type 2 diabetes/EMS?

[noblesteed]

Hi all,
My 18 yo connie x iberian has been laminitic for 5 years since a nasty bout while on loan. I am expert at checking pulses, watching for footiness etc nowadays. He's on restricted grazing with a muzzle. He had a mild lami bout very early this spring and cushings test came back negative. Now he's sound I had the vet out again to see him - a different vet from the first. She says he's classic type 2 diabetes. He's not fat as such but has strange fatty pads in places. He had lots of symptoms - been running out of energy on rides out, can't eat sugar beet, can't eat haylage, etc.
Now that we think we have pinpointed the problem aside from the EMS test which will be sorted soon, what advice do people have regarding management?
He's eating a little mollichaff hoof kind with his turmeric for his spavin, gets the odd bit of devils claw when he's stiff and that's about it. Oh and milk thistle if he seems a bit footy to cleanse toxins.

 

[ycbm]

Has he been tested for Cushings?

 

[noblesteed]

Yes negative cushings. He doesn't look at all cushings either, his fur is fine etc.

 

[supsup]

There's a lot of good info on either http://www.thelaminitissite.org/ or https://www.ecirhorse.org/. The second page in particular has good advice on feeding recovered laminitics, and is pretty detailed at explaining what EMS is. While it is a bit like diabetes type 2 in humans, it's actually not the same. Diabetics get high blood sugar levels, but horses almost never get to a point where blood glucose cannot be controlled and stays high. Instead, their bodies need more and more insulin to cope with the glucose (hence "insulin resistance"). There are great explanations of the various tests that can be done, and what they mean.

If you have a lean horse with weird fat pads, I might try adding magnesium to the diet (e.g. in the form of magnesium oxide). At least anecdotally, extra magnesium can help with getting rid of the fat pads. More generally, I'd add a good quality balancer, preferably one of the powdered type without fillers, so you have full control over what sort of base feed to mix it with. If the mollichaff hoofkind works for him, you could stick with that. A bit of extra salt (~1 Tbsp) might also be helpful, particularly in this hot weather we've been having.
Good luck!

 

[MrsNorris]

As little grass as possible, unless its long, fiberous and not stressed in any way, and a low sugar forage such as marksway hi fibre haylage, which has less than 5% sugar, or soaked hay. Unmollassed sugarbeet is usually suggested as it is very low in sugar, nothing with molasses and no grains. Alfalfa is also thought to affect some EMS horses, there's a bit of info from Dr Kellon about it (google if interested) and magnesium oxide or chloride, as suggested above.
Plenty of exercise if possible, as this really helps to regulate the insulin response, and about 1 to 2 tblsp of salt a day, for some reason this has helped mine a lot, although he does have other problems to contend with too, so it could be related to that. Good luck..

 

[noblesteed]

Thanks guys.
I will look for a supplement with plenty of magnesium in then, and get him some salt.
He's very odd in that he can't have unmollassed sugar beet either, even a tiny bit gives him hot feet.
He also cannot have haylage as it causes lami. In the depths of winter he can handle half hay and half haylage but other than that he's on last year's hay.
Where we are there is only grass turnout as an option so he is muzzled in the starve paddock. I can;t keep him in due to his arthritis.
At least now we have an idea of what his problem is i can keep on top of it!

 

[DD265]

Your vet might recommend medicating with Metformin; it made a big difference to my boy.

 

[wickedwilfred]

I've had experience of using Metformin on our Shetland. He was on it for 6 months and there was no improvement at all. I think it works for some better than others. However, I have recently heard of another failed Metformin user who tried Levo-Thyroxine for 12 weeks and that worked.