Date   

Re: Hard swollen sheath

Kathy Brinkerhoff
 

Hi Dr. Kellon & Mods,

I did a search on Levamisole in the message archives and quite a few messages came up from over the years.  I would still like to ask how  you determine in which situations you should consider using it?   Do you use it year long or for just a limited course of treatment?    


Thank you.

Kathy Brinkerhoff

SE/WI  10/12




 


RePost: Pony problem #194550

hinecedark@...
 


Re: Hard swollen sheath

Kathy Brinkerhoff
 

Hi Jaini,

Can you please expand on the significance of the ACTH of 28 during the seasonal rise for Ulysses.

Would you still recommend getting his ACTH in the mid teens?  

If a 0.8 mg dose of Pergolide is probably insignificant for a 1750# Draft should he even be on pergolide or should he be on a higher dose?!

I am not connecting the dots. :-)

Thank you,

Kathy Brinkerhoff

SE/WI  10/12









 


Re: poor fat digestion and shiny manure

Eleanor Kellon, VMD
 


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

Shiny poop is more commonly caused by a mucus coating,
= = = = = = = =

I have to agree with Jaini.  There's not enough fat in 1.5 oz of flax, or equivalent, to coat 25+ pounds of manure.

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


Re: Help with Jiaogulan?

Maggie
 

Hi Belinda,

Welcome to the list.  Sorry to hear about your dad.  Tough time for sure.  

Jaini has already given you some great information, and has you ready for the vet's visit today.  I'll go into more detail about our philosophy called DDT/E, which stands for Diagnosis, Diet, Trim and Exercise.  Like Jaini said, it's a rather steep learning curve to learn and get all four aspects in place, but so worth it!  To give you the best help we ask members to fill out a case history on their horse.  If you could do that sometime between now and when you get your lab work back it will give us the details to help you better.  To fill out a CH you need to join our sister group called ECHistory8, the "filing cabinet" where we store case histories.  It should not take long to get approved.  The instructions for filling out a CH are on the main page.  Here's a link to that group:  https://groups.yahoo.com/neo/groups/echistory8/info   If yo have any trouble let us know.  We can help you!  More details about the DDT/E philosophy....

Diagnosis:  Jaini has already given you the details of what labs to draw and to do them on a NON-fasting horse.  So I won't repeat that.  Just a quick explanation about why these 4 tests, ACTH, insulin glucose and leptin.  Endocrinopathic laminitis from insulin resistance (IR) or Cushing's disease (PPID) is the most common cause of laminitis.  These 4 tests help us to identify the cause.  Getting the correct diagnosis of  just PPID, just IR or both helps to dictate the treatment.  PPID, not normally seen in horses under the age of 10, is an enlargement or benign tumor in a part of the pituitary gland called the pars intermedia.  It is treated with a medicine called pergolide.  IR is a "metabolic type" of horse, normally, but not always, described as easy keepers with abnormal fat pads such as cresty necks, fat in the hollows of the eye, sheath, etc.  IR is treated with a low carb, low fat, mineral balanced diet.  A horse that has both PPID and IR would need both pergolide and a carefully managed diet for the rest of it's life.

Diet:  To provide the low carb, (less than 10% sugar+starch) low fat (4% or less), mineral balanced diet, we use grass hay, tested to be under 10% sugar + starch, with minerals added to balance the excesses and deficiencies in the diet, plus salt and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E.  This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse.  As Jaini said, for now, best to use the Emergency diet as she described.  More details about the emergency diet can be found on our website here: http://ecirhorse.org/index.php/ddt-overview/ddt-diet  The concept behind the emergency diet is to remove the possible triggers from the diet.  It is meant to be used only temporarily until you can get your hay tested and balanced.  Since you board, we will probably have to have more discussion about how to test and balance your hay.  Meanwhile, just soak it for an hour in cold water or 30 minutes in hot water to remove an average of 30% of the sugar content.  Makes sure you dump the soaking water where the horses can't get to it.  And then feed the salt, magnesium, Vitamin E and ground flax seed in the rinsed/soaked/rinsed beet pulp.  Is he eating that beet pulp OK?  If not, we can make some other safe carrier recommendations.  Just let us know.

As important as what you DO feed is what you DON'T feed!  No grazing!  No sugary treats including apples and carrots.  No molasses containing products.  No red/brown salt blocks--white only.  Stop the Primeglo--it has a sugar content of 7.8% plus 5.9% starch, and contains a minimum of 8% fat.  Stop the Smarthoof circulate and the SmartCombo.  They both contain alfalfa and vegetable oil.  Alfalfa can make some horses footsore and vegetable oil has an upside down Omega 3:6 ratio.  We use ground flax seed to provide the Omega 3's and 6's because it has the closest ratio to grass, about 4:1.

Just a bit more detail about when to start Jherb in message #184957 from Kellon that says this: "I avoid it during the first 72 hours. This is how long the acute inflammatory reaction lasts. Endocrinopathic laminitis is not primarily an inflammatory event but tissue damage triggers an inflammatory reaction. There is mounting evidence that high insulin leads to the vessels being resistant to the normal dilating effect of insulin, resulting in vessel spasm. Whatever the mechanism might be, I'm cautious about trying to increase blood flow when the vessels may be constricted or clotted.  If the cause has been removed, e.g. by addressing diet, Jiaogulan can be started after 72 hours."  Also, we don't recommend NSAID's (i.e.bute) after the first few days of laminitis as it interferes with healing.  You don't want to use bute and Jherb together.

Trim:  A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  It's often the last piece of the puzzle to fall into place in getting a laminitic horse comfortable.  To help you make sure that you have an optimum healing trim in place, we encourage you to post pictures of your horse's feet, as well as any xrays you may have.  If needed, our resident hoof guru can do "markups" for your farrier/trimmer.  Please visit this site to learn how to take the best hoof photos:  http://www.all-natural-horse-care.com/good-hoof-photos.html  All photos and xrays should be posted in the PHOTOS section of the ECH8 site, the site you join to fill out your CH.

Exercise:  The best IR buster there is!  BUT, a laminitic horse should never be forced to move!  Boots and pads are definitely in order to help get your boy more comfortable.  Let us know if you don't have those and we can make some recommendations.  Once able to move around comfortably, hand walking in long straight lines with no tight turns is recommended.

Ok, Belinda, I know we've given you a lot of information!  Don't get overwhelmed.  Just take your time and study the information we've provided.  Read all the parts of our website:  http://ecirhorse.org/   There is a TON of great information there!  It's also a great place to send your vet!  There is also a ton of great information in our files and archived messages.  You can probably find anything you might think to ask there.  But don't hesitate to ask us any questions you have!  Hang in there!  It's a steep learning curve, but it does all get easier!

We ask all members to sign each time they post with their name, date of joining  and general location.  Once you fill out your CH, please put a link to it in your signature as well.  It helps us to find it faster and answer your questions faster.

Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response
https://groups.yahoo.com/neo/groups/ECHistory4/files/maggie%20in%20virginia/ 




Re: poor fat digestion and shiny manure

Nancy C
 

Hi Beverly

Thanks for your updated Case History.

I cannot speak to your fat absorbtion theory but have a few ideas for Ginger based on what you are feeding.

Biotin Plus has Yucca in it.  Yucca has a cortisol effect. and since you are trying to get insulin down I would discontinue if she were here.  See FILE search on Yucca and also see archive message search, drkellon as author, and yucca in message body.

It also appears you are missing Selenium, copper and zinc, all hugely important for IR, skin, feet.

Best choice is to get a load of Standlee, test and balance. You've undoubtedly heard that before. Next best is to switch to California Trace or AZ Copper Complete (Horsetech).  Can't remember the biotin levels but you could always add seperately if you need more. 

The use of high levels of biotin in horses to control IR comes from human medicine and as far as I am aware there is no evidence in horses that it works.

You can read about the effect the above suggestions have in the 2013 Proceedings on ecirhorse.org.

Nancy C in NH
ECOR Group Mod
FEbruary 2003


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

Ginger's history is updated and posted now.

Beverly 6/14
Beverly Texas
https://groups.yahoo.com/neo/groups/echistory8/files/Beverly%20Texas/


Re: Jasper's Journal of Pulse & lameness last 10 days.

Lorna Cane
 


>he spent all day laying down only got up to poop and pee. 

That's a good thing.Getting up.
Many of us have watched our horses go through nightmarish episodes of not even getting up to poop and pee.

What doesn't kill us makes us stronger.Our horses definitely do their best to make us stronger.


Lorna in Ontario,Canada
ECIR Moderator 2002


*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf


https://www.facebook.com/ECIRGroup





Re: Help with Jiaogulan?

janieclougher@...
 

Shoot - responding to my own message now!  I just saw (as I hit "send", naturally), that isoxsuprine was misspelled.

Sorry, team!




Re: Jasper's Journal of Pulse & lameness last 10 days.

corrine haffner
 

Hi 

So both abcesses blew out tonight,still were draining when i did his feet put more numotizine on both feet and re wrapped. Still his pain level is quite high yet at a 4 1/2,he spent all day laying down only got up to poop and pee. The phyto-quench dose i read can be up to 3 scoops a day,i know i was told only 2 like i said in post earlier he was a 3 pain wise then..

I'am not trying to make him pain free just lower his pain score so life is easier for him and me,maybe that's to much to ask.Sorry i can't let the PQ dose thing go i think he needs a bit more relief then what he currently has. Here's my other post 194555 has all other info that was asked for.

Corrine & Jasper
MN 4/2014
ECHistory8


Re: Help with Jiaogulan?

janieclougher@...
 

Hi, Belinda, and welcome to the list.  I am very, very sorry to hear about your dad's illness and passing. 

This is just a short answer - for the blood pull tomorrow, make sure it is non-fasting (ie, have soaked hay in front of her for at least 4 hours, or pull the blood 4 hours after her first meal of the day); no grain or supps before the blood test.  Pull into purple-topped tubes and serum separator tubes; get your vet to pop them in a cooler and take them back to the clinic so they can be spun and separated asap.  (max 2 hours after pull). Freeze the serum and plasma, then ship on ice to Cornell. Ask for ACTH, insulin, glucose and leptin.

You are on the right track with the soaked hay, beet pulp and magnesium.  Best to do the whole Temporary Emergency Diet: soaked hay, rinsed/soaked/rinsed beet pulp to carry a tablespoon of salt, 5 grams of magnesium, 2-4 ounces ground, stabilized flax, and 2,000 IU Vitamin E (in 400 mg capsules containing soy oil)  On the run here - I will look into the Smarthoof and Smart Combo Ultra tomorrow.

Jiagulan is a better circulation booster than isoxuprine, as isoxuprine doesn't last in the system long enough, and results have been equivocal. (possibly due to poor oral bioavailability and short half-life)  However, Jiaogulan shouldn't be used during the acute phase of laminitis. Once all the triggers are removed, and your mare has moved from the acute phase to the healing phase or more chronic phase, then the J herb is a good choice.  A good place to get it is from My Best Horse

http://www.mybesthorse.com/

One of the invaluable first responders will be here to give you more details.  It is a bit of a steep learning curve, but very much worth it.




 


....: had the vet out today and have a case of suspected laminitis. Horse was unwilling to walk. Background: 17 year old quarter horse gelding lame on and off since March on right front and left hind

Belinda

 


Re: Hard swollen sheath

janieclougher@...
 

Thanks for that totally awesome post, Dr. Kellon.  You da bomb!

(and I am blushing for missing the significance of the ACTH of 28 during the seasonal rise!)







 


Re: ACTH Question- Blood Results

Lavinia Fiscaletti
 

Hi Caryn,

The current ACTH is at least double what it should be at this time of the year when ACTH is at its normal low point so is more than a "little bit" above normal. In another month, that will likely begin rising further as we head into the seasonal high period. The group has found that maintaining the ACTH solidly within the middle range of the "normal" values is the best way to manage the disease. The further outside the normal range, and the longer it remains there, the more difficult it is to regain control and the greater the likelihood that there will secondary problems arising. Laminitis is the worst of these possibilities.

No way to know what dose it is going to take to regain control. Prascend is only scored to be broken into halves. Anything smaller than that means the amount of medication in each piece is unknown. If you are going to try to use 1/4 tabs or less, we recommend dissolving a 1/2 tablet in a few cc's of water, administering 1/2 the contents of the syringe one day, refrigerating the remainder and administering it the next day. The other option would be to use compounded pergolide capsules for the smaller doses.

Whatever dose you decide to up Narco to, I would be prepared to keep raising it as the seasonal rise hits. Plan to retest in Sept to see whether you are maintaining good control in the face of the rise or not and adjust accordingly.

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




ACTH Question- Blood Results

Caryn Darmer
 

Hi, 

I have not visited the group in quite some time since it has been two years since my Cushings + IR horse founder episode/diagnosis and he has been doing well. This spring he has been a little bit under the weather at times even with his 1 and 1/4 pill or Prascend daily. At the time I blamed it on unusual Washington heat, but now I know that he was a bit lethargic due to his Prascend dosage not being right. I had blood drawn and sent to Cornell last week and his ACTH came back at 55 pg/ml. Now I do realize that this is raised, however last time (this past spring during his lethargic episode) I attempted to raise his Prascend dosage (by 1/4 of a pill) he went super lethargic even with APF. Right how he is in daily exercise, proper balanced diet, no pasture ect. 20 years old. 


My question is, since he is not too high over the "normal" ACTH range. Do I start off by adding 1/8 of a pill? Do you think that 1/8 of a pill would bring my horses ACTH down enough? 


Thanks!


Caryn + Narco

Sept 2013

Washington State


Help with Jiaogulan?

Belinda Borders
 

I could use some quick help. I joined the group today, June 8th 2015. Location: Northeast Ohio. Reason: had the vet out today and have a case of suspected laminitis. Horse was unwilling to walk. Background: 17 year old quarter horse gelding lame on and off since March on right front and left hind. Back muscles extremely tight. Hocks injected first of April. Didn't see much improvement. Had 2 different vets out along with chiro and massage. Suspected PSSM or some other sort of muscular disease. Robaxin, bute etc. helped somewhat. On rest and pasture turn out. Blood work came back negative for muscle disorder. Had right front x- rayed - no rotation, hoof form looked good. Mild medial/ lateral imbalance. Slight navicular changes - but same as he has had for the last 5 years.  Trimmer out to correct imbalance. Horse seemed to be getting better. Started light work - mostly walk with some trot. Not a lot of work because my dad had gone into ICU and I was pretty much living at the hospital. My dad passed away last Monday and I had not been at the barn but once in the last week ( I board). Last Wednesday I got on and walked for about 20 minutes. Horse was happy to move out, interested, ears up, back swinging. I didn't go on Thursday because that was the day of the memorial service for my dad. During the week sometime we got in a new shipment of this year's first cutting hay. Very green. We had been feeding last year's hay up until this point. Pasture turn out time was also getting increased during this time in 15 minute increments every third day. Up to 2 hours per day. Went to barn on Friday - looked mildly off. Saturday looked very off - suspected maybe an abscess. Went Sunday and he could hardly walk. Vet out this morning and believes its laminitis due to movement, stance, etc. She will be coming back in the morning to pull blood work. Current diet was 6 flakes of hay - 6 ozs primeglo 2x daily to feed supplements with. Supplements include: Smarthoof circulate, Smart combo ultra, performance equine magnesium and 1g selenium. .Changed today to soaked hay, 4 ozs. beet pulp shreds 2x's daily with same supplements. 1gram bute 2x's daily, 20 isox 2x's daily - sorry can't remember the dosage -it's at the barn. was wondering if the jiaogulan would be a better anti - inflammatory after reading some of Dr.Kellon's articles. If so, where would I purchase it and what would be the correct dosage? Any help you could provide would be greatly appreciated.

Thank you,

Belinda

 


Re: Hard swollen sheath

Donna Powell
 

Jaini,
Thanks for some good ideas.  I have hosed and messaged and it doesn't seem to make a difference...so must be inflamed IR fat.  It is painful at times.
I had thought that having his ACTH in the teens might help too.  Maybe the vet will go for a "trail".
 


From: "janieclougher@... [EquineCushings]"
To: EquineCushings@...
Sent: Monday, June 8, 2015 12:47 AM
Subject: [EquineCushings] Re: Hard swollen sheath

 This looks to me very much like a case of treat the horse and not the numbers - if increasing the pergolide to .8 mg helped, but he is still not quite right, then a trial increase would seem to me to be indicated. (but you somehow have to get your vet on board with this)

Meanwhile, back to the sheath.  Is it painful?  Is the one side warmer than the other? Will he tolerate some cold hosing at the same time as a massage?  That is standard treatment for many types of edema, whether in the limbs or elsewhere.  If it is inflamed fat due to IR, this won't make much difference, but if it is a lymph drainage problem it might help. If it persists or gets worse, you will have to call in your vet (but you don't have to go with the steroids or antibiotics if you know that sets Ulysses back)
Jaini (BVSc),Merlin,Maggie,Gypsy
BC 09
ECIR mod/support



Re: Miniature on Prasend

janieclougher@...
 

Thanks for the info, Connie!

  Just so you know, the Previcox dose for a 1,000 lb horse is 45 mg, or 3/4 of a 57 mg tablet.

  For a 264 lb/ 120 kg mini the dose of Previcox is 12 mg, or 1/5 of a 57 mg tablet, or 1/20th of a 227 mg tablet.  For pain relief in minis, it is much better to use the firocoxib formulated for horses, Equioxx.  It is much more expensive to use in a full-sized horse, of course, which is why people use the dog formula.  However, the accuracy of dosing is so important that the Equioxx trumps the Previcox for the little guys; and because one is using so little, the cost isn't that huge.




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

My mini is on prasend now not previcox. 

Sent from my iPhone


Re: Miniature on Prasend

Connie Martley
 

My mini is on prasend now not previcox. 

Sent from my iPhone

On Jun 5, 2015, at 10:03 PM, shilohmom@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Connie,

In addition to all of Maggie's great info, could you please tell us what dose of Previcox your mini is on?

Thanks.

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


Re: Miniature on Prasend

Connie Martley
 

Agree and it stopped working I was splitting 227mg into half daily. So 113 mg each day. That is why I went to presend another vet gave her. 

Sent from my iPhone

On Jun 8, 2015, at 1:03 PM, shilohmom@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Connie,

You're doing fine. We understand that we throw a lot of new info at you.

Got it on the Prascend dose. That is not a problem.

The concern was about the Previcox dose - how much and why. Vets tend to immensely overdose the Previcox, esp in a mini, as this form of firocoxib is formulated to be administered to dogs. Contrary to how it may seem, dogs require much larger doses of firocoxib to achieve therapeutic blood levels. Correct horse doses are much, much smaller than a canine's would be. Therefore, it is almost impossible to correctly dose Previcox to a mini as you would need to cut a 57mg pill into quarters and the pill is not intended to be divided that way.

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






Re: poor fat digestion and shiny manure

beverly meyer
 

Ginger's history is updated and posted now.
On very few supplements except Jherb, Alcar....
Nothing unusual otherwise. No colic. No change in food, etc. No clues about what started this issue 2 months ago. It looks like an oil sheen on water like you'd see in a parking lot. Not visible except in the sun.
Still high insulin, over 150.
The donkey had this blue shiny manure when he was underweight and Dr. Kellon warned me about hypertriglyceridemia. He's better now....
Thanks for any ideas. Her fat dose is minimal and her dandruff is as bad as always.
Beverly 6/14
Beverly Texas
https://groups.yahoo.com/neo/groups/echistory8/files/Beverly%20Texas/


Re: Miniature on Prasend

Lorna Cane
 

>Forgive me if this is a incorrect way of responding. Lots of 

information to take in.

Connie,no need to apologize. There's so much to learn here, it takes time to get comfortable.

Thanks for providing you name, location, date of joining.

Connie KC June 1, 2015

Each time you send a message ,you can just include it at the end of your message,the way I have done after mine below.

If you delete the old message to which you are replying,it is also helpful.

It'll get easier..
No worries!

Lorna in Ontario,Canada
ECIR Moderator 2002

*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf

https://www.facebook.com/ECIRGroup





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