Date   

Re: Tess's Time Line

Lavinia <dnlf@...>
 

Tess is a 16-year-old stock type quarter horse, about a 5 on the body scale. No fat pads, no eye bulges. Out 24/7 with 3 others on 20 acres (two are controlled IR). Diet tight to hay analysis, with ECIR recommended supplementation and additional as noted below. Zero worm counts.
At any rate, she has had continuous abscessing in both fronts with resulting near-destruction of the walls at both toes. No evidence of systemic laminitis per vet but some tipping of coffin bones due to improper hoof form, according to x-rays. Lots of painful weeks over the last 2 years but her feet are slowly coming along now that I am trimming her again. I am keeping her heels down, bars trimmed below wall, damaged toe areas off ground pressure. Treating for thrush just in case.
Cushings type hair coat coming back in rapidly, upped pergolide again to 2.75.
08/01/2012 Here’s where we are now: Heavy coat is beginning to shed in patches, slowly. She has had a terrible time with the heat this summer, alternating between inside the barn where it’s 10 degrees cooler and outside with her mates. Very rapid respirations (60-70) until I hose her down and place her in front of a fan. She is not sweating as much as before. Slightly elevated heart rate, no worse than the others. Gums pink, urine normal looking and normal smelling. Appetite good, apples normal. Lies down 4 to 5 times a day but only for 15 or 20 minutes at a timeâ€"I assume that’s because her feet still hurt although she leads willingly and grazes actively now
Can the need for pergolide increase THAT FAST? Since March 1 we’ve gone from 1 mg to 2.75.
Hi Linda,
Appreciate your including all the details for your girl. Putting all this info in a case history form would be really helpful for us. Reading all the numbers in linear format is tough and trying to then find this post to refer to later when info is needed will make everyone's job so much more difficult.
Yes, sometimes pergolide increases can be large and fast. I started Dante on pergolide last year in Aug (ACTH 1088), ramped him up to 6mg by end of Sept, which got his ACTH down to 46 in Dec. Thought we were OK, then when he was retested this May his ACTH came back at 170 so he'll be at 9mgs soon and crossing my fingers. It is very individual. The non-shedding coat is not necessarily a good indicator of efficacy as many times it does not respond to correct doses of perg that control the ACTH levels. This time of the year all horses will be preparing for their winter coats as it is the length of daylight that is a big trigger and that changed on June 21st(ish). Parasitism and mineral imbalances can also result in haircoat issues independent of any PPID. If your mineral balancing is tight, obviously this isn't the cause.
PPID horses have trouble with thermo regulation as part of the disease. Age also plays a part.Fans/hosing/shade are really important and also watch for signs of anhidrosis (inability to sweat)developing. The dullness may be a sign that her perg dose is too high unless you've done bloodwork since upping her dose to 2.75mg.
The thyroid numbers moving around can be influenced by diet, temperature, IR/PPID and are usually secondary to these primary issues. Thyroid supplement won't help if that is not the primary cause. Can you post the hay analysis and supplements for double checking?
Has she been tested for IR? Would strongly recommend getting Insulin/Glucose/Leptin along with the ACTH and sending to Cornell. Do not fast before testing. Would also not be allowing her on pasture at this point as she is sore-footed. If IR, the sulfa drugs could have been making this worse as they raise insulin in other species. An iron panel from KSU would also be a good idea as iron overload contributes to worsening of IR/PPID.
Post pics of feet for the hoof gurus to give you some input. Tight trim will go a long way in helping any laminitis issues that may be lurking.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Suppport Team


Re: All 3 of my horses test pos for IR - some questions

gverrecchio <verrecchiodvm@...>
 

--- In EquineCushings@..., "Lavinia" <dnlf@...> wrote:


http://pets.groups.yahoo.com/group/ECHistory5/files/G.%20Verrecchio%2C%20No.%20Carolina/
Hi Lavinia, Thanks for the response. Ive answered your questions below.
When you say they were on balanced rations in MN does that mean tested hay and minerals balanced to the assay or?

Yes Hay was tested and minerals balanced to hay.

Mosi: Is his current hay tested?
Yes, current hay is tested but not soaked. Any way to actually weigh it to know for sure how much he is getting?
I shipped the scale and bag I used to weigh hay at home with the horses. They came about 2 weeks before we moved. Barn owner/mgr, weighed hay for Mosi when he first arrived, but was estimating amounts for all horses by the time we moved our household to NC. The last couple months she has been a bit preoccupied because her horse was injured, spent 6 weeks at Va Tech and then when the mare came home she had to give Antibiotics 4x a day. I did not want to ask her to do the additional work to weigh hay. I will try to approach her about my weighing hay meals so she doesn't have to. Barn owner is very good horsewoman, very caring about our horses and has done alot already to help them settle in. She is willing to work with me on this. Talked to her today and the "partners" are open to setting up a dry lot, but need to explore costs. They are surprised about the request because nobody dry lots their horses down here..they are all on pasture
Hay results - Dairy ONe
%moisture 5.5
%dry matter 94.5
DE as sampled 0.89 mcal/lb
Crude Protein 34.0 g/lb 7.5%
Est. Lysine 1.3 .29
ADF 177.9 39.2
NDF 264.0 58.2
WSC 61.0 13.4
ESC 19.9 4.4 )
Starch 2.6 .6 ) sugars =5% correct?
NF 97.9 19.4

CA 1.95g/lb .43%
Phos .57 .13
Mg 1.00 .22
K 4.3 .95
Na .060 .013

Fe 44.0 mg/lb 98ppm
Zn 13.0 29
Cu 6.0 14
Mn 115.0 52
Mb .2 .4

You mention his minerals - do you mean the Uckele Race VM? if so, this is formulated for an alfalfa/legume hay and his current hay is grass. It also contains vit C, riboflavin, thaimin, niacin and iron which are all contra-indicated for an IR horse.

This is my bad. I thought this would complement the barn hay close enough, until we got settled.
The smartpak Senior has MSM(interferes with copper/selenium absorbtion), glucosamine(may be problematic for IR), vit C.

I can cancel this for all 3 horses???

The Omega Horseshine is great for the flax component but 6 oz for an 815 lb horse is pretty high - general recommendation would be no more than 4 oz. Vit E is 1000iu per 500lbs so should up it.
okay, I will decrease Horseshine and increase Vit E

Was the navicular diagnosed thru xray? Nerve blocks? Possible low grade laminitis issues from the IR could also be a factor here. Trim would need to be really tight to make sure it isn't exacerbating things.
Yes. Mosi has been to see Vet/Farrier lameness specialist at least 3 times prior to our move. I am concerned that he is currently having low grade lameness now however, some days he moves pretty "short stepped"..
The stress from repositioning the needle would not cause that much of an insulin rise(77.91) and his glucose is 90 so no gross mismatch there.
How do I interpret his Leptin then? It is 1.96 well within normal range

Sarah: If too heavy, needs to lose the weight. Her Leptin of 11.69 is really high and her glucose is at 93. Would not be allowing any pasture here. Know this is a problem with the current boarding situation. The leptin is saying she is IR at baseline but was being controlled before with the dietary management you had. Sealing the muzzle works but that also prevents her from being able to consume any forage - thinking low s/s hay in a net here - all night. How many hours is that? About 12 hours
I put weight tape on her today, she is 760# and I think she would be a good weight about 715-720#

With IR, want to prevent insulin spikes so aim for no more than 6 hours of no forage at most.
If she won't eat flax at all, she needs to get omega 3's from somewhere. Can use flax oil instead.
I have tried the Nutramax product - ate that for a while then stopped.
What flax oil are you referring to?

Vit E a little low. Can her hay be withheld until she finishes her supps like you did back in MN?

I will talk to barn owner/mgr.

Fonix: Love that name :) Thanks...I really love the horse too!
Primary hypothyroid is rare in horses so the IR and dietary imbalances are probably the culprits. Not sure on him being a stallion part, although that does tend to protect them from IR to some degree. Need one of the medical experts to weigh in on that. Pasture is a risk.

With all of them, the fact that they are working regularly is huge and is probably why the numbers are not worse. Icelandics tend to be air ferns and do not do well metabolically with access to lush pasture. Iron overload is also a possibility for driving the IR and the Race VM is adding extra iron. Really need to get the hay tested to see what is/isn't in it and whether it is safe in ESC + Starch for them. Really should soak it in the meanwhile to be cautious. Balancing the minerals to the hay assay is the only way to truly get their diets correctly balanced.
Hay results are above. I will work on the balancing spreadsheets and contact you to check if that is okay? Thanks for all your comments.
Gloria, Mosi, Sara, Fonix
8/12 in NC

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


Re: Once a horse is on jiaogulan, should it keep taking it forever?

Eleanor Kellon, VMD
 

--- In EquineCushings@..., "Erin G." <caprinesociety@...> wrote:

My PPID gelding, Nick, is recovering from a bowed tendon. Good news the
vet just ultra-sounded him and said he is 2 months ahead of schedule.

Nick is on 6 mg. perg., j-herb, AAKG, and some other things. He looks
great. Should he stay on the j-herb for life, too? Because of his tendon?
Very common to see healing accelerated with the J and AAKG. I usually recommend continuing it during the rehab period, until back in full work. However, since his PPID may have contributed it wouldn't hurt to at least keep him on the J.

As another rehab hint, if you ice the leg for 30 minutes immediately after any formal exercise, even the early walking, it will greatly decrease any inflammation and risk of set backs.

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


ECIR PERGOLIDE DOSAGE DATABASE: INPUT NEEDED!

tomtriv <ThePitchforkPrincess@...>
 

"The only "correct" dose of pergolide is the one that controls his ACTH."
- Dr. Kellon, ECIR Message #132610, Sep 2, 2009.

Ever wonder what the highest dosage of pergolide in the group is? The longest amount of time a horse has been on pergolide? How many horses’ ACTH is controlled? Who is on compounded or a brand name? Well we have the tools to find out! We have the ECIR Pergolide Dosage Database:
http://tinyurl.com/yfahmda

The Pergolide Dosage Database can be sorted by clicking on a column heading. By using that column's arrows you can pick its sorting direction to show horses on high or low dosages. Through case history links, you can see how these horses are responding, their ACTH history, the pergolide formulations and administering details. This can be helpful when considering and discussing a dosage change with your vet.

If your horse is on pergolide and you haven't yet added your information or recorded dosage changes, RUN, don't walk over to http://tinyurl.com/yfahmda and enter your information. It won't take long and your information will help other PPID horses. Currently most of the data is old, with links to Case Histories that are no longer accessible. However, thanks to recent entries, the number of viewable case histories is rising and dosages amounts are starting to reflect today's numbers.

To ensure your data is useful and correctly processed by Yahoo's sorting parameters, please follow the directions posted in the column headings and refrain from adding extra information. The link to your case history should provide access to all extra information.

DATABASE STATISTICS â€" Aug 5, 2012
From 445 Entries (up 24 since Mar 2012):



1 horse on 15mg
1 horse on 13mg
3 horses on 10.0mg
2 horses (1 is a pony) on 8.5mgs
2 horses on 8.0mg
4 horses on 7.0mg
2 horses on 6.5mg
8 horses on 6.0mg
1 horse on 5.5mg
5 on 5.0mg
1 on 4.5mg
10 on 4.0mg
4 on 3.5mg
17 on 3.0mg
1 on 2.75mg
12 on 2.5mg
1 on 2.25mg
32on 2.0mg
4 on 1.75mg
27 on 1.5mg
1 on 1.45mg
5 on 1.25mg
1 on 1.2mg
1 on 1.02mg
135 on 1.0mg
14 on 0.75mg
1 on 0.7mg
1 on 0.6mg
5 on 0.5mg
31 on 0.5mg
7 horses on less than 0.5mg

105 Entries not usable â€" Thank you to those of you who have fixed your entries!

(Note: The numbers have likely changed since the above date. Some entries have been omitted from this list as they were entered incorrectly.)

Thank you for your cooperation.
Owners, Moderators & Primary Response Team of the Equine Cushings List


Re: Once a horse is on jiaogulan, should it keep taking it forever?

Nancy C
 

Great news on Nick!

Need Dr Kellon for definitively answer. Age, Case History, (Case History? )level of resumed work and and severity of tendon issue would have a lot of input as to whether to continue or not, I'm thinking.

Jiaogulan has other benefits as an adaptogen. Some members have reported increased insulin sensitivity - what we are looking for with our IR guys. Also helpful in protecting from ulcers. See adaptogen and ulcer files.

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...

--- In EquineCushings@..., "Erin G." <caprinesociety@...> wrote:

Nick is on 6 mg. perg., j-herb, AAKG, and some other things. He looks
great. Should he stay on the j-herb for life, too? Because of his tendon?
Erin & Nick
OH
11/07


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


Re: All 3 of my horses test pos for IR - some questions

Eleanor Kellon, VMD
 

Primary hypothyroid is rare in horses so the IR and dietary imbalances are probably the culprits. Not sure on him being a stallion part, although that does tend to protect them from IR to some degree. Need one of the medical experts to weigh in on that. Pasture is a risk.

T4 is normally at the low end during hot weather. I wouldn't worry about that number.

His insulin is on the high side for pasture but dry weather conditions are stressing the grasses and leading to a preponderance of clover in some conditions. I would retest him after several hours of soaked hay only to get a better baseline.

He's also old enough that the early seasonal ACTH rise may be playing a role here.

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


Re: Once a horse is on jiaogulan, should it keep taking it forever?

Erin G. <caprinesociety@...>
 

Nancy,
My PPID gelding, Nick, is recovering from a bowed tendon. Good news the
vet just ultra-sounded him and said he is 2 months ahead of schedule.

Nick is on 6 mg. perg., j-herb, AAKG, and some other things. He looks
great. Should he stay on the j-herb for life, too? Because of his tendon?
Erin & Nick
OH
11/07


Re: All 3 of my horses test pos for IR - some questions

Lavinia <dnlf@...>
 

http://pets.groups.yahoo.com/group/ECHistory5/files/G.%20Verrecchio%2C%20No.%20Carolina/
1)Mosi who has been dx IR since March 2011 is only turned out into a drylot with his haybag. The barn owner estimates the amount (weight of hay) fed to him, but his minerals are based on 20# of hay to be fed daily. He has some navicular issues so has been in special shoes/pads for the past several years.
2)Sara: Normal G:I in Feb 2012 in MN on balanced rations. Still over 800# at that time (fat). Never any lameness issues but very very easy keeper. When moved to NC she went into a grazing muzzle for turnout and reduced rations, she has lost quite a lot of weight but still has some more to lose. Very picky, almost impossible to get supplements into her on a regular basis
3) Fonix - normal G:I ratio in Feb 2012 in MN on balanced rations. Now in NC, he is getting worked 5-6 days a week, has lost weight and also some of his too big crest (he is 15 yo Stallion)and is actually pretty fit. But his numbers say he is IR and at significant risk for laminitis.
If I still had the horses at home, I would just dry lot Sara and Fonix with maybe an hour turnout on grass with a grazing muzzle...Any Other suggestions for management? How effective is taping the hole in a grazing muzzle?
Hi Gloria,
Thanks so much for filling out the CH on all of them and including the link. It makes it so much simpler for the volunteers to help you - we appreciate the effort. When you say they were on balanced rations in MN does that mean tested hay and minerals balanced to the assay or?

Mosi: Is his current hay tested? Soaked? Any way to actually weigh it to know for sure how much he is getting? You mention his minerals - do you mean the Uckele Race VM? if so, this is formulated for an alfalfa/legume hay and his current hay is grass. It also contains vit C, riboflavin, thaimin, niacin and iron which are all contra-indicated for an IR horse. The smartpak Senior has MSM(interferes with copper/selenium absorbtion), glucosamine(may be problematic for IR), vit C.
The Omega Horseshine is great for the flax component but 6 oz for an 815 lb horse is pretty high - general recommendation would be no more than 4 oz. Vit E is 1000iu per 500lbs so should up it.
Was the navicular diagnosed thru xray? Nerve blocks? Possible low grade laminitis issues from the IR could also be a factor here. Trim would need to be really tight to make sure it isn't exacerbating things.
The stress from repositioning the needle would not cause that much of an insulin rise(77.91) and his glucose is 90 so no gross mismatch there.

Sarah: If too heavy, needs to lose the weight. Her Leptin of 11.69 is really high and her glucose is at 93. Would not be allowing any pasture here. Know this is a problem with the current boarding situation. The leptin is saying she is IR at baseline but was being controlled before with the dietary management you had. Sealing the muzzle works but that also prevents her from being able to consume any forage - thinking low s/s hay in a net here - all night. How many hours is that? With IR, want to prevent insulin spikes so aim for no more than 6 hours of no forage at most.
If she won't eat flax at all, she needs to get omega 3's from somewhere. Can use flax oil instead. Vit E a little low. Can her hay be withheld until she finishes her supps like you did back in MN?

Fonix: Love that name :) Primary hypothyroid is rare in horses so the IR and dietary imbalances are probably the culprits. Not sure on him being a stallion part, although that does tend to protect them from IR to some degree. Need one of the medical experts to weigh in on that. Pasture is a risk.

With all of them, the fact that they are working regularly is huge and is probably why the numbers are not worse. Icelandics tend to be air ferns and do not do well metabolically with access to lush pasture. Iron overload is also a possibility for driving the IR and the Race VM is adding extra iron. Really need to get the hay tested to see what is/isn't in it and whether it is safe in ESC + Starch for them. Really should soak it in the meanwhile to be cautious. Balancing the minerals to the hay assay is the only way to truly get their diets correctly balanced.

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


Re: WAS: Thyro-L? NOW: high ESC hay/pasture

gypsylassie
 

--- In EquineCushings@..., Nancy Collins <threecatfarm@...> wrote:

My hay is cut at 4 AM. To eliminate stress the fields are fertilized and the soil pH is corrected. My ESC (simple sugar) was up to 9.2% on the first test. I rested, coring 40 bales, and ESC came back at 10%. First time my hay cut at 4 AM has come back like this. It had been averaging around 7 percent, often much less.

IMO, all things point to the drought we had in April and extremely rapid growth in May after the rains causing this increase. Hope to get more hay tests from other growers and times of cutting.

I would not be surprised that pasture would also be higher in sugar. Also not surprised at increased laminitis incidents.
Hi Nancy,
I'm in N.IL. and my hay grower also does what he can to make low s/s hay, but this year with the unusual spring weather it is up to 7.8% s/s. Still OK, but higher than last year. A friend also mentioned that her farrier is seeing more cases of laminitis this summer. We've been in a drastic drought here and the old popular notion of "there's nothing left in the grass, it's safe" is proving totally wrong, as I've learned here.
Laura K. Chappie & Beau
N.IL. 2011


Velvet Looking Good!

ferne fedeli
 

I've "hopefully" attached the correct link for my 28-yo Arab Gelding Velvet's
recent picture after starting Pergolide in Oct. 2011. It is the first time he
has shed out completely in about 5 years.
http://groups.yahoo.com/group/ECHistory4/photos/album/1091060306/pic/490893894/view?picmode=&mode=tn&order=ordinal&start=1&count=20&dir=asc

The farrier was here on Wednesday and he commented on how good
Velvet looks and how his feet are so much better now too.

Another Success Story for this list! My IR Icelandic that foundered in 4/10
and my donkey are doing quite well also.
Ferne Fedeli
No. California
4/2010


Re: Blood test results after Metformin

Eleanor Kellon, VMD
 

--- In EquineCushings@..., "lisa2t" <tomslisa@...> wrote:

Hi all,

Please can you offer some advice. Bonnie's GI ratio before the Metformin was 0.76. I started the Metformin on the 5th July and stopped 3rd August @ 15000mg twice a day. My vet arranged blood tests the day I took her off the Metformin and the GI Ratio is now 0.90.
When metformin is going to work, it works very quickly - less than a week. Effectiveness decreases over time but if it had been working (it doesn't always) you should have seen more marked improvement at the one month time.

How much hay are you feeding her? Underfeeding can backfire in these very IR horses. How lame is she? Does she cycle normally?

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


Re: Help !

Lavinia <dnlf@...>
 

My horse has recently been diagnosed with cushings I have him on pergolide thyro l and aspirin and a low starch pellet to mix meds in . He's been on all that for 30 days - and now refuses to eat his pellets -- I've tried sugar free syrup sugar free applesauce sugar free pepermints - nothing he just refuses to eat
Hi Edvyna
Welcome to the group. It sounds like your boy may be experiencing the "pergolide veil", a temporary disinterest in his food that is caused by the pergolide. It can be helped using APF, an adaptogen made by Auburn Labs. He also may have decided that he just doesn't like the "stuff" that is mixed into his pellets. We can help you sort thru all of this but we need you to fill out a case history for your boy on our sister site ECHistory5. You'll need to join but it will only take a minute. Here's the link:

http://pets.groups.yahoo.com/group/ECHistory5/

The list follows a protocol that we call DDT/E, which is short for Diagnosis, Diet, Trim and Exercise.

DIAGNOSIS: Is thru bloodwork. PPID is treated with pergolide. We recommend the ACTH test for PPID(Cushings) and Insulin/Glucose/Leptin sent to Cornell for IR. How was your boy diagnosed physical symptoms? Bloodwork? We need the test results, lab normals and units of measure. What dose of pergolide is he on in mg?
He may also be Insulin Resistant (IR), a different issue from PPID, which is treated with diet. Why is he on thyro-L? Primary hypothyroidism is rare in horses. Ususally, low thyroid readings are due to deficiencies in the diet and/or secondary to other health issues. It resolves when the diet and health issues are correctly addressed.

DIET: Low fat/sugar/starch forage with minerals balanced to the hay analysis. We recommend sending a cored sample of your hay to Equi-Analytical for the Trainer #603 test($49). Soak the hay until you have the assay back so as to make it safer to feed. You were sent the temporary emergwency diet when you joined. Start your boy on this until you have more information. No feed from a bag, apples, carrots, sugary treats, pasture.

TRIM: Physiologically correct with backed toes and low heels. Is he having any foot issues?

EXERCCISE: Best IR buster there is but never force a sore horse to move. Great for keeping a PPID horse ib shape as well.

Why is he on aspirin? What low starch pellet is he on? Most feeds in a bag won't be low enough to be safe for an IR horse. I know all of this will probably make your head spin - it's normal. We've all been there and are here to help. Ask any questions as they come up.
Please sign your posts with your name, general location and year of joining. This helps us to give you better answers.

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


Wellsolve LS as taste tempter

millionairess1989
 

Is it okay to use Wellsolve LS as a taste tempter at 1/2 to 1 cup per day? How much is too much? Weight gain is not an issue and would be a bonus. Mill has been turning her nose up at the beet pulp and supplements, even when cutting them back. She will maybe eat 3 cups of r/s/r beet pulp if we are lucky. Switching to ODTBC worked for only a few days. I got a bag of TC Lite but it has in it bugs so it is going back to the store.
Thanks,
Jennifer & Mill in TN
Jan 2011
http://pets.groups.yahoo.com/group/ECHistory3/files/Millionairess


Re: Once a horse is on jiaogulan, should it keep taking it forever?

Nancy C
 

Hi Leeanne.

Int eh early days, I used the jherb only until his foot grew out. Now I have him on it permanently. It's relatively inexpensive but if you decide to take her off, watch for changes in clinical signs: foot comfort, attitude, muscle or tendon issues.

You can probably do better with feed grade magnesium oxide, rather than the Remission, which, I agree, is expensive. Check with your feed stores or local feed mills. Should be $20.00 for a 40 pound bag which lasts forever.

Your salt should be higher too - two ounces by weight. Inexpensive insurance.

There are other things in your case history that could/should be eliminated for IR horses if you have not already done so. Thanks for providing the link. Really helps.

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...


Re: RePost - high insulin from other sources

Nancy C
 

Hi Lisa

Would add Iron overload to Lavinia's list which needs to be confirmed via blood test at KSU.

Also check Dr Kellon's recent response to IR worsening with age.

<http://pets.groups.yahoo.com/group/EquineCushings/message/169611>

Recommend this link also regarding Dr Kellon's gelding protocol.

<<http://pets.groups.yahoo.com/group/EquineCushings/message/167492>>

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...

--- In EquineCushings@..., "lonestarquarterh" <mostlyaggies@...> wrote:



--- In EquineCushings@..., "Lavinia" <dnlf@> wrote:

I will bump this up again to see if anyone has any knowledge of any particular disorder or disease process or organ issues that might contribute to insulin being high (and continuing to climb) despite measures to diagnose and address PPID & IR.


Re: Prascend vs. Photosensitivity/Allergies to medication

popularfurball
 

http://pets.groups.yahoo.com/group/ECHistory6/files/Silver%27s%20Case%20Study/
Is the link to my case history... I thInk! I have put photos in there too.

I have actually stopped the medication yesterday as I couldn't watch her suffer "unnecessarily" - I have no idea how much the cushings is impacting life - or not - I am medicating in the hope it will reduce pemphigus flare ups - laminitis is managed with little problem, and theanagement of laminitis complements management of skin thankfully. Last tablet taken Friday AM and already by this morning her skin is significantly improved.


Tess's Time Line

Linda Peccie
 

Hi, y’all. I’m caught in a swamp here and need some “outside” ideas how to help this horse. The information in this message doesn’t appear to me to be appropriate for the history form, so please excuse this long tale of woe.

Tess is a 16-year-old stock type quarter horse, about a 5 on the body scale. No fat pads, no eye bulges. Out 24/7 with 3 others on 20 acres (two are controlled IR). Diet tight to hay analysis, with ECIR recommended supplementation and additional as noted below. Zero worm counts.

Because I was unable to trim her feet regularly myself for nearly three years she was allowed to grow too much foot. I finally had to hire a professional trimmer but he was not particularly well trained and his LIM-style actually made things worse. At any rate, she has had continuous abscessing in both fronts with resulting near-destruction of the walls at both toes. No evidence of systemic laminitis per vet but some tipping of coffin bones due to improper hoof form, according to x-rays. Lots of painful weeks over the last 2 years but her feet are slowly coming along now that I am trimming her again. I am keeping her heels down, bars trimmed below wall, damaged toe areas off ground pressure. Treating for thrush just in case. I don’t have anyone else to help me but I surely can’t do worse than was done before. That’s only the beginning of this horse’s troubles anyway.

03/28/2011 - Large, infected, purulent puncture wound behind RF elbow, possible tree limb. Probed, flushed by vet and then he injected tetanus toxoid, gentamycin, penicillin. Multiple microbes cultured. I flushed the wound and changed the drain every day until the wound finally closed. Also treated with Sulfamethoxazole and Trimethoprim Tabs.

03/31/2011 - eACTH 22.7H (2.0-10.0) pmol/L. T4 “very low normal.” Started pergolide, 1 mg and thyroid supplement. (I can’t get the T numbers.)

04/10/2011 - Severe diarrhea, treated with Ration Plus and Omeprizole but it didn’t resolve so we had to stop the antibiotics and increase the local treatments.

04/27/2011 - Large tooth root abscess, treated by vet with advice that these usually resolve on their own within a year. Afraid to try a’biotics again. This one took 13 months but seems ok now.

07/09/2011 – eACTH 6.1 (2.0-10.0) pmol/L. T4 12.4 “very low normal despite therapy.” Finally shedding heavy, curly coat. Continue pergolide and increase thyroid supp.

She had a thicker-than-normal winter coat that came in at the right time (?) but it didn’t begin to shed like her herdmates’ so we tested again.

03/05/2012 – eACTH 13.6 (2.0-10.0) pmol/L. Increase pergolide to 1.25 mg, observe clinical response.
TT3 0.5 (0.7-2.5), FT3 0.5 (11.7-5.2), TT4 15 wnl, FT4 10 wnl. TSH 7.
Serum Selenium 0.175 ppm (0.14 ppm=adequate, less than 0.05=deficient)

Finally shed out after booting pergolide up to 2.0 mg. Summer coat starting to look good.

05/03/2012 – TT3 0.2 (0.7-2.5), FT3 0.3 (1.7-5.2), TT4 5 (7-27), FT4 5 (6-24).

06/08/2012 – Whole blood selenium 211 (160-275). She has been on Platinum Performance’s selenium for years because our soil/hay is deficient.

Sweating profusely, way more than the others.

Cushings type hair coat coming back in rapidly, upped pergolide again to 2.75.

08/01/2012 Here’s where we are now: Heavy coat is beginning to shed in patches, slowly. She has had a terrible time with the heat this summer, alternating between inside the barn where it’s 10 degrees cooler and outside with her mates. Very rapid respirations (60-70) until I hose her down and place her in front of a fan. She is not sweating as much as before. Slightly elevated heart rate, no worse than the others. Gums pink, urine normal looking and normal smelling. Appetite good, apples normal. Lies down 4 to 5 times a day but only for 15 or 20 minutes at a time—I assume that’s because her feet still hurt although she leads willingly and grazes actively now where before she absolutely would not move unless we beat on her. I started her on Phyto-Quench a week ago, no improvement in suspected pain noted so far. She is just kind of “dull” acting.

QUESTIONS:

Can the need for pergolide increase THAT FAST? Since March 1 we’ve gone from 1 mg to 2.75.

Is the roller coaster numbers for thyroids related to all the traumas? Low T can result in hirsutism, I know. I’ve checked Ts on all my guys annually for years and this is the only problem. I wonder if she just can’t convert synthetic T4 to T3? Would I be advised to wean the horse off the supplement and see if her own system can take over again? In my own case, for some reason Synthroid stopped working after several years and my doctor switched me to Armour.

What other labs might be helpful when vet comes next month to check for “seasonal rise.”

What else can I try??? Prayer hasn’t worked so far...

Thanks for anything,

Linda in NC-2001


Re: Blood test results after Metformin

Lisa Toms
 

Hi Alison,

Thanks! Bonnie is a major sweetie-pie & is doing so well. She is still ouchy on hard surfaces but totally comfortable in the soft sand paddock AND I did her weigh in today and thanks to the Thyroxin she has lost 10kgs ;-)

I was totally convinced that the Metformin was contributing to her improving so quickly??? So I was really surprised by there being virtually no change in her GI Ratio. Bonnie is 1196pounds which is around the same as Diesel so I guess he should be on the same dose as was suggested for Bonnie?

I wonder if Bonnie is maybe just one of those horses that Metformin doesn't work on? Or maybe I was doing something wrong?? Is there anything else that can be suggested that can bring her Insulin down or will she always have such a low GI Ratio? You must be wondering the exact same thing??

Lisa & Bonnie | S.Africa | June 2012
http://pets.groups.yahoo.com/group/ECHistory5/files/Lisa%20%26%20Bonnie%20SA/
http://groups.yahoo.com/group/ECHistory5/photos/album/215467781/pic/list


Re: Blood test results after Metformin

 

I notice that Bonnie is on 15000 mg twice a day, so 30000 mg total? Did I read that correctly? Because Diesel is only getting 8000 mg twice a day, total 16000 mg and I'm wondering if I should increase the dosage. (He weighs 1100 lbs, not sure about the conversion to kg in comparison to your mare).
Hi Alison

Liphook currently recommend 30 mg/kg BW 2 x day for Metformin and apparently data supporting this have been presented at conferences this year.

If Diesel is 1100 lbs that's around 500 kg, so that would be 15g twice a day (a total of 30g/day) - this could also be split into 3 x 10g which may be more effective and is commonly used in hospitals.

The current thinking (from Liphook) is that Metformin (mostly?) acts to prevent glucose being absorbed from the digestive system.

See: http://www.thelaminitissite.org/m.html

Any changes in medication should be discussed with your vet.

Andrea
UK/France Jan 2010
www.thelaminitissite.org


Re: Fionn's results

palomino.1982 <sbaumgardner@...>
 

Michelle,

APF has strong "support" effects when ACTH is high or cold is triggering metabolic problems. APF improves the ability to deal with stress, minimize the 'pergolide veil', and aids in energy levels.

As far as 'staying on it'- each horse is different. Keeping a daily journal will help with your assessment of how Fionn is doing.

Have you read the files re : Adaptogen's?

Susan
EC Primary Response
San Diego 1.07


..................................................


Ordered APF just now. Thanks! Does he just need it at the beginning or does he need to stay on it?


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