Tuesday, November 17, 2009

Equine Pemphigus Foliaceus

Pemph.... what?

Pemphigus foliaceus (pem-fi-gus foli-a-shus) is an auto immune disease that affects humans and dogs and, to a lesser extent, cats and horses.
In horses, it is characterized by primary lesions that often begin on the head and lower extremities; secondary lesions spread to other areas, with an exudate that dries to a crust. There may be extensive edema (swelling) in the legs and abdomen (called "ventral" edema).
Equine pemphigus foliaceus (EPF) is considered rare and signs and symptoms may resemble those of other conditions such as insect bite allergies (crusty lesions), pigeon fever (ventral edema) or other skin conditions.
The primary way to diagnose EPF is by punch biopsy of the skin which is examined by a veterinary pathologist. The pathologist looks for changes consistent with this diagnosis, while also ruling out other causes.
Horses with EPF may also have systemic signs of illness - fever, depression, loss of appetite, lethargy and weight loss. The skin may be painful to touch and swelling can make it difficult to walk or lie down.

Currently, treatment options are limited, mainly focused on corticosteroids (dexamethasone, prednisolone and prednisone) to limit inflammation; prognosis is generally guarded at best with many cases ending in euthanasia. Little is known about specific causes of EPF and what supportive treatments might be useful.
The Equine Pemphigus Foliaceus (EPF) group is hoping to change this. Two horse owners who have been looking for information and answers have recently teamed up with Eleanor Kellon, VMD to look at triggers, what's working and what's not, and how these horses can be supported to continue leading productive, comfortable lives. Dr. Kellon has a long history of developing cutting edge science-based supportive therapies for horses, with an emphasis on precise diagnostics by field veterinarians. By identifying and bringing together owners of afflicted horses, reviewing and comparing their histories, diagnostics, treatment and outcomes, and utilizing available research, a comprehensive picture of how to optimize support will emerge.
If you have a horse who has been diagnosed with EPF - currently or in the past - share your history with others by joining the EPF group. The group will provide information and support for owners, and is focused on improving science-based diagnostics, treatment protocols and outcomes for the horse.

Wednesday, October 28, 2009

Equine Support and Research Group

Celebrates Ten Year History and 8000+ Members

New Web Site Launched - Success Stories Unveiled

Health, longevity and quality of life for horses is an ever increasing concern among owners. Whether acting proactively or trying to help an animal with a history of chronic health conditions, public awareness of equine metabolic syndromes and diseases is on the rise. An all volunteer, non-profit group rising to support horses and their owners, the Equine Cushing’s and Insulin Resistance Group is a beacon on the internet to reach that awareness.

The EC and IR Group is formed to sort myth from reality....

In the late 1990’s, a young scientist, Robin Siskel, was seeking information to help her life long companion and Cushing’s mare, Night Flight, and became dissatisfied with the knowledge available. Little was known then about Equine Cushing’s Syndrome now more accurately described as Pituitary Pars Intermedia Dysfunction (PPID).

“Horse Owners were drowning in bad or no advice. Insulin Resistance wasn’t even recognized back then,” said Siskel in a recent interview. She established a small internet bulletin board to trade information and experience among horse owners that was scientific, specific and medically oriented.

A BS in Biochemistry and a Masters in Health Physics from Texas A&M helped keep Siskel on the path she set for the EC and IR Group. Experiences of horses owners were shared, digging into the details with a scientific medical look. Protocols and marketing claims were required to be backed by evidence. The human owner part of the equation was also key and emotional support for owners was included, but Siskel insisted on digging out the information to fully address any issue.

In December of 1999 Siskel moved the Equine Cushing’s and Insulin Resistance Group to Yahoo. For some time she had been communicating with noted author and veterinarian, Eleanor M. Kellon, VMD. Siskel knew Dr. Kellon as a leader in the fields of nutrition and nutraceuticals. She was also fascinated by Dr. Kellon’s sensible and effective approach using the concepts of Linus Pauling’s Orthomolecular Biology. (http://lpi.oregonstate.edu/) Robin wanted to get Dr. Kellon on board with the EC and IR Group.

“I was aware of Robin’s group and intrigued but at the time, due to other commitments, I could not accept Robin’s invitation” said Dr. Kellon.

Siskel adds, “Eleanor did say I could run any of the hardest veterinary issues or toughest problems past her within reason. And after a while of me teasing and tempting her with the most interesting ones, she gave in and joined the group as a full member in 2001.”

Dr. Kellon became co-owner of the group with Siskel in 2004.

How the EC and IR Group works and what makes it different...

In the ten years since it’s inception, the EC and IR Group has become the largest field trial of it’s kind with current membership of over 8200 horse owners, vets, nutritionists, feed companies, farriers and trimmers.

A clearing house for clinical information and formal study results, most of the leading veterinary Universities also have members on the EC and IR Group who keep their finger on the pulse of what horse owners in the trenches are doing. Grants for formal research have been written based on the anecdotal findings of the group. Researchers who are on the forefront of equine metabolic issues in turn inform the group with the deep background of their findings.

Historical milestones include discovery that soaked hay reduced sugar content beneficial to IR horses, early recognition of PPID/Cushing’s seasonal rise, establishment of the Diagnosis, Diet, Trim and Exercise protocol, FDA approval of compounded pergolide as a veterinary drug, early concern of efficacy of some forms of pergolide, early recognition of high insulin and the compromised hoof, use of herbal and nutraceutical treatments with documented positive outcome, and most importantly, thousands of better informed owners with healthy horses leading productive lives.

The EC and IR group now manages four additional sister groups, ECPhotos, ECHoof, ECHistory and ECHistory2. As of today group archives contain 135,000 messages with over 1000 Case Histories. New members arrive at the rate of 30-50 per week. In recent years similar equine groups for horses diagnosed with Degenerative Suspensory Ligament Desmitis (DSLD) and Equine Polysaccharide Storage Myopathy (EPSM) have been formed to support owners. These groups function similarly to the EC and IR Group with volunteer nonprofit support. They also establish protocols, report clinical signs, and keep track of success as well as areas of needed improvement or further exploration.

Dr. Kellon explains, “The EC and IR Group is an example of the internet working like it should. By collecting histories and laboratory data from thousands of horses with PPID and IR, we have been able to carefully monitor responses to treatment and management changes, both good and bad. This is real life, in the barn research at its best. There are no fees charged or products being sold - it's all about the horses and the dedicated people who own them.”

A new Web Site to celebrate the work of ten years past and into the future...

The EC and IR Group has formed extensive libraries of files, photos, data and archived messages. It can be a daunting exercise for members to get through and understand the material, especially if the owner has the added worry of a horse in crisis. With the help of a dedicated support team, a new or existing member is guided through potential diagnosis and diet issues, trim and exercise suggestions.

To simplify the learning curve, in October 2009 the EC and IR Group launched a new intensive and well-organized web site www.ecirhorse.com

“This is really to help all the new members just coming on board and all the old members seeking new information. It's about providing organized access to information. It’s a place for people to send vets that doesn't require joining anything. I wanted information that was simple enough for the new member who needs to breathe deeply and be armed with enough information to clearly interact with their local professionals,” notes volunteer web designer Amberlee Ficociello of Canada.

EC and IR Group’s new web site explains in detail the signs, symptoms and physiology of Cushing’s/PPID and Insulin Resistance. Detailed information on various testing procedures and treatment is available. For equine professionals and for owners wishing to learn all they can, detailed supporting studies and back up data are also given.

Says Ficociello, “We’ve really just scratched the surface for the potential help this site can offer to owners and their horses. We expect to have much more information up in the coming months.”

A Success Stories section on the new web site illustrates with photos, narrative and data the rehabilitation of several horses through various stages of PPID/Cushing's, IR, laminitis episodes, founder and other health issues.

“The format is the same for all EC and IR Group Case Histories and Success Stories. We stick to sound nutritional and physiological equine science and factual, measurable responses. We’re following Robin’s original tradition of taking apart the confounding factors of the most difficult cases and sharing the info freely,” says volunteer Nancy Collins of New Hampshire, who formats the Success Stories. “There are six Success Stories with updates now posted on the site and many more on deck to be organized and shared. After ten years and a library of thousands of case histories, it's really easy to find them,” Collins continues.

A complete approach to getting results....

“Today people use the term holistic but don't realize that in the truest sense of the word the EC and IR group is probably the most holistic of any horse or nutrition group around,” says long time volunteer member and equine nutritionist, Patti Kuvik of Arizona.

“The group looks at the whole horse. His head, his feet, his insides, his urine and manure, his diet, his environment, the weather. We have a basic healthy diet that addresses all of the horses' requirements. There are modifications available for when the horse is no longer in crisis mode and for return to work,” says Kuvik.

When asked to comment on her continued dedicated contribution of time and skill to the EC and IR Group, Dr Kellon replied, “You know those credit card commercials that run through a bunch of things with price tags and end with a moment that's "priceless"? That is truly how I feel every time a new member comes here frazzled or wired and strung out after being told their horse, pony, donkey or mule should be euthanized and then later tells us about the light coming back in their eyes, those first voluntary steps out of a stall, the first spontaneous trot, buck or canter or when the feet start to concave and a hundred other positive signs of getting well. Most of all, it's about the animals.”

Volunteer Web Master Ficociello concludes, “We look forward to the EC and IR Group’s new site getting lots of use and hope visitors will make ample use of our feedback email address.”

The feedback address is ecirhorse@gmail.com

For more information about PPID/Equine Cushing’s and Insulin Resistance on the web go to




Tuesday, October 06, 2009

Responsible Nutrition

I'm often asked what I think of "this supplement" or a particular feed.
As most people I discuss equine (and human) nutrition with know, I don't believe in "magic bullets". I am adamantly against fear-based promotion (if you don't do this, your horse will die and you are a bad horse owner).
I do subscribe to some basic principles
  • You are responsible for what goes into your horse's mouth. This doesn't mean you need to have a college degree in nutrition, but you should have an understanding of what your horse needs and how to supply it.
  • Most commercial supplements/feeds are based on NRC guidelines and are amazingly similar. However, they can't address deficiencies/excesses in the specific forage base you are feeding - there is no "one size fits all".
  • I, personally, avoid supplements or feeds with "proprietary" formulas - i.e., they won't disclose ingredients/amounts because of ...? No one's going to steal their formula - they're all based on NRC guidelines. Non-disclosure reduces any flexibility I might have in my feeding program and can be potentially dangerous if an ingredient is not compatible with another supplement or herb I might want to use. Good examples of full disclosure include HorseTech supplements and Triple Crown feeds.
  • If it works, don't fix it. If your horse is healthy, sound, has excellent hoof and coat condition, great recoveries after work and an enthusiastic attitude, figure out what you're doing right and keep doing it.
  • If it's not working, take the time to figure out what and why; don't just toss the kitchen sink (or the newest magic bullet) at your horse. Part of the responsibility of owning a horse is not just throwing your hands up in the air and accepting what any one person says, but sorting through the advice, claims and advertising.
Although a commercial supplement can't balance your particular forage, there are a number of excellent supplements on the market which meet or exceed NRC minimums and don't contain potentially injurious ingredients (excess iron, excess levels of vit A or D, etc.) The best ones are mostly pretty basic - they contain flax (Omega-3), generous levels of copper (125 mg or more), zinc (360 mg or more) and vitamin E, some iodine and selenium. A healthy horse usually doesn't need anything else; additions beyond this should be customized to the individual horse/work/stress levels and their forage/feed intake.

Also, don't be misled by lengthy guaranteed analysis lists in supplements. For example, all supplement bases (flax, alfalfa, distillers grains, etc.) contain some amino acids. When nutrients such as lysine or methionine are expressed in "mg" rather than the normal "g" or "grams", that's a tip off that there is no added amino acid and the entry in the analysis is just there to impress you - "400 mg" looks like a lot more than "0.4 g". If there is actually added lysine or other amino acid, it should be listed in grams and also show up in the ingredient list.
On the other hand, some ingredients we don't want or need (iron, manganese if your hay has excessive manganese) won't show up in the "guaranteed analysis" - but you will see them listed in the ingredients.

Tuesday, May 05, 2009

Making It Through the Tough Times

I work with a few people who simply can't afford a basic commercial supplement, even the very cost-effective HorseTech flax-based supplements (including AZ Regional Mix or Rod's standard products).

A healthy horse doesn't need all the extras included in many supplements, such as biotin, methionine, probiotics, etc. As long as requirements are met, pasture or good quality hay with some supporting trace minerals and salt will provide what most horses not in intense work need.

Horses on hay only (often the case in the Southwest) should receive a source of Omega-3 fatty acids (flax) and vitamin E. Horses on good pasture usually are well supplied with these during grazing season.

If you are willing to trade off some convenience, this is what I suggest when money is tight:
  • Buy the best hay you can find - this is not the area to skimp in.
  • Fresh ground flax - 4 oz/day (one full cup). Purchase 50 lb bags, grind once a week and store in freezer or refrigerator.
  • Poly copper and poly zinc - 1/4 to 1/2 teaspoon/day. (Available from HorseTech or Uckele)
  • Vitamin E - 2,000 IU. Use human gel caps - the 400 IU size are usually barely noticed and most horses just eat them right down when mixed in their feed. The oil base improves absorption - this is more important than whether the vitamin E is "natural" or synthetic.
  • Iodized table salt - minimum 1 ounce, up to 3 ounces for idle horses and more for working horses.
  • Selenium - generally 2 mg/day if not in a high selenium area. If in doubt about your horse's selenium status, ask your vet to check whole blood levels. (Selenium yeast from Platinum)
  • Chromium - only if hay is grown in arid conditions where it is likely deficient. 2 mg/day for working horses, more for an IR horse, none for idle horses. (Chromium yeast from Platinum)
Along with quality hay, the best thing you can give your horse is exercise. When we confine our horses, it is our obligation to provide them with as much turn out and movement as possible. Lack of exercise can not be fixed with a "supplement".

The best treat? A good grooming. Besides being inexpensive, it provides exercise for you and an opportunity to bond with your horse. But a healthy inexpensive "food" treat is split peas from your grocery store. Crunchy, yummy and they have a complete amino acid profile.

Does your working horse need a little more in the way of protein, calories and energy? Use a 50/50 mix- by weight - of beet pulp and oats (or alfalfa and oats). This is pretty well balanced for major minerals - and most horses will enjoy a beet pulp/oat mash after a workout. Don't forget the extra salt to replace sodium and chloride losses Unless you're doing intense work, there's no need for commercial electrolytes - many don't supply enough sodium and chloride and the feed will replace potassium and calcium.

You can give your horse what he needs without breaking the bank. Of course, basic hay/forage testing will help you do this more precisely - and is usually the most cost effective method, but the suggestions above will ensure your horse is getting the basics. If your horse has special needs (pregnant, nursing, growth, high level intense work, illness) they may require other additions - but this also can usually be done without costing a small fortune.

As always, I wish to credit Eleanor Kellon, VMD for giving me opportunities to learn the basics of equine nutrition. See the sidebar for links to Dr. Kellon's nutrition courses.