Question: What would you recommend for a 11 year old horse that has tested negative for IR and Cushing's last fall but is still showing signs of metabolic issues ? He is currently receiving California Trace Plus, Arthroxigen joint supplement, 5 gms Magnesium Oxide and a Tryptophan based Calmer in soaked Teff pellets, 18lbs of Teff hay (around 8% NSC) per day, with around 3 hours of turnout on pasture with a grazing muzzle. Thanks.

Dr. Kellon: Blood tests are often not interpreted correctly because the laboratory's reference range includes many different breeds and feeding scenarios. For example, an insulin or 30 or 40 would only be normal shortly after a grain meal.
You didn't mention what signs your horse is showing but a good first step would be to replace the 5 grams of magnesium oxide with Glycocemic EQ. If you are going to turn your horse out you need to make sure the muzzle is sealed.

Question: Thank you for your response, I put the results into the calculator on the ECIR group, here were the results: GI Ratio - 16, RISQI Calculation 0.45, MIRG Calculation 3.7.  Jack was only given hay prior to testing no grain.

Jack shows weight fluctuations with a sensitively to grass (hence the grazing muzzle), excessive hunger despite having slow feed nets, spilt meals etc, occasional cresty neck and heat in feet, rings on his hooves, seems to have flare ups after vaccinations and worming and has developed insect bite sensitivity,  but mainly seems to have a problem with inflammation, for example will exhibit muscle soreness, tendon inflammation after very little changes in environment/diet or exercise.  Jack's coat has also developed dry dandruff and seems patchy in areas and has lost it's usual glossy shine.   He has an ongoing issue with SI problems and has received Corticosteroid injections for SI, IRAP for stifles and OSPHOS injections 6 monthly for the past 12 months.  Jack receives chiro and bodywork regularly.

Would there be any issues with supplementing with Glycocemic EQ and California Trace Plus together as that would be a total of 5mg of Selenium per day ? We are based in the PNW.  To improve Jack's coat I was considering supplementing with Omegas in the form of Omega Horseshine (or Uckele equivalent ) would this be a good idea ? Would you recommend adding Vitamin E (I have the Uckele Vit E liquid) if so what quantity ?

Jack currently has a salt block available, would it be preferable to provide loose salt with his supplements, if so what type and how much ?  Would you recommend switching from teff pellets to beet pulp without molasses as a base to give supplements ?

Dr. Kellon: I wouldn't add any more selenium.  For hays from your area supplement the Glycocemic EQ with 1 scoop Poly Copper and 1.5 scoops Poly Zinc, either powder or pellets.  Try to avoid using corticosteroids. (Sarapin is often an effective alternative without metabolic effects.).  Definitely add a high omega-3 source, 4 to 8 oz/day, and the liquid vitamin E at 1 scant teaspoon.

The block is fine as long as he uses enough of it - 1 oz/day in cold weather; up to 4/day in hot weather.  If you need tight sugar and calorie control use the beet pulp instead. When allowed to soak completely it will have four times its dry weight as water with 0 calories but a high volume.