Can't see the difference between the ECIR diet and the one she's having except that the hay is unsoaked - I will give it another go soaked, and have it analysed ASAP - and the supplements, for which I can't find an explanation on that site? She is not insulin resistant.
I'm going to call both vet and farrier again tomorrow to discuss the issue with the shoes. Instinct is telling me not to mess with anything at all and especially while she is still so uncomfortable. I have doubts as to whether she will even be able to stand for the farrier for long enough.
The magnesium is to help with insulin regulation which is required when a horse is having trouble with sugars ie. laminitic. a diagnosis of IR is not required for the helpful influence of magnesium. Salt is always low in horses diets but especially when fed soaked hay. Vitamin E is not in hay or any preserved forages so is always lacking in a grass free diet. These are very basic requirements that will only help and not hinder and is only a temporary basic mineral supplementation. You will be able to give appropriate minerals when you get your analysis results.
ps. The micronized linseed is fed mainly to replace the omega fats lacking in a grass free diet but has other beneficial effects. It happens to contain the correct omega 3 and 6 ratio required. The pure oil isn't a good substitute in this case.
Given she has not had grass and isn't overweight, my initial thoughts would be either concussion from the concrete paddock or her initial feed was too starchy/sugary. When mine had lammi we took his shoes off as its very painful for them to have nails hammered in at that stage then he wore pads until he recovered. The good thing is there's been no rotation - big hugs to you and your horse and hope a full recovery is made xx
An update - we had another vet out from another practice today for a second opinion as there has been no reduction in symptoms for another whole week. It's been four weeks now in total.
Sadly his portable x-ray machine (why couldn't the first vet have used one instead of having to ship her 20 minutes each way to the clinic?!) went kaput before we could get any images but he confirmed there are now depressions in the coronary band and the sole is slightly convex, indicating probable sinking.
He supported our decision not to use heart bars at this stage - later, possibly, when everything has settled and we have x-rays for the farrier to work from - and has instead taken the shoes off and bandaged on a conforming support.
He was happy with her diet and recommended treating her as an EMS horse regardless of the blood test as she fits the profile.
If you Xrayed every single horse you would find a huge number of them with a sunk p3 - or rather the hoof capsule too high around p3...whichever way you want to look at it.
It is very common and many horses go around like that without anyone knowing anything about it. A flat sole on a horse is always a giveaway......
You will find loading the horse on the entire of the bottom of the hoof, rather than the wall will allow the hoof capsule to relax and therefore p3 will be higher.
When you see some concavity in the sole (the sole will follow p3 in an arch) then you will know you have it sorted.
You need to be REALLY strict about what you are feeding. I don't care whether it has a Laminitis Trust logo on it or if the vet or company nutritionist thinks this or that feed is the dog's b******s......do your research and make your own choice.
Low sugar/starch and balanced minerals are essential.
High levels of iron are consistently found in forage and horse feeds. Two of the many side effects of excess iron are altered glucose metabolism and insulin resistance.
Also consistently seen are low levels of zinc. Zinc (among many other functions is essential to the production and release of insulin).
Excess iron will also depress zinc absorption - so the horses have little chance of having enough zinc in their diet without help.
Before anyone rushes out and buys some zinc, though, you should know that too much zinc will depress copper (also consistently low) which has as many side effects as anything else!
So rather than adding something new to the diet, I really feel that analysing the forage and balancing the minerals will bring more health benefits than anything else.
For those that can't do such - there are two supplements on the market that have been formulated in respect of this trend of high iron and low copper and zinc.
The take home message is that minerals must be kept in balance.
Update from today - he came out to x-ray again and replace temporary bandaged pads. The images have been sent to one of their farriers who specialises in fitting Imprint shoes and he is coming on Monday to fit these.
Note that she had a very thin, flat sole to begin with (don't have access to first x-rays which show this pre rotation, sorry, first vet clinic is not being obliging in providing these) which has made things worse than they could have been but there's been no penetration of the sole and the vet is happy that the level of rotation shown can be treated. Note also long toe - it's been six weeks since she was trimmed, farrier will be aiming to take this as far back as she's comfortable with.
She is happy in the stable on a deep shavings bed but very, very sore on concrete still, on the odd occasion we've tried her. Still on soaked speedibeet, weighed out high-fibre Horsehage in a Tricklenet and recently started on Formula 4 Feet. Vet has also started her on metformin as we still have no idea what precipitated the attack and are thus treating her as an EMS case just in case.