Date   

Re: help with new blood work

Eleanor Kellon, VMD
 

You need to talk with your vet about adjusting pergolide dose to get better control. This is the best time of year for PPID horses but the highest ACTH you have on record.

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


Re: Help Please, I am New to Site- Have Laminitic Gelding

Maggie
 

it is killing me to think this is due to my own negligence


Linda,

Like Dr. Kellon said, try not to be so hard on yourself.  Many, ma ny of the folks on this list were where you are now (including me), so we know the feeling.  Don't waste your energy on regrets, because you' re going to need that energy in managing your  new way of li fe with Roo.  Just wanted to send you some encouragement, because I know how bad I felt when Chancey first got laminitis.  It took me 4 years and many more laminitis episodes before I found this group.  I had made many changes in his management, but never had enough info to do it completely right and prevent him from getting laminitis again and again. Because of Dr. Kellon and the many other experts and the support and knowledge I have gotten here, I am confident that Chancey's laminitis days are over (even tho my vet told me it's not a matter of "if" he will founder again, it's a matter of "when").  Hang in there!

Maggie and Chancey in VA
March 2011
http://pets.groups.yahoo.com/group/ECHistory4/files/maggie%20in%20virginia/


help with new blood work

millionairess1989
 

Hello,
Just got back the results on Mill's latest blood work from Cornell. I am not sure where to go from here. I will get this to her file later today. She has been on 1.5mg of Pergolide.

ACTH 68.1 (9-35)
Glucose 91 (71-113)
Insulin 37 (10-40)
Leptin 4.339 (1-4)

http:/pets.groups.yahoo.com/group/ECHistory3/files/Millionairess

Jennifer & Mill in TN
Jan 2011


Re: Dr. Kellon and/or other IR experts--please advise

Maggie
 

You're not going to learn anything new in terms of whether or not your horse is IR, except whether or not he tests positive when fasted, but Dr. McCue's portion is to look for a genetic component. You could contribute to that.
I don't know how risky the Karo challenge is, but the risk is not zero.



Thanks for the info, Dr. Kellon.  I ema iled them a few questions this morning and am waiting on a reply.  I am not too keen on the idea of fasting my horses overnight.  They are never locked up in a stall and that's the only way I could keep them NPO overnight.  I would like to contribute, but not if it involves stressing my horses out--even it is only overnight.  If I do participate, I will opt out of the OGTT.  T hanks again


Maggie and Chancey in VA
March 2011
http://pets.groups.yahoo.com/group/ECHistory4/files/maggie%20in%20virginia/






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Re: Salt and flax amounts for pony

Chanda
 

While not on the emergency diet, my 350# Cushings gelding gets 1 tsp salt, and 3/4 ounce of flax (I think its around 3 tablespoons - he's getting Omega Horseshine in his SmartPaks at .75 scoop dose, so should be 3/4 ounce). [My normal minis gets 1 tablespoon to 3 tablespoons flax, depending on their needs; the ones on just a tablespoon could probably use a little more, but its ok for now; and those on 3 tablespoons it seems to be about right.]
Chanda
MT 9/04

--- In EquineCushings@..., Teri Riley <teririley@...> wrote:

Can someone tell me how much salt and flax to give a 300 lb pony on the emergency diet?   I've been guessing and giving her 1/2 tsp. salt and 2 tsp. flax (before grinding) am and pm on her BP.

Teri

Indiana
4-2012 

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Re: Help Please, I am New to Site- Have Laminitic Gelding

Eleanor Kellon, VMD
 

--- In EquineCushings@..., "roodle20" <roodle20@...> wrote:


If high sugar noted in hay, I may have to buy "safe forage"... I beleive another post described it. Is that advised if hay cannot be soaked?
If you can't use the hay, you can go to the Ontario Dehy Timothy Balance cubes. Since you can get other TC products, you should be able to get these. If your store isn't familiar with them, give Triple Crown a call directly.

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


Re: Help Please, I am New to Site- Have Laminitic Gelding

roodle20
 

Thank you so much Dr. Kellon for your reply and your kind words! I saw to it he had no grain in the morning and had hay througout the day in a haynet prior to the blood pull at 4pm.

The Cornell test was only for Insulin, ACTH and Leptin; I didn't realize there was no glucose component to test so I can't calc the G:I ratio from the Cornell results.

Nonetheless, from what you say, the glucose result is not really necessary with an insulin of 39.95 after hay only. It seems the diagnosis is pretty clear. The Leptin result is still pending and I'm not sure what it will tell us but I will rely on you and group -members' advice.

I will read the pony study and I will not "give up the fight". Have located a hay probe and will send samples asap to Equi Analytical.

If high sugar noted in hay, I may have to buy "safe forage"... I beleive another post described it. Is that advised if hay cannot be soaked?

Thank you again and again.

Linda House for Roo
Alabama 2012

--- In EquineCushings@..., "drkellon" <drkellon@...> wrote:

Hi Linda,

I'm sorry you don't have more support "on the ground", but you'll find plenty here.

A "normal" insulin depends on when and what the horse was last fed. An insulin of 40 uIU/mL is normal after a grain meal, but not normal if fasting or not fed grain.

You might want to print out the Va Polytechnic pony study in our files for your vet. It clearly shows that pasture laminitis risk is linked to higher insulin. It also shows that normal ponies on the same pasture that caused laminitis in IR ponies had an insulin no higher than 12 uIU/mL.

You have already done quite a lot in the face of stiff resistance, so don't be so hard on yourself. This could have been much worse without the weight loss, exercise and hoof care.

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


PPID Study

Eleanor Kellon, VMD
 

I have been asked to post this here by Dr. Joe Bertone.

Dr. Bertone is a past FDA veterinarian, researcher, author and currently Professor, Equine Medicine, at College of Veterinary Medicine
Western University of Health Sciences, Pomona CA.

Dr. Bertone has an idea for treatment of PPID horses using an inexpensive, readily available drug that could reduce the overall cost of maintenance.

I do not have any more details beyond the above. If you are interested, please ask your veterinarian to contact Dr. Bertone at PPIDstudy@....

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


Re: Help Please, I am New to Site- Have Laminitic Gelding

Eleanor Kellon, VMD
 

Hi Linda,

I'm sorry you don't have more support "on the ground", but you'll find plenty here.

A "normal" insulin depends on when and what the horse was last fed. An insulin of 40 uIU/mL is normal after a grain meal, but not normal if fasting or not fed grain.

You might want to print out the Va Polytechnic pony study in our files for your vet. It clearly shows that pasture laminitis risk is linked to higher insulin. It also shows that normal ponies on the same pasture that caused laminitis in IR ponies had an insulin no higher than 12 uIU/mL.

You have already done quite a lot in the face of stiff resistance, so don't be so hard on yourself. This could have been much worse without the weight loss, exercise and hoof care.

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


ECIR Group Brochure

Nancy C
 

This time of year a lot of members use this handy tri-fold educational piece at clinics, with their vets, farriers, trimmers and with other horse owners to help get the word out.

I just uploaded a 2012 version which includes short info about Leptin testing.

<http://pets.groups.yahoo.com/group/EquineCushings/files/6%20EC%20Education/>


Recognizing and Treating Equine Cushing 2012.pdf

Tri-fold brochure describing diagnosis, treatment and ECIR Group resources

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...


Re: OK to Soak ODTB Cubes in Hot Water?

Nancy C
 

Hi Laura

Warm/hot water is okay. Peas are okay too. Good amino acid profile.

Glad he likes it!

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...


Re: Dr. Kellon and/or other IR experts--please advise--REPOST

Lisa S
 

--- In EquineCushings@..., spiral1957@... wrote:

I am wondering if I should participate.

I participated in this study because I believe in supporting anything that even hints at IR/Cushings/EMS/laminitis research. I do not care if studies are perfectly designed or not, and I don't care if there is any personal benefit for me--I will participate if I can!

That being said, if you are looking to benefit personally from this project, it might not fit your needs. I definitely passed on the OGT test, and I did not get info from the hay testing that I did not already have from Equi Analytical. One benefit for me was that I was pleasantly surprised to learn that my 13-year-old IR gelding was showing no signs of increased ACTH, even in the fall. But interestingly, his non-IR half sibling's value was creeping up a bit--and guess what? She is not shedding well this year!

I am hoping that this project gets a lot of press when it is done so that it will be one more opportunity to keep horse owners talking and asking questions about IR/Cushings/laminitis prevention. I have become somewhat of a missionary on the topic, and I use my gelding as a living, breathing visual aid to demonstrate the 'warning signs' for horse owners. My iPhone has a few pictures of my kids--all the rest are pics of horse hooves, radiographs, cresty necks, supraorbital fat pads, etc.

I'll bet a lot of you ECIR folks are nodding your heads!

Lisa in TX
Pookey Bear
June 2010


Re: Vit. E and how do i edit my personal info

Theresa <tleri@...>
 

--- In EquineCushings@..., "Lavinia" <dnlf@...> wrote:
Thank you!
Theresa and Khaiti
2003, CA

,
> Vit E is fed at 1000iu per 500 lbs bodyweight.> HTH>

Lavinia, Dante, George and Peanut
Jan 05, RI
EC Support Team


Re: Safe to Muzzle?

kimgedckewagner
 

Sky,

Pick a day/time when you can be around to watch and supervise to make sure your horse can't get the muzzle off, as mine have been super devious over the years. I also would caution you about the "few nibbles." I'd tape the muzzle hole shut, and if you have the woven kind, making sure your horse can't grab those nibbles from between the webbing. The reason I mention this is that my IR/PPID gelding has an extremely tight/controlled diet (and well controlled PPID,) with only the exception of a few nibbles of grass that grow along his dry lot, and his insulin number came back in the 200s yesterday.....just from a few nibbles.

Good luck and hope your horse enjoys the muzzle time roving around!

Kim & CG
Winter 2005
New Hill NC

--- In EquineCushings@..., "skyappy95" <skydove103@...> wrote:

How do you know when it is safe to let your horse out of the dry lot
with a muzzle on & perhaps get a few nibbles?


Re: Help Please, I am New to Site- Have Laminitic Gelding

roodle20
 

Mandy,

Thank you so much for your quick reply. I just removed the .docx test results and uploaded as .doc. I believe you can open them now.

My confusion is why Vet (and BO) don't think my horse has IR. I feel as if I am living in 2 worlds...the one at barn where a little laminitis isn't considered a big deal vs. the wider world accessed through this site and reasearch studies which show laminitis IS a big deal and can be caused by IR.

I wish I could tell you how much "discourse" it took to get my Vet to do the blood work according to protocol(thus 2 sets of tests). Vet believed I was "chasing" a "popular" diagnosis. He feels the test results rule out both PPID and IR. Note: Roo is now somewhat thin and the crest is quite reduced but still visible.

Just prior to the April laminitis I transitioned Roo to Triple Crown Lite (thanks to prompting from my barefoot trimmer). He is getting 3/4 of a "scoop" twice/day (I think the scoop is almost 3 lbs). I will weigh it soon and report back.

Delayed having hay tested last Fall because the BO seemed to take offense when I talked to him about it. Kicking myself now obviously. Can't get a probe til next Tuesday from Ext Agent. Don't know how I can soak hay due to Boarding and work schedule...how long prior to feeding can this be safely done? I am already pre-filling haynets for BO so all he has to do is hand them. Should I just purchase the "safe forage " for him to replace hay until i'm sure?

I can begin the supplements immediately.

Please advise. I am crushed that I might not be able to ride him for many months...it is killing me to think this is due to my own negligence. I should have begun the protocol prior to Spring. But he lost all the extra weight and seemed healthy and I was riding him barefoot Dec- March.

Please advise what you think about his test results...the Cornell test "seems" negative for PPID and IR.

Linda House for Roo
Alabama 2012

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

Hi Linda,
Welcome to the group. You're about to enter a new chapter on equine
nutrition and management. You'll watch Roo improve daily with the protocol
that has been designed by Dr. Kellon. The list philosophy is DDT/E.

Since Roo in an easy keeper TWH and laminitic on spring grass ~ you should
start him on the Temporary Emergency Diet now. Pull him off pasture
immediately! Your vet was right about spring grass. Roo most likely is IR
so you need to feed him as if he was. Wont hurt if he's not. WILL help if
he is! He's at the age where Cushings could be involved so you'll need to
get an eACTH test before the end of August for a DIAGNOSIS.

I could not open your Case History docs but I did get the questionnaire to
open. Nancy said your bloodwork states he's IR. IR is managed by DIET.
By removing him from pasture (full of sugar) and feeding him a low
sugar/starch/fat meal with his hay soaked and drained will make a huge
improvement in him. We aim for 10% or less sugar/starch a day. The ER
diet is exactly what he needs. The ER minerals can be purchased at any
drugstore. Vitamin E, loose iodized table salt, magnesium and flax seed.
This is Temporary until you get your hay analyzed and the minerals balanced
to that assay. Feed him 1.5% his body weight a day in hay ~ weigh it dry.
Feed at least 4 small meals a day in small mesh hay nets (use them for
soaking and slowing down his eating) so he has some food going through his
system. Do NOT starve him! What low carb feed are you giving him? Is it
under 10% s/s/f? Read the Start Here file for details. Send your hay
sample to www.equi-analytical.com #603/$49.

TRIM is a balanced foot with toes backed from the top and heels lowered. IF
he's barefoot you can get boots/pads for him. Trimming should be done as
often as weekly to every 2 or 3 weeks.

EXERCISE is hand walking only if he's able. Never force a laminitic horse
to move. Also ~ when he starts feeling better you want him quiet! and not
bucking around. It takes time for hooves to heal. Many horses need to
grow out a complete hoof (about one year) before they are 'released' to ride
or continue their work load.

We know the information here is overwhelming. It will get easier for you!
Please ask questions as they pop up. Start a journal on Roo with pictures
too. Knock yourself out in the files. And take a deep breath for yourself.
You arent alone!

Mandy in VA
EC Primary Response
OCT 2003


Re: Dr. Kellon and/or other IR experts--please advise

Eleanor Kellon, VMD
 

If one goal of the study is to determine if an oral Karo challenge is more sensitive at picking up IR than a fasting insulin and glucose there's not much doubt as to how that will turn out.

Many researchers jumped on the fasting idea because it eliminates potentially high levels from the sugar/starch composition of the diet. This is true, but if the protocol of the Va Polytechnic pony study is followed, feeding is not an issue. In that study, normal ponies had insulin no higher than 12 uIU/mL even when maintained nonfasting on pastures that caused laminitis in IR ponies. No problem with false positives.

On the other hand, there is little, if any, evidence that IR horses overproduce glucose when fasted like humans do. If you look at the prefeeding (assumed fasting) insulin levels in the first link I posted this morning, it looks like the highest was around 20, others lower.

You're not going to learn anything new in terms of whether or not your horse is IR, except whether or not he tests positive when fasted, but Dr. McCue's portion is to look for a genetic component. You could contribute to that.

I don't know how risky the Karo challenge is, but the risk is not zero.

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


Re: Salt and flax amounts for pony

Teri
 

Can someone tell me how much salt and flax to give a 300 lb pony on the emergency diet?   I've been guessing and giving her 1/2 tsp. salt and 2 tsp. flax (before grinding) am and pm on her BP.

Teri

Indiana
4-2012 






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Re: NUTRENA SPECIAL CARE

Eleanor Kellon, VMD
 

Here's another one, same group, that concluded 18% starch was appropriate for horses with metabolic issues because insulin and glucose responses were lower than with 28% starch:

http://www.crfarms.org/new_gfx/trials/Equine/E08%20UK25%20-%20CRF.jpg

However, lower does not mean low enough.

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


Re: NUTRENA SPECIAL CARE

Eleanor Kellon, VMD
 

--- In EquineCushings@..., "Erica" <eureggie2@...> wrote:

I just had a conversation with a Nutrena rep last weekend at our Horse Fair. He informed me that anything less that 20% s/s was acceptable for IR horses and that non-IR horses get up to 60%!
I suspect that came from this study:

<http://www.crfarms.org/new_gfx/trials/Equine/E08%20MSU27%20-%20CRF%20page%201%20jpg.jpg>

It's very sketchy on details and they don't specify type of starch, form of feed (pelleted, etc.), fasting, how much was fed but basically they took 8 horses at random and found some had high insulin responses to feeding (presumably IR) and some did not (presumably normal). A peak insulin of 40 to 50 uIU/mL after grain feeding is fairly common. The "high responders" were much higher.

Because there was no significant difference in insulin peak (about 350 uIU/mL) between 8% and 20% starch in the high responders they concluded up to 20% was safe. I would conclude that even 8% is not safe! However, details such as type of starch, processing of starch and meal size may influence that.

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


Re: Horses needed for a trial

diana5572
 

My pony is a Shetland & therefore not eligible. I would be reluctant to change anything at the moment as he is so stable.
 
Diane Witherspoon

From: drkellon <drkellon@...>
To: EquineCushings@...
Sent: Tuesday, 24 April 2012, 15:42
Subject: [EquineCushings] Horses needed for a trial


 
BACKGROUND: CocoSoya oil is a very aromatic blend of soy and coconut oils that usually works beautifully for fussy eaters. It's also much lower in omega-6 than other vegetable oils.

Because of concerns about the effects of fat on IR and omega-6 on inflammation we have been avoiding using it, but Uckele (where I'm now an advisor) has offered to do a test on the effects of small amounts in IR horses.

CANDIDATES: This trial is for full size horses only. Candidates must be proven IR by lab work and have at least an insulin level available "pre" the trial that was done after any changes in diet/management. In other words, if you have confirming blood work but made diet or exercise changes after that, we can't use that blood work.

Actively laminitic horses are not eligible.

Horses that do not have PPID are preferred but PPID horses will be considered if stable.

TRIAL: CocoSoya will be provided by Uckele and they will pay for repeat blood work after the trial. Supplementation period will be 2 months.

No changes in diet (other than hay), exercise or medications is permitted during the trial.

Anyone interested contact me personally at drkellon "at" gmail.com.

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




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