Re: Zinc carnosine and gastric ulcers and timing of lab work and small pergolide dose increase


Hi, Mimi - I am going to list what is going on with Scarlet, and you can let me know if I have the correct picture.

She has a history of spring laminitis when on grass.

She has a BCS of 3.5, and is underweight.

Her appetite is poor.

She has a history of clinical signs of gastric ulcers which respond to Gastrogard, but then return.

She currently has free-choice alfalfa hay available 24/7, plus 2 lbs of alfalfa pellets, plus 5 lbs TC Senior. ((plus all the other appropriate supps such as Vitamin E etc, but no minerals) She is in a separate paddock, so she can eat whenever she pleases.

Early ACTH, insulin, leptin and glucose were normal (2000 -ish?)

Most recent ACTH and insulin from April 2014 were 13.8 pg/ml (9-35 pg/ml) and 6.18 uIU/ml (10 -40 uIU/ml); on pergolide 1.5 mg/day.

Problem list:

 -Reduced appetite
-Spring laminitis on grass
 - clinical signs of gastric ulcers, which resolve on GastroGard, and resolve when on pasture.
 - Clinical signs of PPID, improved/resolved on pergolide
 - Currently seeming weak, dragging her hind feet.

I have some questions:

1) Were the initial and most recent ACTH and insulin tests done fasting?

2) When you say she responded to pergolide right away, what did you mean by that?

3) When you treat with the GastroGard, do you do a full dose for 30 days,followed by a half dose for 30 days?

4) How much of the hay do you estimate she is eating, and is she eating all of the alfalfa pellets? How much of the TC Senior is she eating?

An aside for newbies here  - TC Senior is not appropriate for an IR horse, as it is too high in starch. Safe feeds for IR horses include Ontario Dehy Timothy Balance Cubes, Nuzu Stabul 1, LMF Low NSC, and a couple of others that I can't quite think of at the moment.

In order to heal gastric ulcers, GastroGard must be used at full dose for 30 days, followed by half dose for 30 days.  Then, if the horse is very prone to ulcers, one continues at 1/4 dose more or less forever, if other methods (free-choice hay, aloe vera etc) don't keep the ulcers at bay.

Regarding the blood work, testing within 2-3 weeks is fine; I would test ACTH, insulin, glucose and leptin now, and I would also ask for an equine screen to make sure there isn't something else going on.

Hang in there - I am sure we can get Ms. Scarlet back on track and feeling better. Thanks for taking the time to sort out these questions for us.

Scarlet seems weaker, especially in the rear and is dragging her rear toes more. Her toes are getting as worn as they were before the pergolide was started. Her pergolide was increased from 1.2 mg to 1.5 mg 15 days ago. Should I do blood work now or wait another week?


Miimi and Scarlet

March 2016

northern VA

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