IBD diet?

[ThreeFurs]

My 19 yo wb gelding Maddie, was diagnosed, after two months of projectile diarrhea, in-appetence, colicking and weight loss, and after a rectal biopsy in December, with eosinphilic colitis 24/12/21. Its a form of IBD that's focused on the hind gut.

Following this, he had the gold standard intro loading doses of Dexamethasone for the first month or six weeks, and has been stabilized on 3mls Dex every five days since February. Since the inflammation and diarrhea were being controlled with the steroid, in March we started 5 mins a day hand walking with Equicore therabands, and built up over three months to 15-20 mins 4x a week either lunging or riding.

'Good' days are characterised by normal manure, horse being bright, with good appetite. I have a great vet; who after the worst symptoms from 2021 were under control Jan - March [two colics, weight loss, total reluctance to eat] prescribes the Dexamethosone to us to be given on an 'as needed' basis time period open ended.

But lately, for about the last month the Dex hasn't been working to control symptoms. He's now needing it once every other day. I'm not sure why; we are in SE Australia, we've had a little Autumn rain the Adelaide hills which has brought up some sweet green grass shoots. Its also an active time for small strongyls, [Maddie was wormed for these in Sept last year, which brought on the symptoms].

Had a FEC on Thursday 14 April of 1050 EPG. Vet said high load due to horse being immuno-suppressed from the steroids, but maybe also just prone. Dosed horse with' Eques Plus Tape' moxidectin/praziquantel wormer Good Friday. 14 days later did another FEC got zero egg count. And he's on a Sand Flusher pellet 5 days every month. His teeth are done every 6 months. He's out 24/7 on local Adelaide hills pasture. He's able to gain and hold weight. see pic. But I just worry so much about the weekly fluctuations of ok manure, to really diarrheric.

Additionally He's on:
Chaff 100% Wheaten) 100.0 g per day
CEN Complete Grain-Free Pellet - 1.5 kg per day [lupin/ lupin hulls with a pre and probitic, hoof supplement and vitamin supplement - 2.6% starch]
Lucerne Hay (Prime) 5.5 kg per day
C3 Type Grass Hay (Prime) 5.0 kg per day
Poor C3 Type Grass pasture 24 hours per day

So its a bland, roughage high, low starch diet.

I'm feeling [and he must be too] feeling a bit like 'we're following all the vet studies, but things are getting worse'. I've heard Professor Andy Durham at Liphook has come up with an IBD diet, and I've had trouble finding it online. Does anyone have it?

 

[Celtic Fringe]

There is an article at Treating Diarrhoea in Mature Horses which might be useful. I can also search the academic literature for you later. You could perhaps try emailing him direct to see if he has any more up to date information as the article is now five years old?
Good luck with your horse - she is very lucky to have such a caring owner.

 

[I'm Dun]

Has he been scoped for ulcers? Those symptoms could be coming from them. I'd also be looking at the equi biome stuff. I've had hind gut issues and colic with mine and am just about to start him on some of their recommendations

 

[ThreeFurs]

Thank you Celtic. I'm an adjunct in Art history at Adelaide Uni, only worth mentioning, as we have a vet school at my Uni! So my library gets all the online vet journals, that I've been searching up the whaazoo. I've read everything I can get my hands on about this disease. [my own vet teases me about this, but there's not a lot known about the disease. https://www.facebook.com/horsemedSA...onths-of-maternity-leave-thi/440222809852969/

 

[ThreeFurs]

Yes as I'm Dun says, there is a complex interplay between helminths, [worms] gut biome, genes, and outside stressors in initiating the autoimmune response. great article here xg

 

[ThreeFurs]

I've been in touch with others on the forum who have horses with this disease [Jim-bob] and I've read everything, but I am worried that at the five month point of being on steroids, my boy seems to be getting worse. Yeah I'm no snowflake, I am aware that this disease is associated with hind gut neoplasias [cancers] but it would just be really good at this point to try the Andy Durham diet, and to get some feedback from those in the same situation. x

 

[nutjob]

The only thing which helped my multiple colicking horse who was suspected but not proved to have eosinophilic colitis was keeping him off grass entirely. It's ages ago and there wasn't the info on it that there is now but he was always worse when there was fresh grass growth.

 

[ThreeFurs]

There is an article at Treating Diarrhoea in Mature Horses which might be useful. I can also search the academic literature for you later. You could perhaps try emailing him direct to see if he has any more up to date information as the article is now five years old?
Good luck with your horse - she is very lucky to have such a caring owner.

Thanks Celtic, its an 'emerging diesease'. Some studies are 1990s, some more recent. Only positive to emerge over the last 10 years is that some vets think is 'clincally manageable'. But yes, will read this with interest. x

 

[ThreeFurs]

Has he been scoped for ulcers? Those symptoms could be coming from them. I'd also be looking at the equi biome stuff. I've had hind gut issues and colic with mine and am just about to start him on some of their recommendations

Has he been scoped for ulcers? Those symptoms could be coming from them. I'd also be looking at the equi biome stuff. I've had hind gut issues and colic with mine and am just about to start him on some of their recommendations

Has he been scoped for ulcers? Those symptoms could be coming from them. I'd also be looking at the equi biome stuff. I've had hind gut issues and colic with mine and am just about to start him on some of their recommendations

 

[PurBee]

Sounds like youve both been really trying to figure out his issues.

My gelding when around 4yrs old suddenly got a few weeks of severe runs, and it was only when i removed the new haylage and switched to another new brand, that the issue stopped. The mare was ok on this haylage but the gelding wasnt. The only conclusion i could settle on was high nitrogen, that he in particular, was ultra sensitive to. Many haylage fields are fertilised with NPK pellets in the uk/ireland. They promote strong growth of the crop yet high nitrates in forage feed can cause the runs.

Your horse got worse after worming you say. Makes me wonder if the parasites were attached to rear gut wall and the wormer killed them off, leaving the rear gut wall damaged, so it inflames and doesnt absorb food/water, resulting in loose poops. Healing the gut wall is worth focusing on.
Recommended for this is aloe vera juice in feed and also glutamine amino acid is essential and excellent for gut wall repair.

The other aspect of feed that has me wondering if there’s a reaction is the lupin you’re feeding. Its not a common horse feed in the british isles for horses and i didnt realise it was a feed used for horses until googling. Its confusing me because i knew of lupins as poisonous to horses, so am wondering why they are using them for horse feed. There’s toxic quinalizidine alkaloids in all parts of the plant, especially seeds/pods thats toxic to horses, according to the horse dvm.
Maybe commercial lupin for cattle feed has lower amounts, but as your horse is struggling still, i would be cutting out any ‘dubious’ feeds and trying to simplify the diet.
From my feed researches, animal feeds receive vastly less ‘parameter testing’ for toxins than human feeds, and despite marketing etc, when you question these feed companies as to levels of x,y,z in their feed and their testing proof, they admit they dont test all batches.
‘If in doubt, throw it out’ is a mantra in the wild edible mushroom collecting groups, and its one i apply to horse feeds too when theyre going through illness.

http://www.horsedvm.com/poisonous/lupines/

The other aspect of his diet im wondering if its hindering more than helping his hindgut at the moment is the lucerne/alfalfa of 5kg per day. I know many americans and australians feed alfalfa to horses and they thrive. its a great high protein roughage for improving muscle and weight gain. Yet the drawback are its very high in calcium - so you need a high phosphate feed to balance it out - grains are usually used for this. However, due to the high protein content and the acids produced from this the high calcium in the alfalfa helps to buffer the metabolized effects of the high protein.

There’s a huge debate between professionals about alfalfa, whether its good for horses or not due to its high protein levels and high calcium - the resounding answer seems to be to get your source of alfalfa tested for calcium and protein levels as they can vary wildly between suppliers….from 14% protein to 20+%. There’s pros and cons to alfalfa.



If your horse before being unwell was very good on alfalfa i wouldnt be concerned about it. Yet, due to his hind gut issues i would now be questioning whether to continue with the alfalfa. The other aspect about alfalfa i found when researching its nutritional effect, because i was supplied a hay with 40% alfalfa in it without knowing, and my horses guts /poops altered - is that there are certain proteins in alfalfa hay particularly that are digested in the hind gut only. Most grass hay proteins produced for horses are all digested in the foregut. Yet in alfalfa, theres a good percentage that are hing gut processed.

So horses not used to alfalfa, wont have the hind gut microbes that can deal with the protein metabolism from the alfalfa and can experience hind gut distress/behaviour change/runnier poops. (Like my horses did) I ended up feeding just 1kg of that hay shared per day once i realised there was alfalfa in it.
As your horse at the moment has hind gut issues, probably caused by parasites than alfalfa, im wondering if you should stop the alfalfa for a while, just in case that is aggravating an already challenged inflamed hind gut?

You would be concerned about maintaining weigh gain, yet if he’s on feeds that are potential toxic, lupins and potentially challenging his damaged hind gut, alfalfa, continuing with those feeds could be making things worse, without you knowing.

I would stick with the prime grass hay and the forage turn out he’s getting - add a pellet/powder multi-mineral and probiotic. Add aloe vera and glutamine for gut repair. Strip the diet right back to basics.
The weight gain will be an issue while the hind gut is inflamed/damaged, no matter the cause. So if focus is on repair of hind gut, and cutting out potential ‘problematic’ feeds - allows the repair and natural weight gain.

Oils are sometimes used for weight gain with dodgy guts, as the liver will metabolise it. Flax oil is nutritious aswell as fatty. I wouldnt use rapeseed/sunflower to be honest, due to high pro-inflammatory omega 6, with very low omega 3 ratio.
But first i would just remove the lupin and alfalfa and add gut repair additions, as stated above - and see how he develops, before adding cups of oil to the diet.
No horse can gain weight with a dodgy gut so many nutritious feeds wont be absorbed anyway. Repair the gut and the microbe balance can start to renew itself.

My gelding lost weight very swiftly with runny poops due to the haylage. He gained it rather rapidly too once the feed was changed and gut settled. Its hard to know whats the offender making things worse, so always worth stripping diet back to kilo’s of mixed roughage, turnout and minerals…take things from there.

Just some suggestions to consider.
Fingers crossed for you both he improves and heals soon.

 

[ILuvCowparsely]

IBD
Are you referring yo Inflammatory Bowl Disease.


If so Professor Andy Durham checked my ponies gastroscope pictures, as vets unsure if ulcers or IBD.

He confirm it was IBD

He asked me what she was on and I told him:


he said her diet to be

Ready Grass
Equivite
Linseed oil That is it. Though he has cleared it with me she can have Timothy chop grass added in winter

Haylage: to be Timothy only as its only 1 grass in the bag.

Also no treats.

My one was colicking allot and lost weight and stood miserable in field and stable.

Here is my instructions. If it is any help


11th August 2017

xxxxxx" xxxxxxxx– Discharge Instructions

Pony name came into xxxxxxxxxx vets for ultrasound examination of her abdomen with internal medicine specialist Andy Durham MRCVS, from Liphook Equine Hospital.

Today ultrasound examination found thickened small intestine but normal large intestine. This is most likely caused by Inflammatory Bowel Disease (IBD).

The initial plan for xxxxxx is to simplify her diet. All changes to her diet should be introduced gradually over a 2 week period. xxxxxxx diet should consist of grass (turnout as discussed in her starvation paddock), 'purple' haylage (timothy grass), equivite and a small amount of readigrass (this can be damped down prior to feeding). Also xxxxxx can have linseed oil, up to a total of 40-50ml per day, this should be introduced slowly and gradually over the next 2 weeks. All other supplements and feeds should be stopped.

xxxxxxx's weight (increases or decreases) should be monitored and she should continue to be monitored for signs of colic. xxxxxx can continue with her normal exercise regime.

xxxxx should be booked in for a repeat blood test in 4 to 6 weeks to review her progress. At this point we will decide if she requires further treatment e.g. steroids.

If you have any concerns with xxxxxxx please do not hesitate to contact the practice on xxxxxxxxxxx

 

[ThreeFurs]

IBD
Are you referring yo Inflammatory Bowl Disease.


If so Professor Andy Durham checked my ponies gastroscope pictures, as vets unsure if ulcers or IBD.

He confirm it was IBD

He asked me what she was on and I told him:


he said her diet to be

Ready Grass
Equivite
Linseed oil That is it. Though he has cleared it with me she can have Timothy chop grass added in winter

Haylage: to be Timothy only as its only 1 grass in the bag.

Also no treats.

My one was colicking allot and lost weight and stood miserable in field and stable.

Here is my instructions. If it is any help


11th August 2017

xxxxxx" xxxxxxxx– Discharge Instructions

Pony name came into xxxxxxxxxx vets for ultrasound examination of her abdomen with internal medicine specialist Andy Durham MRCVS, from Liphook Equine Hospital.

Today ultrasound examination found thickened small intestine but normal large intestine. This is most likely caused by Inflammatory Bowel Disease (IBD).

The initial plan for xxxxxx is to simplify her diet. All changes to her diet should be introduced gradually over a 2 week period. xxxxxxx diet should consist of grass (turnout as discussed in her starvation paddock), 'purple' haylage (timothy grass), equivite and a small amount of readigrass (this can be damped down prior to feeding). Also xxxxxx can have linseed oil, up to a total of 40-50ml per day, this should be introduced slowly and gradually over the next 2 weeks. All other supplements and feeds should be stopped.

xxxxxxx's weight (increases or decreases) should be monitored and she should continue to be monitored for signs of colic. xxxxxx can continue with her normal exercise regime.

xxxxx should be booked in for a repeat blood test in 4 to 6 weeks to review her progress. At this point we will decide if she requires further treatment e.g. steroids.

If you have any concerns with xxxxxxx please do not hesitate to contact the practice on xxxxxxxxxxx

Oh my! thank you so much Iluv. I really appreciate this. I have the diet now from the 'horse's mouth' Dr A D himself. Cheers so much. Quick question though and it might sound strange ... what is 'timothy'? is it like our 'meadow hay'? that is hay cut and dried from normal pasture seeded mix.?

 

[ThreeFurs]

Sounds like youve both been really trying to figure out his issues.

My gelding when around 4yrs old suddenly got a few weeks of severe runs, and it was only when i removed the new haylage and switched to another new brand, that the issue stopped. The mare was ok on this haylage but the gelding wasnt. The only conclusion i could settle on was high nitrogen, that he in particular, was ultra sensitive to. Many haylage fields are fertilised with NPK pellets in the uk/ireland. They promote strong growth of the crop yet high nitrates in forage feed can cause the runs.

Your horse got worse after worming you say. Makes me wonder if the parasites were attached to rear gut wall and the wormer killed them off, leaving the rear gut wall damaged, so it inflames and doesnt absorb food/water, resulting in loose poops. Healing the gut wall is worth focusing on.
Recommended for this is aloe vera juice in feed and also glutamine amino acid is essential and excellent for gut wall repair.

The other aspect of feed that has me wondering if there’s a reaction is the lupin you’re feeding. Its not a common horse feed in the british isles for horses and i didnt realise it was a feed used for horses until googling. Its confusing me because i knew of lupins as poisonous to horses, so am wondering why they are using them for horse feed. There’s toxic quinalizidine alkaloids in all parts of the plant, especially seeds/pods thats toxic to horses, according to the horse dvm.
Maybe commercial lupin for cattle feed has lower amounts, but as your horse is struggling still, i would be cutting out any ‘dubious’ feeds and trying to simplify the diet.
From my feed researches, animal feeds receive vastly less ‘parameter testing’ for toxins than human feeds, and despite marketing etc, when you question these feed companies as to levels of x,y,z in their feed and their testing proof, they admit they dont test all batches.
‘If in doubt, throw it out’ is a mantra in the wild edible mushroom collecting groups, and its one i apply to horse feeds too when theyre going through illness.

http://www.horsedvm.com/poisonous/lupines/

The other aspect of his diet im wondering if its hindering more than helping his hindgut at the moment is the lucerne/alfalfa of 5kg per day. I know many americans and australians feed alfalfa to horses and they thrive. its a great high protein roughage for improving muscle and weight gain. Yet the drawback are its very high in calcium - so you need a high phosphate feed to balance it out - grains are usually used for this. However, due to the high protein content and the acids produced from this the high calcium in the alfalfa helps to buffer the metabolized effects of the high protein.

There’s a huge debate between professionals about alfalfa, whether its good for horses or not due to its high protein levels and high calcium - the resounding answer seems to be to get your source of alfalfa tested for calcium and protein levels as they can vary wildly between suppliers….from 14% protein to 20+%. There’s pros and cons to alfalfa.



If your horse before being unwell was very good on alfalfa i wouldnt be concerned about it. Yet, due to his hind gut issues i would now be questioning whether to continue with the alfalfa. The other aspect about alfalfa i found when researching its nutritional effect, because i was supplied a hay with 40% alfalfa in it without knowing, and my horses guts /poops altered - is that there are certain proteins in alfalfa hay particularly that are digested in the hind gut only. Most grass hay proteins produced for horses are all digested in the foregut. Yet in alfalfa, theres a good percentage that are hing gut processed.

So horses not used to alfalfa, wont have the hind gut microbes that can deal with the protein metabolism from the alfalfa and can experience hind gut distress/behaviour change/runnier poops. (Like my horses did) I ended up feeding just 1kg of that hay shared per day once i realised there was alfalfa in it.
As your horse at the moment has hind gut issues, probably caused by parasites than alfalfa, im wondering if you should stop the alfalfa for a while, just in case that is aggravating an already challenged inflamed hind gut?

You would be concerned about maintaining weigh gain, yet if he’s on feeds that are potential toxic, lupins and potentially challenging his damaged hind gut, alfalfa, continuing with those feeds could be making things worse, without you knowing.

I would stick with the prime grass hay and the forage turn out he’s getting - add a pellet/powder multi-mineral and probiotic. Add aloe vera and glutamine for gut repair. Strip the diet right back to basics.
The weight gain will be an issue while the hind gut is inflamed/damaged, no matter the cause. So if focus is on repair of hind gut, and cutting out potential ‘problematic’ feeds - allows the repair and natural weight gain.

Oils are sometimes used for weight gain with dodgy guts, as the liver will metabolise it. Flax oil is nutritious aswell as fatty. I wouldnt use rapeseed/sunflower to be honest, due to high pro-inflammatory omega 6, with very low omega 3 ratio.
But first i would just remove the lupin and alfalfa and add gut repair additions, as stated above - and see how he develops, before adding cups of oil to the diet.
No horse can gain weight with a dodgy gut so many nutritious feeds wont be absorbed anyway. Repair the gut and the microbe balance can start to renew itself.

My gelding lost weight very swiftly with runny poops due to the haylage. He gained it rather rapidly too once the feed was changed and gut settled. Its hard to know whats the offender making things worse, so always worth stripping diet back to kilo’s of mixed roughage, turnout and minerals…take things from there.

Just some suggestions to consider.
Fingers crossed for you both he improves and heals soon.

Thank you so much PurBee. I'm going to try the IBD diet, which means ditching the lupin-based pellets anyway. Here, lupins crushed, and hulls are used as a cool safe low starch feed for Cushings/laminitic horses and appear on their own and with other things in a range of commercial pelleted feeds. Didn't know they could be toxic.

Maddie wasn't loose on alfalfa before his diagnosis, and on bad days its the only feed he will eat, and he prefers it over nearby green grass, his bucket feed, and ordinary hay. I will try reducing it though. I guess the issue is his hind gut is damaged, and sensitive therefore to everything.

Thanks for your kind wishes. Will also try him on the aloe juice.

 

[ThreeFurs]

D'oh [slaps own forehead]. My vet is English, she can advise on closest Australian equivalents for the Liphook IBD diet.

 

[ThreeFurs]

He's not been scoped for ulcers. Will discuss with vet ta for suggesting this.

 

[Tiddlypom]

Has he been scoped for ulcers? Those symptoms could be coming from them. I'd also be looking at the equi biome stuff. I've had hind gut issues and colic with mine and am just about to start him on some of their recommendations

This.

You can get an Equibiome faecal analysis of the hind gut biome run. Based in the UK, but they offer an international service.

https://www.equibiome.org/product-page/petbiome-faecal-collection-kit-international

I'm not familiar with IBD, but my own mare had a hind gut biome which proved to be way off kilter, and following the post result dietary advice to help restore her hind gut biome to nearer normal has made her far more comfortable. She had scoped -ve for foregut ulcers. Both my regular vet and my chiro vet have seen good results after some of their equine patients have had the Equibiome analysis, and the post results dietary tweaks followed.

In any case, it would help to build up a picture. Disadvantage is that the test takes 8-10 weeks to run.

Good luck.

 

[ThreeFurs]

Well it seems we're going to have to approximate the Liphook anti diarrhea/IBM diet. My lovely English vet texted me back and translated the terms. Timothy grass is not grown in South Australia. Some has gone wild in the Kosciusko Mountains in NSW. We don't have haylage, but we do have hay cubes. We don't have ReadiGrass. We do have linseed oil!

Re: the Equivite, We do have hundreds of brands of similar vitamin/mineral balancers for horses, some imported from Uk. I'm no agronomist, but I do know many horse properties here in the Adelaide hills were once cattle properties, so sown with a cattle fattening seed mix full rye, clover and other stuff that while ok in summer and winter, is diabolical in Spring and Autumn for horses as its far too sweet. This is what we're on. With global warming and a [warm, wet] El Nina two year phase, the flushes go on and on.

My horse came from Queensland, from the tropics, so once again, a very different, all year round green kind of pasture. So I think with meadow hay, a reduced amount of alfalfa, some soaked meadow hay cubes, vit/min balancer, and oil, we can kind of approximate the Liphook diet. Nothing to lose at this point by trying. x

 

[bouncing_ball]

Well it seems we're going to have to approximate the Liphook anti diarrhea/IBM diet. My lovely English vet texted me back and translated the terms. Timothy grass is not grown in South Australia. Some has gone wild in the Kosciusko Mountains in NSW. We don't have haylage, but we do have hay cubes. We don't have ReadiGrass. We do have linseed oil!

Re: the Equivite, We do have hundreds of brands of similar vitamin/mineral balancers for horses, some imported from Uk. I'm no agronomist, but I do know many horse properties here in the Adelaide hills were once cattle properties, so sown with a cattle fattening seed mix full rye, clover and other stuff that while ok in summer and winter, is diabolical in Spring and Autumn for horses as its far too sweet. This is what we're on. With global warming and a [warm, wet] El Nina two year phase, the flushes go on and on.

My horse came from Queensland, from the tropics, so once again, a very different, all year round green kind of pasture. So I think with meadow hay, a reduced amount of alfalfa, some soaked meadow hay cubes, vit/min balancer, and oil, we can kind of approximate the Liphook diet. Nothing to lose at this point by trying. x

Andy's email address is on this link - Professor Andy Durham - Liphook Equine Hospital https://liphookequinehospital.co.uk...s/equine-hospital-vets/professor-andy-durham/

I would try emailing him / getting your vet to email him, and asking what his current (2017 was a while ago) IBD diet is and how you can approximate this to what is available where you are. I think there is a fair chance he might reply. Fingers crossed.

 

[ThreeFurs]

Done! Will let you know how it goes. cheers.

Andy's email address is on this link - Professor Andy Durham - Liphook Equine Hospital https://liphookequinehospital.co.uk...s/equine-hospital-vets/professor-andy-durham/

I would try emailing him / getting your vet to email him, and asking what his current (2017 was a while ago) IBD diet is and how you can approximate this to what is available where you are. I think there is a fair chance he might reply. Fingers crossed.[/QUO

 

[Shilasdair]

Sounds similar to my horse - had eosinophilic enteritis - turned out to be allergic to rye grass.

 

[ThreeFurs]

IBD
Are you referring yo Inflammatory Bowl Disease.


If so Professor Andy Durham checked my ponies gastroscope pictures, as vets unsure if ulcers or IBD.

He confirm it was IBD

He asked me what she was on and I told him:


he said her diet to be

Ready Grass
Equivite
Linseed oil That is it. Though he has cleared it with me she can have Timothy chop grass added in winter

Haylage: to be Timothy only as its only 1 grass in the bag.

Also no treats.

My one was colicking allot and lost weight and stood miserable in field and stable.

Here is my instructions. If it is any help


11th August 2017

xxxxxx" xxxxxxxx– Discharge Instructions

Pony name came into xxxxxxxxxx vets for ultrasound examination of her abdomen with internal medicine specialist Andy Durham MRCVS, from Liphook Equine Hospital.

Today ultrasound examination found thickened small intestine but normal large intestine. This is most likely caused by Inflammatory Bowel Disease (IBD).

The initial plan for xxxxxx is to simplify her diet. All changes to her diet should be introduced gradually over a 2 week period. xxxxxxx diet should consist of grass (turnout as discussed in her starvation paddock), 'purple' haylage (timothy grass), equivite and a small amount of readigrass (this can be damped down prior to feeding). Also xxxxxx can have linseed oil, up to a total of 40-50ml per day, this should be introduced slowly and gradually over the next 2 weeks. All other supplements and feeds should be stopped.

xxxxxxx's weight (increases or decreases) should be monitored and she should continue to be monitored for signs of colic. xxxxxx can continue with her normal exercise regime.

xxxxx should be booked in for a repeat blood test in 4 to 6 weeks to review her progress. At this point we will decide if she requires further treatment e.g. steroids.

If you have any concerns with xxxxxxx please do not hesitate to contact the practice on xxxxxxxxxxx

Dear iluv, how is your pony going? and thanks so much for the diet. I've adapted it for SE Australian [alpine] Adelaide hills conditions and I can already see a change.

We have the 'Jenny Craig/Weight watchers' field, eaten down through summer, and now. just a little green pick coming through, with autumn rains; instead of timothy and haylage, [which we actually can get here, but its really expensive], I'm substituting what you posted, with 3 big slices per day of meadow, [field] cut and dried hay, one each at breakfast, lunch, and dinner, plus a couple of slices of alfalfa, torn up and mixed into the 3x each a day slices of meadow, to make it palatable.

Plus soaked teff [low sugar] hay and and alflafa 50/50 haycubes say, only a handful, 6-10, in water mashed, with the Kohnkes Cell Vital vitamin/mineral supplment, plus 30 g cold pressed linseed oil. So, nothing commercial, and bascially all roughage.

The steroid, [the dexamethasone] gets given 3ml every 3 days, intramuscular. For the last six months, its really the latter that' been controlling his diarrhea.

So we will see where simplication gets us, hopefully, its to a good place. i've not heard back from Liphook, for professor Andy Durham, but I'ved tried to take the philosophy, the 'point' of the diet, into some changes.