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awaywego
Jan. 17, 2010, 09:13 PM
Where do I find one to "hire" to evaluate my horse's feed? After reading so many conflicting opinions on countless threads about putting weight on a hard keeper - my head is still spinning! I'd rather spend $ on getting an "official" opinion than continuing to throw $ out the window perhaps on more cool calories, rice bran, beet pulp, alfalfa cubes...............

I'm not sure if this is something I hire someone for a phone/email consultation or in person?

Mary in Area 1
Jan. 17, 2010, 11:30 PM
Call your local Vet School and ask them if they have a nutritionist on staff or one to recommend. DO NOT use one who is paid by a particular feed company--they are beholden to that company and will try to sell you their products. That would be fine IF they were well-educated and accurate, but they aren't. Usually they are nothing more than sales people who took a workshop on ration balancing or something.

I found MAJOR errors in the knowledge of THREE feed reps/nutritionists in our area. They don't know how to calculate the needs of sport horses (all the charts are in size of horse x hours worked. Who really works their horses for several hours per day? A hard dressage ride or event conditioning lastin "only" an hour would put your horse in "light work" category.

They WAY underestimate the need for certain minerals and vitamins, like vitamin E. They just don't get it. And they really can't differentiate between different metabolisms, like OTTB'S versus warmbloods versus draft crosses. They do NOT need the same food.

Arrrgghhh.

Puddin Pie
Jan. 18, 2010, 07:52 AM
One of the boarders at the barn I board at (whew, that was a mouthful), has contacted Dr. Kellan, the nutritionist guru and has done feed analysis with her and was very pleased.

Auburn
Jan. 18, 2010, 08:44 AM
I second not going to a feed company nutritionist, who only pushes their feed. I learned this the hard way last summer. It was an expensive lesson. :mad:

buggygal
Jan. 18, 2010, 02:34 PM
I've used Kathleen Gustafson - katmando@kc.rr.com - for three years. She is associated with the Equine Cushings group (my horse doesn't have Cushings or any other physical problem). I have one horse that I keep at home. I have room in my barn for a year's worth of hay, so once/year I send a sample of the hay to a lab to be analyzed. They send the results to me and to Kathleen. I complete an online form for Kathleen which gives basic info about the horse and what he's eating. She combines this info with the lab results of the hay and tells me what to add to his diet. For 2009, the lab charged $29 to analyze the hay and Kathleen charged $45 to determine what I need to add to his diet. I find her very accessible and willing to give me advice and information after the analysis is done and if I just have a question. I would definitely recommend her.

spaceagejuliet
Jan. 18, 2010, 02:36 PM
Call your local vet school.

Where are you local to? Dr Sarah Ralston at Rutgers in NJ is a nutritional specialist ( To answer the above, I don't know how tied into Purina she is, etc, but I've found her advice helpful and non-brand loyal )

Melyni
Jan. 18, 2010, 04:35 PM
I do them all the time.
Or there's:
Dr Juliet Getty,
Dr Sarah Ralston
Dr Judy Reynolds.
I can get you contact info for them if that helps

Yours
MW

rcloisonne
Jan. 18, 2010, 04:55 PM
Ditto Dr. Sarah Ralston. She's a COTH member but I haven't seen her post in awhile. You can probably contact her through Rutgers:

http://nutrition.rutgers.edu/faculty/ralston.html

awaywego
Jan. 18, 2010, 09:13 PM
Great. I am in southeastern PA, so I guess I could try New Bolton or Sarah Ralston. I have one horse with severe and chronic allergies and another one that seems to have the metabolism I would die for (doesn't gain a pound and eats everything put in front of him!).

Melyni
Jan. 19, 2010, 07:49 AM
Great. I am in southeastern PA, so I guess I could try New Bolton or Sarah Ralston. I have one horse with severe and chronic allergies and another one that seems to have the metabolism I would die for (doesn't gain a pound and eats everything put in front of him!).

Here's what I need to know.
Details of the horse in question;
Age, size, weight, breed, gender, work load.
Current diet, as in how much (weight) of Hay, type of hay, how much (weight) of grain, type of grain, any supplements.

What the problem is that you are seeing.
It's also helpful to know where you are and what kind of feeds & types of hay are available in your area.

YOurs
MW

DraperEquine
Jan. 19, 2010, 08:31 AM
When I worked as a barn manager, we used KER (Kentucky Equine Research). They have their own product line but as long as you discussed up front that you didn't want to be sold their products, they were very willing to help consult and work with you. I personally loved working with them. They have consultants that usually travel through the area. I lived just south of New Bolton so I know they come through your area.
Here is a link: http://www.ker.com/

SmartAlex
Jan. 19, 2010, 09:13 AM
My farrier was telling me that one of his other clients was using a service where she sent in blood samples on her horse, and there was a company who would mix custom supplements based on what the horse as lacking. He didn't have the particulars, but I'd never heard of such a thing and wondered if anyone else has.

Androcles
Jan. 19, 2010, 01:24 PM
My farrier was telling me that one of his other clients was using a service where she sent in blood samples on her horse, and there was a company who would mix custom supplements based on what the horse as lacking. He didn't have the particulars, but I'd never heard of such a thing and wondered if anyone else has.

Perhaps you are talking about the Nutritional Blood Test developed by Dr. Bob Goldstein VMD

http://www.healingcenterforanimals.com/

The website concentrates on small animals but I and others I know have used it very successfully with horses, such as solving very difficult health problems with very hard keepers.

Katy Watts
Jan. 19, 2010, 03:59 PM
So what does it take to call oneself an equine nutritionist? It appears to be a very malleable title.
There are folks passing themselves off as 'nutritionalists' that have only read books, or have a spreadsheet made up by someone who has read books, or learned about nutrition raising goats in Australia. There are trimmers/trainer/nutritionists that never took a college class in anything. There are Drs in other fields that self studied. There are people employed by feed companies called nutritionists who have a BS in general equine management. There are other feed company employees that have PhD's in equine nutrition. How do we tell the difference?
Are there any industry standards by which we can determine who is actually studied the subject in a university level? Who is really qualified?
I have been introduced as an expert in equine nutrition, but I am always quick to point out I have no training in the subject. I just read a lot of books, and go to a lot of nutrition conferences, rub elbows and ask good questions. Evidently others are not so quick to correct that misconception.
Katy

Melyni
Jan. 19, 2010, 05:04 PM
What does constitute sufficient qualifications/training for an Equine Nutritionist.

A BS in Animal Science and a weekend training course when employed by the Feed company.

4 yrs of higher education learning about surgery, pharmacology, physiology, etc with 1 course, 1 semester on nutrition for all the species lumped together.

4 yrs of grad school concentrating on nutrition of a few species, along with research and plenty of studying. Papers written, articles written, a book published.

Hmm.
MW

Katy Watts
Jan. 19, 2010, 05:14 PM
Gosh. So maybe it is appropriate to ask about qualifications when we hire someone to consult? And perhaps take advice with a grain of salt depending on their training.
Katy

Melyni
Jan. 19, 2010, 07:57 PM
Gosh. So maybe it is appropriate to ask about qualifications when we hire someone to consult? And perhaps take advice with a grain of salt depending on their training.
Katy

Yes, ask about qualifications before you hire!. At least then you know if there is likely to be some solid training and information behind the answer.
MW

Sarah Ralston
Feb. 14, 2010, 10:13 AM
Call your local vet school.

Where are you local to? Dr Sarah Ralston at Rutgers in NJ is a nutritional specialist ( To answer the above, I don't know how tied into Purina she is, etc, but I've found her advice helpful and non-brand loyal )

No connection to Purina what so ever now-I did do some consulting for them back in the late 80's/early 90's on Equine Senior. And their current head nutritionists, Dr. Mary Beth Gordon did start out as my grad student at Rutgers. However, she finished up with an exercise physiologist, non-nutrition person, so I'm not "beholden" to her either. My colleague, Dr. Carey Williams was trained by the same nutrition guru who supervised my PhD, Dr. David Kronfeld (Who unfortunately died recently). Dr. Williams is an extension specialist at Rutgers and does consults on a regular basis and has an "ask the expert" forum at our Rutgers website: www.esc.rutgers.edu. She also trained the newest addition to Nutrena/Cargill's nutrition team, Dr. Emily Lamprecht.

If you contact New Bolton Center with an equine nutrition question you will usually be referred to me! Very few Veterinary schools have equine nutrition specialists on staff-to my knowledge only VPI, Tufts, Iowa, Oklahoma, California and Tufts can claim that distinction at this time. The western schools are using PhD Animal science trained nutritionists. They are great, but often not as tuned into clinical problems.

I was not checking the forums for quite a while (too much else going on) but will start checking in periodically

You can find out what is going on at Rutgers at the website above or my Young Horse site: http://younghorse.rutgers.edu.

deltawave
Feb. 14, 2010, 12:18 PM
The Pony Club "A" manual. :)

I like reading and figuring out this kind of stuff on my own.

sdlbredfan
Feb. 14, 2010, 12:29 PM
You also can learn how to do it yourself via online courses, see
www.drkellon.com

yellowbritches
Feb. 14, 2010, 01:12 PM
When I worked as a barn manager, we used KER (Kentucky Equine Research). They have their own product line but as long as you discussed up front that you didn't want to be sold their products, they were very willing to help consult and work with you. I personally loved working with them. They have consultants that usually travel through the area. I lived just south of New Bolton so I know they come through your area.
Here is a link: http://www.ker.com/
I talked with a KER nutritionist this year to try a figure out the best way to feed Vernon with his allergies. She gave me great info and great advice and helped me figure out what he needed based on his workload, etc, not some formula. Now, full disclosure, she did help me select a feed from the company I already was using and that KER does work with (Pennfield), but that's what I WANTED her to do (if I could feed him and avoid his allergy issues with a feed company I already trusted, that's what I wanted to do). She was great, though, and offered very valuable info...and Vernon hasn't had any allergy issues since I followed her advice!

Sarah Ralston
Feb. 14, 2010, 08:38 PM
Dr. Kellon is not a trained nutritionist. She reads a lot and writes a lot but her nutritional recommendations are frequently not based on evidence based medicine. She also sells supplements and consults. Caveat Emptor.

There are other Equine Nutrition Courses/resources available. Go to www.esc.rutgers.edu for details.

Tamara in TN
Feb. 14, 2010, 09:26 PM
[QUOTE=Sarah Ralston;4686030]Dr. Kellon is not a trained nutritionist. She reads a lot and writes a lot but her nutritional recommendations are frequently not based on evidence based medicine. She also sells supplements and consults. Caveat Emptor.



thank you for saying that
I am about tired of people calling us for hay and then giving us "Dr.Kellon says........blah blah blah"

and we were always polite...maybe now we don't have to be ?? ;)

Tamara in TN

deltawave
Feb. 14, 2010, 09:47 PM
her nutritional recommendations are frequently not based on evidence based medicine

True, but this is hardly a departure from the norm given that a) there is not much evidence-based "medicine" out there for horses period, much less horse nutrition; and b) equine nutrition as a whole is still solidly infiltrated by fads and trends, although that is slowly getting better IMO.

kmwines
Feb. 14, 2010, 10:52 PM
A land grant university or one with an animal science program that has an equine nutrition program would be a great place to start. Definitely check people's credentials and find somebody that has done research or has experience with sport horses and not just reproduction stuff.

Melyni
Feb. 15, 2010, 08:16 AM
Dr. Kellon is not a trained nutritionist. She reads a lot and writes a lot but her nutritional recommendations are frequently not based on evidence based medicine. She also sells supplements and consults. Caveat Emptor.

There are other Equine Nutrition Courses/resources available. Go to www.esc.rutgers.edu for details.

Dr Kellon does not make supplements but she 'consults' for several manufacturers who do.
As you said she is not a trained nutritionist, she is self taught, so while some of her ideas are very interesting they are also a bit strange in the logic and the 'science' she quotes is also a bit strange.
But she does have original and interesting ideas.

She sells her consultations more than any particular products.

There is a quite a lot of Equine Nutrition advice available on the web and elsewhere but do check into credentials.
Yours
MW

goeslikestink
Feb. 15, 2010, 08:20 AM
Where do I find one to "hire" to evaluate my horse's feed? After reading so many conflicting opinions on countless threads about putting weight on a hard keeper - my head is still spinning! I'd rather spend $ on getting an "official" opinion than continuing to throw $ out the window perhaps on more cool calories, rice bran, beet pulp, alfalfa cubes...............

I'm not sure if this is something I hire someone for a phone/email consultation or in person?

any feed merchant like spillers has a nutritionist any vets should have one on board as an associate but do make it large animals or equine not a dog and cat one

equineartworks
Feb. 15, 2010, 08:38 AM
You can also try www.feedxl.com for a few days for a very nominal fee. You plug in your horses details and what you currently feed and it will give you a pretty detailed analysis of what you have going on.

I found it interesting to use because it calculate everything you are feeding for a good overall look.

cottagefarm
Feb. 15, 2010, 08:40 AM
Vets over here are not well versed on nutrition unless its what a feed company tells them.
I live in one of the most horse saturated area's in the U.S (I am English and used to sell Spillers BTW) therefore we have many,many vets .In the 100's
It's amazing how many equine vets don't have a clue about ration balancers and freak out when they see 28%-32% on the protein. At the levels (pounds) you feed a rb you are often feeding less protein than a "regular" feed at the recommended rate.

Haven't read everything on here yet but there is also many differences in some of the feeds within certain product lines depending on where they are produced and what source of protein/grains are locally available.

It really is mind boggling when you start trying to read through all the info and mis-information out there and the fact that reps and brand fanatics often twist things on the competition to make their product seem superior. Believe me I'm very close to it all and it's amazing some of the crap I hear :lol:

Sarah Ralston
Feb. 15, 2010, 08:14 PM
It really is mind boggling when you start trying to read through all the info and mis-information out there and the fact that reps and brand fanatics often twist things on the competition to make their product seem superior. Believe me I'm very close to it all and it's amazing some of the crap I hear :lol:

Amen-on a daily basis for me. Why do people seem to think that if it is complicated or extreme it's got to be better? KEEP IT SIMPLE! :yes:

wateryglen
Feb. 16, 2010, 08:40 AM
Our local farmers cooperative makes their own feed line AND sells other brands. They have a feed consultant ("horse nutritionist" of sorts) who advises for free. They have several branches in this part of Va. so she serves the whole area. I think Southern States does too. Call your local feed stores and connect with THEIR advisors. Compare what they say. Use the collective knowledge of many to use for yourself. If they all say the samething (even if they are brand based) then there has to be some truth to it I figure! :yes:
It's not bad IMHO that many are brand based; I mean, they need to earn a living for crying out loud. They deserve a salary too! :yes: I've attended lectures from several from different brands and really.....they all say the same things! Having a personal consultant for yourself doesn't make it better.
You can also just read & research like you've already done.....bet you already know a lot too!

Watermark Farm
Feb. 16, 2010, 11:20 AM
Don't waste your money with Eleanor Kellon.

All I got from her is the LMF feeds are the devil's work and the reason for the downfall of civilization and my pony's off liver function.

Daydream Believer
Feb. 16, 2010, 11:44 AM
Dr. Kellon is not a trained nutritionist. She reads a lot and writes a lot but her nutritional recommendations are frequently not based on evidence based medicine. She also sells supplements and consults. Caveat Emptor.



So what? Lots of nutritionists being recommended on these threads are affiliated with a company and push their own products. Caveat Emptor indeed! :no:

Dr. Kellon has helped an awful lot of horses and an awful lot of people gained valuable knowledge in her courses.

Sarah Ralston
Feb. 16, 2010, 03:53 PM
So what? Lots of nutritionists being recommended on these threads are affiliated with a company and push their own products. Caveat Emptor indeed! :no:

Dr. Kellon has helped an awful lot of horses and an awful lot of people gained valuable knowledge in her courses.

I'm sure she has. But she is a veterinarian, not a trained nutritionist. She does not attend the Equine Science Society Meetings, where the most current research on equine nutrition is presented every other year. She is not board certified (meaning she has not passed tests geared to evaluate her nutritional knowledge) by either the American College of Veterinary Nutrition or the American Society of Animal Science. Graduating from Veterinary School (I graduated from Penn too and know how little instruction we received in the standard course) does not qualify you as a nutrition expert. The Journals in which she has "published" her "clinical trials", the Horse Journal and John Lyons' newsletter, are not peer reviewed, scientific journals.

As I have stated before, some of her advise is indeed sound but to promote her as the top nutrition expert is really a mis-representation. So she offers on-line courses in Horse Nutrition. Anyone of you could do that in today's world, regardless of your qualifications and actual knowledge, and if you promote it enough I bet someone would pay to hear what you had to say. I still say Caveat Emptor.
Sarah Ralston, VMD, PhD, Diplomate, American College of Veterinary Nutrition

JB
Feb. 16, 2010, 03:56 PM
any feed merchant like spillers has a nutritionist
Any of them? What qualifies them as a "nutritionist"?


any vets should have one on board as an associate but do make it large animals or equine not a dog and cat one
Maybe on your side of the pond. Don't count on anything but the "weird" vet in the US to employ a nutritionist :no:

Daydream Believer
Feb. 16, 2010, 07:34 PM
As I have stated before, some of her advise is indeed sound but to promote her as the top nutrition expert is really a mis-representation.

And I was not suggesting that you promote her as the US top nutrition expert...nor that she deserves such a title...as she clearly does not have all the letters after her name... :rolleyes: but my point is that many nutritionists discussed and recommended on this forum are affiliated with a company and push their own products when consulted.

Sarah Ralston
Feb. 17, 2010, 01:01 PM
My point is that many nutritionists discussed and recommended on this forum are affiliated with a company and push their own products when consulted.

I have no problem with that either-as long as their affiliations are made clear. Many of them, like Dr. Don Kapper and Dr. Mary Beth Gordon, and Melyni (from this list who makes no bones that she has a supplement company and is always at the major meetings) are extremely knowledgeable and reasonable in their recommendations, and attend most of the conferences to keep up to date and in tune with the research that is being done. Sure, they push their own products but their recommendations are based on a scientific background of knowledge of what the nutritional needs are and what their products can and can not do.

I currently consult for Idleacres/Square Meal Feeds, who has donated feed for my research horses for the past 6 years (as have Nutrena and Purina in the past) and recommend their products but I also am careful to also recommend similar products (if there are similar ones, which there usually are!) from other companies too, giving the owner/trainer a choice. :)

sdlbredfan
Feb. 17, 2010, 01:13 PM
Sarah Ralston of the 'impressive credentials' mentioned ' currently consult for Idleacres/Square Meal Feeds, who has donated feed for my research horses for the past 6 years (as have Nutrena and Purina in the past)' - which is useful to know. Although not 'beholden' to them, am sure she'd like to push those products to keep her 'credibility' with, and likelihood of receiving further donations from those companies, eh?

sdlbredfan
Feb. 17, 2010, 01:24 PM
I looked up American Society of Animal Science and it appears to be devoted to livestock especially of the meat source type. (In other words, it has next to nothing to do with horses.) I also looked up the other organization Dr. Ralston referenced, American College of Veterinary Nutrition, and their 'continuing education' of equine type for this year consists of a session at OSU and one in conjunction with KER, http://www.acvn.org/site/view/ContinuingEducation.pml#EQ. That tells me they contract out their educational offerings, not serving as source itself. (filed under 'things that make me say hmmm...')

rcloisonne
Feb. 17, 2010, 01:36 PM
Sarah Ralston of the 'impressive credentials' mentioned ' currently consult for Idleacres/Square Meal Feeds, who has donated feed for my research horses for the past 6 years (as have Nutrena and Purina in the past)' - which is useful to know. Although not 'beholden' to them, am sure she'd like to push those products to keep her 'credibility' with, and likelihood of receiving further donations from those companies, eh?
So, you would prefer your nutritional education come from a vet with no formal training in this field, no scientific studies to back up any of her claims (all testimonial “data”) and one who isn’t even licensed to practice veterinary medicine in any state? Cult member much?

sdlbredfan
Feb. 17, 2010, 03:43 PM
I did some research, and found that despite Dr. Ralston's unprofessional 'dissing' of a colleague, that Dr. Kellon's credentials include four professional/veterinary, peer reviewed, nutrition related publications or meeting presentations in the last 6 years. Her nutrition course is AAVSB approved (aavsb.org) for 90 hours of continuing education credit for veterinarians. The aavsb.org is a big deal, American Association of Veterinary State Boards.

Daydream Believer
Feb. 17, 2010, 03:44 PM
Gosh...I'd just like to see attacks on everyone stop...and that is why I posted earlier about Dr. Kellon when she was being discussed so negatively. I mean...what is the point? Few people act without some self interests. If someone asks about horses for sale, I will try to sell them one of mine first...that's to be expected of anyone in business. My only point was that an affiliation with a product or company is not a reason to badmouth anyone offering nutritional consulting. Now if you think they are not qualified, you can say so nicely... but seriously...the other stuff is so not necessary. The "caveats" and such...

I do think it was nice of Dr. Ralston to tell folks what her affiliations were and admit that she has them.

sdlbredfan
Feb. 17, 2010, 05:02 PM
I agree with Daydream Believer. I found something very interesting in points H and I of the AVMA code of ethics that seem relevant to this discussion:

"Veterinarians should strive to enhance their image with respect to their colleagues, clients, other health professionals, and the general public. Veterinarians should be honest, fair, courteous, considerate, and compassionate. Veterinarians should present a professional appearance and follow acceptable professional procedures using current professional and scientific knowledge.

Veterinarians should not slander, or injure the professional standing or reputation of other veterinarians in a false or misleading manner."

Daydream Believer
Feb. 17, 2010, 07:49 PM
[edit]

I have no affiliations either but did take one of Dr. Kellon's on line courses and found it very helpful. My horses are doing much better now on a custom program her training helped me design. My experience with one of the more "reputable" nutritionists affiliated with a feed company mentioned earlier in this discussion was horrible.

buck22
Feb. 17, 2010, 08:20 PM
this conversation is very enlightening, sadly. I too need some help with my horse's diet. I enrolled in Dr Kellon's class but never was able to take it due to scheduling conflicts. I've done the balancing sheets, so I have a novice's grasp of it all, but thats it. I really should contact her again to take the class finally.

reading through this thread, in the beginning I was like 'oh great, maybe I can just contact this Rutgers Dr and get some advice and solve this issue already...' but then reading through, are things not what they seem?

My horse may very well have a problem that is diet related, I need help and answers. I'd like to know these things for myself, but don't have time to take classes and get the breadth of knowledge needed to make decisions.

I don't want my horse to be my test lab while I tinker with mineral balancing, possibly at the expense of his health.

I don't want some software program telling me all is well.

I don't want to base my dietary decisions off of what I've heard on bb's

I don't want to blindly follow someone as they sell me a line of products only to wake up 2 years down the road to find myself in the same position. But how can I know the difference? Apparently credentials are not as they appear?

Is there nothing to do but knuckle down with the NRC book?

Sorry I'm whining, but today is one of those days where I've just had it, from diet to farrier, training, diagnosing ills, and saddle fit... I've spent the last decade learning to micromanage and self manage every aspect of horse care. I've had it with having to second guess the professionals I hire, or not knowing who I can trust. I never feel as if I can put my full and entire trust in anyone.

What happened to the good ol' days when the horses ate sweet feed, bran mashed on sundays and got monday off, the saddles didn't fit, no one was the wiser, and everyone galloped merrily around? :D Really, it seems so long ago its almost like I'm imaging things. I guess this is horses.

done whining.

(ok not done) And someone please tell the sun to come back! While I'm at it I've had it with the snow too :lol:

(now I'm done) :D

Mary in Area 1
Feb. 17, 2010, 08:35 PM
I got all excited and went to Dr. Ralston's site as well. There is certainly no usuable free nutrition advice there. I went to the FAQ and they were so simple as to be laughable. I've used two company-paid nutritionists and they were useless. I have fabulous hay and I feed it almost free choice. I have it analyzed, but I can't get a proper mineral analysis done (does ANYONE do this????)

First, the "nutritionist" insisted that her grab sample was perfectly scientific (not). Then she said we didn't need the mineral analysis, just feed her ration balancer at the proper amount and all would be fine. Guess what? Many of my horses have a serious Vitamin E deficiency because this RB was not enough. Arrggghhh.

I DON'T believe in feeding grain unless absolutely necessary, or a handful to carry supplements. ANYONE who consults for a grain company is evil, in my opinion, if they don't tell that company that the amounts they suggest are completely wacked. And when people like me feed reasonable grain levels, they can't get the proper vit/min levels without expensive supplements.

I agree with Buck--Why can't anyone be honest and truly share their knowledge without trying to sell zillions of bags of useless, crappy grain?

Ghazzu
Feb. 17, 2010, 08:38 PM
[edit]

Dr. Ralston knows her stuff, and is very generous in sharing her expertise.
Her starments about Dr. Kellon are pretty strightforward and far from libellous or unprofessional.

Dr. Kellon certainly reads a lot, tinkers around a lot with her own stock, has some interesting theories that she comes up with based on that, some of which pan out, and some of which don't, but, as stated, has no post graduate training in the field of nutrition.
Some of her ideas are great, some of her "studies" have holes you could drive a four-in-hand through.

As far as the AASVB and their CE credits, trust me, that group is uber-political, and a fight is brewing right now, as they are methodically denying CE credit to virtually all complementary medicine modalities, with the exception of those under the control of one of the RACE board members. That's how open minded *they* are.

Tamara in TN
Feb. 17, 2010, 08:42 PM
[QUOTE=Mary in Area 1;4694719] I have fabulous hay and I feed it almost free choice. I have it analyzed, but I can't get a proper mineral analysis done (does ANYONE do this????)

doesn't dairy one offer this for hay ?

I'm pretty sure I saw it on the fee sheet...or do you mean equine nutritionists don't do it?

Tamara in TN

buck22
Feb. 17, 2010, 08:53 PM
[edit] I've no beef with anyone, fairly supportive of Dr K actually despite her not being fully embraced, she's out of the box thats for sure and that can produce valuable results... and being a NJ resident, I've always had a great respect for whats going on at rutgers.

but when I read back and forth like this, it makes me doubt everything.

maybe it was inappropriate of me to vent :(

Katy Watts
Feb. 17, 2010, 09:30 PM
but when I read back and forth like this, it makes me doubt everything.

(

This is the path towards true knowledge. Don't have blind faith in anything. There are no short cuts without doing your homework.
Katy
Student of everything. A day without learning something new is a day wasted.

buck22
Feb. 17, 2010, 09:39 PM
you're right. :) I get a little weary from time to time I guess.

thanks for keeping my chin up.

SmartAlex
Feb. 18, 2010, 09:51 AM
What happened to the good ol' days when the horses ate sweet feed, bran mashed on sundays and got monday off, the saddles didn't fit, no one was the wiser, and everyone galloped merrily around?

**sigh** I miss those days too. Heck, I sort of miss the days of nylon halters and barbed wire too. White patches in the saddle area was proof to cowboys that the horse was broke. It's amazing my first horse lived to be 33 unscathed.

Eleanor M Kellon, VMD
Feb. 18, 2010, 10:33 AM
Dr. Kellon is not a trained nutritionist. She reads a lot and writes a lot but her nutritional recommendations are frequently not based on evidence based medicine. She also sells supplements and consults. Caveat Emptor.

I have never sold supplements. Would you care to elaborate on "frequently not based on evidence based medicine"?

There are other Equine Nutrition Courses/resources available. Go to www.esc.rutgers.edu for details.

Negative politics perhaps?

Eleanor

FatPalomino
Feb. 18, 2010, 11:25 AM
I have lived in NJ almost all my life and have known many people who have worked closely with Dr. Ralston (between Rutgers and SRF), and have never ever heard one negative thing about her, which is incredibly impressive.

Oh, and for the last decade she's worked with PMU horses, and students, to make a huge difference in many lives:
http://younghorse.rutgers.edu/history.html
Also, they provide amazing care to the rescue horses in which they use for research (non-terminal). [http://adoptahorse.org -under adopted, scroll down]

Have you checked out Dr. Ralston's bio? It doesn't get much more impressive than that. I'm just another fan of sound science (and also a Rutgers grad, although I didn't have any of Dr. Ralston's courses).
http://www.esc.rutgers.edu/faculty_info/ralston/ralston.htm

"Sarah L. Ralston, VMD, Ph.D., dACVN, is Associate Professor in the Department of Animal Sciences at Rutgers’ School of Environmental and Biological Sciences specializing in equine nutrition. She has been Associate Director-Teaching of the Rutgers Equine Science Center since its inception.

The recipient of a Ph.D. from the University of Pennsylvania in 1982, Dr. Ralston received her VMD degree from its School of Veterinary Medicine in 1980. She earned her board certification from the American College of Veterinary Nutrition in 1989 and has been active on its board of directors ever since.

She occupied the Mark Morris Chair of Clinical Nutrition in the Department of Clinical Sciences at Colorado State University's School of Veterinary Medicine prior to joining Rutgers. She is an adjunct professor in the Department of Large Animal Medicine at New Bolton Center and has served on several regional and national committees, including the American College of Veterinary Nutrition board of directors; American Board of Veterinary Specialties and New Jersey Veterinary Medical Education Advisory Committee. She is also on the advisory boards of The Horse, Equine Practice and Journal of Equine Veterinary Science and a frequent contributor to popular journals such as Equus, Dressage Today and Practical Horseman."
[there's more, feel free to click that link]

Compare to Dr. Kellon:
http://www.ecirhorse.com/index.php?option=com_content&view=article&id=5&Itemid=31
"Dr. Kellon received special training at the University of Pennsylvania New Bolton Center in Large Animal Medicine and Surgery. Dr. Kellon is one of the few experts in the field of applications of nutraceuticals for horses and is an authority in the field of equine nutrition as well as matters pertaining to performance horses. She is a member of the Veterinary Advisory Board for Smart Pak Equine, Veterinary Editor for Horse Journal and John Lyons Perfect Horse, which have published many of her clinical trials. "

Board certification, as Dr. Ralston has worked hard to obtain, is the gold standard in veterinary medicine and should not be underestimated. Since others are quoting the AVMA, here you go
"Only those veterinarians who have been certified by an AVMA-recognized specialty organization should refer to themselves as specialists."
http://www.avma.org/issues/policy/board_certified.asp

Eleanor M Kellon, VMD
Feb. 18, 2010, 06:50 PM
The bottom line is results. I'm confident to let my results speak for themselves.

The only reason I even have a CoTH forum membership is people letting me know of similar behavior to what went on in this thread. I don't have to troll equine chat groups promoting myself by bashing other professionals.

I've been attacked here in this public forum by two veterinary professionals and one wanna-be as "whacky" and non science/evidence based in my recommendations. I am repeating my invitation to give specifics so that I may fairly defend myself. Any takers?

Eleanor

Daydream Believer
Feb. 18, 2010, 07:43 PM
The bottom line is results. I'm confident to let my results speak for themselves.
Eleanor

Good point Dr. Kellon. Since I took your NRC course last winter and learned so much on basic ration balancing and equine nutrition, I followed your guidelines on developing a custom diet and mineral supplementation program for my breeding herd and youngstock. Their health and condition has been much improved compared to the feed they were on before which caused problems for a significant percentage of my horses. That's a long story in itself but the proof is most certainly in the results.

deltawave
Feb. 18, 2010, 07:52 PM
I don't want my horse to be my test lab while I tinker with mineral balancing, possibly at the expense of his health.

I don't want some software program telling me all is well.

I don't want to base my dietary decisions off of what I've heard on bb's

I don't want to blindly follow someone as they sell me a line of products only to wake up 2 years down the road to find myself in the same position. But how can I know the difference? Apparently credentials are not as they appear?

Is there nothing to do but knuckle down with the NRC book?

Ultimately, we DO have to decide to feed our horses something. :) If you've got a novice's background, you're probably far ahead of most people when they begin taking care of horses and making their own feeding decisions. How many people here grew up with "2 scoops of sweet feed" as a base diet for all horses and went from there? I sure did. It wasn't "taught", it was just "the way things are done" back then at a lot of everyday, non-fancy, non-special, not horrible, decent barns.

It's not like we have to invent a horse's diet out of thin air, after all. We start with forage (ideally knowing what's in it or at LEAST what kind it is) and go from there. Forage is 90% or more of their diets, so it's probably appropriate to spend 90% of our mental energy thinking about what it provides. :) If it is obviously deficient, or the horse isn't doing well, you go from there, asking the simple questions: is he too fat? too thin? special needs based on known illness or problems? breeding animal? intolerant of certain things? known deficiency of some nutrient or extra need for some other one? Yes, that list sounds daunting but no horse is going to have ALL of those issues. :)

A little label-reading, a little book referencing (we need a thread on accessible, user-friendly nutrition books!), a little common sense, a little help from people we respect, and before you know it, you have a base diet. Go from there. Think of supplements as "only when I absolutely have to" and not "how many can I afford?" items. Pay attention, reassess, but not too frequently. Breathe. :)

LexusBoBexus
Feb. 18, 2010, 07:59 PM
awaywego: pm sent

FatPalomino
Feb. 18, 2010, 08:10 PM
I've been attacked here in this public forum by two veterinary professionals and one wanna-be as "whacky" and non science/evidence based in my recommendations. I am repeating my invitation to give specifics so that I may fairly defend myself. Any takers?

Wow, do you teach professionalism in your online courses, too?

Proven results? I would love to see them, as there is always something I don't know. Which peer reviewed scientific journal were they in? If you have the direct link or citation that's even better.

SonnyandLacy
Feb. 18, 2010, 08:17 PM
I would try Feed XL software.

buck22
Feb. 18, 2010, 08:23 PM
Ultimately, we DO have to decide to feed our horses something. :)

A little label-reading, a little book referencing (we need a thread on accessible, user-friendly nutrition books!), a little common sense, a little help from people we respect, and before you know it, you have a base diet. Go from there. Think of supplements as "only when I absolutely have to" and not "how many can I afford?" items. Pay attention, reassess, but not too frequently. Breathe. :)
lol. thanks delta :D I'm a bit beyond that, I've got a diet that works, etc, healthy horses, good bloom and weight, toplines, minimal sups and no pain killers for the old man (touch wood), good horn and tight white lines, we're doing alright... and that IS thanks to BB's, Dr. K's work that she's published freely, and just sitting down with labels and reading and plain 'ol good horse sense. And frankly, my horses are the best they've ever looked.

I've got the basics soundly covered, but where I'm struggling is the nitty gritty. One horse has some peculiar issues that may probably have its roots in diet/minerals. Its out of my league, at this present moment anyhow. I don't want to play vet/dietician, thats not fair to my horse, I am at the point I could use some real help, but threads like this make me shrug and say well, where does that leave me? who do I call?

Did that make sense? its been a rotten week and I'm in a rambling mood. :(

deltawave
Feb. 18, 2010, 09:39 PM
Until there are legitimately licensed, freelance (not associated with "a company/product") registered dietitians for horses, like they have for humans, you are probably going to be doing it on your own. And since there really doesn't seem to BE any consensus on feeding things like micronutrients and the importance of minerals ("mineral imbalance" is getting to be one of those terms that makes me go :rolleyes:) your good background, experience and instincts is probably way beyond what most people have when they formulate diets.

Horses are fragile in many ways, but IMO the lack of a few nanograms of something you can't even pronounce isn't going to kill 'em. :D Call me a nihilist, or a neanderthal. I have a sneaking suspicion that some of the "nutritional problems" that are diagnosed in both horses and humans are a reflection of guilt and worry on the part of the one doing the feeding.

We make it, sometimes, much, much more complicated than it needs to be. My patients ask me what sort of heart monitor they need to buy so they can track their pulse parameters when they do a slow 2 mile walk, or they graph their BP on spreadsheets, color-coding and charting it in 50 different ways, before and after exercise, before and after breakfast, in the middle of the NIGHT! Unless they're so VERY sick that this data is crucial, I tell them to chuck all that crap and GO OUT AND PLAY! :D

I guess I'm rambling a little, too. :)

I like to only make things complicated if I'm absolutely forced to do so.

sdlbredfan
Feb. 18, 2010, 10:41 PM
According to Dr. Ralston's info on the Rutgers site, her PhD is in anatomy, not anything to do with nutrition. See http://www.esc.rutgers.edu/faculty_info/ralston/ralston_cv.htm and
http://www.vet.upenn.edu/Research/ResearchTrainingOpportunities/TheVMDPhDProgramatPenn/OurAlumni/DrRalston/tabid/1419/Default.aspx and (referencing the 'The recipient of a Ph.D. from the University of Pennsylvania in 1982, Dr. Ralston...') comment.

Ghazzu
Feb. 18, 2010, 11:25 PM
"I've been attacked here in this public forum by two veterinary professionals and one wanna-be as "whacky" and non science/evidence based in my recommendations."

Attacked?
Hardly.
I merely pointed out that those stating that you were not a specialist were correct, and that some of what you say is not supported by a great deal of hard evidence. You used the term "whacky", not me.
Hell, I frequently tell people that what I am proposing for one thing or another is not evidence-based, but might be worth a go.

Eleanor M Kellon, VMD
Feb. 19, 2010, 05:44 AM
Wow, do you teach professionalism in your online courses, too?

Proven results? I would love to see them, as there is always something I don't know. Which peer reviewed scientific journal were they in? If you have the direct link or citation that's even better.

I'm not the one casting aspersions behind someone's back on a public forum. I'm here to defend myself against the vague accusations of making recommendations not backed in science. Still waiting for even one solid example of that.

Contributing author on laminitis and dietary therapy of insulin resistance in Equine Podiatry, WB Saunders Co, 2006.

Use of the Herb Gynostemma Pentaphyllum and the Blue-Green Algae Spirulina Plentensis in the Horse. Third European Equine Nutrition and Health Congress, Gent, Belgium, March 2006.

Iron Status in Hyperinsulinemic/Insulin Resistant Horses. Third European Equine Nutrition and Health Congress, Gent, Belgium, March 2006.

Treatment of Equine Metabolic Syndrome, Compendium of Continuing Education for the Practicing Veterinarian, Vol 26(2) February 2004.

Also visit:

http://pets.groups.yahoo.com/group/EquineCushings/

http://tech.groups.yahoo.com/group/DSLD-equine/

http://sports.groups.yahoo.com/group/EPSM

For ongoing clinical work.

Eleanor

Eleanor M Kellon, VMD
Feb. 19, 2010, 05:49 AM
[QUOTE=Ghazzu;4697229
I merely pointed out that those stating that you were not a specialist were correct, and that some of what you say is not supported by a great deal of hard evidence.

There it is again. Unsubstantiated accusation. Give an example.

Eleanor

buck22
Feb. 19, 2010, 07:21 AM
Delta thank you, I really really needed a voice of reason. :D



Horses are fragile in many ways, but IMO the lack of a few nanograms of something you can't even pronounce isn't going to kill 'em. :D Call me a nihilist, or a neanderthal. I have a sneaking suspicion that some of the "nutritional problems" that are diagnosed in both horses and humans are a reflection of guilt and worry on the part of the one doing the feeding.

I like to only make things complicated if I'm absolutely forced to do so.
what I'm dealing with are actual problems, that have their roots in mineral imbalance to my knowledge, and to my vets knowledge. This is real, not me wanting to prance around to all my friends 'my horses mineral needs are completely balanced, are yours?" Trust me, I don't want to go here either. I'm tired, I want to ride my horse not play frankenstein's lab, I don't want to spend my money, my time farting around with grams of this and that, and calculation sheets on a saturday night don't exactly turn me on. I am a simple simple person, I live a simple simple life, I don't want to do this, but it has to get done.

but thank you. really so much, I needed your levelheadedness.

Ghazzu
Feb. 19, 2010, 08:16 AM
[quote=Ghazzu;4697229
I merely pointed out that those stating that you were not a specialist were correct, and that some of what you say is not supported by a great deal of hard evidence.

There it is again. Unsubstantiated accusation. Give an example.

Eleanor[/quote]

Unsubstantiated?

Is your name listed here (http://www.acvn.org/site/view/58670_ACVNMemberDiplomates.pml;jsessionid=qo1231ff 0e8g)?

And I'm sorry, but the HJ study on Vitex is not very rigorous.

Katy Watts
Feb. 19, 2010, 08:39 AM
I hesitate to enter this discussion, as it appears that many do not understand that questions and statements of facts do not constitute attacks. I would like to ask some questions, but please note I am not endorsing any perceived derogatory statements in this thread.
Peer review:
“of or being scientific or scholarly writing or research that has undergone evaluation by other experts in the field (peer review) to judge if it merits publication or funding”
Here’s a brief definition of peer review.
http://www.linfo.org/peer_review.html
from that:
1 The word peer is often defined as a person of equal standing. However, in the context of peer review it is generally used in a broader sense to refer to people in the same profession who are of the same or higher ranking.
Also:” But in a broader sense, it could also refer to articles following publication, as such articles often continue to be studied and debated for a longer period and by a much wider audience.”
Regarding the chapter on feeding IR horse in equine podiatry: do you consider this peer reviewed in that Dr. Floyd and Dr. Mannsman are both veterinarians, and therefore your peers? Or is this chapter peer reviewed by other experts in feeding IR horses, such as Drs. Ray Goer or Pat Harris? The dietary management of IR horses is such a new field there are very few experts around. Some academics consider me an expert on feeding IR horses, and I have been asked to review and co-author other articles about carbohydrates in equine diets. While I have published some articles discussing carbohydrate metabolism in plants in peer reviewed veterinary journals, I do not consider vets my peers, or able to properly critique my work, so I have always asked an expert in plant CHO from USDA to review the paper before submission. Do you discuss pasture management, testing of CHO in forage in this chapter? If so, did you seek review by an appropriate expert in plant carbohydrates?

Dr. Floyd asked me to author this chapter in their Eq Pod book, but I declined as the payment was 5 copies of the book and I cannot afford to spend any more time on pro bono work. As I prefer to define peer review of my work as that done by experts in plant carbohydrates, I would not have considered this peer reviewed if I had decided to do it for reasons of gaining prestige. Dr. Floyd did not ask me to review your work. The online reviews at the book sellers say its mostly about feet. It’s a very pricey book, and as I am very pleased with the expertise of my hoof care providers, I have declined from buying it.
Has anyone here read it so we might discuss specific advice given?
Katy

equineartworks
Feb. 19, 2010, 09:07 AM
I am going to chirp in and recommend www.feedxl.com again. Between the feedxl and hay analysis...I feel very confidant that the horses are getting exactly what they need. They look fabulous and it has saved money and diddling.

I attached a PDF for Paco this morning. He receives Vitamin E and Selenium supplementation. I just haven't had a chance to send it to Feed XL for them to add to the database.

***edit*** oops...this was supposed to be Troopers...he is a TB. The report is the same though..sorry!

Eleanor M Kellon, VMD
Feb. 19, 2010, 09:24 AM
And I'm sorry, but the HJ study on Vitex is not very rigorous.[/QUOTE]

Articles that appear in HJ are field trials, not scientific studies. They are reports of observations/findings under field conditions. Period.

That particular field trial was conducted because Vitex, like pergolide, is a dopamine agonist. It spurred two other studies. The first was a small one by University of Pennsylvania, which was negative but included very advanced cases, which even the small HJ field trial said may not be good candidates, and was not corrected for seasonal ACTH variation (because that was unknown at the time). The next was a much larger and longer trial, conducted by the Laminitis Trust in the UK, headed by Dr. Robert Eustace. The preliminary results:

http://www.laminitis.org/Vitex%20trial.html

and as yet unpublished ongoing results (personal communication) were very similar to the original HJ trial. Unlike the U of P study, which dosed pergolide "to effect", up to as much as 5 mg/day, without adjusting dose of Vitex, the UK study did use varying dosages. Final data, particularly laboratory results, is in the process of being corrected for time of year and other factors.

Pergolide is the gold standard for treatment of Cushing's disease, proving itself superior to cyproheptadine and Vitex because the latter lose effectiveness over time. However, if you're going to require rigorous standard, pergolide won't hold up either since it has never been put through the rigorous FDA approval process, or used in a blinded fashion, or with negative controls, etc. Fortunately for the horses, it was tried without waiting for the evidence-based process to say it was OK.

Eleanor

Ghazzu
Feb. 19, 2010, 09:45 AM
One more time.
I have no problem with someone trying things that have not been already proven in a double-blind placebo controlled trial.
I have way more in common with you, Dr. Kellon, than with Dr. Ramey, for example.
I have several of your books, and have recommended them to people.

All I said was that I didn't believe Dr. Ralston was "attacking" you, and that not everything you recommend is the result of a rigorous scientific study.

Katy Watts
Feb. 19, 2010, 11:57 AM
And really, shouldn't vets be fighting on ecn or the aaep listserve, and not in public? :winkgrin:

I think it is important that the public realizes that criticism and debate are invited and considered an important part of the evolution of the science and practice of the art of medicine and nutrition. I have sat in on quite a few luncheon table discussions at veterinary and academic conferences, and lively debate is common and manages to stay on friendly terms. I openly criticize and correct some academics who have remained my best supporters, although it is better to do this in private and therefore allow the recipient to save face. This is why private review by anonymous people might be less intimidating, and less apt to stir up personal feelings and political grudges. We respect most of what each other says and writes, but it is not required to accept everything and still consider each other friends and colleagues. It may take years for our opinions to solidify on various topics.
The give and take between experts in the same field is imperative to the acquisition of the truth.
Katy

deltawave
Feb. 19, 2010, 12:29 PM
Data have no feelings or emotions. :)

sdlbredfan
Feb. 19, 2010, 02:59 PM
Here is something enlightening, note the bold faced parts added by me to make sure you don't miss them. This is a horse owned by someone who decided not to follow Dr. Kellon's nutritional protocols but instead decided to consult with Dr. Ralston. (Note that the EC list nutritional protocols are proven by thousands of horses owned by Equine Cushings list members, whose improved lab values showed clearly and repeatedly that the nutritional advice provided therein works.)
See http://pets.groups.yahoo.com/group/EquineCushings/message/135652
The message (without poster's identity) is as follows:
Fair question. Despite all the changes I made in Toby's diet, Toby became very lame, especially in all his legs. I brought him to New Bolton to check if this was all from EPM and\or any potential neurological issues, as I believed that I had the Cushings in check. I was requested Dr. Jill Beech because of her background in Cushings to spearhead his review. That is how I received the information on the pergolide and feed. Dr. Beech brought in Dr. Zedler to
consult on his lameness. Based on the overall diagnosis and the fact that these doctors were able to look at the horse in question as well as talk to my vet who has been working on Toby for the past 3 years, we made some changes. Dr. Sarah Ralston from Rutgers made the feed change, Dr. Beech the Pergolide change and Dr. Zedler the evaluation of Toby's limbs.
(anyone who wants to see results, peruse that EC list on yahoogroups.com)

Sarah Ralston
Feb. 19, 2010, 03:18 PM
I apologize to Dr. Kellon. My remarks were not intended to slander anyone. I did not say she was not knowledgeable-only that she did not have formal nutritional training. And as others have pointed out that in and of itself does not mean you can not seek out knowledge on your own and come up with good results.

Melyni
Feb. 19, 2010, 03:46 PM
is the ability and opportunity to put your views to an educated audience who can then discuss the various theories you have come up with in an educated and intelligent manner. This is what makes attendance at the various scientific meeting so important. It's no where near as good to just read the published papers afterwards.

Some of the most important points come up in the discussion that follows the presentation of a paper. This is why attendance at the meetings and the ability to listen to the author, ask questions and listen to the answers is far far superior to just cruising the publications on the net.

Honeing your thoughts and theories against the ideas and input of others is much better than any amount of reading published papers. You cannot become a bona fide expert if you never put your ideas and learning to the test of other scientists opinions and input. Staying home and never venturing out to the world gives a warped view of the universe and can lead to you to erroneous thinking.

So scientists who really care, do attend the meetings and join in discussions and listen to the input of others even those who don't agree with them.
Not all experts in any field necessarily agree on all the details, and that is part of how our knowledge progresses.
But the ability to openly discuss your ideas with your peers is a vital part of any scientific inquiry or proposition of a theory.

It's hard for lay folk to understand sometimes that scientists do not necessarily agree on everything, and that just because they don't agree on some point does not mean that one view point is totally wrong nor the other totally right.
YMMV.
JMHO.
MW

sdlbredfan
Feb. 19, 2010, 03:48 PM
I apologize to Dr. Kellon. My remarks were not intended to slander anyone. I did not say she was not knowledgeable-only that she did not have formal nutritional training. And as others have pointed out that in and of itself does not mean you can not seek out knowledge on your own and come up with good results.

Good job, I am glad you added this!

Sarah Ralston
Feb. 19, 2010, 03:49 PM
According to Dr. Ralston's info on the Rutgers site, her PhD is in anatomy, not anything to do with nutrition. See http://www.esc.rutgers.edu/faculty_info/ralston/ralston_cv.htm and
http://www.vet.upenn.edu/Research/ResearchTrainingOpportunities/TheVMDPhDProgramatPenn/OurAlumni/DrRalston/tabid/1419/Default.aspx and (referencing the 'The recipient of a Ph.D. from the University of Pennsylvania in 1982, Dr. Ralston...') comment.

Yep, the only department that would let me study Horse Behavior when I was doing my PhD in combination with my veterinary degree was the Anatomy Department. My PhD thesis was on Factors in the Control of Feed Intake in Horses. I did not consider myself to be a nutritionist at that point in time-I was behavior/GI Physiology oriented. But long story shortened-I was hired by CSU to teach Clinical Nutrition at their vet School in 1984. I really was not qualified for the position but CSU needed more women on their faculty :winkgrin:. I spent the next 6 years studying as hard as I could (taking courses, going to nutrition rounds in human hospitals, attending conferences such as the American Association of Animal Science and Equine Society) and consulting true nutrition specialists like Dr. Ginger Rich (Who, by the way is still a a private practicing Equine Nutritionist) and Dr. Cheryl Nockels (the most incredible nutritionist I have had the honor of meeting-now retired), both of whom were on the faculty in Animal Science at that time. When the American College of Veterinary Nutrition was formed in 1989 I was recognized as potentially qualified but they required 7 years of experience to be "grandfathered in" and I only had 6. So I had to submit a full application (3 peer reviewed, published papers and 4 case studies) and take the all day long exam (3 sections, covering all species) to be come board certified. It is a bit snobby, I admit, but the American Board of Veterinary Specialists (which oversees all the veterinary specialties including surgery, internal medicine, etc) maintains a veterinarian should not advertise themselves as a specialist unless board certified. Similarly if someone says they are an "Equine Nutritionist" it implies they have at least had formal, advanced training like a Masters or PhD from a research group known for it's nutrition research.

I have been accused of being "whacky" too-for insisting repeatedly at scientific meeting in the USA and Europe that people should be looking at insulin in horses in the '80's. I was told by the President of the British Equine Vet Association, Leo Jeffcott, who was chairing a session in an international meeting in England, where I once again asked a presenter of a study if he had measured blood insulin in a study of osteochondrosis in horses, to "Shut up and sit down-everyone knows insulin concentrations in horses are too variable to mean anything" (I actually am now beginning to agree with him!:lol:). I met Katy Watts a few years later and she really opened my eyes to the importance of the grasses-we don't agree on some things but she knows I highly respect her despite her lack of multiple letters after her name,
as I do Dr. Kellon, who, as I said before, does also have some good ideas. I think she will agree with my original contention that she is not a "trained" nutritionist nor board certified.

mp
Feb. 19, 2010, 03:52 PM
And really, shouldn't vets be fighting on ecn or the aaep listserve, and not in public? :winkgrin:

I only see one vet who took offense at what was posted. And one non-vet (I presume) [edit] who seems to have an axe to grind.

ETA to add

high road always the best road....

Oh, the irony.

buck22
Feb. 19, 2010, 06:02 PM
^ indeed. :yes:

Sarah Ralston
Feb. 19, 2010, 07:35 PM
I got all excited and went to Dr. Ralston's site as well. There is certainly no usuable free nutrition advice there. I went to the FAQ and they were so simple as to be laughable. I've used two company-paid nutritionists and they were useless. I have fabulous hay and I feed it almost free choice. I have it analyzed, but I can't get a proper mineral analysis done (does ANYONE do this????) ?

The Equine Science Center site I referenced (www.esc.rutgers.edu) is not "my" site-I am only one of their participating specialists. If you put in "nutrition" in their search engine I think some of the "fact Sheets" (that are peer reviewed) might be useful to some. I can see how free, uncomplicated, science based, unbiased recommendations can be highly suspect.

A lot of the "company paid" nutritionists are just that-trained by the company but the PhD's usually have some training. I mentioned two already I highly respect-Dr. Don Kapper and Dr. MaryBeth Gordon.

What do you consider a proper mineral analysis? Most companies will do the Macro minerals-Calcium, Phosphorus, Magnesium, Sodium, Chloride and trace minerals for which we have good science and for the trace minerals, IN OTHER SPECIES-not horses: copper, zinc, iron, cobalt. Chromium is NOT a recognized major issue and therefore commonly available.

Mary in Area 1
Feb. 20, 2010, 12:31 AM
Sorry I didn't see any search engine on that site. I went to the "Ask the Experts" section which you referenced and found it very simplistic.

"I can see how free, uncomplicated, science based, unbiased recommendations can be highly suspect."--I don't understand this comment. I don't find this type of information suspect at all! That is the type of info I am searching for. Is that a typo?

What I am looking for is the following: a better way to figure calorie needs rather than going by weight and hours worked. I don't think this is useful for sport horses who might work only 40 minutes in upper-level dressage, but the intensity is high. I also don't think the NSC guidelines help with horses with very different metabolisms, i.e. draft crosses vs. OTTB's. I've read that mineral needs don't change that much, but so SOME and how can we know?

I am specifically concerned about Vitamin E and Selenium. I have always supplemented my horses with this combination, but I keep having horses whose blood levels show VERY low Vitamin E and their behavior suggests it. I have only been able to increase the levels with natural vitamin E, but few make it, and no one I know makes it with Selenium. I also can't seem to convince Dairy One to give me an analysis of my hay containing info on Vitamin E and Selenium. I know Vit E disappears quickly, and I know my area is generally Selenium deficient, but I want to REALLY know the numbers, and I can't get them.

I want to know why grain companies supplement their grain to be sufficient only if fed in HUGE QUANTITIES, when that is NOT in the best interests of the horses. (Yeah, I know WHY=$, but it seems unethical). Also, why ration balancers don't really balance everything, and what you should do. These are the types of questions I have that I wish were in someone's "Ask the Experts" site, not whether oats is a good food.

Frizzle
Feb. 20, 2010, 12:41 AM
Just wanted to chime in about minerals. I've been poking around on info about balancing minerals, and have found that, since the combination of your horse's particular hay/grass/grain will produce shortages/overabundances/balance of different minerals. So, if you just give them a mineral supplement, you could be oversupplementing certain minerals and undersupplementing others.
Here are the choices I have found -- either have your horse's hair analyzed for mineral content and then have a custom mineral supplement made (like at http://www.uckeleequinenutrition.com/). or, you can give them separate free-choice minerals and let them self-supplement. You can get them here -- www.a-b-c-plus.com

FatPalomino
Feb. 20, 2010, 03:30 AM
Dr. Ralston,
Your bio is amazing. I only hope one day I can have half of the credentials you have (a long term goal of mine is board certification....). Thank you for sharing!

(And from a NJ'ian who packed up and moved just north of Fort Collins- you were surely dedicated to your field to do the move in the opposite direction!)

Eleanor M Kellon, VMD
Feb. 20, 2010, 06:32 AM
from that:

Regarding the chapter on feeding IR horse in equine podiatry: do you consider this peer reviewed in that Dr. Floyd and Dr. Mannsman are both veterinarians, and therefore your peers? Or is this chapter peer reviewed by other experts in feeding IR horses, such as Drs. Ray Goer or Pat Harris?

Do you discuss pasture management, testing of CHO in forage in this chapter? If so, did you seek review by an appropriate expert in plant carbohydrates?

Dr. Floyd asked me to author this chapter in their Eq Pod book, but I declined as the payment was 5 copies of the book and I cannot afford to spend any more time on pro bono work. .......I would not have considered this peer reviewed if I had decided to do it for reasons of gaining prestige. Dr. Floyd did not ask me to review your work. The online reviews at the book sellers say its mostly about feet. ............ Has anyone here read it so we might discuss specific advice given?
Katy

You can read the book on line, although for obvious reasons many pages and illustrations are omitted:

<http://books.google.com/books?id=Ie4c7dZwT7wC&printsec=frontcover&dq=Floyd+%22equine+podiatry%22+book&source=bl&ots=Fokb-wjtDn&sig=rWdnBAMXnliJm8NYmUY6pmDf-0A&hl=en&ei=AMJ_S7GHNcGQtgfN75DUBg&sa=X&oi=book_result&ct=result&resnum=10&ved=0CCoQ6AEwCQ#v=onepage&q=kellon&f=false>

You have to understand that books are often written a year or more before they actually reach the shelves, and in a book like this written by busy people, there are always delays. My part was actually written no later than 2005, and release was originally planned for 2006. The IR content is virtually identical to what appeared in the Compendium of Continuing Education article.

Contribution is not for prestige, it's a professional courtesy. Drs. the likes of William Bowker, Sue Dyson, Chris Pollitt and Jim Rooney don't need any more prestige. Textbook contributors are always "paid" with book copies. It's standard practice.

I don't know what Dr. Floyd asked you to do, but it wouldn't have been this chapter. It covers all medical causes of laminitis, not just IR.

At the time of writing, there were no experts in feeding IR horses, let alone spontaneously IR horses outside of experimental conditions. The only advice was get the weight off them and don't feed grain. In fact, at the time, the Virginia Polytechnic group was still loudly challenging the idea that there was an equine metabolic syndrome and criticizing Dr. Johnson. The Equine Cushing's group was the largest clinical database of natural cases available. It still is.

Nothing in there about testing pasture, only hay NSC (the "old" WSC + starch standard).

Eleanor

Eleanor M Kellon, VMD
Feb. 20, 2010, 07:13 AM
[QUOTE=Mary in Area 1;4699265]

What I am looking for is the following: a better way to figure calorie needs rather than going by weight and hours worked. I don't think this is useful for sport horses who might work only 40 minutes in upper-level dressage, but the intensity is high. I also don't think the NSC guidelines help with horses with very different metabolisms, i.e. draft crosses vs. OTTB's. I've read that mineral needs don't change that much, but so SOME and how can we know?

I am specifically concerned about Vitamin E and Selenium.

=================

One better way to estimate calories for working horses is by heart rate. The 2007 NRC does a pretty good job of explaining this (chapter 1, energy):

<http://books.google.com/books?id=GZOHSncnWr4C&pg=PR7&dq=nutrient+requirements+of+horses+sixth+revised+e dition&ei=ys5_S_j-AZT0ygSutb3BCw&cd=1#v=onepage&q=nutrient%20requirements%20of%20horses%20sixth%20 revised%20edition&f=false>

If you are using powdered vitamin E, that might be the problem. Try mixing it into a little oil before adding it. E needs to "find" fat in the intestine before it can be absorbed. Selenium is more reliably absorbed in the yeast form. Whole blood selenium is your best test of status.

As for balancing, you need hay analysis or at least regional figures. From there, you can balance to your true needs. Many people end up having a custom mineral mix made for them, but you can sometimes find commercial supplements that are a good fit. For example, if you balance your major minerals using whole foods, check out hoof supplements to correct your traces (except iodine and selenium). Forage in most areas of the country is high in manganese and iron, low to deficient in copper and zinc. Hays grown on alkaline soils tend to be closer to balanced and would be more suitable for the "balancer" products.

BTW, even well fortified and formulated grains usually only provide 50% of the horse's mineral needs when fed at full recommended amount. You just can't get the job done when ignoring the forage.

Eleanor

Eleanor M Kellon, VMD
Feb. 20, 2010, 07:18 AM
[QUOTE=Mary in Area 1;4699265]

I also can't seem to convince Dairy One to give my an analysis of my hay containing info on Vitamin E and Selenium. I know Vit E disappears quickly, and I know my area is generally Selenium deficient, but I want to REALLY know the numbers, and I can't get them.

There's a $35 extra charge to do selenium:

<http://www.equi-analytical.com/Services/Analytical%20services.htm>

E is too low to both measuring.

Eleanor

deltawave
Feb. 20, 2010, 07:58 AM
either have your horse's hair analyzed for mineral content and then have a custom mineral supplement made (like at http://www.uckeleequinenutrition.com/). or, you can give them separate free-choice minerals and let them self-supplementExcept that hair analysis is so poorly validated that you may as well flip a coin or throw darts at the periodic table, and horses are really, really stupid about choosing to eat things that are good or bad for them.

Katy Watts
Feb. 20, 2010, 08:28 AM
The Equine Cushing's group was the largest clinical database of natural cases available. It still is.


clin·i·cal
adj.
1. Of, relating to, or connected with a clinic.
2. Involving or based on direct observation of the patient: a clinical diagnosis.
3. Very objective and devoid of emotion; analytical: "He spoke in the clipped, clinical monotones typical of police testimony in court" (Connie Paige).
4. Suggestive of a medical clinic; austere and antiseptic:

What clinic are you associated with? How can an internet chat room be considered a 'clinic'? Do you define 'clinical' differently than any of the above?

I am dismayed that you used NSC and NFC interchangeably on page 374. Many of us are having a very hard time educating people that they are very, very different.

I too, agree that you have helped a lot of horses by getting the basic information that too much sugar is bad for some horses. But there is also incorrect, unsubstantiated information being distributed by your Yahoo group, all couched in the same language you have presented here that indicates you do hands on research in a clinical setting. This is misleading, and I think needs to be corrected as anecdotal rather than clinical. There is a big difference. The website for PA state licensing says you have not practiced veterinary medicine in 20 years. In the case histories cited in your article, how can you legally recommend changing a horses RX medication?
Katy

Eleanor M Kellon, VMD
Feb. 20, 2010, 10:47 AM
clin·i·cal
adj.

What clinic are you associated with? How can an internet chat room be considered a 'clinic'? Do you define 'clinical' differently than any of the above?

I am dismayed that you used NSC and NFC interchangeably on page 374. Many of us are having a very hard time educating people that they are very, very different.

I too, agree that you have helped a lot of horses by getting the basic information that too much sugar is bad for some horses. But there is also incorrect, unsubstantiated information being distributed by your Yahoo group, all couched in the same language you have presented here that indicates you do hands on research in a clinical setting. This is misleading, and I think needs to be corrected as anecdotal rather than clinical. There is a big difference. The website for PA state licensing says you have not practiced veterinary medicine in 20 years. In the case histories cited in your article, how can you legally recommend changing a horses RX medication?
Katy

I said clinical database. You know perfectly well what the EC group is. The case histories, submitted by owners, contain basic breed, sex, age data, symptoms, laboratory data, treatments and response over time. That is a clinical database.

Read more carefully, including the definitions box on page 375. NFC and NSC are not used interchangeably. Six years ago many people were still using labs that only offered NFC.

I have never said I did research in a clinical setting, or implied it. I left private practice after the birth of my fourth child and have been writing and consulting since then. Consultants give opinions and recommendations - it's the attending that does prescribing.

Just what incorrect, unsubtantiated information is being distributed by EC?

Eleanor

deltawave
Feb. 20, 2010, 11:27 AM
The problem I see with the yahoo group is that it is heavy on subjective and light on hard, cold data. Maybe that is a misperception; I find it hard to spend a lot of time there because it is often so . . . "out there". Putting a database together is a worthy endeavor, but unless the data being entered are clean, hard, and unassailably accurate, not to mention able to be validated, the adage "crap in/crap out" starts to apply almost immediately. A lab value is easy. A layperson's subjective assessment of response to a given therapy is really, really hard.

Katy Watts
Feb. 20, 2010, 12:07 PM
That is a clinical database.

Some of us will respectfully disagree. Data collected, handled, and analyzed by a single clinician, using the same protocols has more validity than when individual horse owners submit numbers from various labs, using different techniques and making their own observations on response.



Read more carefully, including the definitions box on page 375. NFC and NSC are not used interchangeably.

page 375 is not available. They are used interchangeably in page 374.



Just what incorrect, unsubtantiated information is being distributed by EC?


From the Yahoo group, and your new website:
http://www.ecirhorse.com/index.php?option=com_content&view=article&id=11&Itemid=18
This IR calculator
http://www.freil.com/~mlf/IR/ir.html
is based on one, outdated paper that has been superseded by new studies, presented at meetings the last few years. This article, an interview with the leading university researchers, contains their more recent opinions on how to diagnose IR in horses. http://www.thehorse.com/ViewArticle.aspx?ID=12588
At the Eq Sci Soc meeting last May, which I attended, all the researchers agreed that diagnosing IR is difficult, sometimes requiring multiple baseline and dynamic testing. This was also the opinion at the AAEP laminitis researchers workshop, which I also attended. Dr. Ralston is right, insulin and glucose is so variable in individual horses that a single blood draw is not always useful. Dr. Stanier told the audience at ESS that many of the studies in the past and being presented were not statistically valid because of the low number of individuals in the study and recent finding of very high variation in individuals from one day to the next, under controlled conditions. None of the many speakers on IR at conferences gave any credibility to using any ratios, RISQI,or MIRG to diagnose IR. The authors of the original study, when asked in person, no longer consider that those methods as definitive for diagnostic purposes. They say that your preferred method for diagnosis would make about half the horses in existence IR.
Katy

Mary in Area 1
Feb. 20, 2010, 12:57 PM
Dr. Kellon: "Many people end up having a custom mineral mix made for them"

Where do you have this done? I grow all my own hay from my own 110 acres. I would LOVE to do this. Anyone know?

FatPalomino
Feb. 20, 2010, 01:21 PM
The website for PA state licensing says you have not practiced veterinary medicine in 20 years. In the case histories cited in your article, how can you legally recommend changing a horses RX medication?
Katy

Katy,
You brought up a very good point. In everything I've read, it's also required to have a valid patient client relationship to treat, which includes physical examination, not through the telephone or internet.

ASB Stars
Feb. 20, 2010, 01:23 PM
To this day, my personal feeling is that there are a number of different issues/diseases/disorders that horses can have, that the current testing parameters are simply not able to accurately assess on an individual basis.

Examples? IR, and EPM. If you treat the horse-- assuming you do this *correctly*-- and they improve, voila! They MUST have this________ fill in the blank.

I have learned a tremendous amount, solely for the purpose of taking better care of my own horses, from Katy Watts, and from Eleanor Kellon, along with a laundry list of others. Sometimes, you learn what you do NOT want to do-- as well as how to move forward, proactively, as your horses advocate, simply by reviewing all of the information before you, and thus making an informed decision.

The EC list has people giving advise and recommendations, as representatives of Dr. Kellon, on a routine basis. These well intended folks are simply repeating what it is that has been imbued upon them. I am unaware as to their qualifications, professionally. While, without question, the group can be deeply caring, especially to those who come in without any knowledge at all, and who are willing to do whatever they are asked/told to do, the idea of questioning what is accepted by the group as "dogma" can get you in deep doo-doo, rather quickly. While Dr. Kellons anecdotal evidence is accepted as unimpeachable, the mere suggestion that anyone else has done research that can be brought to the table is generally attacked.

Given the fact that there is virtually no funding to provide any serious studies of metabolic issues, the idea of having a database where the testing is paid for by the horse owners is a marvelous notion. The fact that Dr. Kellon offers her advice quid pro quo for the owners who supply the requested tests is laudable. But, I do agree that you have to question the real value of such a mish-mash of data, obtained hither and yon, in the grand scheme of things. Still in all, Dr. Kellon does have access to something that others do not have the use of-- questionable as it may be.

I believe, truly, that metabolic issues are rampant in horses of many breeds, and that we are only just recently coming to grips with the damage that has been done, and continues to be done, with feeding the crap that most feed mills put out. Trainers across the country have come up believing that grabbing a bag of sweet feed for their horses is the way to go, but then, obesity in Americans is at an all time high, as well. Correlation? You decide :lol:

Hopefully, we all continue to study and learn from the folks posting here, and elsewhere, and get a handle on all of this, for the benefit of our steeds.

deltawave
Feb. 20, 2010, 01:28 PM
Trainers across the country have come up believing that grabbing a bag of sweet feed for their horses is the way to go

I grew up this way as well, but can honestly say that other than some Omolene for a pregnant mare who was on a hunger strike, I have never once in the last 20 years bought anything resembling "sweet feed". I don't think we can blame that mentality any more in totality. Maybe there are a whole bunch of people out there feeding the stuff, but I can't imagine it's nearly as much as in the past. I don't know--would love to see some statistics on the most popular types of feed sold.

I blame inactivity more than diet. Just like in people. :)

sdlbredfan
Feb. 20, 2010, 02:42 PM
Well said, Stars! (the 'I believe, truly, that metabolic issues are rampant in horses of many breeds, and that we are only just recently coming to grips with the damage that has been done, and continues to be done, with feeding the crap that most feed mills put out').

One of the things I have seen often in the EC list, which I have remained in even without having an IR or Cushinoid horse at the moment for the sake of learning from it, is that Dr. Kellon is careful to point out to people that they must get their attending Vets involved and that only the attending Vets can prescribe. The data accumulated in EC list files can be and often is shared with those attendings, if the owners perceive a need. Many times I have read that attending Vets have appreciated having some of these extra tools to put into their 'toolboxes' and many horses have thereby benefitted. Knowledge is always useful; the extent of use to which it is put will vary of course.

Daydream Believer
Feb. 20, 2010, 04:00 PM
Dr. Kellon: "Many people end up having a custom mineral mix made for them"

Where do you have this done? I grow all my own hay from my own 110 acres. I would LOVE to do this. Anyone know?

Both Uckele and Horsetech offer this service. I do it myself after what I've learned on the NRC grads group (the course taught by Dr. Kellon)...which saves even more. It is not overly expensive to have it done by Uckele at least who bid doing it for me once but I had a pretty big order.

Daydream Believer
Feb. 20, 2010, 04:09 PM
I believe, truly, that metabolic issues are rampant in horses of many breeds, and that we are only just recently coming to grips with the damage that has been done, and continues to be done, with feeding the crap that most feed mills put out.

It's true...so true....and it's not just sugar/starch that can cause issues. A great example is the recent poll and discussion on soy meal on here and the problems many of us have seen in our own horses. Anecdotal and not real scientific? For certain...but lacking studies, what else do we have to go on?

ASB Stars
Feb. 20, 2010, 04:27 PM
That was my point with the mention of testing for EPM and IR. You simply are better off, IMHO, treating, if you feel that you know what you are dealing with, because hard data is so damn elusive.

I had a gelding present with every indication of EPM ten years ago. The testing, particularly at that time, was a joke. I elected to treat him- even though we ended up having to import the drugs from Canada. It was my wallet- not the horse- that suffered. And he is still with me. :winkgrin: The drug we used was stated to have no adverse affects on mamalian tissue- so we went for it. My Vet- who initially wanted to do a spinal, got on board.

We end up feeling our way through so much of this stuff.

Eleanor M Kellon, VMD
Feb. 21, 2010, 05:40 AM
The problem I see with the yahoo group is that it is heavy on subjective and light on hard, cold data. Maybe that is a misperception; I find it hard to spend a lot of time there because it is often so . . . "out there". Putting a database together is a worthy endeavor, but unless the data being entered are clean, hard, and unassailably accurate, not to mention able to be validated, the adage "crap in/crap out" starts to apply almost immediately. A lab value is easy. A layperson's subjective assessment of response to a given therapy is really, really hard.

Agree. All members are strongly encouraged to get a proper diagnosis as a first step, put up a case history with diet and symptom details and do follow up blood work to document progress objectively. More lurk than actually do it, but we try! The EC group has about 2000 (could be more) case histories, currently housed on 3 separate sites.

Eleanor

Eleanor M Kellon, VMD
Feb. 21, 2010, 05:47 AM
[QUOTE=Katy Watts;4699760]Some of us will respectfully disagree. Data collected, handled, and analyzed by a single clinician, using the same protocols has more validity than when individual horse owners submit numbers from various labs, using different techniques and making their own observations on response.

Of course it is, but that's not the real world. Even those differences can be useful to owners. For example, by comparing split blood draws from the same horse, handled identically, we've confirmed that BET insulins run significantly higher than Cornell. That had been suspected for a long time when members had repeated testing through Cornell, but from a different draw.

Eleanor

Eleanor M Kellon, VMD
Feb. 21, 2010, 05:48 AM
[QUOTE=Katy Watts;4699760]

page 375 is not available. They are used interchangeably in page 374.


Read it again. There is a different threshold used for NFC vs NSC.

Eleanor

Eleanor M Kellon, VMD
Feb. 21, 2010, 06:37 AM
From the Yahoo group, and your new website:
http://www.ecirhorse.com/index.php?option=com_content&view=article&id=11&Itemid=18
This IR calculator
http://www.freil.com/~mlf/IR/ir.html
is based on one, outdated paper that has been superseded by new studies, presented at meetings the last few years. This article, an interview with the leading university researchers, contains their more recent opinions on how to diagnose IR in horses. http://www.thehorse.com/ViewArticle.aspx?ID=12588
At the Eq Sci Soc meeting last May, which I attended, all the researchers agreed that diagnosing IR is difficult, sometimes requiring multiple baseline and dynamic testing. This was also the opinion at the AAEP laminitis researchers workshop, which I also attended. Dr. Ralston is right, insulin and glucose is so variable in individual horses that a single blood draw is not always useful. Dr. Stanier told the audience at ESS that many of the studies in the past and being presented were not statistically valid because of the low number of individuals in the study and recent finding of very high variation in individuals from one day to the next, under controlled conditions. None of the many speakers on IR at conferences gave any credibility to using any ratios, RISQI,or MIRG to diagnose IR. The authors of the original study, when asked in person, no longer consider that those methods as definitive for diagnostic purposes. They say that your preferred method for diagnosis would make about half the horses in existence IR.
Katy

Those same arguments have been around both before and after the pony study. They are referring to a 100% sensitivity and specificity diagnosis. That's impossible in the field. There's also an element here, inevitably, of competition between groups as to whose method is most accurate.

The vast majority of IR horses have an insulin clearly out of the grey zone given there of over 30 uIU (if Cornell testing) at the time of diagnosis. What to do about the horses in the grey zone depends on where you are "coming from". If you are in academia, you will reject the diagnosis because of insufficient evidence on statistical grounds. If you are trying to prevent a horse from ever having laminitis again, you will go better safe than sorry and manage that animal as an IR horse.

It's simply not true that half the horses in existence would be classified IR using the proxies. There are more false negatives than false positives with the proxies. This was consistent across three studies, using multiple breeds, both controlled and field conditions.

The proxies are not perfect, but they are the best option out there. No other easy, economical tests have been validated in the same way under both controlled and field conditions. Good points made on testing conditions, which is precisely why the EC group recommends testing under conditions that duplicate those used in developing the proxies - early morning testing, no fasting, constant access to hay. In fact, many initial tests are done after instituting the emergency diet which calls for only known low NSC hay or soaked hay and follow up tests are done on low NSC diets, further increasing the odds that grey zone results are significant. Instruction sheets on sample handling are also available, calling for sample chilling including in transport, rapid processing to avoid glucose loss, overnight delivery to the lab. The calculator uses both G:I and RISQI in any case, as a double check against inaccurate glucose.

Again, it boils down to your focus. If you have a horse with a history of otherwise unexplained laminitis, or a horse with Cushing's diagnosis, and that horse tests in the "grey zone", are you going to play it safe or throw caution to the wind? There was only a 15% false positive rate in the original proxies study, using predominantly normal horses, and the pony study was 84.6% accurate in predicting which ponies were at risk of developing pasture laminitis. Considering what is at stake, those are numbers I can live with.

Eleanor

Eleanor M Kellon, VMD
Feb. 21, 2010, 06:42 AM
P.S. Regarding various labs. The EC group recommends testing through Cornell. If other labs are used and high insulins come back that don't match the clinical picture, retesting through Cornell is suggested.

Eleanor

Katy Watts
Feb. 21, 2010, 08:05 AM
The vast majority of IR horses have an insulin clearly out of the grey zone given there of over 30 uIU (if Cornell testing) at the time of diagnosis.
It's simply not true that half the horses in existence would be classified IR using the proxies.

IF I go here:
http://www.freil.com/~mlf/IR/ir.html
and put 50 in glucose, and 11 insulin, it says “compensated IR, laminitis risk”.
When using this calculator, insulin above 10 is diagnosed as IR. But here you say above 30. Might you send us to the place where these qualifying statements are discussed on your websites?

According to this calculator, recommended for diagnosis on your website, many horses with insulin over 10 would be considered IR. This is way below what university researchers consider a threshold for cautionary management.

Would you like to respond to Dr. Goer and Frank's opinion from this article?
http://www.thehorse.com/ViewArticle.aspx?ID=12588

Dr. Geor: For the reasons elaborated on by Dr. Frank, we do not use the glucose:insulin ratio for diagnosis of insulin resistance. Related to this question, there has been interest in the use of other proxy markers of insulin resistance based on measurements of glucose and insulin. The group at Virginia Tech developed proxy markers of insulin resistance (RISQI, calculated from blood insulin) and insulin secretory response (MIRG, modified insulin to glucose ratio) and used these to evaluate predisposition to laminitis in a herd of Welsh and Dartmoor ponies. Ponies with a history of laminitis were more insulin resistant as indicated by lower RISQI and higher MIRG compared with the ponies that were never laminitic. However, it must be stressed that the cutoff values used to separate the two groups should not be used for clinical diagnosis of insulin resistance in other populations of horses or ponies. For example, the RISQI cutoff represented an insulin value of 11-12 µU/mL--a value well below our clinically used cutoff for diagnosis of hyperinsulinemia.

Katy Watts
Feb. 21, 2010, 08:12 AM
Read it again. There is a different threshold used for NFC vs NSC.


Can you provide any data or a citation showing that NFC has any significance to IR horses? The biggest difference between NFC and NSC (WSC + starch) is pectin. No researchers at the conferences I have attended over the years, nor any research papers have ever suggested that pectin is a problem. Do you believe pectin has a metabolic effect in horses?

Eleanor M Kellon, VMD
Feb. 21, 2010, 11:15 AM
[QUOTE=Katy Watts;4701065]IF I go here:
http://www.freil.com/~mlf/IR/ir.html
and put 50 in glucose, and 11 insulin, it says “compensated IR, laminitis risk”.
When using this calculator, insulin above 10 is diagnosed as IR. But here you say above 30. Might you send us to the place where these qualifying statements are discussed on your websites?

We would never use a glucose of 50. That's obviously bad sample handling.

RISQI for the insulin of 11 is right on the borderline, would be cause for rejoicing.

I didn't say 30 was the cutoff, they did.

This has been discussed on the EC list before, but the search function isn't working very well. I can't retrieve it right now.

Eleanor

Katy Watts
Feb. 21, 2010, 12:01 PM
We would never use a glucose of 50. That's obviously bad sample handling.

RISQI for the insulin of 11 is right on the borderline, would be cause for rejoicing.

I didn't say 30 was the cutoff, they did.


Sorry, I misunderstood. OK, so use 90 for glucose, 11 for insulin. Your calculator still says 'compensated IR, laminitis risk', which one could interpret as not a case for rejoicing. What is your cutoff for determining IR and increased risk for laminitis? If you think 11 insulin is borderline, then it does seem that many 'normal' horses will be included. Everyone agrees that we all need to re-evaluate what normal means, but your definition is way below what university researchers agree on, being that insulin above 20 or 30 is worth retesting again and being cautious with management. You seem to disagree with Drs. Goer, Frank and Johnson on the definition of IR. Have you discussed this with them? Philip seemed surprised that they would go down to 20 as being suspicious.
I have often found that open discussion allows both parties to gain new valuable knowledge. I frequently change my mind, and sometimes they change their mind. It's an important part of the process of acquiring the best, current information.
If your database is the source of your expertise, might you share what percentage of horses with a history of laminitis have baseline insulin levels between 11 and 20? Perhaps this would be useful to the university researchers?
Have you compiled data regarding what % of horses react to NFC above 12%? Do you intend to publish any of the statistics in your database?

Eleanor M Kellon, VMD
Feb. 21, 2010, 12:46 PM
Would you like to respond to Dr. Goer and Frank's opinion from this article?
http://www.thehorse.com/ViewArticle.aspx?ID=12588

Dr. Geor: For the reasons elaborated on by Dr. Frank, we do not use the glucose:insulin ratio for diagnosis of insulin resistance. Related to this question, there has been interest in the use of other proxy markers of insulin resistance based on measurements of glucose and insulin. The group at Virginia Tech developed proxy markers of insulin resistance (RISQI, calculated from blood insulin) and insulin secretory response (MIRG, modified insulin to glucose ratio) and used these to evaluate predisposition to laminitis in a herd of Welsh and Dartmoor ponies. Ponies with a history of laminitis were more insulin resistant as indicated by lower RISQI and higher MIRG compared with the ponies that were never laminitic. However, it must be stressed that the cutoff values used to separate the two groups should not be used for clinical diagnosis of insulin resistance in other populations of horses or ponies. For example, the RISQI cutoff represented an insulin value of 11-12 µU/mL--a value well below our clinically used cutoff for diagnosis of hyperinsulinemia.

The reasons stated by Dr. Frank were all in reference to different methodologies, sampling and sample handling. As already explained, the EC group recommends a protocol that addresses all of those concerns. When testing methods, sample collection and sample handling duplicates those used in the Va field study, there is no reason to think there would be a population of horses or ponies that would be normal with higher insulins than those ponies on pasture.

The cutoff found between normal and prelaminitic metabolic syndrome in the field study is also entirely consistent with insulins reported in feeding trials done with non-IR prone breeds such as this one:

http://jas.fass.org/cgi/content/full/81/9/2333

where the insulin levels even in obese geldings were below 10 when tested after constant access to hay.

and here (page 52, page 78 - insulin at or below 10 in horses with documented abnormal FSIGT only once in the group allowed unlimited pasture, page 80 - insulin over 10 in the same horses only when grazing)

<http://etd.lsu.edu/docs/available/etd-04152004-095658/unrestricted/Cartmill_dis.pdf>

As University studies come to involve more naturally occuring IR horses, opinions may change. For example, Dr. Frank stated:

" Our studies have shown that the sugars in pasture forage can markedly impact blood insulin (and, to a lesser extent, glucose) levels, potentially leading to a false diagnosis of insulin resistance. This does not seem to be a problem when hay is fed, even when the nonstructural carbohydrate content is moderately high"

I don't think even you would agree that hay NSC is not important.

Eleanor

Eleanor M Kellon, VMD
Feb. 21, 2010, 01:08 PM
[QUOTE=Katy Watts;4701467]Sorry, I misunderstood. OK, so use 90 for glucose, 11 for insulin. Your calculator still says 'compensated IR, laminitis risk', which one could interpret as not a case for rejoicing. What is your cutoff for determining IR and increased risk for laminitis? If you think 11 insulin is borderline, then it does seem that many 'normal' horses will be included. Everyone agrees that we all need to re-evaluate what normal means, but your definition is way below what university researchers agree on, being that insulin above 20 or 30 is worth retesting again and being cautious with management. You seem to disagree with Drs. Goer, Frank and Johnson on the definition of IR. Have you discussed this with them? Philip seemed surprised that they would go down to 20 as being suspicious.

Nick has said more than once he'd like to discuss it! - but we haven't managed to be in the same place at the same time. Have had some e-mail conversations along the lines of what I just posted.

I think the conditions of the testing are very important here. If you are talking about testing horses "off the street" as it were, with no diet control, or reported results when you don't know the conditions of the testing (e.g., horse does not have continuous access to hay and was tested less than 4 hours after a morning feeding), the cutoff of above 20 for "suspicious" and warranting further (controlled) testing may be warranted. There is also the issue of how normal ranges were established. Unless the lab's normal range was also determined under controlled feeding conditions, we're comparing apples to oranges. The Va Tech field study was unique in that respect and there was a very clear distinction between the groups with absolutely no overlap between the ponies with no history of laminitis and those with prelaminitic metabolic syndrome (P < 0.001).

Eleanor

Eleanor M Kellon, VMD
Feb. 21, 2010, 01:25 PM
If your database is the source of your expertise, might you share what percentage of horses with a history of laminitis have baseline insulin levels between 11 and 20? Perhaps this would be useful to the university researchers?
Have you compiled data regarding what % of horses react to NFC above 12%? Do you intend to publish any of the statistics in your database?

Can't give you exact numbers off the top of my head, but before implementation of diet changes very few with full blown clinical laminitis would have an insulin below 20. When we have an insulin in the teens and a horse with severe laminitis it always makes me think Lyme.

Insulin between 11 and 20 is more frequently seen in horses with history of laminitis (and higher insulin) after diet changes have been made. We also have some that test completely normal after diet changes, especially if they can be exercised.

We moved away from NFC a long time ago.

I'd love to publish some information from the database but it is currently not searchable. We have one volunteer going through histories to pull out those with usable pre and post laboratory data but it's a slow process. We're also in negotiations to move to a platform that would allow searching. For now though, it's very time consuming to do and we're all volunteer.

To answer your other question about what constitutes high risk, most horses that are actively laminitic are well above the 30 mark although we do see horses that are still painful with insulins in the 20s. Complicating interpreting the significance of that is there may be trim issues. When insulins are dropping but the horse remains sore, we strongly recommend X-rays to check the trim.

Eleanor

Katy Watts
Feb. 21, 2010, 03:13 PM
I'd love to publish some information from the database but it is currently not searchable.

Definition: A database is an application that manages data and allows fast storage and retrieval of that data.

So, I'm beginning to get a the crux of why we have so much trouble communicating. We do not define terms the same. What you call your database, I would call a pile of un-compiled case histories.
How do you manage to come to any conclusions without the ability to do correlations, standard deviations, or any other statistical procedures? Are you also a mathematical savant? I know many times I have thought there was a trend in one of my field studies, but after days of plugging numbers and doing the statistics, I would be disappointed because there was so much inherent variability that nothing was statistically significant. Some studies just fall apart after proper statistical interpretation.

The whole reason for this thread was for you to give substantiation to the advice you are deriving from your robust database. If you are have not compiled any data, that is pretty much the definition of 'unsubstantiated', by my definition.
I'm sure you are a nice person, and have done a lot of good deeds, but you have no data in the sense that good science requires.
Katy

FatPalomino
Feb. 21, 2010, 03:43 PM
To answer your other question about what constitutes high risk, most horses that are actively laminitic are well above the 30 mark although we do see horses that are still painful with insulins in the 20s. Complicating interpreting the significance of that is there may be trim issues. When insulins are dropping but the horse remains sore, we strongly recommend X-rays to check the trim.

Now, per your words I am only a "wannabe", but, I have a few questions.

What's your thought on horses that may have laminitis that are not IR? Do they exist? I get the impression that someone who reads your posts and forum would come to the conclusion that laminitis is always caused by diet. In fact, I've had some lay people come to me and explain to me that this indeed was in fact the etiology of several foundered rescue horses we have take in- these lay people without any formal training also felt confidant diagnosing and reading radiographs. It was a bit scary to me, to say the least. Thankfully I have a amazing veterinarian who has a special interest in laminitis, and also who examined all of our rescued foundered horses, in which I consult with, as I certainly don't have all the answers and never will!

Is it your belief that diagnostic plans, treatment, and prognosis can be made solely on lab values, without looking at the horse?

Who is the we that is recommending a follow up plan?

You reference trims- does that mean that you are against shoes?

Just wondering.

Eleanor M Kellon, VMD
Feb. 22, 2010, 04:34 AM
[QUOTE=Katy Watts;4701771]

The whole reason for this thread was for you to give substantiation to the advice you are deriving from your robust database. If you are have not compiled any data, that is pretty much the definition of 'unsubstantiated', by my definition.

I spent considerable time yesterday explaining to you why the EC testing protocol is compatible with the use of the Va proxies and how the findings of that study are completely compatible with previously published insulin values in normal and abnormal horses. I don't need to reinvent the wheel. When you can come up with even one study that shows normal horses fed and tested as already described can run insulins of 20, let me know.

The only substantiation that really matters is whether the management advice produces real and lasting results. Anyone who wants to know about that should go to the EC list and ask. There's a reason we have over 8500 members and keep growing at a rate of 30 to 50 per week.

Eleanor

Eleanor M Kellon, VMD
Feb. 22, 2010, 04:45 AM
[QUOTE=FatPalomino;4701812].

What's your thought on horses that may have laminitis that are not IR? Do they exist? I get the impression that someone who reads your posts and forum would come to the conclusion that laminitis is always caused by diet. In fact, I've had some lay people come to me and explain to me that this indeed was in fact the etiology of several foundered rescue horses we have take in- these lay people without any formal training also felt confidant diagnosing and reading radiographs. It was a bit scary to me, to say the least. Thankfully I have a amazing veterinarian who has a special interest in laminitis, and also who examined all of our rescued foundered horses, in which I consult with, as I certainly don't have all the answers and never will!

Is it your belief that diagnostic plans, treatment, and prognosis can be made solely on lab values, without looking at the horse?

Who is the we that is recommending a follow up plan?

You reference trims- does that mean that you are against shoes?
=====================

There are many causes of laminitis besides IR, and mechanical causes of radiographic changes that may look like rotation or sinking. However, IR appears to be the leading cause of laminitis otherwise unexplained by grain overload, colitis, etc.

IR is a laboratory diagnosis. It can't be diagnosed simply by looking at the horse. That said, every case should be thoroughly evaluated from all angles. A horse could have IR and laminitis for a reason other than the IR. A horse can have IR and radiographic changes caused by poor hoof care rather than the IR.

"We" is the collective experience of thousands of owners of horses with these issues.

No, I'm not against shoes. Not against barefoot either. Whether bare or shod, success depends on a trim that correctly aligns the hoof wall with the bones inside it.

Eleanor

ASB Stars
Feb. 22, 2010, 07:30 AM
The only substantiation that really matters is whether the management advice produces real and lasting results. Anyone who wants to know about that should go to the EC list and ask. There's a reason we have over 8500 members and keep growing at a rate of 30 to 50 per week.

Eleanor

I think that this is a bit disingenuous, as well as arrogant.

Metabolic issues are growing at an epidemic rate- and caring horse owners will reach out for any information that they can. Obviously, the internet is the best source, and the EC list is the most prominent.

I still find it troubling that you have people- well intended as they may be-- who have no credentials, other than your blessing, giving out information to that group. They use the parameters that you have designed and blessed, but, this doesn't change the fact that they are essentially prescribing treatment without the benefit of a degree, or licensure.

Your default position is, no doubt, that you do recommend that these people test, and have their Vet involved. You attempt to ensure this by requiring bloodwork, and case history, to fill your database with. This still does not change the foregoing points.

In the absence of any other real resource, and given the stress that these people are feeling, in attempting to help their horses, the EC list does draw a huge crowd.

I hope that there comes a time when real funding can provide real and accurate direction, from carefully executed research.

Melyni
Feb. 22, 2010, 07:55 AM
The huge variation in insulin levels means that unless you do a clamp, and frequently sampled test protocol you really don't know what the insulin level signifies i any one horse.

Testing the Hb-1A level to see the actual degree of glycosation that is going on, would so much more helpful.
Sadly horse hemaglobin will not cross react with the standard Human kits, so you would need a packed column chromatograph.

The machine costs about $20k, there are some around in various research labs, it would be such a useful study to do, just to get a picture of the normal rate of glycosation in the horse.

Anyone know anyone working in a lab with one of these which could be used in a study?

I'd be glad to supply some test horses.

MW

Katy Watts
Feb. 22, 2010, 08:36 AM
When you can come up with even one study that shows normal horses fed and tested as already described can run insulins of 20, let me know.


Presented at Eq. Sc. Soc meeting, May 2010 with short abstract here:

Glycemic/insulemic Response to Feeding Hay with Different Water Soluble Carbohydrate Content in Healthy and Polysaccharide Storage Myopathy-affected Horses
Pages 355-357
L. Borgia, S. Valberg, K. Watts, J. Pagan

This is after feeding .05% BW hay to control horses with WSC content of 9.8%, ESC of 8.9%
19.1 ± 5.3 peak insulin in control horses
120.0 ± 17.3 minutes to peak
Even on the low sugar hay (they came and got some of the hay I feed my own ponies), (4.0 WSC and 1.3 ESC) the control horses insulin was 17.7 ± 5.5 111 minutes after feeding. For those of you inexperienced in scientific nomenclature, the +/- sign indicates the range outside the average.

The control horses in this study would be considered “compensated IR, laminitis risk” by your IR calculator. These are all healthy horses kept in a dry lot.

The full paper has been submitted but is not published yet. It’s often several years from the conduct of a study to the time it gets through peer review and publication. This is why those of us who strive to have the most up to date information attend conferences, where the authors can verbally report without causing problems with prior publication. The busy researchers also have time to chat over meals and during coffee breaks, and I find those discussions most helpful.

sdlbredfan
Feb. 22, 2010, 09:37 AM
I just noticed something odd about the above. Wrt '19.1 ± 5.3 peak insulin in control horses' - the unit of measurement of the insulin is not given. Different labs use different ones, some requiring conversion to another measure in order to use the G/I calculation formula.

One other thing I have found very odd in the posts from KW, is that she only references equine studies. That is sort of like being a one trick pony. There is a lot of data in human medical research that appears to have extrapolation to equids. (Both humans and horses are mammals, after all.)

deltawave
Feb. 22, 2010, 09:40 AM
I've often wondered why glycosylated hemoglobin/A1c wasn't used for horses. Didn't know it was a technical/assay problem. I can't recall, but I thought there was another reason as well. :confused:

I've never ordered an insulin level in my life, except in people suspected of surreptitious self-dosing to produce seizures, etc. :dead: I don't manage diabetes directly any more, but we have so many better ways of assessing it.

KelWin86
Feb. 22, 2010, 10:30 AM
I think the original point of this post was to try to find well qualified help with nutrition-related questions... I'll be honest I did not read all of the responses- just skimmed.. I just wanted to put in my plug for University Extension specialists. Someone else mentioned that a good place to look was your state's land grant university. This is the PERFECT place to look. Several land grant universities will have at least an animal nutritionist you can talk to, if not an equine nutritionist. If they are an extension specialist their whole job is to help you with your questions! Most of the other equine faculty, even if not their actual appointment, are also happy to help answer producer's questions.

I am just giving my props to the extension system... current grad student in equine nutrition at Texas A&M. I think too many people are self-proclaimed experts, so going with a University is a good way to get advice from an actual "professional." These people will have lots of continued education on the subject and probably published research too. Unfortunately most vet school programs do not get into much detail on specifically equine nutrition - they have a TON of information to cover in a limited amount of time - so a PhD in nutrition gets you someone who spent several years specifically studying nutrition.

Just my opinion! :)

Eleanor M Kellon, VMD
Feb. 22, 2010, 11:33 AM
[QUOTE=ASB Stars;4702903]I think that this is a bit disingenuous, as well as arrogant.

It's only meant to be descriptive. The EC list isn't about me. It's about sharing both published information and individual responses to management changes and (attending vet prescribed) drugs when drugs are indicated.

As you know, science starts with observations. Observations lead to hypotheses which must then be formally tested. As you said, that takes money (and time). One person making a management change and having a response is interesting. Hundreds of people doing the same thing and getting the same response becomes much more significant.

The EC group is about sharing what we have found to work for these horses. There's nothing dangerous about a low NSC, forage based diet. Anyone can learn to do basic mineral balancing. It's not difficult. Mineral intakes recommended are all well within those considered to be safe by the National Research Council.

Several studies have ended up suggesting that control of dietary carbohydrates could be appropriate to control IR and laminitis risk in horses. With absolutely no sarcasm intended, that really is pretty much a duh! statement, but no one has gotten around to publishing a feeding trial at different levels of NSC yet.

Many things observed on the EC list have eventually been validated by formal studies, including that IR/metabolic syndrome even exists, that pasture laminitis is usually if not always related to insulin resistance and the seasonal ACTH rise. Other things, such as that hay NSC matters, first suggested by Katy and validated time after time after time by members, still has not been confirmed by a formal study - yet.

I hope that explains things better.

Eleanor

Eleanor M Kellon, VMD
Feb. 22, 2010, 11:43 AM
[QUOTE=Melyni;4702923]The huge variation in insulin levels means that unless you do a clamp, and frequently sampled test protocol you really don't know what the insulin level signifies i any one horse.

Testing the Hb-1A level to see the actual degree of glycosation that is going on, would so much more helpful.

=========================

Have you read the proxy studies? They were validated by FSIGT.

I don't know why you would think HbA1c levels would be useful. They are a measure of hemoglobin exposure to high blood glucose over time but horses with IR typically have normal blood glucose. They're rarely diabetic.

Eleanor

Eleanor M Kellon, VMD
Feb. 22, 2010, 11:51 AM
[QUOTE=Katy Watts;4702982]

The control horses in this study would be considered “compensated IR, laminitis risk” by your IR calculator. These are all healthy horses kept in a dry lot.

===================

Breeds? Body condition scores? Have you considered the possibility that in fact they do not have normal insulin sensitivity? Was this confirmed by FSIGT or CGIT?

Eleanor

Melyni
Feb. 22, 2010, 12:07 PM
I just noticed something odd about the above. Wrt '19.1 ± 5.3 peak insulin in control horses' - the unit of measurement of the insulin is not given. Different labs use different ones, some requiring conversion to another measure in order to use the G/I calculation formula.

One other thing I have found very odd in the posts from KW, is that she only references equine studies. That is sort of like being a one trick pony. There is a lot of data in human medical research that appears to have extrapolation to equids. (Both humans and horses are mammals, after all.)

It is far better and more relevant to stick to data from Equidae.
Humans and horses are NOT the same, and you cannot always extrapolate from one to the other. So it is a very good thing that Katy is sticking to equine data.
MW

Melyni
Feb. 22, 2010, 12:09 PM
[QUOTE=Melyni;4702923]The huge variation in insulin levels means that unless you do a clamp, and frequently sampled test protocol you really don't know what the insulin level signifies i any one horse.

Testing the Hb-1A level to see the actual degree of glycosation that is going on, would so much more helpful.

=========================

Have you read the proxy studies? They were validated by FSIGT.

I don't know why you would think HbA1c levels would be useful. They are a measure of hemoglobin exposure to high blood glucose over time but horses with IR typically have normal blood glucose. They're rarely diabetic.

Eleanor

Because it is the chronically high glucose that is very much part of the problem.

MW

Melyni
Feb. 22, 2010, 12:12 PM
I think the original point of this post was to try to find well qualified help with nutrition-related questions... I'll be honest I did not read all of the responses- just skimmed.. I just wanted to put in my plug for University Extension specialists. Someone else mentioned that a good place to look was your state's land grant university. This is the PERFECT place to look. Several land grant universities will have at least an animal nutritionist you can talk to, if not an equine nutritionist. If they are an extension specialist their whole job is to help you with your questions! Most of the other equine faculty, even if not their actual appointment, are also happy to help answer producer's questions.

I am just giving my props to the extension system... current grad student in equine nutrition at Texas A&M. I think too many people are self-proclaimed experts, so going with a University is a good way to get advice from an actual "professional." These people will have lots of continued education on the subject and probably published research too. Unfortunately most vet school programs do not get into much detail on specifically equine nutrition - they have a TON of information to cover in a limited amount of time - so a PhD in nutrition gets you someone who spent several years specifically studying nutrition.

Just my opinion! :)

Exactly, thank you!
MW

Eleanor M Kellon, VMD
Feb. 22, 2010, 01:01 PM
[QUOTE=Katy Watts;4702982]Presented at Eq. Sc. Soc meeting, May 2010 with short abstract here:

Glycemic/insulemic Response to Feeding Hay with Different Water Soluble Carbohydrate Content in Healthy and Polysaccharide Storage Myopathy-affected Horses

Two more questions please.

What were the starch levels?

What was the range of baseline insulin levels?

Eleanor

deltawave
Feb. 22, 2010, 01:12 PM
So horses with sky-high insulin levels, IR, whatever you call them, have normal plasma glucoses, all the time?

Moderator 1
Feb. 22, 2010, 01:17 PM
We've removed some off-topic and/or personal commentary throughout the thread. It's generally fine to debate the scientific basis for claims made here and elsewhere, to discuss the qualifications required for a given profession, etc.--doing so doesn't constitute an attack or libel, so tone down the finger-pointing.

It's fine to counter those who hold that belief. But, in doing so, you don't have license to personally insult them in response.

Generally, the thread's been on a more productive track of late, so please keep it there.

Thanks,
Mod 1

Katy Watts
Feb. 22, 2010, 01:24 PM
if this gets through, I have to bow out of this until weather settles and I have reliable internet connection

Eleanor M Kellon, VMD
Feb. 22, 2010, 01:28 PM
[QUOTE=Eleanor M Kellon, VMD;4703385]

Because it is the chronically high glucose that is very much part of the problem.

MW

They don't have high glucose. It can happen, in advanced cases, but glucose is usually normal - 100 or lower.

Eleanor

Sarah Ralston
Feb. 22, 2010, 01:57 PM
One other thing I have found very odd in the posts from KW, is that she only references equine studies. That is sort of like being a one trick pony. There is a lot of data in human medical research that appears to have extrapolation to equids. (Both humans and horses are mammals, after all.)

Yes but there are differences in horse and human metabolism. For example they can efficiently use Volatile Fatty Acids as energy sources which are unavailable to humans. In several studies comparing horse glucose/insulin data to human reports there are distinct difference, depending on the diets the horses are adapted to. If they are fed high grain (the old 40-50% of total standard used for the past 20 years or so)-their responses are similar to humans. however if ed low carb, predominantly forages they are more similar to cows!!!
A lot of the NRC recommendations are extrapolated from other species due to a lack of data on horses (ie: the zinc and magnesium recommendations) but if equine data exists-use it!

Sarah Ralston
Feb. 22, 2010, 02:06 PM
[QUOTE=ASB Stars;4702903] but no one has gotten around to publishing a feeding trial at different levels of NSC yet.

Other things, such as that hay NSC matters, first suggested by Katy and validated time after time after time by members, still has not been confirmed by a formal study - yet.


There have been quite a few such studies presented at the Equine Science Society and American Society of Animal Science meetings over the past 6 years. KW and Melyni were there to hear them.

Eleanor M Kellon, VMD
Feb. 22, 2010, 02:19 PM
So horses with sky-high insulin levels, IR, whatever you call them, have normal plasma glucoses, all the time?

Except in rare cases, yes. Same is true is prediabetic metabolic syndrome humans. Their insulins are high long before they cross the line into diabetic glucose range.

Eleanor

Katy Watts
Feb. 22, 2010, 03:14 PM
Insulin measured as µU/m l ± sd.

I made a mistake in previous post. +/- refers to standard deviation in this case.
A St Dev of 25% of the mean indicates considerable variation.

I have limited internet in this snow storm. At scholar.google.com put in ‘insulin camel sheep pony’. Even among herbivores ‘normal’ insulin levels vary significantly. Extrapolation from human studies is a very big stretch.

I repeat: no university associated researcher considers G:I ratio useful, including the authors of the original cited study, deceased members of course excluded.

Starch content of all hays <1.0. Hay tests done by Dairy One and Megayzme.

I don’t have raw data on horses, but control horse insulin mean and error bars all below 10 µU/m l on the chart at time 0. Control horses defined as ‘normal, healthy, unfit QH and paint breeds” Data collected was glucose and insulin every 30 minutes over 5 hours.

Can’t say more. Probably already said too much about unpublished data to suit my co-authors.

We have to stop thinking that all IR is the same. There are forms about insulin sensitivity at the cellular and forms about insulin response to feeding. Complex mechanisms with many different places to get broken. More contemplation about IR at level of liver function: abnormal gluconeogenesis and/or insulin clearance.

I agree with Dr. Ralston. Some good studies being done now. Researchers finally asking good questions, IMO and I’ve been pretty hard on them in the past. 8 studies presented at ESS about glucose and insulin in equids. Both keynote speakers on Met Syndrome. Dr. Pollitt just emailed me today with a case of laminitis cured only by soaking hay and chaff and stopping all hard feed, and controlled, increasing levels of exercise. Horse back to conditioning program for return to competition. We are making serious headway with people whose opinion really counts. Yes, it seems a real ‘duh!’ thing to those of us recommending this approach for years and seeing results all around us, but it seems just too simple for many practicing vets and horse owners to believe. I’ve been going around behind a local vet changing the program for horses with laminitis, and finally went to the source and invited him and his wife for supper. Sent him home with about 50 pages of current information. Maybe if a few more folks would invite a vet to supper we could make more headway. My hobby as iconoclast/PIA in equine nutrition has been enormously frustrating, but I think fruitful. I am actually feeling more comfortable about going back to my previous hobbies.

Daydream Believer
Feb. 22, 2010, 03:35 PM
Yes, it seems a real ‘duh!’ thing to those of us recommending this approach for years and seeing results all around us, but it seems just too simple for many practicing vets and horse owners to believe. I’ve been going around behind a local vet changing the program for horses with laminitis, and finally went to the source and invited him and his wife for supper. Sent him home with about 50 pages of current information. Maybe if a few more folks would invite a vet to supper we could make more headway.

Wow...I so second this! As I trim and deal with a lot of problem horses, I see a lot of messes after the fact. I've been stunned speechless almost by some of the awful advice still being given by some vets particularly in regards to metabolic issues.

Eleanor M Kellon, VMD
Feb. 23, 2010, 05:31 AM
[QUOTE=Katy Watts;4703921]Insulin measured as µU/m l ± sd.


I don’t have raw data on horses, but control horse insulin mean and error bars all below 10 µU/m l on the chart at time 0. Control horses defined as ‘normal, healthy, unfit QH and paint breeds” Data collected was glucose and insulin every 30 minutes over 5 hours.

==================

What about the 12 hour fast you forgot to mention? That could explain the discrepancy between these results and the other published studies where normal, continuously fed horses on forage only diets had insulins less than 10. There's fairly universal agreement that horses should not be fasted prior to testing.

If "unfit" means overweight, that could also have influenced the results. Obesity alone can induce a degree of insulin resistance.

Eleanor

Katy Watts
Feb. 23, 2010, 07:43 AM
What about the 12 hour fast you forgot to mention? That could explain the discrepancy between these results and the other published studies where normal, continuously fed horses on forage only diets had insulins less than 10. There's fairly universal agreement that horses should not be fasted prior to testing.

If "unfit" means overweight, that could also have influenced the results. Obesity alone can induce a degree of insulin resistance.


If you feel that Dr. Valberg's experimental design is faulty, it is more appropriate for you to discuss it with her after publication and give her or Lisa Borgia the opportunity to defend themselves before you render the study results unworthy in a public forum. If one follows these forms of professional courtesy, we find sometimes that further discussion will change our minds, or we may agree to disagree. Same goes for abstracts. It's not really fair to make judgment from an abstract.
It is my experience that when I email a concise, good question to a researcher regarding their published work, they will usually answer. So far, most researchers I have contacted seem to appreciate well thought out criticism. This is also a good conversation starter when approaching researchers at a conference. How can you know what is universally agreed on if you do not attend conferences? Even newly published work is from studies conducted 2-3 years ago. LOTS is happening right now. Yes, its expensive, but I have found that if you get invited to speak or present a poster they usually wave registration fees and sometimes they pay expenses and a small speaker fee. As an educator of a sort, I feel it is absolutely vital to stay up to date.

At the conferences I have attended the last few years, there is still a lot of debate about what is proper testing procedure. The only agreement that I have heard is that when a horse is suspect for IR, multiple tests of various types should be performed, something dynamic, over time, fasted vs unfasted. That a single blood draw is NOT enough.

Eleanor M Kellon, VMD
Feb. 23, 2010, 08:22 AM
[QUOTE=Katy Watts;4705376]If you feel that Dr. Valberg's experimental design is faulty, it is more appropriate for you to discuss it with her after publication and give her or Lisa Borgia the opportunity to defend themselves before you render the study results unworthy in a public forum. If one follows these forms of professional courtesy, we find sometimes that further discussion will change our minds, or we may agree to disagree. Same goes for abstracts. It's not really fair to make judgment from an abstract.
========================

I didn't say it was unworthy. I said the insulin responses could not be compared to insulins in horses having constant access to forage. A design difference is not necessarily a fault, but it does preclude comparing it to other works with a different design. I asked you to refer me to studies that found insulin over 10 in normal horses continuously fed forage. You then put up some information from that abstract on this forum but the conditions of testing used do not apply.

Eleanor

ASB Stars
Feb. 23, 2010, 08:28 AM
At the conferences I have attended the last few years, there is still a lot of debate about what is proper testing procedure. The only agreement that I have heard is that when a horse is suspect for IR, multiple tests of various types should be performed, something dynamic, over time, fasted vs unfasted. That a single blood draw is NOT enough.

While I also completely agree with the balance of KW's post, I feel this point is vital.

The testing protocols are imperfect-- the parameters are not well defined enough, at this point, to do more than give anecdotal evidence, albeit with numbers!

My horses all eat a low carb diet. Period. I treat them all as though they have metabolic issues. I want to believe that, because they never have the chance to be *poisoned* by too much sugar, if you will, that they have a better chance of actually NOT developing these issues, to the extent that they are compromised by them.

I may be wrong, but the horses are proving otherwise. In essence, I would ask each horse owner, "why NOT feed your horse a healthy, low carb diet-- from day one?" You have nothing to lose by going thise route- and everything to gain.

AZ Native
Feb. 23, 2010, 11:30 AM
While I also completely agree with the balance of KW's post, I feel this point is vital.

The testing protocols are imperfect-- the parameters are not well defined enough, at this point, to do more than give anecdotal evidence, albeit with numbers!

My horses all eat a low carb diet. Period. I treat them all as though they have metabolic issues. I want to believe that, because they never have the chance to be *poisoned* by too much sugar, if you will, that they have a better chance of actually NOT developing these issues, to the extent that they are compromised by them.

I may be wrong, but the horses are proving otherwise. In essence, I would ask each horse owner, "why NOT feed your horse a healthy, low carb diet-- from day one?" You have nothing to lose by going thise route- and everything to gain.

Here here !! Yes ! :D
This is what we tell all of our client's, and I think Katy would agree with ASB.
Regardless of the test, the management (low carb, with correct mineral balance)would be the same.

Melyni
Feb. 23, 2010, 03:39 PM
So horses with sky-high insulin levels, IR, whatever you call them, have normal plasma glucoses, all the time?

And that's part of the problem. We don't get enough info from one blood sample.
We need some kind of better handle on just what is going on with the glucose levels.
We could find out more if we had the Hb1Ac, but we don;t have that.

Do you have any ideas we could use from human meds?
MW

ASB Stars
Feb. 23, 2010, 05:19 PM
And that's part of the problem. We don't get enough info from one blood sample.
We need some kind of better handle on just what is going on with the glucose levels.
We could find out more if we had the Hb1Ac, but we don;t have that.

MW

I think that the real issue is that you are trying to take tests, which do not adequately analyze the issues, and make them say something useful. When you start with a bad premise, your outcome cannot be much better.

It is like trying to use stone knives, and bear skins, and make that part you need for your car. Say what?

We need for the whole system to take a step back, and determine what they actually need to find real values on, and then develop a testing procedure that does just that. Trying to use a system that is broken is just creating a whole lot of bad information, and worse feelings.

And it ain't helping the horses, neither! :lol:

deltawave
Feb. 23, 2010, 05:28 PM
Do you have any ideas we could use from human meds?

My mind is still trying to wrap itself around the concept of chronically elevated insulin levels with normal blood sugars. If the cells are so gigantically resistant to insulin, where is the sugar going? Maybe there's so much tissue in a horse (muscle) that they just . . . handle it.

Insulin resistance/diabetes treatment with drugs is the tip of the iceberg. Without diet and exercise, you're just spitting in the ocean, if you'll pardon the mixed metaphor. I'm pretty sure I've heard here that people are using metformin for horses to improve insulin sensitivity; this makes sense. But if the horse is standing around 23 hours a day and is 300 pounds overweight and eating the wrong stuff, well, the horse is going to have about as much success as my patients who sit around 23 hours a day and are overweight by the same proportion, eating at Burger King. :sigh:

Keith A. Bryan
Feb. 23, 2010, 08:54 PM
I am sorry I caught this thread so late, but I have enjoyed reading through eight pages of SOME useful infoormation.

Let's begin by considering Equine Nutrition as a science that must be practiced! It is no different than medicine or law! We learn from a variety of sources and ALL sources have various degrees of credibility. Marginal science published in a peer-reviewed publication should be viewed with the same skeptical scrutiny as case studies that found a particular treatment/feeding regimen corrected one issue in one horse at one time.

As for qualifications of Equine Nutritionists...let's look at it this way - who is more credible:

1) The high school graduate who has been feeding hundreds of horses for the past 30 years,

or

2) The highly trained, magna cum laude, BS, MS, PhD, DVM in Equine Nutrition who has been selling used cars down at the corner for the past 30 years?

I challenege everyone to provide me with the correct answer; basically tell me the truth. There is no truth...no one really knows!

Nutrition is an "inexact" science and should be viewed as such. There are people who view me as a 'quack' and some use stronger language than that, but I make recommendations based on the science available to me at the time of the inquiry.

Do I have all of the answers? No! Neither does anyone else.
Have I read every scientific article on a particular subject? No! But neither has anyone else.

Suffice it to say...you will NEVER find two horses that are the same! Similar, maybe, but not the same. Even identical twins are not identical.

Science is about finding 'the truth' through carefully planned, controlled and executed studies that are shared among those interested in a subject. It is continually evolving and some of what I learned yesterday will be outdated tomorrow.

Keith

Katy Watts
Feb. 24, 2010, 07:40 AM
My mind is still trying to wrap itself around the concept of chronically elevated insulin levels with normal blood sugars. If the cells are so gigantically resistant to insulin, where is the sugar going?

Equines are able to pump out huge amounts of compensatory insulin. Enough to the the job done. They do not seem to reach the state of pancreatic exhaustion more common to humans. Researchers say that the few cases of true diabetes in horses are usually associated with PPID.

Also note that not all hyperinsulinemic horses are fat. Dr. Frank agrees that the thin ones are often the most difficult to treat. Also note that hyperinsulinemia may also be caused by other abnormalities than IR at the muscle cellular level. It is hypothesized certain horses can have an abnormal response to feeding without the baseline IR. They are looking at a form of IR in the liver cells. We can't lump all cases of hyperinsulinemia together.
Katy

deltawave
Feb. 24, 2010, 07:57 AM
Maybe they need partial pancreatectomies. Although that's an organ even the bravest of surgeons will go near only if forced to. :)

Eleanor M Kellon, VMD
Feb. 24, 2010, 08:07 AM
My mind is still trying to wrap itself around the concept of chronically elevated insulin levels with normal blood sugars. If the cells are so gigantically resistant to insulin, where is the sugar going? :

There's a good human review here:

http://circ.ahajournals.org/cgi/content/full/112/17/2735

It's a slide into frank diabetes. Much of the pathology is already present before they develop hyperglycemia, e.g.:

http://linkinghub.elsevier.com/retrieve/pii/S0026049508002916

There's some evidence that horses are less reliant on GLUT-4/insulin requiring glucose disposal than humans. For example, post exercise carbohydrate loading increases GLUT-4 expression and glycogen repletion in people. In horses GLUT-4 expression is not changed, but glycogen levels are still higher.
Whatever the mechanism, this would put them at lower risk of hyperglycemia, which clinically seems to be the case.

Eleanor

Melyni
Feb. 24, 2010, 08:22 AM
As for qualifications of Equine Nutritionists...let's look at it this way - who is more credible:

1) The high school graduate who has been feeding hundreds of horses for the past 30 years,

or

2) The highly trained, magna cum laude, BS, MS, PhD, DVM in Equine Nutrition who has been selling used cars down at the corner for the past 30 years?
Keith

Except you can't get to be a highly trained BS, MS, DVM, PhD by selling cars, you need to study, study, study, work in research and work with horses, pass exams, write papers, do more research.
It just does not happen that Degrees in Equine Nutrition are earned by selling cars.

Sorry your comparison makes no sense.
MW

Melyni
Feb. 24, 2010, 08:41 AM
Why are these horses getting laminitis and subsequently foundering?

Lets face that's the main interest for most horse owners. It'd be nice to know all the details of carbohydrate metabolism etc. etc. But what we really need to understand is why the IR leads to laminitis.

If we didn't have to deal with the laminitis /founder problem we wouldn't really worry about the glucose/ insulin levels.

What is the underlying cause of the laminitis is the crux of the question.

Is it because of the high insulin, as Dr Kellon proposes.

Is it a chronic inflammation such as obese people suffer from, with high levels of C -reactive protein? Has anyone been looking at C-reactive protein in these horses?

Is it because of a problem in circulatory response to a metabolite?
Is it a problem of mineral or carbohydrate metabolism?
Is it something else entirely.
There is a huge amount we just don't understand about why the laminae get inflamed in the first place.

So many questions.. I think I'll go ride my horse.
MW

ChocoMare
Feb. 24, 2010, 08:44 AM
Also note that hyperinsulinemia may also be caused by other abnormalities than IR at the muscle cellular level. It is hypothesized certain horses can have an abnormal response to feeding without the baseline IR.
Katy

Have been lurking/learning here, but your statement above, Katy, jumped out at me.

I had bloodwork done last week on my Percheron. She is confirmed EPSM (heck, Dr. Valentine said she could be the poster child for it!) and metabolic issues. I wanted current bloodwork done to check glucose/IR, CBC and a PPID panel. Thankfully all came back within normal range and gave me assurance that the diet I have her on is a good fit (no live grass, plain beet pulp, EquiPride, etc.)

However, in my e-mail discussions I had with Dr. Valentine prior to having this bloodwork done, I asked if there were any studies being done about a possible link between EPSM and Metabolic Issues/IR. Alas, she wasn't aware of any. Do you know of any?

I'm just a lay person... but the possible connection between the two conditions just made sense to me and made me go "Hmmmmm, I wonder????"

Katy Watts
Feb. 24, 2010, 09:20 AM
However, in my e-mail discussions I had with Dr. Valentine prior to having this bloodwork done, I asked if there were any studies being done about a possible link between EPSM and Metabolic Issues/IR. Alas, she wasn't aware of any. Do you know of any?


Other researchers think that the high fat levels recommended by Dr. Valentine cause obesity and subsequent IR. They contemplate that if you control NSC sufficiently (in hay, too) and exercise enough, that the fat is not necessary to successful management of EPSM/PSSM. They recommend oil only in sufficient quantities to maintain condition for high levels of exercise. Is your mare too fat? Obesity is one cause of IR.
Katy

Katy Watts
Feb. 24, 2010, 09:23 AM
http://www.sciencedirect.com/science?_ob=PublicationURL&_tockey=%23TOC%2313106%232010%23999699997%23174309 7%23FLA%23&_cdi=13106&_pubType=J&view=c&_auth=y&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=2d1188bee40e49aed4081dcbedc6f8ea

JEVS Volume 30, Issue 2, Pages 65-118 (February 2010)

Proceedings of AAEP Laminitis researcher workshop. Some good stuff in here. Sorry they did not put abstracts online. Worth a trip to the library.

ChocoMare
Feb. 24, 2010, 09:27 AM
By my own judgement, I never fed the full fat amount recommended by Dr. V. I chose to only feed "enough" to maintain muscle condition/energy and HIGHLY controlled her sugar/starch intake. She is not over or underweight actually and my vet is pleased with what she sees in Tank, her diet and how I control it. Believe me, this has been a lengthy process to get her balanced on both the EPSM and metabolic sides.

deltawave
Feb. 24, 2010, 10:49 AM
[quote=Eleanor M Kellon, VMD;4707492]There's a good human review here:

http://circ.ahajournals.org/cgi/content/full/112/17/2735

Thanks, I subscribe to Circulation and am pretty familiar with human diabetes. :)

deltawave
Feb. 24, 2010, 11:00 AM
Why are these horses getting laminitis and subsequently foundering?

As with many, if not all, chronic diseases, there probably isn't just one answer.

Why do people have heart attacks when their cholesterol is perfectly normal, while other people with really high cholesterol have no heart disease? Why do some kids get every cold that goes around, while others are never sick?

We often feel compelled to find "A" reason, or to uncover the "hidden" reasons for things. That's when stuff like "environmental toxins", "allergies", and "inflammation" get trotted out as suspects; although those things are certainly real, it's incredibly hard to prove cause and effect.

My sneaking suspicion is that there's probably gigantic genetic influence on what makes certain individuals vulnerable to disease, while others are not. This is possibly slightly easier to see in equines, where you have lots and lots of different breeds, whereas in humans we only have racial and ethnic differences to compare, (and this is fraught territory to say the least) when we want to figure out why "A GROUP" is different in terms of susceptibility to things. And genetically, the differences between races is virtually nonexistent on the large scale, so you have to dig deeper. I presume the same is true for horses, dogs, etc: the genes look very, very similar, but there are still (my theory) large genetic influences on why disease shows up in some but not in others.

Take your "poster child" breeds for IR--anyone could list them, spot them in a lineup, and successfully contrast them phenotypically from a non-IR-prone breed or individual. BUT of course there are exceptions to every rule, and someone out there has a lean, IR TB, I'm sure of it. :)

Do IR-prone breeds tend to wind up with people who feed horses in such a way as to "bring out" this vulnerability? Are less-expert and informed owners more likely to buy a small, quiet, easy-keeping breed to keep at home, ride once a week, and allow to stand around in a 1/2-acre pasture or (worse?) throw it out with the cows to graze? I don't know, and I realize this is too simplistic. Just musing on the vast question of "why do horses (or people) get sick in the first place?" and expressing my conviction that we are a lot farther from knowing than we think. :)

Melyni
Feb. 24, 2010, 02:15 PM
I take your point about the IR phenotype, but there is more to it than that.
Definitely there is a huge genetic factor, the easy keeper breeds being so much more prone to the problem.

And the work load is a huge factor, you don't usually see IR in hard working horses (hard work = 1 or more hours per day of WTC, gallop and jump), but occasionally you do.

I've seen and dealt with GP dressage horses and GP jumpers who had IR and chronic laminitis, even tho they were not obese (Their BCS was 6 or less), and they were in full work.

The one common factor I see is the abnormal fat, not just a lot of fat as in obese, but abnormal, as in cresty necks, eye pads, tail pads shoulder pads and this fat does not palpate 'normal' it feels very much harder and less flexible than normal fat.
Preston Burr, at Missouri did a biopsy of one of these for me and reported that the adipose tissue was a different type, it had a very different structure and architecture from normal adipose tissue, more honeycombed and far fewer but bigger adipocytes.
I wanted to do a follow up and wasn't able to. But I would still love to do more histology.

So what does the abnormal adipose tissue signify?

The abnormal adipose tissue usually precedes the laminitis so it could be used a warning sign.
And it is this abnormal adipose tissue that responds to magnesium/chromium.

So what is going on?

MW

katmando
Feb. 24, 2010, 04:25 PM
So what does the abnormal adipose tissue signify?

MW

Go to PubMed and access:

de Ferranti, S., Mozaffarian, D. (2008) The Perfect Storm: Obesity, Adipocyte Dysfunction and Metabolic Consequences. Clinical Chemistry. 54:6 pp 945-955.

If you can't access the PDF I can provide a copy.

Kathleen (KFG in KCMO)

Melyni
Feb. 24, 2010, 04:32 PM
Go to PubMed and access:

de Ferranti, S., Mozaffarian, D. (2008) The Perfect Storm: Obesity, Adipocyte Dysfunction and Metabolic Consequences. Clinical Chemistry. 54:6 pp 945-955.

If you can't access the PDF I can provide a copy.

Kathleen (KFG in KCMO)

I'd love a copy, I don't get on well with PubMed.
MW
please send it to
melyni@ntelos.net

MW

Melyni
Feb. 24, 2010, 04:40 PM
Go to PubMed and access:

de Ferranti, S., Mozaffarian, D. (2008) The Perfect Storm: Obesity, Adipocyte Dysfunction and Metabolic Consequences. Clinical Chemistry. 54:6 pp 945-955.

If you can't access the PDF I can provide a copy.

Kathleen (KFG in KCMO)

But it won't let me down load the full copy. If you happen to have it I would love it.
MW

deltawave
Feb. 24, 2010, 05:41 PM
Maybe the horses with these atypical fat deposits are the equine equivalents of Inuit and Pima indians, who have staggering rates of diabetes and also have unusual patterns of truncal fat deposition. Is lipodystrophy described in equines?

katmando
Feb. 24, 2010, 07:02 PM
Is lipodystrophy described in equines?

Probably the most common and well described lipodystrophy in equines is associated with insulin resistance. It's classic - the lumpy fat deposits, cresty neck, fatty sheath or udder. Fat and inflammation.

Kathleen (KFG in KCMO)

Katy Watts
Feb. 24, 2010, 07:05 PM
Maybe the horses with these atypical fat deposits are the equine equivalents of Inuit and Pima indians, who have staggering rates of diabetes and also have unusual patterns of truncal fat deposition. Is lipodystrophy described in equines?

Ya, only in horses it's neck fat that is the worst.

Pro-Inflammatory Cytokine and Chemokine Expression Profiles of Various Adipose Tissue Depots of Insulin-Resistant and Insulin-Sensitive Light Breed Horses
JEVS Volume 30, Issue 2, Pages 65-118 (February 2010) Pages 96-97
T.A. Burns, R.J. Geor, M.C. Mudge, L.J. McCutcheon, J.K. Belknap

katmando
Feb. 24, 2010, 07:32 PM
Ya, only in horses it's neck fat that is the worst.

Interesting. So, if I'm following this, none of the inflammatory cytokine markers showed a group difference - between insulin resistant and insulin sensitive. However, when the results were lumped together, the adipose tissue from the nuchal ligament had significantly higher inflammatory markers for 2 of the 5 cytokines/chemokines measured.

What's really interesting is that, for both groups, body type was the same and the group distinction was based on insulin response.

Kathleen (KFG in KCMO)

Katy Watts
Feb. 24, 2010, 08:14 PM
Interesting. So, if I'm following this, none of the inflammatory cytokine markers showed a group difference - between insulin resistant and insulin sensitive. However, when the results were lumped together, the adipose tissue from the nuchal ligament had significantly higher inflammatory markers for 2 of the 5 cytokines/chemokines measured.

What's really interesting is that, for both groups, body type was the same and the group distinction was based on insulin response.

Kathleen (KFG in KCMO)

Yup, yup, yup. IR and IS categorized by FSIGTT.

Total RNA extracted. cDNA analyzed via rt-PCR.

Results: No differences in expression of TNF-a, Il-1B, IL-6, PAI-1, or MCP-1 were noted between IR and IS groups for each depot. When data from IR and IS groups were pooled, the expression of IL=1B (p=0.009) and IL-6 ( p= 0.023) was significantly higher in nuchal adipose tissue than in other depots.

Relevance: Nuchal AT is an appropriate non-invasive sample for the study of adipobiology of obesity and IR in adult horses.

Keith A. Bryan
Feb. 24, 2010, 09:29 PM
Except you can't get to be a highly trained BS, MS, DVM, PhD by selling cars, you need to study, study, study, work in research and work with horses, pass exams, write papers, do more research.
It just does not happen that Degrees in Equine Nutrition are earned by selling cars.

Sorry your comparison makes no sense.
MW

Herein lies the most obvious fault with THIS and other threads...Read the comments, then re-read the comments! If you don't understand something ask a question.

In order to earn ALL of the degrees mentioned and sell cars for 30 years this person would be approaching 60-65 years of age, regardless of whether he sold cars then earned the degrees or earned the degrees and then sold cars! Obviously, the passion is selling cars and NOT PRACTICING THE SCIENCE (study, study, study, work in research and work with horses, pass exams, write papers, do more research) OF EQUINE NUTRITION! MW, thank you for helping me make my point.

Ghazzu
Feb. 24, 2010, 10:20 PM
And a new leader emerges in the Non Sequitur Sweepstakes!

katmando
Feb. 24, 2010, 10:49 PM
Relevance: Nuchal AT is an appropriate non-invasive sample for the study of adipobiology of obesity and IR in adult horses.

Their conclusion, that adipose tissue in the crest is more likely to show inflammation certainly holds true to personal experience. As for being non-invasive... something about a scalpel, incision and biopsy sounds kind of invasive to me!

KFG

katmando
Feb. 25, 2010, 09:44 AM
As with many, if not all, chronic diseases, there probably isn't just one answer.

Just musing on the vast question of "why do horses (or people) get sick in the first place?" and expressing my conviction that we are a lot farther from knowing than we think. :)

If I may, I’d just like to offer a brief commentary. When I read discussions about IR I think of the analogy of the blind men and the elephant. With a complex metabolic condition like IR, it’s easy to adopt a narrow focus or line of investigation which may reveal a partial truth or piece of the puzzle, but the puzzle may never be completed. Clearly, hyperinsulinemia is key and to date, appears to be the most likely trigger for laminitis. Obesity, abnormal fat distribution and the presence of inflammatory cytokines give us another pathway to investigate. Or perhaps consider the STAMP/STEAP proteins that appear to be a molecular link between obesity, inflammation and IR. These proteins are implicated in iron or copper entry into cells and decreased activity could disrupt the metabolic machinery and lead to IR. Knowing that most forages don’t provide adequate copper and at times, excess iron, lends credibility to this line of investigation. Then of course, we can consider leptin and leptin resistance and all the other appetite regulating hormones. Or perhaps a fetal programming model where maternal under nutrition or over nutrition alters fat distribution and hormone regulation in the offspring and increases risk for IR. We can’t forget GLUT-4, or the effects of exercise or whether fat cells become hypertrophic or hyperplastic and the list goes on and on. Keeping our eyes open to all of the potential mechanisms will lead to a greater understanding and meaningful discussion.

Kathleen (KFG in KCMO)

Melyni
Feb. 26, 2010, 02:10 PM
These proteins are implicated in iron or copper entry into cells and decreased activity could disrupt the metabolic machinery and lead to IR. Knowing that most forages don’t provide adequate copper and at times, excess iron, lends credibility to this line of investigation.
Kathleen (KFG in KCMO)

Except that the levels of iron in forages have very little relationship to iron intake. Iron salts have very low digestibility and the higher the level of iron the lower the digestibility. The GI tract is good at not picking up too much, high levels of iron in forage do not necessarily lead to high iron in the animal. It's pointless to fuss too much about the iron in the forages.
Yours
MW

Eleanor M Kellon, VMD
Feb. 26, 2010, 04:27 PM
[QUOTE=Melyni;4712691]Except that the levels of iron in forages have very little relationship to iron intake. Iron salts have very low digestibility and the higher the level of iron the lower the digestibility. The GI tract is good at not picking up too much, high levels of iron in forage do not necessarily lead to high iron in the animal. It's pointless to fuss too much about the iron in the forages.

Not true, especially in insulin resistant horses:

<http://www.cababstractsplus.org/abstracts/Abstract.aspx?AcNo=20063129300>

The efficiency (or not) of horses to downregulate iron absorption has never been studied.

Eleanor

katmando
Feb. 27, 2010, 12:53 AM
Except that the levels of iron in forages have very little relationship to iron intake. Iron salts have very low digestibility and the higher the level of iron the lower the digestibility. The GI tract is good at not picking up too much, high levels of iron in forage do not necessarily lead to high iron in the animal. It's pointless to fuss too much about the iron in the forages.
Yours
MW

I don't think I'm following the reasoning. Are you saying that the level of iron in forage does not equal iron intake or do you mean that the level of iron in forage is not all bioavailable? I've heard that not all iron in forage and processed feeds is bioavailable, but I haven't seen a publication or analysis that can sort out exactly how much is and is not?

If it's pointless to fuss about iron, is it equally pointless to fuss about the other trace minerals, particularly those that are deficient?

I threw in the STAMP/STEAP family of proteins because they have generated considerable interest due to their expression in adipose tissue. For a long time, adipose tissue was viewed as simple a place to store energy. We now view it as a complex metabolic and endocrine organ, indeed the largest in the body. Linking metabolic disease and inflammation was a step forward in understanding some of the mechanisms and STAMP2 is an interesting new player. It's heavily expressed in adipose tissue and is reduced in the obese mouse model, ob/ob. The presence of STAMP2 increases insulin sensitivity and the absence increases inflammatory markers. Knocking out STAMP2 in mice results in hyperlipidemia, weight gain and impaired insulin signaling.

Obviously, understanding how these proteins regulate metabolic homeostasis is going to require more investigation, but it is known that this family of proteins have iron and copper reducing activities (metalloreductases) and that suggests that they might regulate iron and copper entry into cells. Bottom line, their role might be to maintain metabolic homeostasis and a decrease in activity could lead to insulin resistance.

I read about this in a commentary in Nature Immunology and Cell Biology and probably would have passed it up, except the title "Inflammation and Obesity - STAMPing out insulin resistance" caught my eye. It's definitely generated interest in human research.

Kathleen (KFG in KCMO)

Melyni
Feb. 27, 2010, 09:58 AM
I don't think I'm following the reasoning. Are you saying that the level of iron in forage does not equal iron intake or do you mean that the level of iron in forage is not all bioavailable? I've heard that not all iron in forage and processed feeds is bioavailable, but I haven't seen a publication or analysis that can sort out exactly how much is and is not?

If it's pointless to fuss about iron, is it equally pointless to fuss about the other trace minerals, particularly those that are deficient?

Kathleen (KFG in KCMO)

If something isn't there then it can't be absorbed, so that is important, but to fuss about something being present in too high an amount when you have no idea how much is being absorbed is pointless. Iron that passes out i the manure is not going to cause problems with cell metabolism, so until we know for sure that high iron intake = high iron absorption (and there is no evidence of this), then =rejecting feeds and hay because they have high iron just makes life harder for people. It hard enough to handle these horse with making it even more complicated.
MW

Melyni
Feb. 27, 2010, 10:02 AM
Not true, especially in insulin resistant horses:

<http://www.cababstractsplus.org/abstracts/Abstract.aspx?AcNo=20063129300>
Eleanor

This URL did not work sadly, I tried to look up the abstract but could not.
MW

Melyni
Feb. 27, 2010, 10:06 AM
Dr Kellon wrote about <http://www.cababstractsplus.org/abstracts/Abstract.aspx?AcNo=20063129300>
But it was only an abstract, could you send me the whole paper please, there isn't nearly enough information in the abstract to see what was done and how.

Thanks
MW

deltawave
Feb. 27, 2010, 10:57 AM
Iron is not really a trace mineral. I was under the impression that the ferric/ferrous (I can never keep it straight) "state" of the iron ion in soil/forage was what impacted its bioavailability.

The fact that ferritin is an acute phase reactant always seems to come up, but it is far less than clear to me that this is a direct, clear "cause and effect" type of thing.

Katy Watts
Feb. 27, 2010, 11:09 AM
If something isn't there then it can't be absorbed, so that is important, but to fuss about something being present in too high an amount when you have no idea how much is being absorbed is pointless. Iron that passes out i the manure is not going to cause problems with cell metabolism, so until we know for sure that high iron intake = high iron absorption (and there is no evidence of this), then =rejecting feeds and hay because they have high iron just makes life harder for people. It hard enough to handle these horse with making it even more complicated.
MW

I agree with MW on this. It should be very easy to analyze some dried manure to compare what goes in and what goes out. One mineral costs about $5, I think. Should be very economical to do 4 reps each horse- $20. Seems cost effective compared to a special custom mineral mix that may or may not be indicated. I think the data would also be enlightening in that it will show the huge testing error for iron at the labs. Makes it really hard to find any statistically significant differences with repeated testing of the same bale of hay.
http://www.safergrass.org/pdf/Haytimechart.pdf
sampling should insure no soil is sampled in the manure, as soil is very high in iron, which amounts for most of the iron in forage samples. pick top turd in the pile.

Eleanor M Kellon, VMD
Feb. 27, 2010, 11:48 AM
Dr Kellon wrote about <http://www.cababstractsplus.org/abstracts/Abstract.aspx?AcNo=20063129300>
But it was only an abstract, could you send me the whole paper please, there isn't nearly enough information in the abstract to see what was done and how.

Thanks
MW

Sent.

Eleanor

Eleanor M Kellon, VMD
Feb. 27, 2010, 11:51 AM
Maybe the horses with these atypical fat deposits are the equine equivalents of Inuit and Pima indians, who have staggering rates of diabetes and also have unusual patterns of truncal fat deposition. Is lipodystrophy described in equines?

Equine IR is most similar to antiretroviral induced lipodystrophy and insulin resistance, but normal baseline glucose, in AIDS patients.

Eleanor

Eleanor M Kellon, VMD
Feb. 27, 2010, 12:08 PM
Iron is not really a trace mineral. I was under the impression that the ferric/ferrous (I can never keep it straight) "state" of the iron ion in soil/forage was what impacted its bioavailability.

The fact that ferritin is an acute phase reactant always seems to come up, but it is far less than clear to me that this is a direct, clear "cause and effect" type of thing.

Not sure what you mean by iron not being a trace mineral. Yes, that's true (bioavailability), but under conditions of acidic pH, even iron oxides dissociate. There is evidence that soil is an important iron source for horses.

<http://www3.interscience.wiley.com/journal/119825674/abstract>

Ferritin is more than an acute phase reactant. In the absence of inflammation or malignancy, ferritin is the most accurate measure of total body iron stores. For iron and IR interactions, see:

<http://diabetes.diabetesjournals.org/content/51/8/2348.abstract>

or do a PubMed search.

Eleanor

katmando
Feb. 27, 2010, 01:26 PM
It should be very easy to analyze some dried manure to compare what goes in and what goes out. One mineral costs about $5, I think. Should be very economical to do 4 reps each horse- $20. Seems cost effective compared to a special custom mineral mix that may or may not be indicated. I think the data would also be enlightening in that it will show the huge testing error for iron at the labs. Makes it really hard to find any statistically significant differences with repeated testing of the same bale of hay.


I think the huge testing error might extend past iron. Does the lab provide any data on same sample variability? That would be really useful. There's a lot of variability in your data but then you were asking a different question so you have repeated measures at different points in time.

If the data on manure sampling would be enlightening in that it would show the huge testing error for iron, then that pretty much negates the utility of the measure! I think I'll pass on that one. :)

So far it's been considerably more cost effective and less labor intensive (only speaking for myself) to provide what's deficient based on the hay analysis. I think that's a pretty universally accepted practice, no? Certainly supported by Dr. Johnson at U of MO and my vet's practice. Since I've started this practice, I've had no more issues with IR in my horses who have been on pasture for the last 3 years.

Are you and MW suggesting that the analysis isn't worthwhile, or get the analysis and ignore iron? What's the rationale behind discarding the iron figure besides dirt contamination and lab variability? Is the variability equally high for the other trace minerals? If we selectively discard one trace mineral value, hold do we hold the others? Assuming we know how to sample properly and avoid dirt contamination are you recommending ignoring the excesses (that would be Mn for me) and supplementing only those that are deficient? Or, can we trust any of these numbers given the variability? Or do we just ignore iron because...? What's the rationale? If all the trace mineral values are so variable that they're useless then why mess with forage analysis at all?

I'm beginning to see why Feed Reps are such a big hit! :winkgrin:

Kathleen (KFG in KCMO)

Katy Watts
Feb. 27, 2010, 01:58 PM
Kathleen,
Of course hay testing is valuable. Only some of the numbers generated are more credible than others. Paul Sirois, the manager of DO willingly discussed their testing error with me. Perhaps you or EK should inquire as well. The CV for iron is particularly high, way more than the rest, which makes those numbers less credible than others. He told me that all the variability in my hay over time study was within their testing error range, therefore not significantly different.
Sampling technique is also a huge factor, because the iron is where the soil dust is. DO pulls your sample from the top of the bag. The dust settles, therefore subsequent samples will represent a different profile in those elements inherent in contaminating soil. Any numbers generated from hay samples that are used correctly in a scientific study must be replicated at least 3 or 4X to insure that any difference is real, rather than inherent variability of the sample, sampling procedure, sample preparation or the testing procedure.
Also necessary to know if the iron is inside or outside is the pH of soil where the forage is grown. I see many samples of supposedly high iron forage from areas with high pH soil, where iron is not bioavailable to plants. The more data you have available, the less credible one single data point becomes.

deltawave
Feb. 27, 2010, 02:19 PM
Trace mineral, the way I was taught, means it is only required in TRACE amounts. But I would stipulate that iron is one of the "in betweeners"; we need more iron than we need manganese, for instance. But not as much as we need of other things like calcium, etc.

I do not agree that ferritin is the best indicator of totaly body iron. It is one of many parameters that need to be looked at and, most importantly, taken in context of whatever else is happening. If we really want to know about iron stores, we have to do more than look at one parameter.

I note that the abstract referencing a connection between iron stores, inflammation and IR states loudly and clearly that the connection is not understood well and that more study is needed. :)


The extent of this influence should be tested in large-scale clinical trials, searching for the usefulness and cost-effectiveness of therapeutic measures that decrease iron toxicity. The study of individual susceptibility and of the mechanisms that influence tissue iron deposition and damage are proposed to be valuable in anticipating and treating diabetes complications.

katmando
Feb. 27, 2010, 03:36 PM
I note that the abstract referencing a connection between iron stores, inflammation and IR states loudly and clearly that the connection is not understood well and that more study is needed. :)

Absolutely, and that's my point. There's a lot of things we don't understand about metabolic disease. The fact that more studies are needed doesn't negate a hypothesis - it should serve as a springboard for more studies. Like I said, we used to think that fat was an inert blob for energy storage but now we appreciate that it's an active endocrine organ with very complex signaling pathways. A few years ago, that statement would have gotten you tossed out on your ear in a scientific meeting. "Obesity is an inflammatory condition?! Off with her head!"

Many years ago I stumbled on a finding that put me in front of my peers making claims that went against the current scientific dogma. People were outraged! However, that crazy thought led to the discovery of retinal dystrophin (Dp260) and using a human retinal Dp260 transgene in mice with muscular dystrophy. Expressing the human eye protein in mice with no muscle dystrophin allowed them to live a normal lifespan with a very mild muscle disease while those who did not express the transgene died at 6 weeks.

http://www.jci.org/articles/view/117250

http://www.nmd-journal.com/article/S0960-8966%2806%2900025-3/abstract

The transgene, some 16 years after the first "aha" moment, is up for gene therapy trials. Science moves at a snails pace.

I'm sharing this not to toot my own horn, but to illustrate that sometimes concepts that seem implausible at first sometimes pan out. Sometimes they don't, but that's science. C'est la vie. It's not about right and wrong, it's about adding to the knowledge pool. Anything that adds to our understanding of a very complex issue is worth thoughtful and polite consideration.

Kathleen (KFG in KCMO)

PS - My pet theory is that omega-3 fatty acids will cure all disease and result in world peace! :winkgrin:

deltawave
Feb. 27, 2010, 05:19 PM
My pet theory is that omega-3 fatty acids will cure all disease and result in world peace! :winkgrin:

That's YOURS? Dang, I wondered where that came from. :p

Sarah Ralston
Mar. 1, 2010, 06:43 PM
That's YOURS? Dang, I wondered where that came from. :p

What I want to know is where you obviously erudite people (EK, KW, Deltawave, etc) who are debating this have the time to do all this reading in obscure journals and post so frequently on this forum if you are otherwise gainfully employed and have families/horses of your own! I certainly can't get caught up in these debates-too much else on my plate!

Glad to see the reasonable discourse. Katmando and Delta wave-I love your train of thought!

deltawave
Mar. 1, 2010, 08:47 PM
Multi-tasking. Right now I have just finished supper, am putting the finishing touches on a revamped set of stress testing guidelines, and am sort of watching the NFL combine while COTHing. My husband is washing the dishes. :D :D Alas, I didn't have much horse contact today other than AM and PM feeding, cleaning stalls and the daily eyeball check. :sigh:

SmartAlex
Mar. 2, 2010, 10:13 AM
What I want to know is where you obviously erudite people (EK, KW, Deltawave, etc) who are debating this have the time to do all this reading in obscure journals and post so frequently on this forum if you are otherwise gainfully employed and have families/horses of your own!


I wondered that too, I'm too busy soaking hay and rinsing beet pulp. ;)

katmando
Mar. 2, 2010, 10:33 AM
What I want to know is where you obviously erudite people (EK, KW, Deltawave, etc) who are debating this have the time to do all this reading in obscure journals and post so frequently on this forum if you are otherwise gainfully employed and have families/horses of your own! I certainly can't get caught up in these debates-too much else on my plate!

Glad to see the reasonable discourse. Katmando and Delta wave-I love your train of thought!

Well, sometimes my train of thought is the engine, sometimes the caboose and sometimes it just gets derailed.

My gainful employment requires that I read obscure and not so obscure journals and since I'm preparing a grant dealing with obesity, exercise and prenatal programming (and n-3 fatty acids of course!) then all that information is bubbling to the top. I often have one computer crunching numbers so during the wait I can multi-task. No family other than my dear, retired husband. We made a deal that I'd stay employed if he did everything around the house - shopping, cooking, cleaning and horse care. I just work, come home to a cold beer and work some more. Role reversal at its finest!

Kathleen (KFG in KCMO)

deltawave
Mar. 2, 2010, 12:30 PM
Love to hear more about prenatal programming WRT obesity! Hardly horse-related, though. :(

Melyni
Mar. 2, 2010, 04:17 PM
I think the huge testing error might extend past iron. Does the lab provide any data on same sample variability?

Are you and MW suggesting that the analysis isn't worthwhile, or get the analysis and ignore iron? What's the rationale behind discarding the iron figure besides dirt contamination and lab variability? Is the variability equally high for the other trace minerals?

Or do we just ignore iron because...? What's the rationale? If all the trace mineral values are so variable that they're useless then why mess with forage analysis at all?

Kathleen (KFG in KCMO)


I routinely send out feed and product samples for analysis and I often send the same sample to different labs to get an idea of variability.
The iron levels reported back vary enormously between labs and between samples, by as much as 50-60%, plus the analysis does not tell you what form the iron is in, just how much their particular method of analysis has measured.

With such a huge margin of error, plus the variability in absorbance, there is no way to be sure that the sample you have had analyzed really does contain what you think it contains. So "tightly balancing" other minerals based on the level of iron is so fraught with error that it becomes pointless.

I agree with the observation that most of the time horse feeds are too low in copper, and copper needs to be in the correct ratio with zinc. But often times I find just supplementing the zinc and copper does the trick.

I also think that the NRC values are minimum requirements not optimum ones and I suspect that we will in fact move to higher Cu and Zn requirements over time as more research gets done. but I don't think that the iron values as reported from most forages are reliable enough to be used as a basis for supplementation of other minerals.
YMMV
MW

Mach Two
Mar. 2, 2010, 04:58 PM
To the OP's question about what makes an equine Nutritionist (that was the question wasn't it?)
Someone who has background, education, and knowledge.

Personally, I count on my friendly equine specialist from a feed company, he has a Bachelors degree in animal husbandry, decades of experience in performance horse training and management, and continuing (annual updates and testing) education from equine nutritionists who are well known, and well qualified to conduct the continuing education courses for that company's specialists (who are not feed salesmen, but consultants and educators themselves)

I am all for continuing education and findings...but it's still a fact that greats like Seabiscuit still managed to run on probably rolled oats and hay. :D

Sarah Ralston
Mar. 3, 2010, 06:31 PM
I am all for continuing education and findings...but it's still a fact that greats like Seabiscuit still managed to run on probably rolled oats and hay. :D

Amen-people are making things WAY too complicated. As I have said before many times, trying to micromanage nutrients that we really know very little about and ignoring the basics is IMHO a waste of time and money. Sticking to feeding primarily forage, avoiding excessive concentrates (including supplements!) and letting the horses get plenty of exercise (preferably including turnout, not just under saddle/forced) will keep them healthier, happier and more sound.

BestHorses
Mar. 6, 2010, 12:50 PM
Oh my! I am completely exhausted reading this. I think I am less clear now on who can interpret my hay analysis and tell me what, if any, changes should be made to my feed. Ask a simple question... :lol: I guess the ponies will continue eating the same old stuff until I can devote another morning to slogging around the internet and leaving messages with the extension service.