Date   

Re: ACTH Level & Pergolide Dosage & Tasty additives

Lavinia Fiscaletti
 

Hi Stephanie,


One of my boys had an ACTH of 1088 the first time he was tested in Aug. He went from 0 to 6mg in approx. a month's time. ACTH was retested and was at 84 in Sept so because the rise was still in full swing he was upped to 9mg to compensate for further rising and get it even lower. We achieved 46pg/ml the next round of testing, which was acceptable for him.


 There are others here that have also had numbers in the 1000+ category so you are not alone. It is highly unlikely that 1mg of pergolide, in a large boy, during the seasonal rise period will bring the ACTH down into the normal ranges but it is possible. How a horse reacts to the meds is a very individual thing. The only way to know is to test about 2 weeks after he has been on the med to see where you stand. Getting the ACTH under good control is vital to managing the disease process over time as even with good control it is a progressive condition. The longer the ACTH stays uncontrolled the harder it becomes to get it controlled.


Have you had a chance to get King's case history done? I see that you have a file but it's empty. Having all that info will help us help you better.


Look in file #8 Pulling it Together. Check the folders Introducing New Feeds and Supplements and the Picky Eaters Checklist for ideas on how to get your boy to accept his changed rations:


https://groups.yahoo.com/neo/groups/EquineCushings/files/8%20Pulling%20it%20Together/


Lavinia, Dante, George Too and Peanut

Jan 05, RI
EC Support team





ACTH Level & Pergolide Dosage & Tasty additives

Stephanie Stout
 

HI everyone,


I have been searching the files about Pergolide dosages, and found the files on it but am curious.... My guy was just diagnosed with Cushings and high IR levels(but hoping that it is caused from the uncontrolled Cushings). His ACTH titer is 1,160. Has anyone ever had a level that high? If so, how much Pergolide is your horse on?



I know each horse is different, but my vet(that has very, very little experience with Cushings/IR) only thinks my guy needs 1mg per day of Pergolide and I really don't think that is even close to enough to get this Cushings/Laminitis/IR in control(he has rotation). He's a Dutch Warmblood, was very healthy before all of this, and weighed about 1400-1500 before. He's lost some weight since, so only probably weighs between 1200-1300, I'm trying to get him back to his normal weight/body score but he doesn't like his low sugar hay(or his beet pulp that is now no senior added) so he isn't eating much. Which then brings me to my next topic -  anything to add to his beet pulp that will make it a little tastier that he can have?? He is beyond picky!


Thank you SO much for your thoughts!

Stephanie & King

Oregon

Member since Oct 2014





Re: Is Naproxen appropriate for laminitis pain relief?

Betty Ann
 

Hi Lavinia,

The vet phones/sends the scripts to the Pharmacy. I tried to get him to give me a script so I could select my own pharmacy but he wouldn't. This pharmacy is a couple thousand Km away so it takes a couple of days to get here even with overnight shipping. I am concerned about product stability during winter shipping; our temps can get down to -35 or -40 C. Last winter they sent it in a styrofoam box with a cool pack. I don't know how the box gets stored getting up here.

Is it possible to just increase the dose from August or September until October or November? 

Are you able to answer the Naproxen question? 

Thanks for your help,
Betty Ann
Mar 08


Need help administering meds

beverly meyer
 

Ginger is 30, mostly toothless, IR and PPID. She eats only ODTB.  She starting quidding badly a month ago. The dentist came yesterday and did what she could

I have been opening her Pergolide 1 mg. and sprinkling on the food along with Ranitidine and vitamins.  But with the increased quidding, and some reduced appetite, I need ideas dosing her.

If I syringe the meds, she fights me, and loses a lot of the liquid.

Since she can't chew very well, I've never given her capsules in grapes, etc. as she quids that too.

Any ideas of getting the meds down the hatch?

Thanks very much!

Beverly 5/14

https://groups.yahoo.com/neo/groups/echistory8/files/Beverly%20Texas/



Re: QUESTION TO THE GROUP

Jane Hewitt
 

I did want to mention that I will be increasing Lad's pergolide to 6.5 for one week and then increasing to 7mg for November. My question is related to decreasing; I'm assuming I would decrease by 1mg weekly? Not sure about the decreasing and retesting once we hit December?


Re: QUESTION TO THE GROUP

Jane Hewitt
 

Hi Nancy:
I was wondering if you could give me your input on my next steps.
Thanks,
Jane Hewitt


Re: Is Naproxen appropriate for laminitis pain relief?

Lavinia Fiscaletti
 

Hi Betty Ann,


Know you are doing the best you can under difficult circumstances.


Mishandling will lower ACTH results.


You are correct that it is likely the combination of factors that pushed Shahir over the edge. Your instincts about testing in Sept were good. With the high-normal test in the spring, and no raising of the pergolide dose for the seasonal rise, it is likely your perg dose just isn't high enough to control the seasonal ACTH rise. Do you purchase your pergolide thru the vet? Or does the vet call in scripts to the pharmacy and you purchase from the pharmacy?


Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team


WAS: 2 crippled ponies.NOW: Diatomaceous earth

Nancy C
 

Hi Christine...

The short answer is there is no proof that it works.  It really makes no sense that it would. 

as a gardener I use DE to slow slugs.  It looses effectiveness and must be replaced when wet. Horse stomach is very wet. Lots of discussion in the archived messages.  Here's a link to some

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/109963

 

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/81999

 


And a good article thanks to Lorna
The miracle of DE aka Diamataceous Earth and its one giant flaw

 

And on natural dewormers

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/101390

 

Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
www.ECIRhorse.org
Check out the FACTS on Facebook
https://www.facebook.com/ECIRGroup
Support the ECIR Group Inc., the nonprofit arm of the ECIR Group
Equine Cushing's and Insulin Resistance Group Inc.

 





---In EquineCushings@..., <ccbgshelley1@...> wrote :

Has anyone tried using diatomaceous earth as a de-wormer?

Christine
Colorado
2014


Re: 2 crippled ponies.Please help.

Christine shelley
 

Has anyone tried using diatomaceous earth as a de-wormer?

Christine
Colorado
2014


Re: Is Naproxen appropriate for laminitis pain relief?

Betty Ann
 

Thank you for your response Lavinia,
I was hoping the .5% wouldn't make too much difference. He has been o.k. on this hay since July; the recent access to some remnants of grass is what I suspect tipped the scale so-to-speak, especially at a time when his ACTH could be higher and the nights are getting near freezing with warmer, sunny days.

He has been on 1.25mg for many months. He was started on 1mg and when the next test showed a little high for ACTH the dosage was increased slightly. While most of the tests have been done pre-rise seasonally I wanted to test in Sept this year to see if he was controlled adequately during the rise.  It is a challenge to work with this vet; the horses are not his full-time line of clients and he is often unable to respond in a timely way or with reports etc., He is from the next province and comes our way for one or two days every two or three months with his mobile unit. I had a real panic experience trying to get him to respond to requests from myself and the pharmacy to get new run of repeats set up recently, I actually ran out for a couple of days. I have two on pergolide and have only ever received one note for payment due which arrived via email last winter - no invoices - ever. I have no idea how much I owe for all the Pergolide used beyond that and frankly, as time goes on I'm getting nervous of getting a big bill. Without clear info on cost I'm not sure I can afford to increase dosing. The visits alone for blood draws usually average about $700.00 which is barely affordable. We live in a remote area without a full-time large animal vet. There is one other vet that is coming from two provinces away for one week at a time each month or so. I am considering trying his services for blood work the next time I need a vet. The last time I checked with the local small animal office that brings him in, the blood work was even more expensive than the mobile vet. The first vet is still required for portable digital x-ray service. 

There shouldn't be any alfalfa in this hay but there could be some clover here and there....it's the hay that I have. Soaking is likely out of the question as I ruptured the L5-S1 disk in 2011 and had experience with soaking in 2013 for a couple of boarding horses with heaves. Lifting soaking wet hay out of a tub while bent over was way too much of load on that disk and put me back into pain. Our nights are already getting down to near freezing temps; our winters are too long and waay too cold to feed wet hay. 

I have sent a query to the vet to see if the late Sept. blood reports are back yet; I'm sure Cornell would have processed them by now. It's a wait and see at this point.  You say that hemolysis with negatively affect ACTH, do you mean it will appear higher or lower than actual?  He did bring the centrifuge on his last trip, not sure why he didn't this time, I did message both him directly and the local scheduling contact that the usual blood work would be done this trip. I did give him the info from Cornell when we first started with all of this. Guelph was used a couple of times for the EMS type tests. 


Shahir's CH is not up to date, but thank you for the reminder and link.











ACTH LEVELS HAVE DECREASED

Jane Hewitt
 

Hi All:
I've searched for my original message but can't seem to locate it?

Back around 9/19/14 I had notified the group that my horse Lad's ACTH had gone from 247 on 7/24/14 up to 332 on 9/19/14. During this time I have slowly been increasing his pergolide dosage and tried another compounding pharmacy per Dr. Kelllon and Nancy.

Lad is now on 6mg of pergolide through Pet Health Pharmacy and I was going to be increasing the dosage up to 6.5 next week because I assumed with the seasonal rise that his ACTH would still be quite elevated.

I'm happy to report that from 9/19/14 to 10/22/14 his ACTH levels have gone from 332 back down to 156! I know this is still high but it's a dramatic drop from last month even with the seasonal rise.

He has had no laminitis/founder episodes while Ive followed the advice of this group, he was diagnosed with Cushing's back in 2005 and I have followed the strict recommendations of this group since then. I want to also share that Lad is a 33 years old SB/TB gelding and has been able to keep his weight on and still kick up his heels even though he is on a steady diet of OD soaked Timothy balanced hay cubes and supplements per Dr. Kellon.

Question: I'm assuming I should still increase to 6.5mg for a week and see how he does on 7mg for the month of November? By December 1st I'm hoping his levels will be back down within the normal range. After the seasonal rise is over where should I start with a dosage, I'm assuming after the seasonal rise he won't need the 7mg and I'd rather not keep him on that high of a dosage if he doesn't need it.

I owe everything to this group!
Thank you so much,

Jane Hewitt in North Reading, MA
Sept 2005

http://pets.groups.yahoo.com/group/ECHistory8/files/Lad and Jane/Revised Case History for Lad/Lad New Case History 082014.doc/


Re: Farrier in Colorado

melfrool
 

Christine, here's the web page for you.  Owl Canyon Hoof Care and Rehabilitation

He also has a Facebook page, which is outdated but he's still in business.  I've had good success with him.

 

Good luck with your horse!

 

Glennda

SE Wyoming  2008

Lotto(Cushings)/Bella(IR) 


 


Re: Soft Ride inserts

Christine shelley
 

I have both as well, but my horse right now has a need for the standard one's because his heels are too long. The dual density allow his toes to sink down in, but we need the opposite right now.  If I were you I would hold onto at least a few pair.  I never thought I would use mine either, but he is a lot happier right now with them until the farrier comes out.

Christine
Colorado
2014


Soft Ride inserts

Marjie
 

I use Soft-Ride boots for my horse, but we order either the dual density or the purple inserts, so I have a building surplus of the standard turquoise inserts in size 5 or 6 long.  Does anyone want any? or have ideas on how to recycle them?  They are not cheap, but what do you do with ones you don't need?  It has been my experience that boots wear out long before the inserts do.


If you are interested in any, email me at mstmsed@... or reply to this thread if you have recycling ideas.


Have to say Soft-Ride boots have made all the difference for us...plus they are awesome for holding a poultice on if needed...no more crazy vet-wrapping..just half a baby diaper with the poultice placed in the boot, close it up and you have one secure poultice.  


Re: Brennivin Case History uploaded

Dee Kenville
 

Thanks Lavinia!
Yes, thanks, he is a cutie and a real "good citizen"...always taking care
of the grandkids and me also! A very playful boy too, even in the pain he
is in...gotta get him better!
Ok, I won't worry about another insulin/glucose test but will try and get
an ACTH done as soon as I can!
And thanks for replacing the photos properly and sending me the link!
Another gal in my area on this list also was extremely thoughtful and sent
me an email with a place to get low sugar hay that has been tested...it's
right on the way to my barn and I am going in the morning!:)

Dee in Santa Cruz CA
Oct 2014
https://groups.yahoo.com/neo/groups/echistory8/files/Dee%20Kenville/

http://ndeewoods.com/


Re: Farrier in Colorado

Christine shelley
 

Thank you!  I will try and look him up.  If I don't have any luck I will let you know.  Maybe someone can help on how to do it, I am struggling too!  Half the time I can't get it to copy.

Christine
Colorado
2014


Re: Farrier in Colorado

melfrool
 

Sorry Christine but I can't figure out this "new and improved" Yahoo group format.  If you would like Blaine St Peter's phone number, I'll be glad to get it to you if we can figure out a way.  I'm just hesitant to post it in a public forum.  Maybe one of the moderators could help with that. 

 

It's wise to be cautious, and I assure you I have no hidden agenda.  I just remember how intimidating it was and how isolated I felt when I started into my Cushings and IR diagnosis journey(s).   Just know you are in great hands with this group!  

 

Glennda

Lotto(Cushings)/Bella(IR)

SE Wyoming  2008


Re: Farrier in Colorado

Christine shelley
 

Lavinia,

Would having the x-rays in the e-mail I received from the vet help?  They come up in a program that allows you to draw on them. 

Christine
Colorado
2014


Re: Farrier in Colorado

Christine shelley
 

Thank you.  The e-mails just had names and phone numbers of farriers in them that people are reluctant to put on the site.  I appreciate the feedback though, because one thing I have learned having horses is that everyone has an opinion and some can get you in trouble.  His current trim shows that, this was a farrier my vet recommended and she is not at all happy with what he has done.  In fact she said she was going to show the x-rays to him to determine why he had done that. 

Lavinia, I would love to have a mark up thank you!  I know my vet will do one as well.  Also both farrier's we have in mind are also vets, so they will do their own.  I would love to have something to go to the farrier with to be able to make sure this doesn't continue. More information is always better than less in my opinion.  

The plan I agreed with my vet on was clogs for a variety of reasons.  One, they are going to be put on with essentially casting material, no nails or screws so easier on his feet.  Two we are getting weather and keeping boots on in our clay soil just doesn't work and causes a host for thrush. 3 she explained a lot about the blood flow and what the clog does to improve the blood flow and I am convinced that is why he keeps getting laminitis. And last, they saved him the first two bouts, and he made a quick recover on those two.   To me that give me more evidence that blood flow is the issue.  Those two were cold induced, everything I have read from Dr Kellon says cold induced is due to blood flow.   I am going to insist though on shorter intervals between trims.  I am done trying to get farriers to do what I want, if they won't I will find another one.  If I have to go to CSU, I will.


Christine
Colorado
2014



Re: Farrier in Colorado

PapBallou@...
 



The hard part is the last two farriers specialized in laminitis.  Keep in mind his feet were trimmed every 6 weeks and we are 6 weeks out now.  I wanted shorter periods but my farrier wouldn't.  I don't think he got this long in 6 weeks, I think we have been building this heel all summer and the farrier just wasn't cutting them short enough.

Christine -

I totally agree with you.  The form issues are of long standing, and actually longer than just the past few months.  

Resolvable?  Yes!  But it will take time, so you will need to have plenty of patience.  Lavinia has offered markups for you that we will gladly do if wanted.

BTW - you shouldn't be receiving unsolicited emails regarding your horse.  If someone has something to say to you, they need to say it to you by posting to the list.  When they go 'stealth', we have found that often they are pushing their own agenda while using our list as their own vehicle.  

Awhile back someone sent markups to another list member unsolicited, and didn't take into consideration some form issues that the suggested unsolicited trim would have made worse.

Linda
EC Primary Response
West Coast
May 2004



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