Hi Sue,

Dr Kellon and/or Dr. Clougher will correct me if I'm wrong here but the way I understand it, the whole point of doing a Regional Limb Perfusion is to get highly concentrated doses of antibiotic into the area where the infection is located. Oral abx cannot get anywhere near the concentration into the foot that the RLP would. Princess doesn't have a systemic infection that needs a steady blood concentration of antibiotic everywhere, she has a localized infection in an area with compromised circulation which is preventing systemic abx from reaching it at a therapeutic dose level.

SMZ has the potential to raise insulin so is not recommended for use in an IR horse, esp one who already has severe foot issues and uncontrolled IR.

I couldn't find any real information on The Winning Edge Supplement other than it was a "proprietary formula" so no way to evaluate it's possible benefit/risk. Ask whoever is suggesting it how exactly it is supposed to help? If this was my horse, I would decline at this point.

YES! Getting her diet as tight and supportive as possible would be one of your best investments right now. I suggest you take Dr. Kellon up on her offer to go over Princess' diet and fine tune it for you. Just get her a list of every morsel of anything that is passing your girl's lips right now and the precise amounts.

It's good that she is eating better. Not so sure that her standing for longer periods is necessarily a good thing right now as it may only be due to pain being masked by the ozone treatment and the NSAIDS that she is on.