# PSSM/head tilting/hind end lameness- Help me solve this!



## Harmony308 (Mar 11, 2013)

Hello, 
I have a horse with lots of issues and need all the help I can get in figuring this out. I have worked with lots of vets and every time we solve one issue another comes up. I will try to sum things up for the sake of time. If you need more details on something mentioned just ask. 

I have a 6 year old Belgian Warmblood mare (not draft cross) who was diagnosed in the fall of 2011 via muscle biopsy with type 1 mild PSSM/EPSM. She has been on a low starch and high fat diet since then. muscle tone is now normal. She has always had stifle issues, but in the past 6-8 months the below issues developed. 
Prior to this diagnosis she was tested for EPM with blood work and spinal tap but was negative. Her neuro exam was normal once she developed normal muscling via PSSM diet. overall she is not the most balanced or coordinated horse- has always had issues with staying relaxed and balanced when cantered under saddle. 

Current issues:
Head tilting and sometimes shaking worse when going to the left, not present at walk, bad at trot and worse at canter. Not seen while under saddle- only when lunging or free lunging without or without any tack on. Sometimes seen in turn out or similar stretching/tilting while in cross ties. teeth are fine. I would see her head tilt like this as a baby once in a blue moon but now its every time we work. (see video) 



Hock lameness- tested positive in flexion tests for both hocks, right was worse. Had both injected 2 weeks ago. improved in terms of more flexion and hind end power, but not sure if they worked entirely. 
Stifles: Intermediate UFP, worse with right stifle. Had internal blister done 5 weeks ago, helped a lot but still have some issues. (has full turn out in dry lots) Had 2 blisters done as a 2 year old but the effect wore off. Now considering surgical method.
Occasional muscle soreness in hind end/glutes
Out of alignment- atlas and or sacrum have been an issue. 

Other issues: 
high head set at canter
resistance to pick up canter, worse to the left
swapping back leads
dropping out of canter
lack of power in canter
bunny hops with both back legs sometimes when cantering fast
canter never looks effortless for her, she prefers to trot
kicking out when asked to pick up the canter on the lunge line
sour mood- seems like she is always uncomfortable in some way, but is such a willing horse she will work under saddle well because she knows she is expected to behave. 

Chiro helped at first and now doesn't. Head tilting developed when she came home from 4 hr. a week dressage training (was in training for 8 months). Symptoms list above became noticeable at a show 1 week prior to her leaving training. She is lunged way more at home due to my back issues- i cant ride as frequently. I'm sure this hasn't helped her joints but I have to keep her moving somehow because of the PSSM. 

That is as brief as I can be. ANY advice is helpful. I have seen multiple threads online about horses that are almost identical to mine in terms of hock and stifle issues/lameness, PSSM or suspected PSSM, back/hind end soreness, sacrum alignment issues, etc. Somebody help me fix my horse- I can't stand to see her uncomfortable. I am now considering nerve blocks or investigating the head tilting as a separate issue than the hind end lameness (vestibular, balance/neuro issue, maybe do an MRI or scope her pouches?) We are also considering surgical splitting of stifle ligament (not cutting it entirely). Another note: she had xrays of her hocks and stifles 2 years ago and they were perfectly fine.


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## deserthorsewoman (Sep 13, 2011)

My my, that is one unlucky horse.....poor girl....poor owner also.

Okay, IF she was mine:
Head x-rays, searching for tooth infection or the like
Thoroughly examining her diet again. She might have to be maintained on 20-25% fat in her overall diet, since she is positive PSSM/EPSM
For UFP, i'd go non invasive, square, and I mean SQUARE toes behind.
In general, I would concentrate on the EPSM. 
A different chiropractor/ bodyworker and look into acupuncture. 

On ruralheritage.com is a lot of info about EPSM/PSSM, absolutely worth reading. 
I feel for the both of you......


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## wausuaw (Apr 15, 2011)

So far as her head, have you checked her ears? Made sure there were no mites or infection? My mare had similar head tossing, pushing head to the side, etc. and turned out there were these little flies laying eggs that were the culprit. Just lazing around, didn't seem to bug her, and her ears weren't sensitive to touch (unless you REALLY rubbed them at the base) but when working she would toss her head or try to hang it sideways, would get worse as her gaits progressed. (Though this was on the ground and under saddle)

The good news was a few hours of making my mare extremely upset and having homocidal thoughts against my existence, the problem was fixed. 

Seems like with all the other things going on that it may not be something simple like that, but I hope you get to the bottom of it and she gets to feeling better  

I am not familiar with these issues at all, so I won't try to give other suggestions, but it does look a lot like what my mare was doing.


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## Oldhorselady (Feb 7, 2012)

Wow Harmony, I do feel for you....and your horse. I agree with Wausuaw to look into something facial with the ears. Maybe it's an inner ear thing? Maybe it's mites. Maybe some type of nerve thing, even though she doesn't seem to be leaning on the halter when lunging. I really wish I could tell you where to start with this one.

I don't think it is EPSM related, but you just never know. If you have read other threads on this site, I'm sure you've seen mine. I have one EPSM Type I pos horse and the other is Type I neg, but have not ruled out Type II. Mine are on the diets and have been for about a month.

I actually contacted Dr. Beth Valentine, DVM, PHD up at Oregon State University. I believe her email address is on the Rural Heritage website Deserthorsewoman mentioned. She will get back to you in a day or so via email. She is awesome.

I will watch this thread for sure. Kudos for you to be able to do so much for this horse. She is very lucky.


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## Harmony308 (Mar 11, 2013)

deserthorsewoman: She is currently on Progressive ProAd Ultimate (vitamin/mineral) and Progressive Envision Classic (fat supplement). The fat supplement is 26% fat per pound (.52 of a pound of actual fat- so she gets a little over a whole pound a day and she is not overweight). She gets alfalfa pellets for taste, MSM and the joint supplement Actistatin. Her hay is professionally analyzed and well within ESPM requirements so I'm not sure what further investigation I can do in the diet area. She does tolerate grass, but has not been on it in months. The hind end muscle soreness on occasion makes me think EPSM though. I have heard a lot about Magrestore and Equiwinner (electrolyte) patches. Maybe I should look at those. She is on a sugar free electrolyte in the summer. I can try squaring the toes, but we have tried some farrier work and it didn't help. I am familiar with Dr. Valentine and have talked to her/read her website. 

Wausuaw: I don't think it's bugs, but I will double check her ears when I see her next. She does get insect bites in her ears in the summer and can throw a fit in the pasture but it has never looked like what she is doing now. 

Oldhorselady: I have seen your posts. I don't think the head tilting is related to EPSM, I think it is her way of showing discomfort that is hind end related or specifically her stifles. The tilting has improved with the stifle blister and hock injections but it didn't solve it. I am considering investigating an inner ear thing. 

Thanks for the support everyone. I will keep posting- I am waiting on a phone call from one vet and the other is coming out next week. I hope we figure this out, but I'm sure it will involve more months of frustration and thousands of dollars that we don't have, but will spend anyway


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## deserthorsewoman (Sep 13, 2011)

Harmony, we were just going through the fat problem of the diet with Oldhorselady's horses. You want 20-25% fat of the total ration. Grass hay has 2-3%, so you can do the math and see it takes more than just a lb of your high fat supplement. 
I would first take care of the one subject you can without spending another fortune. The UFP could be an EPSM symptom, that's why I'd be for non invasive measures for that. What the square toe does: it's breaking over earlier, means leave the ground, before the leg comes to a complete stretch and the ligament can get caught over the patella. If it doesn't help, at least it hasn't done anything wrong. 

I do agree the head tilting is something different.


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## Harmony308 (Mar 11, 2013)

Deserthorsewoman, 

I will pull out the hay analysis and review her feed again. As far as her feet we did try the squaring of the toes exactly how you described and added shoes with extensions on the back for more support. I felt she did not improve, but I can always as my farrier if we could (keeping the shoes off) square her toes more than they are at the moment. We thought for a a year that the UPF was EPSM related but she has normal muscle tone and still had issues 6 months post diet change and while she was in regular dressage training. I suppose it could be, but there is no way I can work her daily or as extensively as needed to prevent UPF due to my back injury. All non invasive methods seem to require a whole lot of strengthening and maintenance. If 8 months with a trainer didn't help then I don't know what will. I have debated selling her for this reason because I can't ride without back pain so I may not be the best owner for her considering I can only tolerate a limited amount of riding. Clearly she is a mess and can't be sold right now. Such a sticky situation.


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## starlinestables (Nov 24, 2008)

Are you doing any IV/IM joint supplements in addition to your IA injections (Hock injections)? I agree with squaring the toes too. 

With the head shaking and tilting... the only additional things I can think of is to try some of the "head shaking syndrome" remedies. Fly mask that covers the ears, eyes and nose that is UV rated. You can also opt out of a few vaccinations to see if the situation improves (several people blame vaccines such as Rhino). Could it make a difference? Possibly.

Keep in mind there are legitimate medical reasons why a horse exhibits certain behaviors that become learned behaviors and training problems after their medical issues have been addressed. I would find a good driving trainer to build muscle back and teach your horse how to use himself again.


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## existentialpony (Dec 4, 2012)

I have mostly dealt with small animals, but I would probably lean towards calling your mare's behavior some kind of vestibular or neurological head-tilting rather than irritation (after watching the video). Does she head-tilt if you trot or canter her in a straight line? I feel like she tilts to compensate for knowing she's unbalanced, but not quite how. If you rule out mouth issues, I might wonder about some kind of vestibular infection/disease.

Another possibility... have you checked her eyes/sight?

I am so sorry that you and your sweet mare are going through this hard time. :-(


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## existentialpony (Dec 4, 2012)

Just wanted to add... after re-reading your mention of her doing this as a foal, and also reading through your problems list, I really think you should have a vet do some kind of evaluation of her balance/vestibular function. (Just hypothesizing here!) I wonder if she had a minor vestibular infection as a foal that caused some kind of damage, which was emphasized or worsened when she was asked to do balanced work (ie. dressage training).

Again, just throwing ideas out there. I wish you and your mare the best.


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## deserthorsewoman (Sep 13, 2011)

I guess that's what we're all doing, throwing ideas out there, in hopes of hitting the bull's eye....

Im still stuck on the nutritional aspect. The UFP symptoms are EPSM symptoms, and since hocks and stifles were clear, and treatment didn't
really do anything long-term. 

She was in dressage training, which is pretty demanding energy wise, so she could have had not enough of any of the key components.


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## Left Hand Percherons (Feb 1, 2011)

Kudos to your mare for the heart and try she seems to have. She's obviously in a lot of discomfort while you lunge her but she's still trying.

As far as the high fat diet, you are nowhere near providing enough fat in the diet if the Envision is the sole fat source. The .52# of fat in the Envision (if she gets 2# per day) provides 2 Mcals. The other stuff in the Envision is about 1 Mcal. If she gets 20# of alfalfa pellets and hay, that's about another 18 Mcals. The fat portion will only represent 9.5% (2:21) of the diet. That needs to be more than doubled. Her hindend muscles are starved for energy. Cheapest place to start.

Have you done any acupuncture on her? Anything neurological in origin could benefit from acupuncture. It is late in the game if she has been doing this from a young age but it's still a cheaper alternative to some of the things you've thrown out. I would do a minimum of 3 treatments (2-3 week intervals).


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## Harmony308 (Mar 11, 2013)

Starline stables: I have not done any other IV/IM joint supplements. She does have a fly mask with ears, but I have a hard time thinking its the head shaking syndrome because it it no consistent enough- only when lunging, not when ridden and not when turned out (other than when she runs around like an idiot). I hope she does not continue this behavior out of habit. Knowing her personality I don't think she would. As far as training I will have to try and find a knowledgeable rider that can come rider her when I am unable to. I can't afford training at the moment and have already borrowed 8,000 for the dressage training and owe another 7,000- dang ponies are so expensive!

existentialpony: I have also thought it could be a balance or vestibular problem and have considered looking into that, but I can't decide if I should put that at the top or bottom of my diagnostics to try list. I have not checked her eyes. She will do the head tilt straight, but not as much. She seems worried at the canter undersaddle and she used to seem worried at the canter on the lunge so it has made me wonder if she feels unbalanced. She had multiple neuro exams when we were in the process of diagnosing the EPSM and the last one was pretty normal but that doesn't mean she couldn't have a minor vestibular issue- thanks for the idea!

deserthorsewoman: I was a little unclear with my phrasing- she gets 2 pounds of envision classic a day, which I was told by the grain rep that that was equal to 1 pound of fat a day. BUT reviewing Dr. Valentine's calculations she would need 4 pounds of Envision to get one pound of fat a day. I FEEL HORRIBLE that this was not caught earlier  I couldn't sleep last night because of it. Apparently the vet I had at the time didn't catch it either. There is no way I can afford to pay 30 dollars a week for a fat supplement so I will be adding the other half a pound of fat through oil. This mistake has now changed my mind about UPF treatment. We need to wait until she has been on the proper fat before jumping into surgery. 

Left Hand Percherons: Thank you for the compliment- Harmony is SUCH a sweet and good worker and it has been so hard to see her personality fade because of her discomfort. See my comment to deserthorsewoman about diet issues. I have not done acupuncture, but I have someone that could do it. I will speak with that vet when she comes out next week. 

Current plan: Fix the fat issue ASAP, talk with farrier (first week of April) about squaring her toes as much as possible, have her blood drawn next week to check electrolyte levels- if there is an issue I would like to try the Equiwinner electrolyte patches. Thank you everyone for the ideas. I don't know if I will be able to forgive myself for the fat miscalculation, but I will keep moving forward and doing everything I can to help this poor girl. I've had her since she was one and she is very important to me.


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## deserthorsewoman (Sep 13, 2011)

I hope so much that I can be glad to have been so persistent with the nutritional issue.....;-)
With squaring the toe I WOULD WAIT also. It helps a lot with true UFP, but I don't think it is it. Rather the muscle issue.


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## Foxhunter (Feb 5, 2012)

To me this screams misalignment. I would say that she is misaligned C!/C2/C3 this in turn will have put her wrong down through her body.

I would like to know what the chiro did and thought when they saw her.

Would it be possible to see pictures of her standing square, taken from behind, and, standing on something tallish from above and also of her stood square, of her knees up to her chest.


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## wausuaw (Apr 15, 2011)

I hope she gets to feeling better!


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## Harmony308 (Mar 11, 2013)

Foxhunter: I could get some pictures, but it will be the weekend before I can do so, I am finishing up midterms this week. She has been seen by 2 different chiros. Her atlas has been out of alignment twice (end of the summer and fall), but they past two times she was adjusted/checked her neck was not out of alignment and her lateral flexion was fantastic. I will work on getting some pictures this weekend. 

Wausuaw: Thank you!


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## Harmony308 (Mar 11, 2013)

*EPSM diet costs*

Ok, 
I have figured out the necessary changes for Harmony's diet. The downside: It will cost $275 a month for her vitamin/mineral supplement, pelleted fat supplement, alfalfa pellets, MSM and joint supplement. 
I have not even figured the cost of her needing 1 cup of oil a day. 
Plus I have to factor in 50-60 dollars a month in hay. 

How much do other people pay for EPSM diets? This is insane and I don't know how my parents or I can afford it. We will have to, but seriously- we are talking $4500 a year to FEED my horse.


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## BigGreyHorse (Sep 28, 2009)

While the pelleted fat supplements are great, the cheapest route to fat supplementation is bulk vegetable oil from Sam's or Walmart. Get the big 5gal bottle and put a 1 ounce pump on it.


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## Left Hand Percherons (Feb 1, 2011)

I don't know how you're figuring your costs but if you were to provide all the fat calories with oils, that would run you less than $1/day. I'd rethink everything else and up the hay. It's the cheapest part of the diet.


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## Harmony308 (Mar 11, 2013)

The problem is the price of Progressive brand. If I stay with Progressive this is the cost break down:
2.5 pounds of Progressive ProAd Ultimate x30 days = 75 pounds= 3 bags a month= $126
2 pounds of Progressive Envision Classic x30 days = 60 pounds = one 50 pound bag plus 10 pounds a month = ~$50
3 pounds of alfalfa pellets (we may need more) x30 days= 90 pounds a month = just under 2 bags a month= $32
MSM = ~$4 a month
Actistatin = $65 a month

Total = $277.00 a month

The vitamin/mineral one is a 25 pound bag for $42 ad the fat supplement is a 50 pound bag for $40. Her joint supplements add extra cost, but cannot be cut.

Plus the other half a pound of fat would come from vegetable oil which is not included in that cost. 
Also, they hay is $5 a bale on average and that is not in the cost above. 

I think I need to switch to using only oil as her fat supplement and use alfalfa pellets for absorption. I am not comfortable not feeding either a vitamin and mineral supplement or a low sugar/starch complete feed. I need to find a different brand for that. 
The Progressive food rep said I needed double the normal amount of the Vitamin/mineral supplement than is suggested on the bag to make sure she gets enough amino acids. Thoughts on this? This seems odd to me- he is wrong to suggest that or their feeding instructions on the bag are not accurate. Dr. Beth didn't mention a concern about amino acids and muscle function, that is, in terms of adding extra to the diet.


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## deserthorsewoman (Sep 13, 2011)

Please post links, if possible, to all supplements, so we can start looking for substitutes. Main supply of fat from oil is a big step to savings. 
Up the hay, use alfalfa pellets only for hiding supplements, you should be good with one bag/month then. 
Why MSM AND joint supplement? Would either be okay?
Vit/min...there are less costly versions, I'm sure. 
An Omega supplement, like Omega Horseshine, for example, supplies 30% fat, and has anti inflammatory properties, and supplies some vit/mom's too. 
And I'm pretty sure there's more


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## deserthorsewoman (Sep 13, 2011)

Oh, you beat me
Will get to it once I'm done picking poop....but look into the Omega Horseshine....there are your amino acids.....


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## Oldhorselady (Feb 7, 2012)

I think, for me, starting at the bottom of the barrel and working your way up is best. In other words, start with the neccessities that your horse needs....this in the beginning is 'fat' and how to get your horse to change over to it and actually eat it. Start with the cheapest, lowest sugar/starch stuff to mix it with and go from there. If you have to add something else for your horse to eat the fat that is higher in NSC's etc., then you may have to for a period of time. From my experience, after finding a way to get my horses to eat the mix with all the oil in it, you can start to fine tune the mixture with the other stuff. You may also find you don't need as much of the other stuff. Vit E and Selenium are the most important according to Dr. V. The other stuff matters too if he is deficient, but in the beginning, the main thing is to get the fat in something the horse will eat, then adjust a little at a time.

Dr. Valentine's diet that she emailed me:

*EPSM (PSSM, EPSSM) DIETS*​​Designed by Dr. Beth Valentine with assistance from Drs. Harold (Skip) Hintz, Bob Van Saun, Don Kapper, and Kent Thompson​ 
*Goals:* To provide no more than 15% total daily calories from starch and sugar, and at least 20-25% of total daily calories from fat

*Forage: *

Either *grass or legume hay* (such as alfalfa) can be fed. Alfalfa hay does not have a high enough starch content to be a concern.

Grain hays such as oat hay and barley hay with remaining seed heads should be avoided.

The amount of forage is not critical - it can be varied depending on whether the horse needs to gain or lose weight. Just do not feed less than 1% of the horse’s body weight in forage per day. 
Lush spring pasture will be higher in starch and sugar than summer grass, and the amount of dietary fat may need to be increased during this time.

*Vitamins and minerals:*

*Vitamin E*: At least 1 IU vitamin E per lb of horse per day is important for all horses, especially those not on alfalfa products or green grass for much of the year. You cannot hurt a horse with extra vitamin E.

*Selenium*: About 1-2 mg selenium per 1000 lbs of horse per day is essential in areas that are selenium deficient. Selenium can be toxic at high levels, though, so be aware of all sources of selenium in your horse’s diet, and ask your veterinarian to have blood tested for selenium levels if there is any question of selenium deficiency or excess.

*“Broad spectrum” vitamins and minerals*: Horses on fat supplemented diets often will not be eating the manufacturers recommended amounts of fortified commercial concentrated feeds per day. If forage quality is good, most vitamins and minerals will be adequately supplied by forage. For horses on lesser quality forage, hard working horses, breeding horses, and growing horses, addition of a daily vitamin and mineral supplement is important.

*Other supplements*: Hoof supplements, joint supplements, etc. are not a problem when feeding EPSM horses.

*Fat:* * EPSM horses need at least 1 lb of fat per 1000 lbs of horse per day.*

Start with small amounts, such as 1/4 cup oil per feeding, and increase by about 1/4 cup every few days. Use the general rule that *two cups of oil = 1 pint = l lb.*

*Treats for EPSM horses:* Most EPSM horses are fine with carrots and apples in moderation. Avoid treats with grain or sugar. My horses like Kellogg’s Cracklin Oat Bran, which has about 20% calories from fat.


*Specific Diets for EPSM Horses*​ 
** At the time of this writing there is no feed high enough in fat to provide the proper calorie ratios to EPSM horses without an additional fat source*

In general, aim to feed no more than 5-6 lbs of any feed other than a pure forage based feed per 1000 lbs of horse per day.

*Feed the minimum amount of feed in the bucket that gets the horse to eat the maximum amount of daily fat while maintaining good weight*.

If it takes a small amount of something “sweet” (molasses, carrots and apples, apple juice, peppermint flavoring, a handful of oats or sweet feed, etc.) to get your horse to eat the right amount of added oil early on, this is not a problem. You can aim to decrease or eliminate this small amount of starch and sugar later.



 
*Examples of very low starch and sugar feeds:*

Alfalfa pellets
Other hay pellets
Alfalfa cubes - soak in water when adding oil
Beet pulp, low molasses content - soak in water
Complete feeds - meant to replace hay if needed
Dengie or chaff products
Chopped hay products


*Examples of low starch and sugar feeds**:

***In general, feeds higher in protein and fat will be lower in starch and sugar. Ingredients such as soy hulls, beet pulp, bran, wheat brans, and wheat middlings are relatively low in starch and sugar.

Below are examples of low starch and sugar feeds, there are many others. If in doubt, contact the company and ask about starch and sugar content. Look for feeds no more than 33% starch and sugar.

If you can see grains in the product it is likely too high in starch and sugar for an EPSM horse.

Purina Strategy (14% protein – NOT 12% protein) 
Nutrena Compete
Nutrena Safe Choice
Blue Seal Hunter, Demand, Vintage Gold
Senior feeds
LMF Stage 1
LMF Complete
Equi-Pro Carb-Safe
Platform horse feeds
Triple Crown Senior, Complete, Growth
Triple Crown Lite
Triple Crown Low Starch
Purina WellSolve L/S and W/C


*Examples of higher fat feeds*:

These are examples of feeds that allow addition of less added fat. Most companies suggest using these only as an addition to other feed. For EPSM horses, feed these alone along with good quality forage or a daily vitamin and mineral supplement:

Kent Feeds Omegatin (20% fat)
Nutrena Empower (22% fat)
Farmer’s Cooperative High Fat Low Carb (20% fat)
Moorglo (15% fat)
Rice bran, powdered (20% fat)
Buckeye Ultimate Finish (25% fat)
Nutrena Farr XTN (12% fat)
Re-Leve (about 10% fat)
Purina Ultium (12% fat)
Purina Amplify (30% fat supplement)

Calculate amounts of fat fed from these products by multiplying lbs fed per day by the percentage of fat. For example, 3 lbs of Ultimate Finish is 3 x 0.25 = 0.75 lb of fat.

Feeds with 20% or more fat can be supplemented with rice bran (20% fat) to provide additional fat. All other feeds require addition of a 100% fat source.

*100% fat supplements*:
Any salad type vegetable oil, such as soy, canola, corn, safflower, cottonseed, etc. Cocosoya and wheat germ oil are also fine, just more expensive.

Cool Calories dry fat product, by Milk Specialties - 800-323-5424 ext.1156, ask for Catherine Gerardi.

Cool Calories dry fat product, by Performance Horse Nutrition, Weiser, ID 208-549-2323.

Ultimate Finish 100, Buckeye Feeds


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## greentree (Feb 27, 2013)

Thanks, OHL, very helpful information!!

Nancy


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## deserthorsewoman (Sep 13, 2011)

I guess starch/NSC is not so much of a concern.....I cringe with more than 20% NSC;-)

OHL, the Omegatin never crossed my mind....I have only an empty bucket in the feedroom, which I store my Horseshine in...duh......it's about 30$ for 20lbs


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## deserthorsewoman (Sep 13, 2011)

So, for the OP, what's eating up, literally, the most money are the two feeds....not the supplements.
I'd start with more, better hay, more or less free choice, weigh how much she actually consumes. Calculate calories the hay provides, and the difference between need and provided by hay is made up of fat or high in fat feeds, with alfalfa pellets as carrier . Add vit/min, the joint Supp and MSM. Done.


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## Harmony308 (Mar 11, 2013)

Thanks for all of the information guys.

Could the following vitamin and mineral supplement work for Harmony? It is not listed on Dr. V's list, but I don't see why it wouldn't work. When compared to Purina's WellSolve L/S it is only 1-2% higher in sugar/starch so it is still in the acceptable range as I understand.

Purina Horse Feeds - NATURE'S ESSENTIALS

Could someone clarify if she would be getting enough/too much selenium if she got 2-2.5 pounds of this feed? (I need to pull out the hay analysis for you guys as well.)
I would feed this and then all fat via oil mixed with alfalfa pellets. 
My hay is very high quality 60/40 alfalfa grass mix and Harmony gets about 17-20 pounds a day, more if she appears to need it. She weighs just under 1200 pounds. I cannot feed free choice hay because her companion is a pony and he would explode!:lol: Plus, usually if I increase her hay she gains weight so if I went free choice I am assuming she would keep gaining. Her muscle tone is normal- even if she is having issues due to a lack of fat, she does not need to gain a lot of muscle mass like the concern expressed when switching a horse to the EPSM diet for the first time.


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## churumbeque (Dec 20, 2009)

Harmony308 said:


> Foxhunter: I could get some pictures, but it will be the weekend before I can do so, I am finishing up midterms this week. She has been seen by 2 different chiros. Her atlas has been out of alignment twice (end of the summer and fall), but they past two times she was adjusted/checked her neck was not out of alignment and her lateral flexion was fantastic. I will work on getting some pictures this weekend.
> 
> Wausuaw: Thank you!


 I have had the experience with using 2 different chiro's. 1 was good at aligning the front of the horse and the other was good at aligning the back. I wish I could find a chiro that was good at both and I would have another reputable chiro take a look. Also stand behind the horse and did your fingers into the rump so that they lift their back. Does the spine look crooked? How far up the spine is the horse able to lift his back?
This can tell you alot.


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## churumbeque (Dec 20, 2009)

Harmony308 said:


> The problem is the price of Progressive brand. If I stay with Progressive this is the cost break down:
> 2.5 pounds of Progressive ProAd Ultimate x30 days = 75 pounds= 3 bags a month= $126
> 2 pounds of Progressive Envision Classic x30 days = 60 pounds = one 50 pound bag plus 10 pounds a month = ~$50
> 3 pounds of alfalfa pellets (we may need more) x30 days= 90 pounds a month = just under 2 bags a month= $32
> ...


 I don't know where you live but why feed pellets over actual hay? Hay is easier, cheaper and they get the enjoyment of chewing the roughage.


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## Harmony308 (Mar 11, 2013)

Churumbeque: OH MY!! I hope it didn't appear as though I don't feed hay! The list of feeds you quoted are what she gets as "grain" but she eats 18-20 pounds of 60/40 alfalfa grass mixed hay. I am not a fan of feeding grain actually, I prefer hay and pasture and only give concentrated vitamin and mineral supplements to make sure they don't have any gaps in their nutrition. The pelleted alfalfa was just used in her diet for taste because she doesn't like to eat her other supplements plain. Sorry for the confusion!

I have worked with the only semi-local chiropractors in the area- I'd have to travel an hour or more to use anyone else. I will try getting her to "lift her spine"- I have seen this done before.


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## deserthorsewoman (Sep 13, 2011)

Have you considered slowfeeder haynets? 
Slow Feeding Horses on Paddock Paradise Tracks - Paddock Paradise Wiki

That way she can eat little, but all the time, and pony also. 
Those feeders/nets do amazing things....my horses never run out of hay, but consumption is down 40%...blimp horse lost weight, hardkeeper gained. And they're happy.

Re the vit/min....check on Purina Enrich or other ration balancers ...gives you all necessary nutrients, a bit mass compared to a 2oz supplement, for adding the oil.
For selenium, I'd see what your hay provides, and would add extra, above of what the vit/min or Rationbalancer provides only if hay is severely deficient.


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## churumbeque (Dec 20, 2009)

Harmony308 said:


> Churumbeque: OH MY!! I hope it didn't appear as though I don't feed hay! The list of feeds you quoted are what she gets as "grain" but she eats 18-20 pounds of 60/40 alfalfa grass mixed hay. I am not a fan of feeding grain actually, I prefer hay and pasture and only give concentrated vitamin and mineral supplements to make sure they don't have any gaps in their nutrition. The pelleted alfalfa was just used in her diet for taste because she doesn't like to eat her other supplements plain. Sorry for the confusion!
> 
> I have worked with the only semi-local chiropractors in the area- I'd have to travel an hour or more to use anyone else. I will try getting her to "lift her spine"- I have seen this done before.


 I understood that you fed hay it just seemed like 50.00 a month was low. I pay 5.00 a bale and 
I spend 75.00 per horse and yours looks large. So thinking that sounded like a low number depending on where you live.


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## Harmony308 (Mar 11, 2013)

$50.00 a month was just my guess. 
I pay $5.00 a bale and they weigh on average 50 pounds each. 
I just took 18 pounds (average daily feeding) x 30 days = 540 pounds of hay a month divided by 50 (weight per bale) which equals 10.8 bales a month. So 11 bales a month times $5 a bale gave me about $55 a month for her. Of course I'm sure it varies a decent amount so it's probably closer to your cost since I don't weigh every feeding.


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## Oldhorselady (Feb 7, 2012)

Harmony308 said:


> Churumbeque: OH MY!! I hope it didn't appear as though I don't feed hay! The list of feeds you quoted are what she gets as "grain" but she eats 18-20 pounds of 60/40 alfalfa grass mixed hay. I am not a fan of feeding grain actually, I prefer hay and pasture and only give concentrated vitamin and mineral supplements to make sure they don't have any gaps in their nutrition. The pelleted alfalfa was just used in her diet for taste because she doesn't like to eat her other supplements plain. Sorry for the confusion!
> 
> I have worked with the only semi-local chiropractors in the area- I'd have to travel an hour or more to use anyone else. I will try getting her to "lift her spine"- I have seen this done before.


Yes, I felt the same as you, especially since my guys are such easy keepers...no grain, just RB and hay. However, the high fat diet changes all of that thinking. But, it's not as bad as I thought once I got them eating the mixture. My 1100lb horse only gets a pound of the TC Senior, a pound of RB and then the Cool Cal, Omega, Oil and Vit E. My 2000lb horse gets double. It sounds like a lot of stuff, but it's not. They eat it up fine now too and seem to eat less hay. They only get about 40lbs a day between the two of them and half is in slow feeder hay bags. You will get there, just get over the hump of frustration and confusion and it will all come together.


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## Left Hand Percherons (Feb 1, 2011)

Harmony308 said:


> The problem is the price of Progressive brand. If I stay with Progressive this is the cost break down:
> 2.5 pounds of Progressive ProAd Ultimate x30 days = 75 pounds= 3 bags a month= $126
> 2 pounds of Progressive Envision Classic x30 days = 60 pounds = one 50 pound bag plus 10 pounds a month = ~$50
> 3 pounds of alfalfa pellets (we may need more) x30 days= 90 pounds a month = just under 2 bags a month= $32
> ...


I think Progressive products are great quality products but they are overpriced. Why does the feed rep say you need twice as much amino acids as the rest of the equine population? You are feeding a legume hay blend as the base of the diet. You are already supplying adequate amounts of protein (amino acids) in just your hay. Some quick math. At 13% (average t&a) you're providing 2.2# protein. Add alfafla pellets, another .5#. 2.5# ProAdd is another 1.37. The Envision another .3#. Grand total 4.37# of protein a day. Protein is the most expensive nutrient in the equine diet. I would not be wasting my $$ overfeeding it. If you need more protein, roasted soybeans are high in protein and high lysine for a great price plus has a high fat value.
PSSM horses do not have a muscle building issue inspite of the muscle wasting they exhibit. They have muscle wasting because they can't fuel and use the muscle to keep it tone.

I do think horses need some type of vitamin/mineral supplement as well. Progressive makes a quality loose mineral blend that will only run $.25/day. Rep probably didn't bring that product up.

I think you can provide everything she needs with some wise choices for less than 1/2 of what your current feed bill is.

Envision also switched to 40# bags so that cost is higher.


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## Harmony308 (Mar 11, 2013)

deserthorsewoman: I didn't quite understand your comment about the Purina product. Could you explain what you meant? 
"Re the vit/min....check on Purina Enrich or other ration balancers ...gives you all necessary nutrients, a bit mass compared to a 2oz supplement, for adding the oil."

I have considered the slow net feeders and I would like to get one or two. I am debating where to put it and which type- some of the reviews were bad so I need to find a well constructed one. WAY more natural for them!  Downside: our hay is in very tight flakes so that would involve lots of hand pulling apart and fluffing. If I can get my parents to do that I would like to switch (Horses live on my parents farm- I don't feed).

Oldhorselady: I agree that grain is ok if it benefits the horse. I used to feed a lot of it previously. Can I ask is your horse on the TC Senior because she/he needs a senior supplement, for weight gain, for adding fat to the EPSM diet? I'm assuming it is a little bit of each of those. I considered feeding Purina WellSolve L/S, but it says she needs 10 pounds to get all vitamin/mineral and its $30 a bag. The way I understood it is that this feed is designed to provide vitamins/minerals like a RB, but because of the bulk of roughage in it you get more calories and can feed less hay. If this is the only advantage (for my horse) then I would rather just feed the Enrich 12 RB. I am definitely open to adding grain at some point if she needs it or I want to feed less hay. 
Also, is the Vitamin E in your grain/RB low and that's why you have a Vitamin E supplement?

Left Hand Percherons:
I agree Progressive is overpriced, at least for a horse like mine it doesn't work well. I don't understand the rep's idea of more amino acids either. He has seen the hay analysis so his recommendation doesn't make sense. Plus, doesn't doubling the RB cause you to over feed vitamins and minerals? Obviously feeding varies by weight, but I was under the impression that 1 pound was sufficient for 1000-1100 pounds.
You are right about the muscle building- I didn't phrase that correctly. 

Thanks for your help everybody! 
P.S. As if I'm not busy enough figuring out all of these issues, Harmony went and gashed her head open today! :shock: We are going to get stitches this afternoon. What a little booger!:wink:


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## deserthorsewoman (Sep 13, 2011)

I wasn't sure if you were familiar with ration balancers. From what I hear the Enrich is quite good. Since you feed at least a pound, it gives you "mass" to pour the oil over. A vitamin/mineral supplement, given by the ounce, wouldn't be enough to suck up the oil

Slowfeeder: tight flakes are no problem as long as the feeder "gives". Netting does that, metal grates not. For ease of filling for your parents, I would suggest the Nibble Nets, hung high enough so she can't get a foot in ( if shod. If barefoot, it's no problem). For further ease for your parents I would get big nibblenets who have enough space for two days worth of hay

ETA: for gashes on the head....bubble wrap....;-)


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## Light (Mar 4, 2012)

I use a "Freedom Feeder" for my horse and it works very well. I have had it over a year now and it is holding up well. It costs around $35 to $40.

I am sorry you are having health issues with your horse. She is very pretty.


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## Harmony308 (Mar 11, 2013)

*Update*

Ok, I wanted to give a more complete update on my plan. 

Yesterday, when Harmony had to go the vet for minor cut (not my normal vet, but one who has seen her once) we talked a lot about her head tilting. I have really been working to see what is causing it and he said since I already blistered her stifles, injected her hocks and tried chiro adjustments that he would like me to try something less invasive. We will be giving Harmony a low dose of bute for 3 weeks to see if that has any affect on the head tilting and then report back to him. This means unfortunately that for the next 3 weeks we will not be upping her fat intake because we need to be able to distinguish what helps her. I am not very happy about this, but I think we need to proceed. 
After the 3 weeks, her fat will be upped to the one pound a day. Then we can judge if that fat increase works miracles in itself. Do you guys have a guess as to how long it would take to see positive changes from increasing the fat? When I begin increasing fat (and assuming my vet analyzes my hay and supports the decision) I would like to stop feeding a ration balancer. (I posted a thread about this in horse nutrition) This being said I would like to feed this supplement:
E-Se-Mag - Horse Antioxidant Supplements from SmartPak Equine

Eventually I would like to try the Equiwinner electrolyte patches to see if that helps anything. I am debating having my vet draw blood to check electrolyte levels next Tuesday. 

I will get those pictures for you guys this weekend of Harmony's spine. I know postponing the diet change isn't the best idea, but trying the 3 weeks of bute will allow us to then further investigate the head tilting and have some direction. I will not be working her anymore than I have to during this time since the fat won't be increased.


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## Left Hand Percherons (Feb 1, 2011)

Don't even consider adding Se to the diet without knowing if your hay is deficient in it. That's a whole nother can of worms. 

When you had a hay analysis done, what did you test for? Can you post the results?


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## deserthorsewoman (Sep 13, 2011)

If she was my horse, I'd contact Dr. Valentine and ask if the head tilting is stemming from EPSM , if she has ever seen it. If yes, I would not postpone the proper diet. Period. It can take up to six months until the effect of the diet is visible. 
I would not give her bute until I'd have a definite diagnosis on her neck. 
Take everything with a grain of salt, I said "if she was my horse". But she has had enough stuff done to her which wasn't necessary at all and didn't heal anything either. 
If my horse was diagnosed with EPSM, I'd have it on the proper diet and 24/7 turnout within hours. I would not experiment with any symptom treatments until I was sure the diet is fully working. 
This is due to the fact that, in my 45 years with horses, I've seen my share of clueless vets who, and that's the bad part, are not capable of admitting that they're clueless.


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## Harmony308 (Mar 11, 2013)

I would hope that once I change the diet it won't take six months to see improvement considering she has already been on the basic EPSM diet, just not to the extent she needs to me. I have a hard time telling myself that I should wait months and months to see if the diet works while my horse continues to have such consistent symptoms. Since it seems that any effects that come from upping her fat intake will not be immediate then I will begin adding fat now and give the bute. If she stops head tilting while on bute and then begins again when off it we know it is not diet related. If it doesn't get any better we can cross some things off the list all together and wait for changes via the diet and/or do head/neck x-rays. 
I have talked to Dr. Valentine about the head tilting and she said if it is there even when the horse is getting the proper diet then look elsewhere. She did not say she has seen it before. 
I don't think that the internal blisters where unnecessary seeing as the UPF has decreased by at least 60%. That has to count for something. Though her stifles may be entirely related to ESPM, I think it is likely that she just has UPF and EPSM doesn't help her situation. We can only wait and see.
I have SUCH a hard time with vets. I have worked with 5 or 6 and they all have strengths and weaknesses. I don't trust any of them entirely nor do I have the money to drive long distances and pay for a specialist. I appreciate the advice given. I have tried my best and though the treatment route I chose could have been different at least I did something for my horse. When I bought her as a yearling I was 17 years old. I've done the best I can in the 5 and a half years I've owned her and have yet to find one person I can trust with horse advice- that's why I ask everyone.


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## Harmony308 (Mar 11, 2013)

As far as the hay analysis I tried to post it here and it says the file is too big. I'll have to work on that. I had a basic analysis done and checked for sugar, starch, WSC, ECS, NFC, etc. Unfortunately it appears Selenium is not listed. Guess I'll have to run another test.


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## deserthorsewoman (Sep 13, 2011)

I understand completely what you're saying. Im in no way criticizing you. You did way more than a lot of owners would do. I basically said the same thing as Dr.V
Oh, and it COULD take up to 6 months, but it doesn't HAVE to. Oldhorselady here is already seeing results after what, a week or so.

Do you know where your hay is grown? If so you can ask the grower or the county extension office if there is a selenium deficiency. They can also tell you if Se should be supplemented.


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## Light (Mar 4, 2012)

I'm sorry I can't offer any advice . I just wanted to say I think it is great but you are working so hard to try to help your horse


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## Harmony308 (Mar 11, 2013)

deserthorsewoman: I hope that it doesn't take 6 months- I am hopeful for visible changes in a month if we get lucky! 

lightning: Thank you for your support. It has been rough, but I have a responsibility to my horse to put in the effort. It will be a shame if I am not able to ride without back problems and end up selling her after going through all of this, but regardless I want her to be happy and healthy.


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## deserthorsewoman (Sep 13, 2011)

I told Oldhorselady to videotape progress. Every month, so she can compare.
I'd suggest the same to you. Sometimes, if you see your horse every day, you won't notice changes. The video will show it. Just tape at the same place, the same activity


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## Left Hand Percherons (Feb 1, 2011)

Where she is at receiving 10% of her calories from fat, she is not "training" the muscles to use the fat as an energy source. You have just been feeding her extra calories. Until you get her up to the desired 20-25% fat, the muscles are going to use glycogen as it's main energy.

You will see improvements quickly (if diet is going to help). Typically you will have measurable changes by the end of the first month. It will take a few months to plateau. That will be as good as you get just by diet.


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## Swany530 (Apr 9, 2013)

I have been trying to forever to get an account set up on here to post on your thread!! I found it while recently googling head tilting. Look into Temporohyoid Osteoarthropathy. My mare was just diagnosed with it after acouple months of showing a head tilt that progressively got worse. Has to be diagnosed with a scope into the guttural pouch. We are currently treating her with 30 days of antibiotics & bute. If no change or her condition worsens we will have to discuss surgery. There isnt alot known of this condition as far as what causes it. I am currently still researching personal experiences myself. It can either be caused by a guttural pouch infection/inner ear infection (which is what we're hoping) or that the joint is fusing from normal wear & tear. If it is fusing, once fused mobility will be limited and eventually the horse will get a pressure fracture just from going about it's normal every day functions. When it fractures is when surgery will have to be done to remove a bone in the joint. Google it for best explanations.

Here is a video of my mare prior to diagnoses. We just got her diagnosed Saturday so in about 2 weeks I will do an updated video






Best of Luck!


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