Tag: Insulin Resistance

Finding information about insulin resistance in horses

A friend of mine emailed me this weekend about insulin resistance in horses. She has a new boarder with a horse with IR and wanted to learn more about managing this condition.

One of the best sources is the Equinc Cushings and Insulin Resistance web site (http://ecirhorse.com/), which summarizes the Yahoo Group with the same name. (See information below in the next paragraph). The IR treatment page is very good.

I have found a lot of information on IR in the Equine Cushings yahoo group (http://pets.groups.yahoo.com/group/EquineCushings/). Look in the files section in the Getting Started folder for an introduction to concepts and how to begin managing a horse with IR. The mailing list is high traffic with about 10k members. Searching the message archive is also a good source. The files section has information on what you can and can not feed an IR horse for commercially available feeds and supplements.

I hate to say it, but it is such a relief to not have to worry about a horse with insulin resistance. Isis was the most amazing horse I’ve ever had, but there were so many things we couldn’t do because of limitations from her condition. Some days it was so frustrating and made me so sad for her. We had what time we had and we did as much as we could do. I learned so much with her.

I miss her so much, my little 15 hand mare who was built like a warmblood and moved like a cloud across the ground.

Isis’ 2011 EPM episode: Picture comparison

Equine Protozoal Myeloencephalitis (EPM) is a serious equine neurological disease caused by an infestation of protozoans–either Sarcocystis neurona or Neospora hughesi. (The web site, EPM horse, has an excellent explanation of what EPM is, the life cycle of the protozoans involved, and the symptoms horses with EPM can exhibit.)

The Pathogenes’ webinar, “A Novel Strategy for Treatment and Protection against EPM,” provides a good overview of EPM, existing treatments, and the new treatment Pathogenes is making available, Oroquin-10.

Isis responded very well to Pathogene’s Oroquin-10 treatment. I never would have learned about Pathogenes and Oroquin-10 from the EPM Horse web site.

This series of pictures shows how she looked over the course of the summer:

Isis, May 3, 2011

Isis, July 9, 2011 (covered in mud)

Isis, Sept 13, 2011

September 22, 2011

October 1, 2011

And then she was gone…

This is a post I never thought I would write: the details of the passing of my beloved mare, Isis Bint Sirdar. You always know you’ll have to write this type of post, but you never want to think about it, and you never want to actually do it. I’m doing both because I am hoping that the details of what happened with Isis will help someone else avoid what we went through.

The vets at Carolina Equine Hospital have provided some of the best care for Isis since she has been in North Carolina. Both Dr. Stinson, my regular vet, and Dr. King, the on-call vet who came out for Isis, were honest with me about what Isis’ treatment options might be (and might not be). I appreciate their honesty, compassion, and integrity.

The following information is a transcript of Isis’ medical notes from her log book. I have a composition book that I started when Isis was first diagnosed with laminitis in 2003. I have notes on everything that happened to her. I cope with medical emergencies by documenting them. Any errors are my fault.

Update 8 Nov 2011: Dr. Stinson noted that she thought Isis’ death was probably caused by some brain trauma. What happened to Isis was atypical of EPM. Because no necropsy was performed, there is no way to know what actually happened to Isis.

5:45 PM

Jon from the barn called me and said that Isis wasn’t having a good day: she was wobbly and standing in one of the stalls in her paddock (her paddock has a run-in shelter with two stalls). She was reluctant to turn around or move. Jon left Isis in the paddock and I headed to the barn.

He also said that Isis was keeping her nose against the wall.

6:15 PM

By the time I arrived at the barn, Isis had managed to walk out of the stall and was at the corner of her paddock. She nickered at me when I approached, but didn’t lift her head off of the ground much. She knew I was there, and her ears followed the sounds of where I was, but she didn’t lift her head very far from the ground. Putting my hand on her made her wobble. The lymph nodes around her neck were swollen.

6:34 PM

6:30 to 6:45

Left a message with the emergency service and waited for a call back from the on-call vet. Meanwhile, called Dr. Stinson, my regular vet and told her what was happening. While I was on the phone with Dr. Stinson, Isis collapsed to the ground and was unable to get back up.

6:46 PM

Isis’ eyes moved in an odd manner: they looked down towards her cheekbone and then back and forth involuntarily. The movement lasted for 30-60 seconds, and then she would come out of it. She would recognize me and nicker, and then her eyes would return to the strange movement.

I confirmed with Dr. Stinson that Isis should have a dose of banamine at 1000 pounds. I gave it to Isis just after Dr. Stinson and I ended the conversation. Dr. Stinson called Dr. King to fill her in on what was happening.

Isis did manage to return to a move upright position, but her head was in a very strange angle. It just didn’t look right (you can also see how her eye looks odd too).

6:50 PM

We left Isis where she was and didn’t try to put a halter on her. I stayed with Isis so she could hear me, but not so close that she could move around and hit me.

7:00 to 7:30 PM

Isis tried several times to get up. At one point, she was up on her front legs and her rear legs kinda passed up and she collapsed into the fence. Luckily, facing into the paddock and not into the fence. She succeeded in standing finally at 7:25 PM. All of her weight was balanced on her left legs. Her right front leg was out to the side. Her nose was firmly planted on the ground.

Jon put up some lights so we could see in the back without moving Isis.

7:30 to 8:00 PM

Dr. King arrived and was glad to see Isis was standing. Isis wobbled from the slightest touch, so Dr. King did was careful with the exam and told us that there were a few things that might be causing Isis’ symptoms. We knew it was the EPM, but it might be swelling on her nerves or brain damage.

Dr. King summarized three possible treatment options:

  • Try to get Isis to NCSU vet school. It would be very difficult to get her onto the trailer and she could injure herself on the drive there. The vet school might be able to offer additional options, depending upon exactly what was wrong with Isis.
  • Give Isis a shot of dexmethizone (a strong steroid) and see if she improves in 45-60 minutes. If she did, then her symptoms might be caused by swelling on the nerves. Treatment options, while still not optimistic, might be there. Dex is generally avoided in insulin resistant horses because it increases the chances of the horse getting laminitis as a side effect.
  • Put Isis down.

7:54 PM

Isis was given 40 mg of dex. Dr. King said that if Isis didn’t show marked improvement, may end up taking her to the vet school or may end up putting her down. If Isis did improve, then the best case scenario might be that Isis might eventually learn how to compensate for whatever nerve or brain damage she had. She probably would never be able to go out with other horses again.

Isis’ nose firmly planted on the ground was a sign of cerebellar problems: Isis couldn’t tell where the ground was (extreme case of vertigo).

The lymph node swelling around Isis’ jowls was from having her head down for such a long period of time.

8:51 PM

Isis showed no improvement. She was still wobbly and severely ataxic.

9:00

Made the decision to put Isis down.

Video comparisons of Isis

For most of the summer, I’ve watched Isis just not quite seem right. Whether it was the heat that bothered her or something else (EPM, most likely) that gave her more off days than good ones, one evening in early August she surprised me. My girl was back that evening. She started trotting like she normally does, kinda dragging her toes, not very enthusiastic. And then she stopped and looked at me. Pivoted. Took off at a gallop. I was so happy. For that one day, my girl was back.

Compare that video with the video I took this week of her. Notice how she is moving, especially on her hind quarters. Her back toes drag. She has no energy and isn’t playful. She seems subdued.

Isis in July of last year. The difference in how she looks now and how she looked then is striking.

The good thing is that her insulin resistance has been very well controlled all year so at least that isn’t an issue.

Isis, IR, and heat – update

Nasty weather this week. Temperature hit 98F today (heat index of 109F) and tomorrow the temperature is supposed to be 100F with thunderstorms in the evening. Looks like the girls will have tonight and tomorrow off.

Some good news for Isis: The barn owner called me back. Isis seemed to be better around noon. She was eating her food and was back to being her lovable bitchy self. Phew.

Isis supplement update

Mom Mom sent me a link to a new product from Platinum Performance, called Platinum Metabolism Support. The ingredients, Magnesium and Chromium, are common in metabolic support supplements like Quiessence. Platinum has good research info available, including a study of Glucosamine in metabolically challenged horses. I didn’t know about the Glucosamine study, for example, showing that feeding metabolic syndrome horses glucosamine had no adverse effect.

Isis is currently on Quiessence (for Mg and Chromium, $25/month), people Vitamin E 5k units/day ($25/month), MSM for joints ($10/month), and PreOx from Horse Tech for trace minerals ($20/month). This combo gives the same vitamins Isis was on before except at about half of the cost: Foxden Flex IR ($80/month; removed completely because it didn’t seem to help), D-Carb ($55/month; equivalent of Quiessence + PreOx), MSM ($10/month), and Vita-E 5000 ($70/month). I purchased most of my supplements from Smart-Pack Equine and was pleased with their service.

The biggest difference in the two sets of supplements was switching from D-Carb to Quiessence / PreOx. D-Carb contains trace minerals that IR horses need. Quiessence by itself does not contain the trace minerals. My vet wanted Isis to have those minerals. The Cushings list had talked about two options from Horse Tech: a custom Arizona mix and PreOx. I chose PreOx because it also has additional Vitamin E and uses a flax base. For Isis’ EPM recovery, she is supposed to get 5-10k units of Vitamin E per day. The PreOx adds another 2.5k on top of the 5k from the Vitamin E gel tabs. (Other people on the Equine Cushings list were using the people Vitamin E gel tabs as well, so I thought it might be safe to try them.)

The proper way to choose supplements for an IR horse is to do a blood test on Isis, and then test hay, soil, pasture, and grain and then custom balance minerals. Easier to do if you own your own place and are not boarding. It’s one of the things I need to do, but have not had the time (or funding) to take care of it.

Lumps and bumps on Isis’ skin

Isis has always had skin issues: rain rot, fly bite allergies, scratches, etc. For the most part, these things last a little while, are treated, and then resolve. For the past two months or more, Isis has had lumps under her legs, right where the girth goes. Initially, the lumps did not interfere with the position of the girth. The lumps were slightly in front. However, wearing the girth irritated the lumps.

The lumps are behind Isis’ front legs right in front of the girth. The lumps appear to be only in the skin: I can move the lumps easily around. They feel mostly hard and small. The lumps are not uniform in shape. The one on Isis’ right side is long and tube-shaped, while the ones on the left side are like clustered pearls.

The lumps have gotten worse in the last week (see pictures).

Attempted treatments

I’ve tried a variety of things to deal with these lumps and so far, nothing has worked.

  • Early May: Clipped the hair around the lumps to try and help keep the area cool in case the lumps were related to the increasing heat. Made sure we had fly spray in case the lumps were fly bites. I tried using Sore No More Sports Salve on the lumps to help prevent chafing.
  • Early June: As the weeks passed, the lumps became larger. My vet suggested trying antihistamines, so we started Isis on Histall (which has helped for other conditions). After about a week, the lumps seemed to be softer and slightly smaller but did not go away.
  • Early July: Isis has been off of Histall for about a week and she continues to have more trouble with the lumps. They have gotten larger and are harder again. She is having trouble with the heat so she is also on electrolytes. Her IR has flared up (fat pads above her eyes and on her rump even though she doesn’t look fat), most likely due to lack of exercise. It has been too hot to ride most evenings.

My next step will be to call the vet and see what she recommends. Maybe a biopsy? Maybe this is caused by clogged sweat glands. Who knows?

[2003] Dew poisoning on Isis’ legs

Just before I started this blog in 2004, Isis had a record year for Bad Things. Okay, not as bad as later years, but up until that time it was Bad. Laminitis, rain rot, sprained tendon, and dew poisoning.

A reader asked a question about Isis’ February 2006 case of belly gunk. In addition to her gelding having the same belly gunk that Isis had, he also has a bad case of scratches or dew poisoning.

Back in the winter of 2002/2003, Isis had a horrible case of dew poisoning. I had not documented what happened with her case on the blog so I am writing about it now. Just in case what I learned can help someone else (like 3horsemom who commented on the Belly Gunk post).

Bad scratches, no donut

Isis’s 2002/2003 case of dew poisoning (a.k.a., scratches), a skin condition that causes crusty scabs, inflammation, and irritation to the horse, was bad enough that she was lame. Dew poisoning most often appears on the horse’s heels or around the pasterns on legs with white socks. In mild cases, the horse has some bumps that are easily treated. In bad cases, the horse may be lame from the painful scabs and have swelling.

Her worst case of dew poisoning started around Thanksgiving of 2002 as a few small bumps behind her fetlocks on her back feet. I treated them by washing her legs with antibacterial soap (so much fun in cold weather), clipping long hair from around the scabs, and picking off the scabs before applying zinc oxide ointment. Over the course of the winter, the dew poisoning got better.

By mid January, the scabs had exploded all over her legs. The scabs went from her hocks to her coronary band on her back white stockings, her front white sock had scabs, and so did her front black. Her back legs were the worse. The scabs were as thick as my thumb in some places. (Other cases of dew poisoning I’ve treated on my mares, the scabs are the size of small beads clumped together.) When the scabs were pulled off, she bled.

Treatment

I finally had the vet out. The treatment she gave me worked for Isis, so I’ll repeat it here:

  • If the horse is in a wet or unsanitary pasture, change the environment if possible. (The quality of the care wasn’t an issue in Isis’ case. We were able to turn her out later so she avoided the dew on the grass.)
  • Do not pull the scabs off. They will fall off as they heal. Pulling scabs off irritates the skin underneath and can actually cause the stuff to spread.
  • Gently wash the area periodically with an antifungal/antibacterial shampoo. You don’t have to wash every day.
  • Use an ointment on the scabs to kill the gunk causing the scabs. Some people use zinc oxide, Monostat (yeast infection treatment for people), or other concoctions (see recipe below).

It took several weeks for the scabs to disappear and for Isis’ legs to heal properly.

Recipe

The goop I used on Isis was made up of:

  • 1 ounce of .5% hydrocortisone cream
  • 1 ounce of Desitine (the kind in the jar, not the tube)
  • .5 ounce of Desinex (athlete’s foot powder)
  • 1 ounce Nitrofuracin ointment

I mixed the ingredients in an old Cool Whip container using a plastic spoon.

Isis and arthritis

Isis ad a lameness exam today. She has been moving stiff since early April. Not enough to where she was lame or off, but just enough that she wasn’t moving right. She was unhappy when I rode. When I ride, she falls in on the right side.

The vet came out today and did a thorough lameness exam as well as x-rays of Isis’ back left and right hocks. Lameness exams take some time: over two hours in this case. She found some soreness on Isis’ front right leg and stiffness in Isis’ back left hock.

The vet did two nerve blocks on Isis’s heel and pastern to make sure the soreness was not caused by something deeper in Isis’ foot. I’m still not sure what caused her soreness there. Maybe it is because she has to compensate for her back left hock hurting?

The vet had a digital x-ray machine: she took the x-rays and then immediately developed them. Pretty spiffy. The x-rays showed that Isis has some arthritis.

The vet is going to make a recommendation for treatment early next week. Possibilities include intramuscular Adequan, IV Legends, or hock injections every six months. Adequan and Legends both are given every week for the first 3-4 weeks (at $50-60/dose) and then once a month after that. The hock injections give HA directly into the hock joints. It’s about $400-500 each time, but it’s only that once. (The bad part is what if something gets into the hock joint when the injections are performed.)

And then there is the whole question about how Isis’ IR might react to these treatments… The vet wants to do more research for treatments and how they might interact with Isis’ IR.

I felt relieved when the vet told me that it was arthritis. It’s not comfortable for Isis but at least it isn’t some strange complication from the IR. It’s just part of my girl getting older.

Catching up: Isis’ insulin resistance flares up

I quit doing regular updates here when things in real life exploded. Isis’ insulin resistance flared up, my job stress went through the roof, and my back (then knee and hip) all had problems.

During the middle of March, Isis’ crest became more pronounced and she looked like she wasn’t feeling good. It took a few days to really register it, but the subtle symptoms of insulin resistance were back.

My first priorty was to get Isis’ IR under control by investigating her feeding program and upping her exercise. I started by reviewing the factors that had recently changed:

  • Warmer weather so she was using fewer calories
  • Isis was moved to a new barn in mid-February with different hay, but was still on Nutrena Safe Choice, a low-starch pelleted grain.
  • Her exercise program was inconsistent.
  • She was off grass and keped in a dry lot (a good thing).

Read More Catching up: Isis’ insulin resistance flares up

Getting Isis in Shape

My posts here have been reduced since Isis has been in NC. I’ve been out to the barn almost every day so I can work with her.

Most of her first week was spent lunging and getting her in shape. Her feet were long, so I had to wait until after her trim to work with her under saddle.

She was trimmed on Wednesday afternoon by the new farrier. He seems really good. He was patient with Isis and willing to explain how and why he trimmed her the way he did.

Thursday morning the vet came out and drew blood for a test for insulin resistance. Once the test results come in, we’ll know where Isis is as far as her metabolic condition. Isis is slightly under weight — a good thing for a horse who has been IR in the past. The vet didn’t think Isis would show that much on the test. The results will provide a good baseline, though.

The goal is to go to a horse show in October. So we’re on our way…

Miracle Mare: Above and Beyond

A friend of mine is working on a book and had asked me if there were any situations I’d like to share where my horse had gone above and beyond what might normally be expected.

My initial reaction was ‘Where do I start?’

I have lost almost half of Isis’s available riding time to medical issues. Isis had two boughts with laminitis and recovered fully with little to no rotation and the farrier has said several times that Isis’s feet look perfectly normal. We had a riding accident in 2005 caused by Isis tripping due to thin soles from the laminitis. Grazing muzzle, spiffy shoes, supplements, low starch grain, and chiropractic treatments later: she fully recovered from the laminitis and her IR is carefully managed.

I have always wanted to show Isis. Ever since she was little, I had dreamed about taking her to shows and winning under saddle or over fences. When we were in the middle of dealing with her medical issues, I never though I would get to show. There were days I would have been happy to know that she would be safe to ride.

It’s hard to imagine how far she had come by July 2006. Laminitis behind her, new shoes to help her tender feet, and chiropractic work so her muscular-skeletal system was working well. Her rain rot was under control thanks to the supplements she was on. Finally we were making progress. My vet had cleared Isis for regular work and for some jumping (nothing very high, and not a lot of it over sustained time periods).

My riding instructor and I had discussed whether to take Isis to a show that summer. We both agreed it might be a better idea to let me get some experience on a seasoned show horse and then take Isis to a later show. Besides, the trailer was full so we didn’t have space for Isis. I focused on working my instructor’s horse and didn’t ride Isis that much prior to the show.

The day before we left for the show, my instructor asked if I would like to take Isis. There was space on the trailer. I jumped at the chance to take her to a show just for the experience for both of us. That evening, I went to the barn, pulled her out, worked on her gaits, and jumped her a few times over cavaletti. We also cantered on cue for the first time since our riding accident in 2005.

The next day, my trainer picked us up at the barn and hauled us over to where the rest of the riders were meeting to caravan. My instructor had me pull Isis off the trailer and then tack up for a quick riding lesson. This was the second time Isis had ever been ridden away from home and the first time she had ever seen a ring with a full jump course (the jumps were lowered to 18 inches for us, instead of the 2’6″ for the other riders). She had never seen plastic flowers around jumps. She had never been ridden in a ring with more than one other horse, much less horses she didn’t know.

My instructor was skeptical: last time she had seen Isis and I riding, we had a lot of work we needed to do. She was pleasantly surprised. Not only did the Bay Wonder Mare take the jumps (after some encouragement) and do a course, but she eagerly headed towards the jumps. The other horses didn’t even bother her.

We rode at the show that evening to practice on the jump course. All of the jumps we took at home were cross rails. The jumps in the ring were set at 2 feet and were solid rails with flower boxes. I was nervous. I’d never asked her to jump anything like that. Of course, she picked up on it and shied at one of jumps.

The last time I had done a jump course at a show was on my old Appaloosa gelding when I was in high school. He had a bad habit of shying at a fence: teleporting sideways and leaving me hanging. I remembered that experience and became nervous because I expected her to do the same thing.

We approached the jump several times and each time she shied. I was a nervous wreck. My instructor had me get off of Isis and let one of the other girls ride her. They worked with her again on going over the fence and she did it. I then got back on her and we took the fence. Humiliating to not be able to deal with a situation like that and nerve wracking. My confidence had felt demolished — until we really rode together and took that jump. And took it again and again.

The next morning, Isis and I rode in the warm up ring before our classes. There were probably 20-30 people in that ring riding at different gates, taking jumps left and right. It looked like a swarm of bees trying to find the entrance to a hive. And we rode in that. And survived. Isis was jumpy at first – because I was nervous with all of these kids running around. It was worse than driving on the beltway around DC during rush hour.

My instructor gave me excellent advice: you can’t be nervous if you sing. I picked a silly trotting-speed ditty and sang. I calmed down, Isis calmed down and things improved. The biggest distraction turned out to be not from the other horses in the ring – but from the other horses tied to the trailers parked on the hill. Isis kept whinnying to them. No matter what I did, she was always looking for her buddies.

Because this was my first show in way-too-long, I decided to do something simple. Our classes were in the Walk-Trot division: three over-fence classes with 18” jumps and one under-saddle class. We had 9 people in the division, seven kids on ponies and two 30-something adults.

The biggest surprise of the day? Isis loved it. She headed for the jumps and wanted more. After the first ride, we were both grinning. The second ride, she knew her stuff. We even cantered the course in the the third ride. My instructor was impressed. Isis did pretty well in the equitation class, too. In fact, she kept trying to head for the jumps. We had a few bumps where she pulled against the bit, but that was more my fault than hers.

At the end of the equitation class, Isis and I waited in the line up. I wasn’t expecting anything. I knew we hadn’t done that well, but you know, the fact that we had gotten through it was amazing. I did a double-take when the announcer said our names. And then I grinned and couldn’t stop grinning. (I’m still grinning as I write this.) Isis and I won sixth place in all three of the over fence classes and then took fifth in the under saddle class.

She went above and beyond my expectations and certainly those of my instructor. Isis tackled a set of new situations and obstacles with intelligence and curiosity – and would have done a lot better if her spastic Mom had been calmer initially.

Later I realized that it’s possible that all of the people in that division got ribbons, but you know what? I don’t really care. Those ribbons represent a dream come true after years of dealing with assorted problems and medical issues. To this day, they still hang on her tack room door along with the show number.

Six weeks after this horse show, Isis had colic surgery on August 28, 2006. She fully recovered and we’re now working on low-level dressage lessons. We jump periodically as a reward for a job well done.

Sadness

I’m on a mailing list for owners of horses who are insulin resistant and/or have Cushings. These can be very serious conditions for horses if left untreated. These metabolic conditions can not be cured, only managed. Isis has insulin resistance and so far we’ve kept her well managed. We have been lucky. She had two cases of laminitis back to back (side effects of the insulin resistance) but neither episode left much damage. In fact this past trim, the farrier said if she didn’t know Isis’ history she would be able to tell that Isis had had laminitis in the past. Amazing.

I feel truly blessed to have Isis still. Last summer when she colicked was the closest I’ve come to losing her. It was devastating to even have to consider preparing to make that kind of decision.

I just read several women’s accounts of how they just had to put their horses down. It was gut wrenching. It is like losing a child or a family member. I can almost imagine what they are going through because I was almost there last year.

To those brave women who have to face this, may your horse find greener pastures and run free. They and the rest of your herd will be waiting for you when you cross over.

When to breed?

The question of whether to breed or not to is especially hard to me. I grew up on a breeding farm. We bred the best Crabbet and Egyptian Arabians (later only straight Egyptians) we could afford and always made sure they found homes. My primary mare, Isis, is a product of the Crabbet/Egyptian breeding. She is the granddaughter of our first Arabian mare. I have had the honor of meeting the majority of her grandparents and even great-grandparents.

I’ve thought about breeding Isis to have her daughter as a replacement. She is an exquisite mare with a lot of jumping and dressage potential. Isis is insulin resistant (see safergrass.org for info on this condition). She is carefully managed now. Prior to her diagnosis, she has had laminitis twice (luckily with little to no rotation) as a result of her body’s inability to properly process fructans. She has also had skin-related issues (rain rot goes systemic, for example) due to immune system problems caused by IR. There is a chance that she could pass this condition on to her foal.

My Mom has a stallion who would cross beautifully with Isis. The foal would have an amazing pedigree and considering the two phenotypes–potentially gorgeous and athletic.

So here is my question… Would you breed a mare with insulin resistance to preserve a much-loved bloodline? How do you weigh the love of the horse and wanting to have her or her daughter around with the potential repercussions on a foal?

(As a side note on a long post After two years of recovery, chiropractic/accupuncture sessions, specialized shoeing, and close work with a trainer, Isis went to her first show July 8, 2006. Four classes, three over fences (18″ walk-trot 😉 and one equitation. She pinned 6th in all of the over fences and 5th on the flat out of 9. I was so proud of her. Six weeks later, she colicked from two lipomas (fatty tumors suspended from stalks) that had wrapped around 70% of her small intestines. I do not know if the lipomas were related to the insulin resistance or not. One of her vets (who specializes in IR) said he has seen lipomas frequently in IR horses, but doesn’t have any evidence to show a connection.

Surgery, one week in intensive care, and a lot of careful management…She is (mostly) recovered. I rode her for the first time in the saddle last Friday.)

Grain Goes a Long Way

The vet said that Isis could indeed begin having grain again. She is allowed a cup of grain two to three times per day along with a quarter cup of corn oil morning and evening. I have my doubts whether Isis will actually eat the corn oil. She has objected before to things being in her grain. We will see. The corn oil is a high fat supplement that can help horses with insulin resistance gain weight. With an IR horse, you don’t want to add a lot of grain to their diet. Instead, you look for other ways to increase their calories without increasing the starch or sugars.

After a week on this regimen, she’ll be allowed to have 1 1/2 cups of grain 2-3 times per day with a third of a cup of corn oil twice per day. She can also go back on her regular hoof/coat anti-rainrot supplement (yay!).