Re: Update on Flirt


Eleanor Kellon, VMD
 

Roger,

Do NOT increase his Invokana. Do make sure he's actually ingesting it and tighten up that diet. Invokana does not compensate for uncontrolled ACTH or a diet that is too liberal.

Is the farrier you are calling your "regular" farrier the same one that was trimming him last August?

Something I think that needs addressing with Flirt is that he cannot "recover". He has lost at least half of his coffin bone, probably more, and has extreme rotation. These are not reversible. I have seen ponies with these changes be able to walk comfortable if their insulin was strictly controlled and with a hoof that suited them, i.e. all the parameters we always talk about plus higher than normal sole depth. However, that doesn't mean this is possible with all of them. Smoldering deep infection, a distinct possibility in his case, is one thing that will keep the pain magnified. Others just don't have enough bone left to ever achieve comfort.

Has Flirt ever been at a place where his trim was as good as last August and his insulin was low? In August his trim was very good but insulin still high and he was still extremely lame.

When dealing with a chronic case like this with significant irreversible damage it's important to have clear goals and guidelines. The will to live is the most powerful force in the universe but that doesn't mean we should keep going until they are so beaten down and overwhelmed they give up.  Reasonable freedom from constant pain is certainly one criterion. So is the ability to maintain body condition. Horses in constant pain often can't hold a normal body weight.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

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