Re: Audi Update (Increase Pergolide?)


lindsaykrauland@...
 

Thanks, Dr. Kellon.  I’ll try Audi on 3 mg.  Unfortunately, I don’t really have my vet on board with his treatment.  He wrote the prescription for pergolide, of course, but only as a “trial” and so far hasn’t agreed to write for anything over 1 mg.  (Since Audi’s ACTH was technically “in range” at his recheck, the office felt everything looked good.) My vet doesn’t seem well versed in PPID, but he does keep an open mind and hasn’t disagreed too strongly with me on anything yet.  If Audi seems to be doing well on 3 mg, I’ll test his ACTH after a month or so.  I think if we have a good ACTH + a horse who’s looking well, my vet is more likely to get on board with everything. 

I didn’t know that about EPM muscle wasting being asymmetrical.  That’s good to know, thanks! And I will consider Stabul 1.

Regarding blood work, I did have a serum chemistry run in late July.  Everything was within normal limits.  I have the report in my CH.  I have not done a CBC but can certainly have that run next time I do bloodwork.

I think the chem panel has ruled out organ failure?  

Regarding parasites, I dewormed Audi in late June.  He had had a clean fecal exam in April, but I went ahead and wormed him based on advice here in case any parasites were lurking that couldn’t be seen on the fecal.  As you can see from the photos, he didn’t gain any significant weight following the deworming. The dewormer used was EquiMax (ivermectin 1.87%/praziquantel 14.03%). Going forward, I plan to deworm him with the EquiMax twice a year, in addition to twice-yearly fecals and treatment as necessary.  Is this a sound strategy?

I honestly don’t think his issue is a dietary one, as I’ve changed up his diet multiple times based on advice here, and there has been no appreciable change in weight as a result.  We’ve added in beet pulp, increased beet pulp,  removed beet pulp, increased his TCTBC, added in Safe Starch, increased flax, added Tri-Amino, etc, and it just doesn’t seem to matter.  His weight has been pretty steady for months regardless of our dietary interventions.

That said, I separate the horses for mealtimes, so I know that Audi eats:
*5 lb TC Timothy Balance Cubes
*2 lb TC Golden Ground Flax
*2-5+ lb Safe Starch (I start with 2 lb and top off his bowl until he finally leaves it.  He goes through a 40lb bag in +/-5 days.)
*Supplements including 20g Tri Amino

The horses are together to eat their hay, so I can’t say for certain how much each consumes.  When I took the time to weight hay bags recently, the two horses consumed a total of 34.5 lb in twenty-four hours.  We have multiple hay nets set up, and I don’t see any significant competition between the horses for hay.  So far, I’ve been free-feeding hay in slow feeder nets, but my other gelding is getting too fat, so I’m going to start being more careful about limiting/weighing hay for him while giving Audi ample time to eat as much as he wants.

Our hay is low in protein, although we’re down to the last round bale and will hopefully get better quality hay going forward.  In the meanwhile, I’m trying to calculate dietary protein to ensure each horse gets an adequate amount.  I’m not sure how the Tri Amino factors into those calculations.  Does the Tri Amino “count” for a particular amount of protein?

Thanks, Sherry, for the thoughts!  I agree with your and Martha’s observations.  I’m curious, though— How much weight would you expect a horse to gain in a month?  I “feel” like Audi is gaining too slowly, but I honestly can’t say what an expected/healthy weight gain would be?!

--
Lindsay in TX 2020

Audi Case History:  https://ecir.groups.io/g/CaseHistory/files/Lindsay%20and%20Audi

Audi Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=248156 

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