Re: Update on Apollo
I'm thinking I should start metformin now and retest insulin/glucose in 7-10 days which will also coincide with/near peak of rise. Here's why I thinking this way (let me know if I'm off track):
1. Is feeding current hay going to make much of a difference in insulin compared to soaked grass hay (ESC 7.4 + starch of 0.5 = 7.9 before soaking) when insulin/glucose testing was done. If soaking that hay for 1 hour lowered ESC 20-30%, then ESC possibly 5.92 - 5.18 (20% & 30% reduction) for total ESC+starch of 5.68 and 6.42 (20%-30% reduction). Current orchard grass hay (unsoaked) is ESC 3.88 +starch 1.92 = 5.80. Granted it may help but will it be enough to get insulin into desired range so his hooves can heal.
2. Lag time involved in getting vet out to take sample, send it to lab and get results back is probably 7-10 days and there will be on-going damage to hooves with current high insulin. Current orchard grass hay started on 8/15 i.e. mixed with hay he was eating, slowly transitioning to all orchard grass over 7 days. So he's been on all orchard grass hay for about 12 days. right now.
3. Trying exercise to lower insulin before metformin would be ideal but given Apollo's hoof condition that's probably not wise. However, if metformin works his hoof condition should improve faster provided we also get his trim right. My understanding is that when properly administered, metformin is generally a low risk medication, making benefit/risk ratio of starting metformin now having more benefit than risk.
Coming up on 1 year anniversary of onset of Apollo's laminitis. Knowing what I know now, it's likely it had been smoldering for some time. I know I've made many mistakes and wasted time trying to get his insulin down, with Apollo's hooves paying the price.
Apollo Case History: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Apollo
Photo album: https://ecir.groups.io/g/CaseHistory/album?id=275817