Date   

Re: Understanding Bonnie's insulin results

newuser1971@...
 

Hi Dr Kellon

>>Are her radiographs posted?<<
Sorry, I thought they were in her folder. I have now added them (link attached below) but they are not marked up as they should be (the next set will be marked up now that I know what to do).

Bonnie's ACTH levels are now controlled (her latest number was 16.9) but her feet are still sore. I am trying to work out why. The insulin calculator (if I include "2.0" as the insulin number) indicates that she is not IR. I have not had my hay tested but it is Rhodes Grass hay and generally it tends to be low sugar and starch. I am about to send it off for testing to make sure and will then be getting her diet balanced accordingly; she is currently on the emergency diet.

I am assuming my problem is trim but just wanted to make sure I wasn't putting in the wrong insulin numbers! 

ECHistory8

 

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/126538761

 


Cinder's laminitis

bsbygolly@...
 

My 28 yr old, Appy mare has mild laminitis.  I’ll list the events of the past 3 weeks and my treatment.  I welcome any suggestions for something that I may be missing.

5/2 trim, 5/5 she was a bit picky about where she walked on a 2 hr flat/sandy trail ride, 5/7-14 Pergolide lost in the mail and she did not have her 1.5mg those days, 5/11-12 quick choppy steps when moving in her corral, unwilling to turn in the trailer to exit, 5/17 standing with her back feet in a hole to take weight off the front feet, 5/18 right front hoof very hot, 5/20 very off trotting clockwise and somewhat off counter clockwise, 


Treatment:  5/11-23 cold water hosing on both front feet. Boots with pads and her stride looks normal, even caught her cantering twice when something startled her in the turnout. Eating-drinking-pooping-peeing have remained normal throughout.  Continue 2x/day hosing hooves although not heat or pulse can be detected.  Continues to be off trotting straight or in a circle.  Started J-herb 5/24


Her diet is not tight since adding Mt Sunrise Tim/Alf pellets this past year as she is having difficulty eating enough hay (tight balance 2006-2013).  I was concerned and watching for issues but her labs in Feb(?) were all good.  I get 300 lbs of the hay pellets and there was not change in lot number during this time.  I’m thinking 7 days without Pergolide was the trigger.  I have located ODTC and plan to go pick up a couple bags to replace the hay pellets.  I do not have Xrays yet. I am in the process of getting my vet of choice here for xrays before her next scheduled trim 6/13.  Trimmer and vet are not local.


She has been on estradiol since 9/2011.  This spring her cycle has been more like it was pre-estradiol.  Dr. Kellon, is there ever a need to increase the original dose?  Could a hormone imbalance be a factor in the laminitis?


CH and hoof pictures are in the files.  All suggestions welcome.


Betty & Cinder 4/2004 SoCA

https://groups.yahoo.com/neo/groups/echistory8/files/Betty%20and%20Cinder/

 



Re: understanding ACTH test results

janieclougher@...
 

Hi, Debora - There is no "ACTH" calculator per se, but there is a graph from Liphook that shows ACTH variability through the year between normal and PPID horses (file is second from the bottom - PituitaryParsIntermediaDysfunction.pdf:

https://groups.yahoo.com/neo/groups/EquineCushings/files/Blood%20Testing%20for%20IR%20%26%20Cushings%20Disease/ACTH%20TESTING%20%26%20INFORMATION/

 



The test is from August, which *should* be the beginning of the seasonal rise, so based on that ACTH the horse is not PPID.  However, one of our group members have found that MSU under-states the ACTH level.  She sent replicate samples to MSU and to Cornell, and found the Cornell ACTH much higher (which confirmed her suspicion that her mare was PPID since she had many of the signs, but kept getting normal ACTH results from MSU)  I realize this is a one-horse study, but I have been suspicious of MSU results ever since.

So...... back to DDT/E for chronic laminits.  Is the diet really tight?  It would be great if the owner could join the group and post a case history.  Any chance of iron overload, lyme?  For diagnosis, I would strongly suggest that the owner repeat the blood work and get it sent to Cornell, and emphasize the reasons why, and also the reasons for proper handling.

Can't really comment further without a case history.

HTH!

Jaini (BVSc),Merlin,Maggie,Gypsy

BC 09

ECIR mod/support

https://groups.yahoo.com/neo/groups/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/




........Is there a ACTH calculator like the IR calculator?  ................


Debora 

Montana 

2/12 (I think) 



Re: Pony problem

hinecedark@...
 

Thank you so much Jaini. I needed to know if the symptoms despite IR controlling diet were possible, and obviously they are. Cato (leptin 2.4) gave me no experience with underlying IR and neck crests. I will call our vet now - he diagnosed Cato initially by pergolide trial - and hope he is willing to do the same for Bambino. If we can get Bambino's symptoms cleared up this way, then testing later with Cato will tell us where we are re control going into fall. Sounds like a plan.

Thanks again,

Melinda and Bambino

In  2010



p.s. Sorry, I seem to be unable to figure out how to delete parts of previous post.


Re: Pony problem

hinecedark@...
 

Thank you LeeAnne. Sure couldn't have done it without all of your detailed directions!!

Melinda


Re: OK to Test if Still Ouchy? WAS: Trim Review and Shedding Question

Suzanne Mansolilli
 

Thanks for laying this all out, Kerry.  

I kept my appointment yesterday and am very comfortable w/new vet.  She pulled plenty of blood to do all tests, keeping in mind circumstances under which blood was drawn.   

Still working on tightening up his diet, as he's been picky about eating minerals.  Am in process of switching carrier  to BP. So Diet part of DDTE is not ideal yet, nor is Exercise, as he's had virtually no excercise for the past few weeks .

So yes, pieces of puzzle are still missing.  Will report blood results when I get them, and am planning on re-testing in a few weeks.

Thanks for the support ,

SuzanneM & Monty

Western Colorado — July 2014

Photo Album: https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1794323561

CH: ECHistory8

 

---In EquineCushings@..., <kerry.isherwood@...> wrote :

Furthermore, if todays insulin is high you'll likely have to increase perg (if rest of DDTE is good) and (ideally) be re-testing ACTH in 3-4 weeks for dose assessment

 


Re: Pony problem

ThePitchforkPrincess@...
 

HI Melinda,
Just saw your case history on Bambino

Lovely job!  Way to go.  

- ​LeeAnne, Newmarket, Ontario

ECIR Archivist 03/2004

 

Are you in the Pergolide Dosage Database?

   ECIR Files Table of Contents

      Dawn's Case History

Taken For Granite Art - Lightweight Cement Sculpture and Memorials

 








Re: Pony problem

janieclougher@...
 

Hi, Melinda - This sounds very much like a situation I had with Maggie.  Her diet etc was well-controlled, she looked great and was doing well, then suddenly started getting a firm crest plus filling of the supra-orbital hollows.  She had normal ACTH up until then; when I tested because of these signs, her ACTH was 4 X normal.  Time for pergolide!  After she had been titrated up to 2 mg, the symptoms resolved.  Pergolide was the only change - there really wasn't anything else I could do re diet. 

The quick check-list for symptoms despite dietary control is: PPID, iron overload, Lyme disease.  Other causes of frank laminitis like Potomac fever have concurrent signs that are impossible to miss.

If this were my pony, I would do one of two things:  test now; or, start him on pergolide, titrating up by .25 mg every 3 or 4 days, and see what happens after you reach 1 mg.  Then test in August.  Of course, 1 mg might not be sufficient, but it is a good start.

Either approach is fine. The purist would go for testing now, but we all know that funds are not inexhaustible. Treating by symptoms can be a very good start.  Make sure you keep a journal.

HTH



Please, can someone tell me what I am missing? With no excess weight, no other fat pads, at this time of year and on this diet, I can't understand how Bambino's crest is swelling and his feet tender, even if he might be beginning PPID. I'm more inclined to trial him on pergolide than wait for test results, if it is possible that PPID could be causing this despite what pretty much amounts to the emergency diet . . . .

Thank you,

Melinda and Bambino

In 2010







Re Testing ACTH & Doxycycline Question

corrine haffner
 

Hi 


Here's my question should i re test jasper's ACTH now even though he's on doxy yet ? Maybe his current sore footed problems are do to uncontrolled ACTH?? Would stopping doxy for a week before Re testing be something to consider or is that a bad idea? would him being off doxy for a week cause a relapse problem at this point and time in treatment? He's been on doxy since march.

I started a journal this morning on his pulse,lameness,how many times i apply capaisin on a day to day basis and how much he eats hay wise and ODTB in a given day. Sorry for all the questions here lately.


Thank you in advance,for the help,

Corrine and Jasper

MN 4/2014

ECHistory8


http://groups.yahoo.com/neo/groups/echistory8/photos/albums/1622081710


Re: Understanding Bonnie's insulin results

Eleanor Kellon, VMD
 


Since she's a thoroughbred, this insulin level may well be real.

Are her radiographs posted?

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


Re: ACTH, iron overload and WNV titer results for IR mare

Kerry Isherwood
 

".... Her observable symptoms are elevated leptin and one slightly runny eye. Coat and muscle are normal. No footiness ever. ..."


Fascinating! My mare's left eye has had chronic, clear discharge off/on for years. Bc of her pink sclera, as time wore on I'd resigned to the possibility of an eventual nasty cancer diagnosis but magically pergolide 'cured' the discharge for once and for all!

That's why I love this group!!

Sorry I can't offer any actual help...

Best of luck to Cayuse

Kerry in NY
Sept 2014


Re: Understanding Bonnie's insulin results

Kerry Isherwood
 

Hi Sarah,

I will have to defer to others more experienced to interpret that unusually low result. i would ask your vet to call the lab to explain how that <2.0 is possible. As another mentioned, its quite possible there was an error at some point in process from drawing blood to submitting to lab to lab handling to equipment malfunction, etc. Sometimes with vastly unusual results the lab(s) will run new samples at no charge.

Sorry i cant offer much help, but see if your vet or the lab can shed some light on the matter,

Good luck,
Kerry in NY
Sept 2014


Re: Understanding Bonnie's insulin results

takarri@...
 

Hi Sarah,

I did the same as you with the Ir Calculator. The only reason I suggested there might be a handling error is that I had a similar low results with one of my Insulin tests early on and that's what was suggested,
plus I double checked the archives for previous messages on low insulin numbers. Hopefully one of the vets will chime in to add their wisdom. Kerry is also much more experienced with blood issues as well.  It's also possible that she is just PPID- not IR . Sorry, that doesn't make it any clearer for you...

Pauline & Spur
Sth West Vic
Australia Aug 07
EC Primary Response
http://tinyurl.com/7qbdyas

Hi Pauline. >>Was she fasted before the test? << Bonnie was not fasted before the test; she had access to grass hay all morning.

Hi Kerry

>>The number you would use is the one where the '<2.0' number is in the
sequence of results. The numbers in parentheses are what the lab gives as low/high normal parameters.<<

When I put <2.0 in the IR calculator it comes up with "NaN". I assume I therefore need to put "2.0" in the calculator?


 


Pony problem

hinecedark@...
 

I have learned a great deal from this group in the last five years and my PPID horse Cato is doing well. Now his companion pony, Bambino, has a problem and I hope for some suggestions how to help him. I have requested to join EC History 8 to supply a case history for him.

Bambino is 16 years old, 9hh, and 295lb. He was foundered when I adopted him from a horse rescue six years ago to be Cato's dry lot/track companion. I rehabbed his feet successfully, got him some chiropractic treatments for results of an old injury, got about 50 excess pounds off him with diet and exercise, put him on the same diet as Cato (in proportion) and he has been healthy, happy and active since. Until last fall. The old injury, which had stiffened his hock, resulted in hip dysplasia,  discovered when his hip spontaneously dislocated. Vet reduced the dislocation once, but it popped right back out. Radiographs of the femur were normal. Since it was a painful procedure, we stopped there. I kept Bambino stalled for a couple of months until he was getting around remarkably well, then added a small dry lot that he has access to 24/7. He gets himself in and out, up and down, has significant shortening of the leg and a pronounced limp. He only walks, no trot. His attitude and appetite have never wavered, he's still alert and interested in everything, especially food. He gets tested orchard grass hay in slow feed nets, 2 1/2 to 3 lb., and 12 to 15 ODTB cubes, 400 IU vit E cap, 1 T. flax with minerals balanced to hay, a.m. and p.m. White salt block in his pen which he never touches.

Three weeks ago I noticed Bambino's crest seemed to be thickening and hardening. I attributed it to the tiny bit of green sprouting in his dry lot. Stalled him, sprayed and killed the green and removed anything he could reach through the fence. After about a week and two hard rains, dry lot bald as a cue ball, I let him back out, but his crest had not reduced any. Since this most recent hay tested at ESC 9.7, starch .5, I began soaking his hay, 1 hour, cold water. One week ago he had a hoof trim, I have turned that over to a professional barefoot trimmer due to the complications of his hip. His feet were tender before the trim, and have remained tender since. I have not seen him assume a founder stance, but don't know if he could, but he is not down any more than usual. His feet are somewhat warm, I can't detect his digital pulse, trimmer did but did not think it significant. I've added about 1/3 scoop of PhytoQuench a.m. and p.m. since his feet have been tender. At about the time of the trim, I thought his crest was possibly softening some at the ends, but now I am even more concerned as it seems to be thicker and harder than ever today. I had thought when Cato has his regular bloodwork in August I would have Bambino tested as well (eACTH, G/I, leptin).

Please, can someone tell me what I am missing? With no excess weight, no other fat pads, at this time of year and on this diet, I can't understand how Bambino's crest is swelling and his feet tender, even if he might be beginning PPID. I'm more inclined to trial him on pergolide than wait for test results, if it is possible that PPID could be causing this despite what pretty much amounts to the emergency diet . . . .

Thank you,

Melinda and Bambino

In 2010







ACTH, iron overload and WNV titer results for IR mare

 

I hope to get some insights on recent test results for my 10 yo TWH mare Cayuse. She isn't foot sore or otherwise in pain, so not your top priority! I've know for several years she is severely IR.  First and most troubling, her ACTH tested at 26.5 pg/ml, barely within Cornell's normal range. This is an elevation over 18.6 pg/ml that we had 2 years ago as a baseline. Do I need to engage my vets about treating her with pergolide now in anticipation of the rise? Her observable symptoms are elevated leptin and one slightly runny eye. Coat and muscle are normal. No footiness ever.


Second, I'd like to understand the KSU iron panel results. 

Serum iron- 299,  lab normal 75-228. 

TIBC - 506, lab normal 231-455. 

Ferritin - 178, lab normal 43-261. 

I don't know how to evaluate her iron overload status and what, if anything, I should do about it, since I'm already balancing her trace minerals, usually at a ratio of 3.5:1:3:3. Is there any benefit to dropping the ratio of Fe:Cu:Zn to 3:1:3? Dietary iron is 1242mg, including hay, Nuzu Stabul 1 and ODTBC, the last two being added because of low nutrient quality hay.


Last, because she is such a problematic vaccine reactor, this year I asked for both rabies and WNV titers. Rabies hasn't been received yet. Cayuse's last WNV vaccination was March, 2014. The Cornell WNV SN titer result was 512, described by my vet as "adequate." This is much lower than my other mare's titer of 2048, so I'm trying to  understand what it means - - is annual titration necessary? Is the result adequate for now? Do we have any idea how long it will remain adequate?


I can add hoof shots in a day or two, after Thursday's trim. 


Thanks for your time.


Cass for Cayuse

Sonoma County, Calif

Oct 12

https://groups.yahoo.com/neo/groups/echistory7/files/Cass%20in%20Calif/

body condition photos: https://groups.yahoo.com/neo/groups/echistory7/photos/albums/1837846198



Re: Understanding Bonnie's insulin results

newuser1971@...
 

Hi Pauline. >>Was she fasted before the test? << Bonnie was not fasted before the test; she had access to grass hay all morning.

Hi Kerry

>>The number you would use is the one where the '<2.0' number is in the sequence of results. The numbers in parentheses are what the lab gives as low/high normal parameters.<<

When I put <2.0 in the IR calculator it comes up with "NaN". I assume I therefore need to put "2.0" in the calculator?

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 


vitamin E and selenium

paulah@...
 

When evaluating blood test results for vitamin E and selenium, do the laboratory ranges indicate optimal levels or are there better guide lines?
Thanks,
- Paula, Cory and Onyx
Bucks County, PA


Re: Diet help!

Melissa Coupar
 

Hi Jaini, 
Thank you so much again for your advice. It is very helpful learning how to actually interpret the nutrient specs! Hopefully I will become more proficient with analyzing them soon. The price difference is quite significant- easy to think more expensive must mean better. 
I will definitely get on the new hay analysis ASAP. 

Thanks again to everyone for being such great resources!

Melissa Coupar, BC, Canada
May, 2015






>> The Omneity IR mix has a bunch of stuff of questionable value, but bless their hearts for including the iron figures!  This allows us to coax out how much of the copper and zinc are "useable" (ie,not negated by the iron) 

Each serving gives81 mg of iron (actually, a nice, low number); plus 275 mg zinc (214 mg useable); and 45.6 mg copper (20 mg useable)  It costs $2.00 per day.

Now, have a look at the Trace Mineral Mix:  negligible iron, as what is in there is just from the manufacturing process, not from the dicalcium phosphate or other ingredients.   523 mg zinc, 130.7 mg copper, 5.44 mg I, 3 mg selenium.  (similar iodine and selenium in the more expensive Omneity mix)  The cost is $0.20 per day.  Twenty cents per day vs two dollars per day.

To be sure, the Trace Mineral Mix won't supply calcium, magnesium or phosphorus, but the Trace Mineral Mix is only a stop gap while you are getting the new hay analysis.  At that time, we can address the major minerals.
 


 


Re: Diet help!

janieclougher@...
 

Hi, Melissa!  In addition to Lavinia's excellent response, here are some interesting numbers for you:

The Omneity IR mix has a bunch of stuff of questionable value, but bless their hearts for including the iron figures!  This allows us to coax out how much of the copper and zinc are "useable" (ie,not negated by the iron)

Each serving gives81 mg of iron (actually, a nice, low number); plus 275 mg zinc (214 mg useable); and 45.6 mg copper (20 mg useable)  It costs $2.00 per day.

Now, have a look at the Trace Mineral Mix:  negligible iron, as what is in there is just from the manufacturing process, not from the dicalcium phosphate or other ingredients.   523 mg zinc, 130.7 mg copper, 5.44 mg I, 3 mg selenium.  (similar iodine and selenium in the more expensive Omneity mix)  The cost is $0.20 per day.  Twenty cents per day vs two dollars per day.

To be sure, the Trace Mineral Mix won't supply calcium, magnesium or phosphorus, but the Trace Mineral Mix is only a stop gap while you are getting the new hay analysis.  At that time, we can address the major minerals.

Mad Barn means well, but they are lacking some crucial and cutting edge information on equine mineral absorption and IR/PPID.

No worries about asking questions - it IS a steep learning curve, and no one is born knowing about IR, PPID, horse nutrition or the sometimes dubious marketing practices of feed companies.

I am quoting Lavinia below, as this sentence nicely states what so many of us have learned, sometimes after prolonged, expensive, and detrimental efforts to the contrary:

" The best product is going to be the one that most closely matches and complements the excesses and deficiencies in your particular diet. The kitchen sink approach is never the best or most economical."

Cheers,





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

Hi Lavinia, 
Thank you so much for the reply. It is a big learning curve, isn't it :)

Warm regards,


Re: Diet help!

Melissa Coupar
 

Hi Lavinia, 
Thank you so much for the reply. It is a big learning curve, isn't it :) I sort of assumed if there was such a great all-in-one product available for these IR horses, everyone would be using it! I have to stop talking to these feed supplier reps, I am too easy of a sell hah! Glad I stuck with the basic package then. 
I am slowly making my way through some of the archived discussions and documents (I am a Master's student, so crave any non-school reading I can get-though there isn't much time for it haha!), and was able to find some discussion around the questionable effects of other minerals/vitamins. Sorry if I am repeating some of the questions that have been asked in the past, don't want to waste anyone's time or resources, just learning the system still!

Thank you again for the help! 

Warm regards,

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