This is a partial list of suggested things to avoid for horses who tend to founder, have equine Cushings, or are insulin resistant:

• STEROIDS should be avoided in horses prone to laminitis. This includes low dose administration for the Dex Suppression Test. The exception would be in a life threatening situation.
  
  
• Antibiotics in the SULFA DRUG family (like the commonly used SMZ) should be avoided in horses prone to laminitis because they can alter glucose metabloism.
  
  
• GLUCOSAMINE - oral or injected should be avoided or used with extreme caution in the laminitis prone horse.
  
  
• With high dose ACE in a horse on Cushings medication, one should be aware that ACE and pergolide (and Vitex) have opposing actions on brain chemical dopamine. One could also speculate that high dose ACE and high dose pergolide could lower blood pressure to an undesirable level.
  
  
• New wormer drug PRAZIQUATEL should be avoided or used with extreme caution (see FILES section of the EquineCushings list).
  
  
• Herbal YUCCA, and possibly WILD YAM.
  
  
• Long term/high dose use of NSAIDs like bute and banamine will of course, increase the well know risks of ulceration of the stomach and GI tract and possible kidney damage, but will also, over time decrease circulation and healing by limiting blood gas Nitric Oxide.
  
  

If we have learned anything from our list member's horses it is that horses prone to laminitis (Cushings or not) can be very sensitive to stress and changes. Sensitivity to individual substances varies tremendously.

• If a horse is not stable, any and all drugs (including vaccinations and wormers), feed additives, herbs and feeds should be viewed with suspicion and reviewed.
  
  
• A orderly, systematic elimination trial will often reveil a substance the horse is sensitive to.
  
  
• It is impossible to list all of the things suspected of causing problems or make generalizations. A case by case, careful observation of reactions should be employed.
  
  
• Some general potential trouble feeds outside of the obvious of any GRAIN PRODUCTS and SUGARS might include: Soy, clover, alfalfa, live probiotics, yeast, seed meals, MSM and DMG.
  
  
• Some horses thrive on the above, others cannot have them at all.
  
  
• Try to avoid starting too many new things at once, and avoid multiple challenges at once (for instance - doing a major teeth floating with sedation should not be done on the same day necessary vaccines are given; worming should be avoided right before a long trailer ride).
  
  
• Vaccines should be discussed with Vet to access risks to the actual diseases and kept to a minimum and well spaced out. A number of these horses seem very sensitve to vaccinations.
  
  
• Feed additives and herbs are variable too. Pause before adding anything new to your horse's routine. When considering one, try to establish its mode of action, and ask yourself how it might affect the horse. Some herbs and supplements claim to "lower blood glucose and improve diabetic conditions", but upon closer inspection we might find that rather than helping with cell sensitivity to insulin, they might stimulate pancreatic activity.
  
  
• Be cautious of herbs that alter hormones unless it is something that we know is helpful (like Vitex/Chasteberries), but be sure it is indicated for your particular animal.
  
  

Then there are substances that may be helpful in some situations and contraindicated in others:

• Vitamin C is a wonderful, powerful antioxidant but should not be supplemented when there is high iron in the diet.
  
  
• Milk Thistle Seed is useful for liver protection and in blocking iron absorption, but contains significant amounts of selenium that must be factored in to the overall diet.
  
  
• Specific amino acids can be very useful in diets with marginal protein, but some specific animo acids stimulate a glycemic response and need to be used with caution - likewise for chelated minerals as they are chemically bound to amino acids.
  
  
• Avoid significant amounts of fat/oils, high nitrates and excess protein, and stress that these will depend on individual sensitivities and situations.

With the laminitic horse, for me EVERYTHING needs to be looked at because sometimes it is what you least expect!

Laurie