Possibly Insulin Resistant - The Horse Forum
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post #1 of 13 Old 09-25-2020, 12:08 PM Thread Starter
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Possibly Insulin Resistant

I think that my horse may be insulin resistant (IR).

According to SmartPak, MerckVetManual, TheHorse, TripleCrown, and ScienceDirect, Tennessee Walking Horses (TWH), as a breed, are more prone to IR, and older age and being overweight contributes to risk factor. According to ECIR, MSU, LifeDataLabs, SouthernStates, and ElishaEdwards, some symptoms (that my horse has) include abnormal fat despsits, crestiness, fat in the supraorbital fossae, muscle wasting, low energy level, seemingly excessive hunger, and a *pot-belly appearance. Although, she has never had laminitis or founder.

What should I do? I have read that @walkinthewalk has some IR TWHs. I have already joined the ECIR group.

The veterinarian is coming this (U.S.) fall for shots. I may be able to ask them what they think and set up tests.

Excess weight is one of the "easier" things to take care of and that can be started now. What is a good weight loss plan? She is on grass and grass hay 24/7; she is fed California Trace, a magnesium (oxide) supplement (5,000 mg), Vitamin E supplement (1,000 - 2,000 IU), 4 oz. (113.4 g) of ground flaxseed, and 2 oz. (56.7 g) of loose white salt. I currently board my horse, so there are some things that I cannot control. I cannot control the hay, for example. They are large round-bales with a hay net. There is no dry lot, unfortunately. There are stalls, but I'd really prefer not to stall her. I should probably muzzle her, but I am inexperienced with muzzles. What are some muzzle recommendations? How do you prevent rubs? Can horse eat though a muzzle and hay net? How often and long should it be on? Should I stall her for some of the day and muzzle the rest or just not stall at all and keep the muzzle on most of the day?

I have read that Chromium (Cr) can help, but does it actually? Though, I'll probably wait until she is actually diagnosed with IR before giving it to her.

*She has been wormed.

Thank you.
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post #2 of 13 Old 09-25-2020, 12:16 PM
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If you wanted, you could post some pictures of your horse, and maybe pictures of her hooves, and people could comment on what they see.
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post #3 of 13 Old 09-25-2020, 02:04 PM
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Good timing to ask this question with your vet coming. The easiest next step is to have the vet pull blood and send it for a metabolic panel. Often the vet will test for PPID ("Equine Cushings") and Insulin Resistance (IR) at the same time, since they can go hand in hand. Though horses can have one but not the other. There are many different types of blood testing to research and consult your vet on. Mine prefers the endogenous ACTH/insulin combo test from Cornell. Your vet will probably tell you that testing at this time of year is complicated because of the "seasonal rise" in hormone levels as horses in the northern hemisphere transition to fall/winter. However, there are reference ranges available in most lab reports that take into account the seasonal rise. My vet cautions it does make the results from this time of year (vs. spring) harder to interpret.



My vet was actually here this morning to do fall shots, and my two Morgan mares in their mid-20s had blood pulled to check for PPID and IR/EMS. I have been testing them every fall and spring for years. So far neither tests as PPID+, but the 23 year old tested in the elevated insulin range for the first time this spring. She is a heavier built horse even when in work, but has a notable crest and a fat deposit in front of her teats. She wears the GreenGuard grazing muzzle nearly 24/7 and it has helped with her overall body weight since she began wearing it in the spring - you can feel her ribs and her condition looks pretty good, aside from when you feel her neck. She is also on the InsulinWise supplement per the vet. Her hay is tested in is low in Ethanol Soluble Carbohydrates (ESC) and Starch. She eats a small amount of a low carb ration balancer. But I have to be constantly vigilant about having the grazing muzzle on her. She does live outside all the time on a combo dry lot/pasture. It's challenging because she moves much more when in the hilly pasture, and just stands around in the dry lot- so constantly weighing the tradeoff of her getting SOME grass and some movement vs. no grass and little movement.


My horses are at home with me so I can control all of these factors and tweak when needed. If your horse does end up coming back as insulin resistant, it may be challenging in your current feeding program to get what she needs. That of course depends on your barn owner/barn manager and the type of accommodations that can be made. My horse is in the grazing muzzle all day except when I feed her the ration balancer, and she does manage to eat out of the hay net with the muzzle on. But it might depend on the style of hay net. Fortunately, the GreenGuard muzzle adjusted properly has not caused any problems with rubs for us, and she does not seem stressed or resentful of it.


Given the physical signs your horse is showing, it probably makes sense to treat her like an IR horse regardless of the blood test results. A low-carb, forage-rich diet on low ESC/starch forage (here's an overview of how to test hay, and how to interpret results) generally does a good job for horses that don't have other more intense nutritional needs (pregnancy, heavy duty athletic work, etc.).


You didn't mention what kind of exercise your horse gets. My mare I've been discussing technically came to me for retirement, and isn't ridden anymore. That contributes to her weight problem. She gets handwalked for ~0.5 mile up and down hills several times a week, but more exercise for her probably would help her slim down even more.
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post #4 of 13 Old 09-25-2020, 04:10 PM
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Hello and welcome to the forum:)

@egrogan pretty much summed things up:)


Yes, I’ve had two TWH’s with metabolic issues.

1. Duke was 20 when he diagnosed with EMS. He was 27 when I laid him to rest from colic due to strangulating lipomas.

Initially Duke had lost ~80# in six weeks. He never had a laminitic day in his life. I never muzzled him. I did change his diet and shortened his pasture time by a few hours daily.

2. Joker’s insulin resistant resistant diagnosis hit me like a bucket of dirty diapers in 2012, as he was already on Duke’s diet and reduced pasture time. I had not however, been testing hay; which I started after Joker was diagnosed and also seriously foundered.

Joker has been in IR remission since 2015. I attribute that more to an even “tighter” change in diet and getting my hay tested.

Joker wore a muzzle nine months of the year, 2012 thru spring of 2015. He has not worn a muzzle since. Yes it left scars on him, even though I kept clean moleskin on the rubbing spots every day.

Joker never had to eat hay thru a hay net with the muzzle on, however. I would worry about the horse not only not getting enough to eat but also the frustration of trying to pull hay and not being able to, possibly leading to ulcers.

I don’t feed round but during the cold months, when I had four horses, I scattered hay on the ground and Joker became very adept at pulling the hay on the ground thru the muzzle.

Joker was diagnosed with Cushings (PPID) in 2019 and is now on Prascend. His blood work is interpreted by Cornell. Last May both his insulin numbers and his ACTH numbers were well within normal range.

I like the way Cornell interprets as they include what the acceptable low/high range should be, so you know how long to keep the oxygen mask on, after reading your horse’s results:)

****
You have done a tremendous amount of research. I know the time that takes, so Thank you for making your eyes look like road maps for the well being of your horse:)

1. California Trace — if you are feeding the Trace PLUS, that is good. If not switch to it because it has all three of the necessary amino acids, whereas the regular California Trace only has two.

1.1. CT has a high amount of selenium. Do you live in an area that is low enough in selenium (grass & hay) to justify feeding that large amount? Pasture and hay also have selenium in them, and it doesn’t take much extra selenium for the horse to become toxic:)

My area is a tch low in selenium but my county Ag person still said CT has too much in it, once pasture and hay get figured in:)

1.2. That said, I am only somewhat of a fan of CT because it does not have all of the vitamins & minerals a horse needs. If the hay your horse receives, tests adequately for everything, the CT should be ok. Otherwise I might look at some other condensed supplement that does not use soy as it’s protein source.

I have been using HorseTech for grass fed horses since 2015. I feed the meal form, which is cheaper than the pellet form. A 35# bucket lasts me ~90 days for two horses.

2. If you decide to get blood work done. The horse does have to be put up with on,y hay and water after 10:00 PM. It cannot have anything else until the vet draws the blood. The earlier the vet arrive the better so as not to stress the horse, which could give a false reading.

One vile of blood to check insulin levels
One vile of blood to check ACTH.

Ad egrogan alluded to, baselines have been established for Fall readings to help make them more accurate, albeit it may still be difficult if you’ve never had this type of blood work done before.

3. Lastly, I feed my horse 1500 mg daily of L-Citrulline, another amino acid. There are credible studies regarding the benefits for human diabetes athletes use it for muscle recovery.

I believe Dr. Kellon does briefly mention L-Citrulline in a winter laminitis article. I’m not saying to use it, but research it and make your own decision after you get the blood results back:)

I buy “Source Naturals L-Citrulline on Amazon as it’s about $15/bottle cheaper than my local health food store.

4. If the hay typically comes from the same place, get it tested and get some blood work done:)

I hope this helps:)
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post #5 of 13 Old 09-25-2020, 05:29 PM
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I have two horses, 20 year old half draft gelding, shows signs of IR, and 18 year old TWH mare, negative for IR, positive for PPID as of this past spring. Both are inclined to overweight. Trying to get them to lose weight is utterly maddening. They each get 1.5% of their body weight in forage and a safe ration balancer. I use FeedXL.com to manage their diets. The vet is coming out Monday to test both horses for IR/PPID. I need a baseline for the gelding, and make sure the mare's PPID is controlled on 1 mg. of Prascend. Monday begins the week of peak ACTH production.


My horses are kept on a fairly stripped paddock. When the grass starts in spring and fall, their area is greatly restricted.


I have bought low carb orchard grass hay for many years. The dealer tells me it's low carb, I buy a year's worth and test it myself. He's always right. However, it doesn't seem to be enough. So I have started soaking my hay. I went so far as to send two samples of the hay to Equi-Analytical. One sample is straight out of the bales. The other I soaked for an hour in cold water, then dehydrated. The results of soaking are impressive. I am not seeing a drop in weight yet, but it hasn't been that long.


Winter laminitis: Dr. Bowker has an interview on the Humble Hoof podcast wherein he says that yes, metabolic laminitis can be a culprit, but he very strongly suggests that very cold weather restricts blood flow and can also be a cause. The podcast is very worth listening to.
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post #6 of 13 Old 09-25-2020, 05:48 PM
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@dogpatch , wish I could like your post twice. I totally empathize with how hard it is to get the weight off these guys! And a +1 for the Humble Hoof podcast- I really enjoy that and learn a lot from it.
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post #7 of 13 Old 09-25-2020, 06:53 PM
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Hi & welcome,

Joining ECIRhorse & studying what's available there is probably the single best thing you can do to educate yourself well on it.

It's not a 'disease' but a natural body function, response to chronic 'good-paddock-ness'. Therefore, while some breeds are more or less 'susceptible', EVERY horse is 'at risk' if under the wrong conditions. So, you could get your vet to test for it, but especially given the signs of obesity & IR you have said, I'd just take it as a given that she is IR & manage her as such.

Not sure if a grazing muzzle with a slow feed net would be a good move - you could try & see. She may not be able to get enough through it. And if the hay is rich, sweet, it may even still be too much for her anyway. So that is the biggest prob I see - that she has 24/7 access to rich hay. Unfortunately, people go on about getting the horse off grass & onto hay only, but don't understand that the hay may well be just as sweet as the grass you're disallowing, as it doesn't lose sugars after being cut!
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post #8 of 13 Old 09-26-2020, 01:06 PM
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Currently the makers of Prascend are offering free PPID - cushings tests. ..in Canada, anyway.

My GF's Morgan just got accepted - I believe the test is usually around 200$

https://www.bicanadaequine.ca/ppid
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post #9 of 13 Old 10-01-2020, 03:19 PM
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@walkinthewalk , what do you use as a carrier for your Horsetech supplement? I'm thinking about going back to my customized High Point supplement.
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post #10 of 13 Old 10-01-2020, 03:41 PM
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Quote:
Originally Posted by 3Horses2DogsandaCat View Post
@walkinthewalk , what do you use as a carrier for your Horsetech supplement? I'm thinking about going back to my customized High Point supplement.
I'm not who you asked, but the barn I formerly worked at used alfalfa or timothy pellets, with water and an oil supplement. The horses ate it fine.

He's Ultimately Fine - Toofine - 1998 Half Arabian
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