One of my boys has mild PSSM. His daily intake is 2lbs Purina Ultium,2 lbs McCauley’s M10 balancer cubes, 2 flakes Standlee compressed alfalfa, a scoop of vitamin E, and free choice grass hay. We have some grass in the pasture. He is plump and healthy.
is there anything else going on besides PSSM? What about EPM?
What amino acid supplement are you using? That will help with knowing how much lysine (and methionine?) he’s getting from that.
If you can stomach the cost, get a Greenguard muzzle for him. There will be no hyperventilating 
It’s very, very well ventilated
I don’t think I see it, but forgive me if I’m just missing it - how much does the 6qt of the Re Leve weigh? That will help me know what you’re feeding in relation to the recommended feeding amounts.
I wonder if he might like a modification. For example, one thing that comes to mind is cutting the Re Leve in half, adding 1lb of a ration balancer, and several pounds of alfalfa pellets. That would give him more protein, more lysine, and may be something to help him.
Maybe thats the solution… Maybe there is some condition inside his body which causes problems. Fingers crossed that this will solve the problem!!
Slowly I am trying to answer your questions. Very slowly.
5.5. quarts of Re-Leve = 3.5 pounds.
His amino acid supplement is with him at the rehab place. I am going to see Goobs on Friday and will get the info.
I got a call from the rehab place to update me. Goobs is being a good boy, but he is being a dork on the treadmill, trying to lick the poor lady standing in front of him. I told them that he cross ties very well, so the poor lady does not have to stand so close.
One worrying thing is that, with the water up over his knees, he could not walk straight; he will have to go on the “dry” treadmill for a while. I have been carefully looking at his hind end ever since the diagnosis was made — and have not seen any unevenness. Perhaps both his hind legs are so weak that he is unable to stay straight. 
I guess this is bad news/good news. We now know how weak he is, and that he is at the right place to help him get stronger. He has 2 sessions a day --one on the dry treadmill and one on the wet. For a while, both sessions will be on the dry treadmill.
Of course I will be asking all about this when I go over there on Friday
Assuming you’re using the original formula and not the concentrate, you should be feeding at least 6lb. Since another 2.5lb of this might be too many calories for him, I’d start by adding 1lb of a ration balancer, any one you can find. That’s about 1250-1300 calories, but a good bit of protein and lysine
I will buy a ration balancer and cubes today so I can take them to Hassingers tomorrow. Thx.
In my experience, PSSM horses don’t typically gain weight on the PSSM diet. Their body is using the fat differently, so they don’t get fat like a non-PSSM horse would get on a PSSM diet. Which makes me think that you may need to up the hay and possibly the grain to help him gain weight. Possibly try adding hay cubes or pellets to his grain for some extra calories. Have you treated him for ulcers? Up to date on worming?
I have had really good results with Tribute Essential K mixed with hay pellets and her supplements for my PSSM mare. We also tried the Purina Special Care, but I didn’t like it as much. Currently she is on Tribute Kalm N EZ, 2 cups oil per day, 8000 IU of Vitamin E per day, and SmartCalm Ultra which contains 10,000 mg of magnesium (she stopped eating straight Mag Ox). She gets free choice hay, and is currently turned out on grass.
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