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Re: Pergolide availability issue

tsm693@...
 

Thank you so much, what is the reason?



Susan

-----Original Message-----
From: drkellon <drkellon@...>
To: EquineCushings@...
Sent: Mon, Jul 18, 2011 9:56 am
Subject: [EquineCushings] Pergolide availability issue




We have been informed that VetPetSolutions/Thriving Pets will be unable to fill pergolide orders during August and possibly into September. If you will need a refill during that time, it has been suggested you place that order before July 30.

For details, please contact the company directly.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Digest Number 9885

Mandy Woods
 

Hi Debby,
Lorna sent you the information about where to get pergolide powder/capsules in Canada. The shelf life is so much longer. Please use these and taper on when you start giving the drug. I think I would retest him NON fasting in about 4-6 weeks. We are entering the seasonal rise and he needs to get his ACTH numbers in the normal range. Starting the Temporary Emergency Diet will help him too even thought he does not appear to be IR. The recipe is in the "Start Here'' file. This diet will support his Cushings. Can you get soy hull pellets in Canada? They have a similar mineral profile to plain shredded beet pulp. You can add some to his diet as a carrier for his minerals (Vit E, Salt,Flax,Magnesium) or extra calories if he needs them.

I could not open his CH. My computer requires the format to be PDF. I"ll ask for help changing that. The Case History that you opened otherwise is good. Please download his xrays in there and photos of his latest trim! There's a file to how to take good foot photos. And when you get your hay analysis you can post that in the same place. All your data will be in one file!

Hay analysis. Since forage is his main diet, You need to know exactly what is in the hay and balance the minerals to that. Perfect diet! Do you have your winter supply in yet? Can you core it and send samples to www.equi-analytical.com and get the Trainer #603/$49. Poke around that site for instructions. There are, or used to be some low sugar/starch cubes in your area that could be soaked for him. I dont remember the name!

So keep him in a drylot with soaked/drained hay in front of him. Keep his feet comfortable with a correct trim, boots and pads. Debby, you're doing fine. You are on the right track for his health!

Mandy in VA
EC Primary Response
OCT 2003


Re: Elevated blood sodium levels in cushings gelding - please help

jendoe11
 

In response to some questions we may have missed, Dr. Kellon...Skin turgor is normal. His urine specific gravity was measured on 7/14/11 at New Bolton Center and it was 1.016. He is not receiving any additional salt with his food or supplements. He receives flax in his PM feed, One AC with AM and PM feed (started 7/12/11), Suspensory Saver (by Figuerola Labs) with AM and PM feed (started 12/2010), and Nublada's Cure Tumor Formula (by Earth Angel Herbs) with his PM feed (started approx 4-5 years ago).

Will post newest set of blood and urine tests ordered on 7/14/11 from New Bolton Center including later today.

Thank you again so much for any comments and suggestions.

Sisters Steph and Jen, and horse Raf
Southeast Pennsylvania
July 2011


Re: Pergolide Source in Canada/Debby

Lorna <briars@...>
 

I have Pergolide in the liquid form, so I guess I should inquire about the availabilty in the powder/capsule form.
Hi Debby,

I sent this to you privately but thought I should post here,too,since we have more and more Canadians joining us.

A wonderful Canadian compounding pharmacy is Island Pharmacy,in B.C.
877-743-6944
Ask for Kathryn.
Or email her at <shawnigangirl@...>

She is very knowledgeable and helpful,and will answer anything you could ask.

I know it's the other side of the country from you.But my orders get here to Ontario in 3 days or less,and I don't imagine it would be more than 1 more day to you.I think someone in N.S. uses them,too.


Lorna in Eastern Ontario
2002
EC Moderator
http://www.ecirhorse.com
http://www.nolaminitis.org/first-annual-no-laminitis-conference


Fw: Digest Number 9885

murtagh@...
 

Equine Cushings and Insulin Resistance

From: Debby M
Sent: Monday, July 18, 2011 12:47 PM
To: No Reply
Subject: Re: [EquineCushings] Digest Number 9885

Thank you for your advice Mandy! Gah....I had a long response typed and ready to hit send this morning, when we lost our hydro for the morning.
I made typing error in my earlier post regarding the Pergolide dosage. The veterinarian says 1mg=5ml per day. I just feel I need to double check this, since I’m a bit uncomfortable with what he is telling me. I live in New Brunswick Canada, and we have provincial vets here; he did take it to the provincial equine specialist for his input and this is what they came up with. I did create a file for Jim on the other list, so it is there now if that will make anything clearer.
http://pets.groups.yahoo.com/group/ECHistory4/files/Jim/

I have Pergolide in the liquid form, so I guess I should inquire about the availabilty in the powder/capsule form. Blood was drawn by our regular vet and I am confident that she would have handled things appropriately; she did ask that Jim fast from midnight the night before she would be here to draw the samples, which was 9:30 the next morning. So do I now need more testing? Guelph University did the testing.

Jim’s teeth are quite good for a fellow of his age; he did have a loose tooth last spring which was extracted. I try to find hay that is finer in texture as I sometimes find hay wads if it’s of the coarser variety. All his hay is soaked~ I have a horse with allergies as well, so everyone gets soaked hay here. He is in a small turnout area for now, since he is still a bit ouchy on harder ground. Radiographs revealed rotation of 16degrees in his RF and 14degrees in his LF.

I hope this will shed some light...I’m so afraid I will do something that will be harmful. Thank you so much for your help!

Debby in NB


[Non-text portions of this message have been removed]


Re: Pergolide availability issue

Susan Pitlock <strawberryblnd_101@...>
 

I use Monument Pharmacy in Colorado. They offer a 10% discount on the price you paid from a competitors cost. I ordered over the phone and once they receive your vets Rx for the pergolide, it was super easy. PLUS free first class shipping!! Super nice people.

http://www.monumentpharmacy.com/
Susan









 
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Re: Pergolide availability issue

Marilynn Gittings <tecamom@...>
 

Thank you for the 'heads up'......I just reordered!!!...............Marilynn
Gittings



From: EquineCushings@... [mailto:EquineCushings@...]
On Behalf Of drkellon
Sent: Monday, July 18, 2011 6:56 AM
To: EquineCushings@...
Subject: [EquineCushings] Pergolide availability issue





We have been informed that VetPetSolutions/Thriving Pets will be unable to
fill pergolide orders during August and possibly into September. If you will
need a refill during that time, it has been suggested you place that order
before July 30.

For details, please contact the company directly.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Pergolide availability issue

Ginger Reid
 

I get my pergolide thru Pet Health Pharmacy in AZ - can see if they are able to fill..I just got 90 days in last week..
Ginger


Re: advice/ interpreting latest blood work/Pergolide dose

millionairess1989
 

Linda,
Thanks for the advice-

The last thing you want to do is play Pergolide Catch-up in the fall. Once she is at the 1 mg dose, again if mine and testing ACTH is not really an option, I'd increase her to 2 mg starting in late August.
I have already started Pergolide 0.5mg twice daily since Friday. Can I just do 1mg once daily? What about after tapering up to 2mg? At what point is it best to divide into 2 doses?

Thanks again,
Jennifer & Mill in TN
Jan 2011


Pergolide availability issue

Eleanor Kellon, VMD
 

We have been informed that VetPetSolutions/Thriving Pets will be unable to fill pergolide orders during August and possibly into September. If you will need a refill during that time, it has been suggested you place that order before July 30.

For details, please contact the company directly.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: ginseng

Eleanor Kellon, VMD
 

Only North American/Canadian ginseng, Panax quinquifolius. You could use Aralia as an alternative.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Jim

Eleanor Kellon, VMD
 

--- In EquineCushings@..., "Mandy Woods" <bittersweetfarm@...> wrote:

Just as a PS to Mandy's (as usual!) excellent response, there's an error somewhere in the glucose calculation. It's actually 79.2, which is low normal. Unless he was fasted, no need to repeat.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Dr Kellon, could you comment on this suggestion please?

Eleanor Kellon, VMD
 

There is no safe way to suppress testosterone except the CTB. If he was acting more rambunctious on that, it may well be simply because he felt better.

If he is a cryptorchid or "cut proud", you could consider a proper work up:

http://www.betlabs.com/equ_hcg.html

to confirm that but only surgery can fix it.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Dr Kellon--what is your take on "HealthyMouth" water additive?

Eleanor Kellon, VMD
 

This product won't have any negative effects on the balancing. It might help with gingivitis, but won't with the dental loosening that is caused by PPID.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Dr Kellon, could you comment on this suggestion please?

 

--- In EquineCushings@..., "Christine" <muff747@...> wrote:

Thank you very much Dr Kellon. I have tried him on CTB on a two or three occasions but it seemed to coincide with some very stressful episodes where he would gallop around screaming for one of the herd that was missing.
Have you given any thought to red raspberry leaves? I've had my mare on them for years and you can give this to geldings also. Might not be the correct herb to give but it is suppose to be calming.

You can get rr leaves from Herbalcom.com or Horse Tech (Mare Berry). Might be worth buying a pound and trying.

Jean in SC
August 2004


Dr Kellon--what is your take on "HealthyMouth" water additive?

grayarabiankasha <kvshopping@...>
 

HealthyMouth is recommended (by the comnpany, of course) for Cushings horses who have dental problems (as my Kasha does). It is added to the horse's water bucket; the vet who does my horses' teeth told me about it.

On the website, the ingredients listed are: Purified Water, Organic Glycerin, Organic Pomegranate, Organic Yucca Extract, Zinc Gluconate, Organic Blueberry, Natural Xanthan Gum, Organic Papain (Papaya Enzyme), Riboflavin (Vitamin B12), Ascorbic Acid (Vitamin C), Organic Clove Extract, Organic Cinnamon Extract, Chlorophyll, Sorbic Acid (natural preservative derived from mountain berries).

Could the addition of these ingredients mess up the balancing of the OTDB cubes? Would this be worth a try?

(I thought I posted this a few days ago, but I couldn't find it, so in case this is a repeat, my apologies)

Thanks much,

Kathy & Kasha
SoCal
2003


ginseng

 

Hello all, is there any particular ginseng that is better for a cushing horse. Sorry if this already has been answered, i was unable to find it. Im after chondroitin, I am not able to source this in austalia only accompanied by other additives. Does anyone know if this is able to be shipped from USA. I believe Joan n Dazzle maybe able to help us here.thanks.
Leanne n Rani.
Aust 2010


Re: New member

 

Hello Amy,

We usually use the glucose to insulin ratio to determine if a horse is insulin resistant but they have to be from the same blood draw. There is another proxy called RISQI that can be used too and only requires insulin levels.

Your mare's RISQI is 0.18 which is considered severe IR and high risk of laminitis. Many vets think that because insulin falls within the lab's normal ranges, there isn't a problem but studies have shown differently. I would definitely consider her IR and treat her as such.

I would also consider rechecking your mare's ACTH Aug or Sept. Her level 32.1 was towards high end of normal and she may go above normals during the seasonal rise and benefit from pergolide at least during the fall.

Unfortunately, I can't tell you anything about the T4 results.

Barb in western CO
(with Sierra, Libby, Josie the donkey, Lola and Katie)
2005
EC Support/Primary Response

www.ecirhorse.com
www.nolaminitis.org

The reference intervals on the lab sheet are: ACTH 9-35, Insulin 10-40, and T4 it has two different intervals being 1-2.8 and 1-3.8
I have the glucose from her regular blood profile done in March; it was 113mg/dL with a reference interval of 65-110mg/dL


Re: great test results?

 

Hi Monti,

No need to be discouraged!! You've made a lot of progress and it takes longer when exercise has to be limited as it does with your horse.

A G:I ratio > 10 is considered normal. Many (most??) IR horses aren't going to get there without being in regular work.

Neither Focus HF nor Su-per Farrier's Supplement contains selenium. I don't recommend either one as a stand alone mineral supplement but they are more palatable to some horses so they are a way to get some minerals in while figuring out how to get the horse to eat a custom supplement. Another pelleted mineral supplement that can be used is CA Trace (http://www.californiatrace.com/ingredients.html). That one does contain selenium if your horse needs it. I've never used it so have no idea how palatable it is. I get the other supplements through mail order - Valley Vet or KV Vet.

One of my horses is still not totally convinced about her supplements. Sugar-free peppermints help plus I find that she eats it better if I put the beet pulp/hay pellet/mineral mix over a small amount of wet hay so one more thing you could try.

Now remember - hang in there and don't be discouraged. You and Jake are making progress and have come a long ways already.

Barb in western CO
(with Sierra, Libby, Josie the donkey, Lola and Katie)
2005
EC Support/Primary Response

www.ecirhorse.com
www.nolaminitis.org

Thank you for the help again. What G:I ratio is ideal/goal? I will keep working on body condition.


Re: Jim

Mandy Woods
 

Hey ~
Welcome to the group. I recalculated the numbers of your bloodwork results and it appears that Ben is NOT IR but he is PPID (Cushings) We do not recommend dosing a horse with a large amount of pergolide the first day! Infact, our protocol is to taper slowly to avoid the 'pergolide veil' which is going off their feed and acting spacey. We usually start out at 1/4 mg a day for 3 days, then 1/2 mg for 3 days etc. The average dose in the beginning will be one mg ~ then retest after 4-6 weeks to see if you have the ACTH in the normal range. Is your pergolide liquid? We recommend the powder/capsules for their longer shelf life.

The philosophy here is DDT/E. You've done your blood work. Where was the blood sent? Which lab? Do you know the lab normal ranges? The values that I have ended up with ~ Insulin 7.8 uiu/L and Glucose 18 mg/dL make me think the blood was mishandled and sat somewhere and it degraded. The Insulin number is possible but the Glucose number is very low. The ACTH number could be higher! and that may be why your vet thinks 5 mgs is appropriate but tapering on would be easier on Ben.
You may have to repeat the blood testing. Please read the File on how to handle the bloodwork. We also recommend Cornell for testing blood. Was Ben fasted for these tests? We recommend just feeding soaked/drained untested hay the night before and the morning of the test. Keep this hay in front of him.

DIET is a low sugar/starch/fat hay with minerals balanced to it. A grass hay like timothy or Orchard grass is good. Does Ben have trouble eating because of his teeth? There are small cubes called Ontario Dehy Balanced Timothy cubes that are a complete balanced meal. These cubes can be 'misted' with water to help him chew them. Does he graze? We'll be anxious to see the questionnaire you fill out on ECH4!

TRIM is a balanced foot with the toes backed from the top and the heels lowered.
EXERCISE what the horse can handle. Hand walking is excellent.

I"m sorry your vet was injured and your new one is not familiar with this syndrome. You could direct the new vet to www.ecirhorse.com for a condensed version of 10 years of Dr. Kellons work. You will find the answers in the Files on the Cushings list as well as on the ecirhorse web site.

Ben is a lucky boy to have you! Please sign your name, where you live and the date you joined. If you can copy/paste the link to your Case History when you get it up ~ add that under your name too! It really makes it easy for the gurus to help you faster.

Mandy in VA
EC Primary Response
OCT 2003

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