Posts Tagged ‘Insulin Resistance’

Isis and arthritis

May 22nd, 2009, posted in Horses

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

May 16th, 2009, posted in Horses

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).

Getting Isis in Shape

September 4th, 2008, posted in Horses

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

March 11th, 2008, posted in Horses

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

December 5th, 2007, posted in Horses

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?

March 16th, 2007, posted in Horses

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

September 18th, 2006, posted in Horses

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!).

Monday update

August 28th, 2006, posted in Horses

I just spoke with the vet. He said Isis is doing about as expected, which is pretty good considering everything her small intestines have been through. She had some issues with electrolyte levels today. That has been corrected and is being monitored. She still doesn’t have any motility in her small intestines and may not for another 24-72 hours. It all depends upon how she starts healing.

She was transferred from the emergency vet to a regular vet today. Well, he’s not just a regular vet, he happens to be a specialist in insulin resistance. Isis is truly in the best possible hands for her case.

Bay Wonder Mare in the hospital

August 26th, 2006, posted in Horses

Five second summary: Isis had colic surgery today (VERY BAD). I had written a long post about Isis being in the hospital with colic and a slippery-finger mistake caused me to delete the entire entry. It’s too raw to rewrite now.

She was okay at breakfast this moring. The barn manager called me at 9:30 AM, the vet was at the barn about an hour later, and Isis was at the hospital being prepped for emergency surgery by 11:30 or noon. She was out of surgery and in recovery by about 4:30 or so this afternoon. All praises be to close veterinary hospitals.

Isis in the hospital before surgeryOne day she was happy and being her normal playful self. The next she’s lying on her back on the operating table… and you don’t know if she will be there the next day. And this only after a month when she had been showing and doing so well. I’m still in shock…

During the surgery, the vets found a lipoma(1) that had wrapped around Isis’ small intestines. A lipoma is a fatty deposit in her abdomen that, in this case, was suspended from a stalk several inches long. The stalk got twisted around her intestines. On top of that, she part of her large intestine was twisted around, and she had a minor impaction-in-the-making towards her sicum. This type of colic is one of those fluke things that happens. You don’t know when it will strike, or what will happen. It wasn’t caused by any external factors. It was all internal. There was nothing that anyone could have done to prevent this. For being such big, powerful animals, horses are so fragile.

The barn owners were so awesome and supportive. Isis has been boarded at their barn for over eight years. I was one of their first boarders. Isis is like one of their family, just like she is mine. They hauled her in for me and stayed for several hours while we watched her go through tests and surgery.

I’m one of those people who would prefer to watch the surgery instead of waiting some place pacing and not knowing what is going on. As hard as it is to see a horse on her back and her intestines being examined, it’s harder still to be waiting and not knowing. Your imagination has an opportunity to run wild, and that is counter productive, especially when you have to keep your wits about you. I was grateful to the vets for keeping me posted during her surgery and letting me know what they found almost real-time. It was hard to watch, but at the same time, it was a relief to be included in the process.

Keeping focused on getting her care and how she was doing was the only thing that helped me keep my sanity during the day. All I could remember was the last time I’d been on my way to the hospital with a colicky horse. That horse was Isis’ grandmother, Indian Symphony. She died on the recovery table, and left an orphan three-month old chestnut filly (Isis’ dam).

I remembered Symphony’s surgery and the way the small intestines looked grey instead of bright pink. During Isis’ surgery, it was heartening to see that the intestines at least looked pink and had some mobility so they were still functioning. Some of the intestines did look red and aggrevated.

Surgery lasted about four hours. I stayed and watched most of it (except the initial incision, something about that I can’t watch). After she was sutured and closed, she was wheeled into the recovery room. While she was gradually coming around, the anesthesiologist came out and talked to me about her. The two vets who did the surgery also gave me updates. They were all very communicative and helpful. It was comforting and frightening at the same time. They were candid with me, which I appreciated.

They felt that she has a good chance to recover from the surgery (maybe 60%?). One major concern is that she has had laminitis in the past. Any shock or trauma can trigger laminits, as can excess toxins in a horse’s body. The surgery could have both factors. It is possible that she could have some toxicity from the damage caused by the colic. She was given anti-toxin medications as a preventative. Everything that can be done has been done to prevent complications. You just don’t know.

For now, it’s touch and go. I don’t know what will happen. I hope and I pray that my kid will get through this without any problems. Her recovery will be long and hard — 30 days stall rest after she comes home, 30 days small paddock turnout, 30 days pasture rest. It will be much worse than that if she has any complications.


(1) Lipoma: benign fatty tumors that develop on the mesentery around the digestive tract. Some are attached to the mesentery by a very long, narrow stalk. These pedunculated lipomas may entwine around intestine causing a strangulation obstruction. From Terminology Used in Equine Colic, Athletic Animals.

Frustrating feet

August 18th, 2005, posted in Horses

I think I should expand my consulting business to include “horse health specialist.”

With all of the special requirements Isis has for managing laminitis and insulin resistance, I’ve learned more with her than all of the years I’ve had horses. Low carb grain. Grazing muzzles. For months, last year through the beginning of this year, we struggled with keeping the grazing muzzle on her. Finally after we get that to stay on no matter how many times she rubs it against the fence, she trips and falls with me during a lesson… And thus began the second phase of intense frustration. She recovers from the second episode of laminitis, only to trip and fall. We recover from the bruises and scrapes, and then are left wondering why she tripped. Was the tripping caused by muscular-skeletal issues, sensitive feet, neurological problems, or some combination of any of the above?

The one piece of good news was that her problem appears to be muscular-skeletal and sensitive feet, and not neurological (BIG relief). “Team Isis” tried for several months to coincide the farrier and chiropractor visits. It helped, but it didn’t resolve the issue. She still tripped. The only other option was to try using shoes, preferably glue-ons to preserve her feet and not use nails.

Following in the fine tradition established with her grazing muzzle grace, we can’t keep the shoes on her. Yet again, Isis’ shoes are off. And she is ouchy when moving out in the field, near the barn, on almost any hard surfaces. I can’t work her until either she is trimmed again or she has new shoes. The shoes, clips, and glue have to be ordered from different Web sites and take a week or so to arrive. A rush order boosts the shipping to cost almost as much as the shoes.

I’ve had it. I’ve ordered a year’s worth of shoes, glue, clips, and spare tools. No more waiting on orders and losing weeks to waiting on package.