Re: Jasper's Lyme Results


 

Nancy and Lorna (and anyone else who has gotten this far):

Thank you so much for your responses.  I think I cant help my butting in because Im trying to understand a key point to Jasper's scenario. Instead of my anecdotes as evidence, let me instead ask a question, which arose from following Jasper's long history:

If Jasper (or a theoretical horse) has been definitively diagnosed with IR & PPID and is showing overt clinical signs of IR/PPID (PU/PD, foot soreness, insatiability, etc), and an effective pergolide dose has NOT been determined as yet, then why does the horse in the scenario NOT go on the Emerg Diet of soaked hay, etc, esp if he's showing laminitic symptoms?  Furthermore, why would this horse not STAY on the diet until IR symptoms satisfactorily abate?  That's what Im having trouble understanding. 

Also, very importantly, Im in no way saying the cubes are bad--please! no one think Im casting shade on the very useful ODTBCs--they are the foundation of both of my well-controlled IRs' diets at present. The ODTBC are a true godsend!

(Nancy Ill address your finer points under separate cover; I was just so eager to ask my question!  You remarked on several interesting points re: my horses' scenarios and I'd like to learn more with dialog [poor Nancy])

Thx so much,
Kerry in NY
Sept 14

Ps, sorry i could not delete attached past msgs --doing a million things at once


Sent from my iPhone

On Sep 21, 2015, at 5:23 PM, threecatfarm@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Kerry

Good caveats.  :-)

Every time this comes up I am still left with the same question.

Did her insulin come down because she had better controlled ACTH or because she got off the Cubes.  I don't think that has been separated out. 

As discussed in other recent posts, the symptoms of uncontrolled IR and uncontrolled PPID overlap. I kow you know that.

Improvement of foot comfort can come in a matter of days from increased dosages of pergolide, just as it can when switching from high ESC&Starch feeds/diet to lower ESC&starch intake. 

As I understand it you did both at the same time.

Just to be clear for new people ODTB Cubes are not high ESC&starch adn this report is unusual so it is why we are pulling apart the confounding factors. A process that our founder Robin established as and ECIR keystone so long ago.

My take of Dr Kellon's response to this and my own personal experiences is that diet is critical to controlling IR, but the system can be overwhelmed by uncontrolled diseases driving insulin levels far beyond anything you can control with diet alone.  It takes control of the diseases to control the IR.  If you don't control the disease, no amount of diet tweaking will fix hyperinsulinemia.

Just like pergolide will not fix "insulin resistance related to genetic predisposition, obesity, diet or any other nonpituitary cause", diet alone will not fix IR from disease states like PPID.


I'm paraphrasing but I think Dr Kellon described it as when ACTH, Lyme, Mare issues, iron overload and other are out of control, no feed will be low enough to control hyperinsulinemia.  You have to address the disease. As you did. 


As for your gelding, It would be helpful to see the rest of the diet and well, you know,,,,,a CH.


In any event, in the last go around, it was suggested that Corrine use soaked hay and the emergency diet if she felt that was the best for Jasper, until he was more stable or at least there was a clearer picture of his dx, 


I offer this Kerry, with all respect for the work you have done with your horses.


Nancy C in NH
ECIR Group Moderator 2003

To learn more about the impact of fructan, understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available. Guest Speakers





---In EquineCushings@..., <Twinoats@...> wrote :



However, I've observed from direct experience that when my mare's PPID was not controlled, she could not handle the ESC & starch in the cubes in *any* amount fed (even <1lb).  Her insulin normalized only when I found her target dose of pergolide and she consumed the Emergency Diet. Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well).

My IR gelding does well at 0.5% BW (6lbs/day for a 1200-lb horse), but any higher % of BW he gains too much weight and his insulin climbs.  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble.  If his weight does ever increase, I will decrease the % of cubes.  Luckily, so far, his weight has dropped or held steady at each weighing.


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