Insulin resistance testing

[Birker2020]

My horse is having this test in the next week or so. Can someone point me in the direction of information about the test please, in particular what the horse can/can't eat prior to the test?

He's been on box rest since 3rd May for suspected laminitis. Prior to that he was being rehabbed by me at home on box rest following an accident at retirement livery on 13th April. He'd had a period of box rest and vet gave all clear to go out. Day one I turned him out for 3 hrs and then out overnight on days 2, 3 and four in a 12m x 6m paddock rotated daily (see photo) . On 4th morning he came in footy.

I confess the grass was good, but it was fairly long too, and as he was in such a confined space I honestly thought he'd be okay as the horse in the paddock next door (Lari's old paddock) was using it to graze in at night without restriction and had been for over a week and was fine.

Lari's symptoms were footiness and pointing the left toe (see photos). He would also rock back once on all four legs when stood for a length of time and asked to walk on, but I only noticed this symptom during the box rest (my physio says can be related to his other problems causing him to seize up a little.) He doesn't seem to do this much now.

Had shoes removed 23rd Nov but been a bit footy on and off for last 10 or 12 weeks on concrete. Fine on grass.

Vet came out and said it could be seedy toe/ hoof wall separation - he had a small amount of both. Could be adhesions from tendon injury from field accident. Or could be laminitis.

So he's been on box rest, I'm following EMS diet (low starch, low sugar) and bucketing water onto nets thoroughly.

He's not particularly cresty or fat (see photo). But vet saw him when he had gas bloat so I think he looked fatter than he was.

Suggested EMS test - sure he said the insulin resistance test. Said to keep on box rest, then on a given day an hour before my appointment with him, I was to graze him for exactly an hour, he'd then do insulin test.

So if you have had the insulin test for your horse was this pretty much what you were told to do? There is so much conflicting advice on the internet and it says it's very easy to produce a false negative by not doing the test correctly but then there is conflicting advice on how to do that too.

As Lari's life is pretty much determined on the result of this test (he will be returning to retirement livery with access to 40 plus acres with 20 other horses) then I want to make sure the test is being carried out correctly.

Some of the advice says to starve for 6 hours, other info says to take bloods after minimum of two hours, but no more than three.

Help!. I'm almost wondering with all the variables if the test is even worth doing. Exactly how easy is it to tell if a horse has had/got laminitis or EMS from this test?

Also as he's been on box rest, if he goes out on grass he will have to be sedated. Will the sedalin have any effect on his blood sugars?

Surely any horse that has been eating hay for weeks on box rest will have an insulin spike after an hour at grass? Is it not like us eating weetabix for weeks and then being handed a packet of skittles?

I'm confused.com

 

[SEL]

There's two ways the vets do this. My preference is to take bloods whilst they are eating their normal food. Mine live out so about an hour after breakfast to pull bloods.

The other is to give them a measure of syrup and monitor the insulin spike. They should also test glucose at this point.

I'm going to try and find Dr Kellon's laminitis site because that gives the gold standard.

 

[SEL]

Here you go

Equine Metabolic Syndrome (EMS) Calculator

Use these calculators for determining your equine's Equine Metabolic Syndrome (EMS) calculations.

www.ecirhorse.org

 

[Sandstone1]

Probably best to get clear instructions from your vet.

 

[Zoeypxo]

My horse stood with her foot like that when she injured her ddft in her foot and had NPA in both.

It may be worth doing a cushings test also whilst they are out?

 

[Pearlsacarolsinger]

My horse stood with her foot like that when she injured her ddft in her foot and had NPA in both.

It may be worth doing a cushings test also whilst they are out?

I would definitely do the TRH-Stim test, don't bother with the ACTH test it's not reliable enough.

 

[Birker2020]

My horse stood with her foot like that when she injured her ddft in her foot and had NPA in both.

My physio has suggested this already as a possibility but he's walking so well I'm not entirely sure.

Did yours walk well?

 

[Birker2020]

Here you go

Equine Metabolic Syndrome (EMS) Calculator

Use these calculators for determining your equine's Equine Metabolic Syndrome (EMS) calculations.

www.ecirhorse.org

Thank you, very informative

 

[Zoeypxo]

My physio has suggested this already as a possibility but he's walking so well I'm not entirely sure.

Did yours walk well?

Sometimes yes sometimes no never very consistently sore or not sore, it was odd. Was mainly on off lameness and standing with her foot as you pictured

 

[Red-1]

I think any test will be muddied at the moment. Even the vet isn't sure he has lami.

I think, with Lari's retirement, I would take a pragmatic view.

For low sugar and starch diet, bucketing water onto the hay will have little effect on the sugar levels. It needs thoroughly immersing, for some time (like 2-4 hours), until the water is mucky. That is the sugars dissolving onto the water. Then the nets need lifting and the mucky water rinsing off: that part could be done by bucket.

The water needs to be fresh for each net or else you are simply immersing the hay into a sugar solution left from the last net.

I would follow your vet for advice on the test he recommends.

When Rigs had his test for EMS, I had to be up for a small haynet at 3.30am, which had to have run out by 6am. Then, when I got home at midday, I syringed in a caro sugar syrup. The vet did the test 1 - 1.5 hours after that. You could, of course, arrange for his test to be later in the day to avoid a 3.30am haynet but I wanted to be out of the house while he was hungry as, if he could see me, he would have called for food.

That is apparently the most accurate way but , as Lari has been in pain, the results from a super well administered test will be muddied anyway, so what the vet has suggested will just give a general over-view.

As for the toe, it could be something as silly as walking toe first as he has had pain from the thrush in his frog, or pain from an abscess, or pain from his tendon. If he has been walking abnormally, that could cause him to be inflamed.

I would simply do what the vet says, but change the hay prep to actually soak it rather than just doing the rinsing part.

 

[Birker2020]

I think any test will be muddied at the moment. Even the vet isn't sure he has lami.

I think, with Lari's retirement, I would take a pragmatic view.

For low sugar and starch diet, bucketing water onto the hay will have little effect on the sugar levels. It needs thoroughly immersing, for some time (like 2-4 hours), until the water is mucky. That is the sugars dissolving onto the water. Then the nets need lifting and the mucky water rinsing off: that part could be done by bucket.

The water needs to be fresh for each net or else you are simply immersing the hay into a sugar solution left from the last net.

I would follow your vet for advice on the test he recommends.

When Rigs had his test for EMS, I had to be up for a small haynet at 3.30am, which had to have run out by 6am. Then, when I got home at midday, I syringed in a caro sugar syrup. The vet did the test 1 - 1.5 hours after that. You could, of course, arrange for his test to be later in the day to avoid a 3.30am haynet but I wanted to be out of the house while he was hungry as, if he could see me, he would have called for food.

That is apparently the most accurate way but , as Lari has been in pain, the results from a super well administered test will be muddied anyway, so what the vet has suggested will just give a general over-view.

As for the toe, it could be something as silly as walking toe first as he has had pain from the thrush in his frog, or pain from an abscess, or pain from his tendon. If he has been walking abnormally, that could cause him to be inflamed.

I would simply do what the vet says, but change the hay prep to actually soak it rather than just doing the rinsing part.

Ok thank you Red. I will soak from now on. What a palaver. It's my back that will struggle lifting it up to tie it I think.

Mind you now he doesn't have shoes it doesn't need to be that high.

3.30am! Blimey that's dedication, I think I do well at 5.30am

Thanks x

 

[Red-1]

Ok thank you Red. I will soak from now on. What a palaver. It's my back that will struggle lifting it up to tie it I think.

Mind you now he doesn't have shoes it doesn't need to be that high.

3.30am! Blimey that's dedication, I think I do well at 5.30am

Thanks x

I bought some containers with taps on the bottom. Fill, soak, drain THEN lift. Then tie to the wall to woosh water on. It was a PITA in winter when it froze, must have loved Riggers. Once his EMS was under control, it was all much easier. He now simply has the haylage that is high fibre - easy!

The 3.30 was only a one off. It was easy as I was very excited to see what the result was and whether I'd turned the EMS off.

In theory, he is now handling sugars and could go back to a more normal diet, as long as he keeps his weight down. But, keeping weight down is easier on the haylage.

I'm thinking yours may not even have EMS, fingers crossed. Hence following the vets instructions for a test, to have a look-see.

 

[Widgeon]

There's two ways the vets do this. My preference is to take bloods whilst they are eating their normal food. Mine live out so about an hour after breakfast to pull bloods.

Same here. This is what we've been doing - mine also lives out, 24/7 on fairly minimal grass. Vet seems happy with the procedure and the pattern of results the test has been giving is certainly very believable.

 

[Birker2020]

I've decided to explore a track system if his levels are high and he can't go back to retirement. They seem to be very expensive though.

 

[HappyHollyDays]

I know you like your yard and you don’t need a huge track if your existing yard can help. Mine is just an acre with a loafing area that was an old school. both my boys are out on it all summer with minimal grass and hay dotted around each day away from the trough. It cost me about £200 is wooden corner posts, plastic posts and wide electric tape. They both looked so slim and it was the first year DP didn’t have any sheath swelling, footiness and no muzzle for 8 years.

 

[sport horse]

Why do it in a net? we soak in large tubs, tip over to drain then tip on floor of stable. No lifting needed.

 

[Birker2020]

Why do it in a net? we soak in large tubs, tip over to drain then tip on floor of stable. No lifting needed.

Because unless it's in a net said horse trampled it all into his bed for some reason.

I'm actually managing ok with trying the ners lower than normal thank goodness!

 

[Birker2020]

I know you like your yard and you don’t need a huge track if your existing yard can help. Mine is just an acre with a loafing area that was an old school. both my boys are out on it all summer with minimal grass and hay dotted around each day away from the trough. It cost me about £200 is wooden corner posts, plastic posts and wide electric tape. They both looked so slim and it was the first year DP didn’t have any sheath swelling, footiness and no muzzle for 8 years.

I'm on a livery yard where I'm rehabbing him at the moment, where I've been for 16 plus years. My paddock has been taken by someone but we couldn't really build a track anyway.

The retirement place feed dry hay in big cattle feeders in the winter. It is what it is, I'm sure he doesn't have EMS but waiting for blood test from vet.

 

[Dexter]

My vet said to never EMS test when the horse is injured or in pain as it skews the results.