing muzzle makes him walk even more so it helps him move and stay comfortable. He’s also stays in full work as we caught it way before he was an actual risk for lami(he is in rehab work now cause Butt head got stuck in mud and tore his sdft. He also stayed on pasture turn out just in a half acre medic paddock) but his routine has not changed from pre EMS/Cushings diagnosis to post aside from medication. Which is just prescand and equiox as he is 22yo. He also gets adequan shots cause we give that like candy here in the states. He’s rehabbing fantastic. Heals fantastic and thinks he should be allowed to go galloping around at this point but is holding his manners lol. I would say go for feeding ad lib but if you’re concerned start off with stuffing a hay net or two for him and seeing how that goes. Then he can’t scarf it all in one sitting or risk choke from eating without chewing.
 
I feed as lib (in a hay net. As much as I can shove in there and if he’s eating it all down I would add a second but it’s a huge hay net) my guy is also on a big lush pasture (we’re talking 20-30 acres) in the state of Kentucky. Think grass as rich as Ireland. (We’re moving to the UK soon. Like end of this month so that’s why I’m here) now he is in a grazing muzzle until the grass dies and I wear yellow tinted sunglasses cause I find it easier to spot the hints of green when it’s coming back alive and immediately muzzle again. My guy also gets a flake of orchard/alfalfa with his farm hay. I find the grazing muzzle makes him walk even more so it helps him move and stay comfortable. He’s also stays in full work as we caught it way before he was an actual risk for lami(he is in rehab work now cause Butt head got stuck in mud and tore his sdft. He also stayed on pasture turn out just in a half acre medic paddock) but his routine has not changed from pre EMS/Cushings diagnosis to post aside from medication. Which is just prescand and equiox as he is 22yo. He also gets adequan shots cause we give that like candy here in the states. He’s rehabbing fantastic. Heals fantastic and thinks he should be allowed to go galloping around at this point but is holding his manners lol. I would say go for feeding ad lib but if you’re concerned start off with stuffing a hay net or two for him and seeing how that goes. Then he can’t scarf it all in one sitting or risk choke from eating without chewing.

Just digressing from this thread for a moment: welcome to the UK! Hope you enjoy living over here. A permanent move?

Back on thread: it sounds as though you are bringing your horse over too. What strategy do you have in terms of EMS for him to manage the journey - just out of interest. Soaking is out of the question (I assume) but I also presume exercise during the travel period, so will just the meds control it? Hope also that the sdft injury behaves.
 
Does anyone feed ad lib hay with good results . Have been having problems soaking hay in this weather at moment I’m currently not living near yard so only am and pm visits, finding my pony has been bullying and harassing the other pony he lives with, that one is restricted also.

Been talking to a friend who has a horse who has had better results with ad lib as her horse was scoffing before , now regulates as nearly always got constant hay . Bloods are a lot lower than when she soaked and weighed out .
None of mine regulate to the level where they stay thin. I had a load of issues last winter where both my EMS one and the pony gorged, expanded and required a re-think.

If the hay was super low sugar then maybe it would work but mine consistently tests around 8% and that's obviously too much.
 
Another EMS horse here. Age 21, weight good (though this means always on less food than he’d like), able to be exercised, soaked hay, hay mixed with straw (vet says soaking straw probably reduces risk of impaction), has stable plus a small exercise yard, and goes out unmuzzled on short grass for about 4-5 hours during the day.

Earlier in the year there were signs of raised insulin levels. They were within range after 10 hours in on soaked hay/straw, but about 75 after coming in from the field. He went on ertugliflozin and after 6 weeks, re tested after coming in from the field, same weight, same management regime, and levels had gone down to 10.
So essentially the drugs mean he can still go out for some hours of the day to be a horse, moving about with his head down grazing, which (in my view) will also benefit the rest of his body. Teeth, digestion, joints, guts, etc.

The vet said it might be possible to trial coming off the drugs during august, when grass sugar levels drop, but to put him back on it in september, when they rise again. I’m trying it out right now and the jury’s out…cross fingers as that might mean the drugs are only necessary during high grass sugar months. But I think he may need it all year round :/

I disagree with that Liphook vet btw on cost: medication which costs £2.5K a year (for a 500 kg horse) alone, plus of course blood tests etc., is not a low cost treatment imo. Can’t remember the exact wording used, but it was something along those lines… ‘reasonable cost’ or similar is used in the Q & A posted on p1.
 
Just digressing from this thread for a moment: welcome to the UK! Hope you enjoy living over here. A permanent move?

Back on thread: it sounds as though you are bringing your horse over too. What strategy do you have in terms of EMS for him to manage the journey - just out of interest. Soaking is out of the question (I assume) but I also presume exercise during the travel period, so will just the meds control it? Hope also that the sdft injury behaves.
Yes permanent thank you! He doesn’t typically get his hay soaked but when I do it’s usually in a hay net. We’re not where it’s feasible to soak it constantly. The vets aren’t worried about the tendon but it’s getting checked right before he leaves and then when he’s arrived we’re rechecking to be safe. It’s mostly med control but also staying on as much turn out as physically possible. Min 14hrs a day but I try to keep it at least 18-20 hours. With a muzzle he walks a lot so it helps him a ton with not losing condition and staying comfortable. I think it’s also helped a lot with healing. I’ve noticed it seems to be very different opinion of outcome on these injuries in the states vs the UK. The states are still pretty big on box resting but more vets are comfortable with them turning out on soft tissue injuries. Usually smaller paddocks for turn out and I think it’s more common the second they can physically manage the walk to turn out it’s Dr. green time here in the states it looks like but that might also just be the more commonly shared experiences on here and not necessarily the common experience overall.
 
None of mine regulate to the level where they stay thin. I had a load of issues last winter where both my EMS one and the pony gorged, expanded and required a re-think.

If the hay was super low sugar then maybe it would work but mine consistently tests around 8% and that's obviously too much.
Same here I cannot give ad-lib grazing or hay even when soaked. I feed straw and hay mixed that keeps the weight off.
 
Neither of my girls have officially been diagnosed, but I strongly suspect EMS for both due to their odd fat deposits. Both of them have been VERY fat at some point before they arrived with me, and both are excellent doers.

Saus is near her ideal, and cob would no longer be a successful TOYS prospect, but still has a little way to go.

The issue is now how I’m going to maintain their weight, so they’re not boinging around between fat and ideal. Plus, I want to avoid boredom and hanger.

Would being on standing hay with a grazing muzzle overnight, and in diet paddock during the day be alright for them? Any muzzle recommendations?
 
Neither of my girls have officially been diagnosed, but I strongly suspect EMS for both due to their odd fat deposits. Both of them have been VERY fat at some point before they arrived with me, and both are excellent doers.

Saus is near her ideal, and cob would no longer be a successful TOYS prospect, but still has a little way to go.

The issue is now how I’m going to maintain their weight, so they’re not boinging around between fat and ideal. Plus, I want to avoid boredom and hanger.

Would being on standing hay with a grazing muzzle overnight, and in diet paddock during the day be alright for them? Any muzzle recommendations?
Tough one breathe easy, green guard, flexible filly are all good ones to use. Green guard be mindful of how big the water trough opening is because it’s harder for smaller openings for some horses
 
I've been looking at acetyl l carnitine and it seems there is evidence to support it in insulin resistance but its bioavailability to horses is low and negatively related to the amount given. Has anyone tried it in EMS management?

I might try D on 10g a day and see .... She has lost 21kg now and sound though. Actually very bouncy and enjoying "working" judging by how easy she is to catch and that she's trotting down the field to see me 😅💖 NF also lost 11 but more worried about her PPID now 😮‍💨
 
Does anybody use Horsehage instead of hay? I got a bale to try and my horse loves it, but I'm afraid she's going to wolf it down and then be hungry for the next couple of hours. It's meant to be low sugar and good for fatties.
 
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