Re: Dr Kellon Invokana and Lipemia - urgent


Nancy & Vinnie & Summer
 

Update from yesterday. I got word at about 12 pacific time that Vinnie's triglycerides had increased to 1500 from 1000. He was eating well and so their thought was that Vinnie had been in an anabolic state from not having enough digestible energy from his diet being so low in sugar. I shared my hay tests and the diet protocol i had been using and upon doing calculations of DE etc  they felt that was not as big of a factor as hypothesizd.  Actually, they said I had been doing an amazing job with his diet for a metabolic horse. ( thanks to this group..gave a shout out) .

They then concluded that as Dr Kellon suggested the day before; that during the period between 2/17 and 3/8 ( incidentally.. started prascend)  Vinnies insulin dropping well into normal ranges and then perhaps the invokana dumping too much glucose out of the bloodstream and then the DE of his really tight diet not being able to compensate for this loss in glucose, that his body started to dump triglycerides for energy use. This also coincides with the dramatic weight loss and the weird neuro like symptoms I was observing.  (I am guessing this is like what can happen to people when they are in extreme keto diets and go into ketoacidosos??)

**Dr Kellon I will defer to you to share what you think prudent about Invokana with the group in context to Vinnie's case and things that may be necessary to keep an eye on.**

I got to see Vinnie yday he looks thin but amazing.  He was walking sound off meds and more like my spicy old Vinnie "the unicorn" I used to see. He actually dragged me all over the parking lot as I was sobbing uncontrollably with joy....a funny sight to see I imagine for onlookers.. heehee. Then he proceeded to try and drag me back to the barn..( I guess he was hungry heehee)

I got to speak with his main veterinarian overseeing his case. She commended what I have been doing to manage him metabolically and how great his feet look;  commending my farrier. 

He will be hospitalized for a little longer maybe through the end of next week. The plan is to increase his glucose by IV and adding amino acids by IV to nourish his body and try to the get ttriglycerides back to what ever the new normal for his body may be. She said he may never come back to normal ranges they just aren't sure.  I brought another hay up that had a higher esc + starch of 10.1 and they are feeding that to see of they can eventually stop IV and have his body sustain itself on the higher sugar hay.  They are holding off all meds, they will monitor insulin to make sure that he is stable.

I was relieved when I saw how he looks and am really hopeful for when he comes home.

The plan at home will be similar to manage his diet by ensuring he has enough DE so the body uses glucose for energy.  Yes we may use invokana again of he needs it for high insulin. We are planning on doing a
a trh stim to test if he is truly ppid and will  medicate accordingly and monitor to see how or if introducing prascend at the time that we did played a role in this. 

I will continue to update as we know more.  Thanks so much for the prayers and energy.

Now to plan a tack sale as this is a heap of change I didn't plan for this year:) ...

Xx
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

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