Managing an Insulin Resistant Horse

[onthebit]

@Renn/aissance

Well, different vets have different approaches to this, but from experience, if you’re not testing, you don’t know what’s up and you don’t know what you’re treating.

MonaLisa is correct. It has been well shown in studies that you can do every cushing’s test available on a horse (dex suppression, ACTH, TRH stim), have them all come back negative, euthanize and necropsy the horse and realize that they do have Cushing’s. Most vets experienced with Cushing’s/PPID agree that if the horse is symptomatic it should be treated even with a negative test. There is NO test to date that can reliably identify all cases of PPID/Cushing’s. She is right to treat via symptoms.

OP, I would do whatever I could to make sure your horse is moving in turnout. Turnout does not necessarily equal much movement, and the BEST tool to manage any metabolic horse is to keep them moving as nature intended. Lots and lots of walking and low impact exercise is what manages insulin. We live with 20+ PPID/Cushing’s horses, and several had foundered prior to retiring with us, and we have no issues despite the fact they are on lush grass much of the year. The key is movement, movement, movement. Our pastures are really big (20-25++ acres each) relative to the number of horses in them. Turnout is in groups, and groups + pasture size means they naturally do a lot of walking over a 24 hour period.

[monalisa]

My 25 year old mare has been tested many times and she has been negative every time. I agree about the exercise. My paddocks are big so mine have lots of room to run and play. I have a youngster out with my older mare and that has helped her a lot emotionally (giving her a job and close buddy) and with movement.

My gelding normally runs around a bit but lately not so much. He is getting tested tomorrow - to check his IR levels again and for Cushings. I will treat him for Cushings regardless of the test results as I am pretty convinced he has both now. Poor guy. I want him to happy in his older age and he can still be ridden and shown which is good given his condition if I can only get him to feel himself again.

[Renn_aissance]

@onthebit

MonaLisa is correct. It has been well shown in studies that you can do every cushing’s test available on a horse (dex suppression, ACTH, TRH stim), have them all come back negative, euthanize and necropsy the horse and realize that they do have Cushing’s.

Absolutely, I’m not disregarding that research, but to discard testing entirely and opt for symptomatic treatment only for a horse who’s never been tested before, because you have a horse who’s symptomatic but tests negative, is kind of like saying that you’re not going to bother getting the flu vaccine because your friend got the shot and still got the flu. Which is not what MonaLisa is doing, so the whole thing might be moot.

In any case, MonaLisa, I’m glad that you are testing, and hope that you get something useful to inform how to best help your kid feel better. I do recommend APF for inappetance- it wasn’t an immediate help by any means for my guy, but it did help get his appetite back on track. Fingers crossed that you’re able to quickly find the right combination of meds, food, and environment updates to help him feel more like himself!

[SLedbetter]

I have a gelding that tests negative/normal on his ACTH every year. He started showing symptoms two years ago, slow to shed, increased drinking/urination, loss of topline, etc etc. My vet consulted with Cornell University, they suggested treating based on symptoms. Started him on Prascend, and we saw huge improvement. We retested again last year, results more ‘normal’ than usual. All of his symptoms improved, most noticeably, that he started to shed in February instead of June last year, and was done shedding in a few months. Jack also tested negative for I/R, but had symptoms for that as well this last year. I’ve cut as much sugar as possible, and he looks and feels 100% better.
Jack struggled with the Prascend ‘veil’ for several weeks. We had to quit the meds, and restart at the lowest dose and go from there. He went off feed, acted depressed, etc.
If it hasn’t been long since your horse has been on the Prascend/Pergolide, I would suspect the ‘veil’. It was tough at first, but once you can get them stable, on a good dose it’s not that hard to manage on a daily basis. I stayed in close contact with my vet, keeping her posted on what I was seeing.
I know my horse very well. I agree that if you think something is off, it probably is. Going down the ‘rabbit trails’ until you get an answer can be frustrating. Hang in there, wishing you the best of luck and that you can get a resolution to his symptoms soon so that everyone can feel better!

[Coreene]

Hygain Zero. 5.5% NSC.

[Ghazzu]

If you can’t test the hay (and it does sound hella impractical in your situation), I’d just start soaking it as the default method.

[Jungle_Monkey]

Best recommendations for soaking? Hot water? cold? Length of time etc? Anyone have any tricks in winter?

[monalisa]

I soak for 20-30 minutes in a muck bucket and then drain it. Going to start using a cooler with a drain - then it will be easier to drain. Thinking about buying a steamer but the reality is I can’t sit and steam for an hour before feeding time every day. My work schedule won’t allow it so that’s not practical for me. I wish there was another way but soaking seems like my best solution. My free time is very limited. I use cold to luke warm water - my only option in the barn.

[Jungle_Monkey]

You can buy a heavy duty timer for the steamer and set it to come on automatically for one hour but my understanding is that steaming will not remove the sugars, only dusts/molds. Correct me if I’m wrong please.

I like the cooler with a drain idea…

[walkinthewalk]

Steaming is for horses with COPD – it does NOT leech out starches.

1. Weigh your hay dry. Then fill slow feed hay bags.

2. Place the filled hay bags in a tub of water, I used cold water because that was all I had at the barn.

2.1. I only soaked for twenty minutes. It is my understanding any more time than that can start leeching out the good vit/min.

3. Pull the hay bags out, hang them up somewhere to drip out excess water( ideally a hook over the tub they were just soaked in:), Then tie them so the horse can’t get its hooves/legs tangled in them.

This way you barely get miserable wet from all that yucky water.

[pasolover2]

The ECIR group recommends soaking hay one hour in cold water, thirty minutes in hot.

[walkinthewalk]

Ok – because I can’t remember where I got the 20 minutes from, to soak hay, I went looking for a scholarly article.

there IS confusion as to what is a reasonable time to soak and what isn’t; also hay can be over-soaked thus leeching out valuable minerals. Here is a great 2018 scholarly article from KER. The whole article is well worth reading - it is short:).

https://ker.com/equinews/thoughts-soaking-hay-horses/

thankfully I only had to soak hay for a short time. I am thankful to be able to buy from the same grower in my county and his hay always tests low.

[Ghazzu]

Square tote with laundry basket inside it works well, if you’re not using a net. (thn dump into a fleixble rubber tub (like Tubtrug, etc.)