Date   

Jacque: Finding my case history file

Lorna Cane
 

Hi Jacque,

Did you see my message to you about giving us the details here,until you get your case history worked out?

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/196701

 

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

 


>>Hello...trying to update my case history files. Can anyone help me find my way?

Thanks much,

Jacque white



 


Re: Reposting(2nd try): ACTH Results Back

Claudia Goodman
 

>>I would love to retest 3 weeks after I reach the 5.5mg, but I will have to see if I can do it financially. 

Stephanie, I also have been trying to get the pergolide dose right during seasonal rise. I tested back in July, and my mare mare had already unexpectedly jumped just beyond the normal range, so I immediately raised her .5mg pergolide to 4.0 mg. I have to make a point of saying no changes in symptoms were at all apparent, which for her is loss of brightness, first and foremost.
 
Tested again at end of August and she continued slightly upward, so I increased dose .5 mg to 4.5, for a few weeks and again to 5.0 mg pergolide. No symptom changes have been seen.

I plan to test her the end of Sept, believing that she is controlled for now, but I do want to see for sure that she stays controlled during the rise, so will test again. My goal is to keep her under the 35 pg/mL ACTH high end of normal during seasonal rise, believing that the more tightly controlled we keep them, the better off they will be long term.

I think once we see how seasonal rise affects a horse's ACTH values, it is a bit easier to judge how to dose in subsequent years. I learned from last year's pattern that I needed to go up 2.5 mg to keep my mare controlled during the rise. And after seasonal rise, she needed more pergolide (3.0 mg) than before the rise started (2.0 mg).  
Best of luck with King. 

Claudia & Silhouette   2014   California central coast

https://groups.yahoo.com/neo/groups/echistory8/files/Claudia%20%26%20Silhouette/




Re: Jasper's Lyme Results

corrine haffner
 

Dr Kellon 

I'll have an anwser to your questions in a day or so, not trying to avoid it, i just honestly don't remember a thing that was told to me over the phone with cornell,or my own vet. Read my last post to Nancy last part of it.


Re: Jasper's Lyme Results

Nancy C
 

Hi Kerry

Good caveats.  :-)

Every time this comes up I am still left with the same question.

Did her insulin come down because she had better controlled ACTH or because she got off the Cubes.  I don't think that has been separated out. 

As discussed in other recent posts, the symptoms of uncontrolled IR and uncontrolled PPID overlap. I kow you know that.

Improvement of foot comfort can come in a matter of days from increased dosages of pergolide, just as it can when switching from high ESC&Starch feeds/diet to lower ESC&starch intake. 

As I understand it you did both at the same time.

Just to be clear for new people ODTB Cubes are not high ESC&starch adn this report is unusual so it is why we are pulling apart the confounding factors. A process that our founder Robin established as and ECIR keystone so long ago.

My take of Dr Kellon's response to this and my own personal experiences is that diet is critical to controlling IR, but the system can be overwhelmed by uncontrolled diseases driving insulin levels far beyond anything you can control with diet alone.  It takes control of the diseases to control the IR.  If you don't control the disease, no amount of diet tweaking will fix hyperinsulinemia.

Just like pergolide will not fix "insulin resistance related to genetic predisposition, obesity, diet or any other nonpituitary cause", diet alone will not fix IR from disease states like PPID.


I'm paraphrasing but I think Dr Kellon described it as when ACTH, Lyme, Mare issues, iron overload and other are out of control, no feed will be low enough to control hyperinsulinemia.  You have to address the disease. As you did. 


As for your gelding, It would be helpful to see the rest of the diet and well, you know,,,,,a CH.


In any event, in the last go around, it was suggested that Corrine use soaked hay and the emergency diet if she felt that was the best for Jasper, until he was more stable or at least there was a clearer picture of his dx, 


I offer this Kerry, with all respect for the work you have done with your horses.


Nancy C in NH
ECIR Group Moderator 2003

To learn more about the impact of fructan, understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available. Guest Speakers





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



However, I've observed from direct experience that when my mare's PPID was not controlled, she could not handle the ESC & starch in the cubes in *any* amount fed (even <1lb).  Her insulin normalized only when I found her target dose of pergolide and she consumed the Emergency Diet. Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well).

My IR gelding does well at 0.5% BW (6lbs/day for a 1200-lb horse), but any higher % of BW he gains too much weight and his insulin climbs.  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble.  If his weight does ever increase, I will decrease the % of cubes.  Luckily, so far, his weight has dropped or held steady at each weighing.



Re: Jasper's Lyme Results

Lorna Cane
 

>>Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well

<snip>

>>  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble. 


My understanding here  is that  horses who are working are being compared to a horse who is not in work.

I'd like to see either all horses working, or no horses working  .


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

 




Re: Jasper's Lyme Results

corrine haffner
 

Hi Nancy

Took hay out of diet because of unknow  minerals, Lavinia felt i needed to tighten up his diet due to the numbers on test going up quite a bit from test in August.  I had the choice of testing current hay getting it mineral balance or going to all ODTB cubes.

Testing hay is not an easy option big rounds stacked roof high can only get to maybe 4 to core and test. That's on hay from one field. Hay on other side of hay barn comes from 2 different fields, so i felt going to all cubes made more sense. 

Yes i'am working with vet right now he's gone so kinda on my own. He still peeing excessively and drinking excessively so still out of control PPID or IR or both,reason for major diet change,so that's not part of problem.

Vet that came last night isn't the best i don't have alot of faith in her or he ability she over tranqed him and he went down,while he had tube down his nose. So i'am not real appt to have her back i thought jasper was going to die last night. Took him 2 hour before he got back up i demand vet stay till my horse got up and was ok,she did so willingly. I wasn't rude i was just a very worried horse owner and dealing with a very emotional daughter who was freaking out,so that was how my night went NO sleep...


Re: Reposting 196660 spring worming for Cushing/ir pony

Nancy C
 

Hi Sandie

Sorry you got lost in the flurry of posts.

I'm hoping one of our Australia members will add their experiences, dewormer resistance in Australia,  and product ideas, but in the meanwhile, have you seen the file on Deworming? Look for first one here

Equine Cushings and Insulin Resistance

 

You are right in that some horses cannot handle praziquantel.

There are some good ideas in the above file that hopefully will bring it home for you.

Nancy C in NH
ECIR Moderator 2003
Do you have a mare? Attend NO Lamintis! 2015 and learn about the special issues mares can have that drive Insulin Resistance and laminitis.

NO Laminitis! Conference Registration

 




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


Then, what do I rotate with? What do I do in autumn? I usually worm 2X / year and fec in between. If I need to worm more than that what is recommended to rotate with?

Sandie g harries
Victoria, Australia
Since June 2015


Re: Jasper's Lyme Results

 

I understand this post may stir up a hornet's nest -- again -- but being an open forum where advice is commonly solicited and anecdotal reports from owners are encouraged, Im sticking my neck out FWIW....

From careful studying of my two very sensitive IRs, and their experience consuming varying %BW of ODTBC, that IME/IMO, I would try putting Jasper back on the soaked hay only (no cubes) Emergency Diet until there's clinical evidence that his PPID is under control with the increasing pergolide dosages.  Now compounding in the choke episode and the questionable Lyme status to the unabating PU/PD, ongoing hoof soreness, unsatiable appetite, etc.

I do not have published research to provide.

I did not ask Dr Kellon's opinion prior to posting this.

I am not a moderator. 

However, I've observed from direct experience that when my mare's PPID was not controlled, she could not handle the ESC & starch in the cubes in *any* amount fed (even <1lb).  Her insulin normalized only when I found her target dose of pergolide and she consumed the Emergency Diet. Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well).

My IR gelding does well at 0.5% BW (6lbs/day for a 1200-lb horse), but any higher % of BW he gains too much weight and his insulin climbs.  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble.  If his weight does ever increase, I will decrease the % of cubes.  Luckily, so far, his weight has dropped or held steady at each weighing.

Again, FWIW...my purpose in posting is only to try to get Jasper on the road to recovery. I mean no ill will by offering advice that may appear puzzling or unsolicited. Im just hoping to throw some observations out on the table to possibly help Jasper. That is my only intent.  My apologies for invading your inboxes if this post was unwanted :)

Kerry in NY
Sept 2014


Sent from my iPhone

On Sep 21, 2015, at 1:15 PM, threecatfarm@... [EquineCushings] <EquineCushings@...> wrote:

 

IME, hungry all day is part of uncontrolled IR.

You need to do what you need to do to avoid choke. 

Some members have used large rocks in the feed pan/bucket to slow them down. Psyllium previously mentioned.

Nancy C in NH
ECIR Moderator 2003
Join us at the 2015 NO Laminitis! Conference, Georgetown TX, November 6-8, 2015
 
www.nolaminitis.com




---In EquineCushings@..., <sassafrass45@...> wrote :



With no hay in diet i feel like i need to give more then 22 lbs of cubes,i know i run the risk of him getting to fat,i don't know what else to do other then feed 30 lbs a day.He hungry all the time...


Re: Jasper's Lyme Results

Nancy C
 

Hi Coririne

Can't tell you about the pergolide.  You need to look at symptoms and work to the plan you have with your vet. The goal is to control ACTH.

Some folks use these to slow down cube consumption.

nose-it

 



My concern would be that he has choked twice on hard cubes. 

Will all the posts, I honestly have lost track of why you stopped all hay.  If it's low sugar hay, putting a pound or two in a slow feeder might keep him busy in between cube meals

You are going to have to experiment.

Nancy C in NH
ECIR Group Moderator 2003

Why do herbal remedies not control PPID? To learn more about the understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available.http://www.nolaminitis.org/index.php/program-schedule/guest-speakers



---In EquineCushings@..., <sassafrass45@...> wrote :

I put a few big rock in his feed dish today slowed him down some,he searched out cubes that were scattered and ate those first.  Had 5.5 lbs gone in an hour,i put out another 3 lbs of cubes scattered out around corral to keep him busy.  

Or he starts eating on the wood rails and posts this is new in just the last 2 days,if he cant do that he eats on salt lick or eats dirt.  This is all new stuff he's started doing since hay has been cut out of diet. He spends his day looking for stuff to eat. I am soaking cubes i put in feed dish the rest i just throw out on ground around corral. When he's out of cube i put out more or he's looking for trouble..not sure keeping cubes in fornt of him is ideal??

Do i up his pergolide another 1 mg or wait a few more days??


Re: Reposting(2nd try): ACTH Results Back

Stephanie Stout
 

Hi Nancy,

Thank you so much for replying. I try really hard to watch his symptoms closely, as I see him several times a day(he's at home). I have noticed that his crest has increased a little over the past couple weeks. I'm planning to start by adding .5mg(starting today), and then adding another .5mg 4-5 days after so he will be on an added 1mg. Does that sound appropriate/good to you? 

I would love to retest 3 weeks after I reach the 5.5mg, but I will have to see if I can do it financially. 

The vet is a whole topic in itself - I am struggling/arguing with the vet that I have started working with since she is convinced that the ACTH reference range from Cornell is up to 105(!!) so he doesn't need anymore Pergolide. I finally got her to write the prescription for the .5mg last week by explaining that I'm on this group, and that King needs more Pergolide for the seasonal rise(we will see what happens when I have to do a refill). 

@LJ I will never be able to prove/confirm it, but I believe that he went into kidney failure because his PPID and Insulin levels were so high originally. His kidneys(knock on wood quick) have been WNL and fully functioning for over a year now. He has been doing GREAT, I'm so proud and thankful to this group!  

Thanks all! 
Stephanie & King
Oregon
2014
ECHistory8

 







Re: Jasper's Lyme Results

corrine haffner
 

I put a few big rock in his feed dish today slowed him down some,he searched out cubes that were scattered and ate those first.  Had 5.5 lbs gone in an hour,i put out another 3 lbs of cubes scattered out around corral to keep him busy.  

Or he starts eating on the wood rails and posts this is new in just the last 2 days,if he cant do that he eats on salt lick or eats dirt.  This is all new stuff he's started doing since hay has been cut out of diet. He spends his day looking for stuff to eat. I am soaking cubes i put in feed dish the rest i just throw out on ground around corral. When he's out of cube i put out more or he's looking for trouble..not sure keeping cubes in fornt of him is ideal??

Do i up his pergolide another 1 mg or wait a few more days??


Re: Dutch and Prascend

Eleanor Kellon, VMD
 

If you send your hay analysis through the "Ask the Vet" form on this page:

Ask Dr. Kellon - Uckele Health & Nutrition

  I'll let you know if a Uckele product will work.


Eleanor in PA

www.drkellon.com

EC Co-owner

Feb 2001




--


Re: Dutch and Prascend

bigelow.rebecca
 

I looked at my most recent hay analysis today and the sugar and starch total 9.5%.  It leaves a lot of minerals that need supplementing though.  I thought the easiest thing to do was to add a multivitamin/mineral supplement that didn't contain anything that Dutch wasn't supposed to have and use single minerals to balance his diet from there. That's why I was wondering about either the Target IR or the Uckele U-Balance Foundation. If I used just single minerals I would need to add lysine, calcium, magnesium, copper, iodine, zinc and selenium. Some of these are at reasonable amounts in his hay but would be needed to balance the ratios. 

I ordered the APF to see if that would help his appetite. I could use some help deciding what dose of Prascend I should be using. Should keep it at 1/4th or 1/2 pill until I get him to eat his minerals or should I just move the dose along? He's currently on 1/2 tab and has been for about a week. Sorry I forgot my signature last time.

Rebecca and Dutch
Elk Grove, CA     2009
Case History:ECHistory8

 



Re: IR or PPID symptoms?

Nancy C
 

Hi Suzanne

Case History opens beautifully.  Thank you.

The problem and confusion with symptoms is that they can overlap.

If you can I would skip the bute.  If he has laminitis it is not going to help that area and could hinder him.   A layman's symposis of why this is so is bute whack the good nitric oxide as well as the bad, j herb can help with a likely vasospasm culprit, endothelin-1.  Bute has been described as a centrally acting drug and does not work on the pain of the feet during on going laminitis.

Bute is also horrible on the system.  You've got the PQ coming which is great.  Might eventually want to transition to jherb.

To read more about any of the above go to ecirhorse.org.

On symptoms
Cushing's Disease

 


Insulin Resistance

 

On symptoms and on bute go to   2013 Proceedings & Recordings Table of Contents


And look specifically for


Bowker -

Nerves, Nerves, Nerves: Why are they so important to the horse?

Kellon -
  • Getting the Right Diagnosis for PPID/ Cushing’s and EMS/IR
  • Endothelin-1: Key Player in Equine Laminitis?

Not sure which hay you are feeding but you might be able to tighten the Calcium:Mag ratio.  I would do that by using Mag Oxide vs Quiessence. Dr Kellon explains how important the role of mag is in her proceeding on minerals at the above link.

Nancy C in NH
ECIR Moderator 2003

FACT: With knowledge of the nutrient profile of the forage and the animal's weight and level of work, one can supplement only what is needed to target nutritional needs.
Join us at the 2015 NO Laminitis! Conference, Georgetown TX, November 6-8, 2015

Continuing Education Credits

 




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


Thanks again,
--------------------

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

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/42876

There is absolutely no solid evidence at all to suggest that
pergolide is of use in treatment of insulin resistance related to
genetic predisposition, obesity, diet or any other nonpituitary cause.


Note the reference to" nonpituitary cause".





 


Re: Metabarol for IR?

 

Will do. Thanks so much.

Cass for Satra
Sonoma County, Calif Oct. '12


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

I'll try to get a dialogue going with Dr. Adams.  Time short this week though so please send me an e-mail next Monday and remind me.


Re: Falki X-Rays

Connie Proceviat
 

Hi Lavinia and All,


I've added 4 hoof pics that were taken last Friday Sept 18. Sorry pics are not very good but it seems Falki has an abscess brewing now on right front. Very sore since Thursday. I have been poulticing then wrapping in a plastic bag then covering with boots. He has not had a abscess in a long time so maybe it has been brought on by more aggressive trim and increased exercise. Hopefully that's a good thing. Will get better pics when he's able to. Not sure if you are able to provide any feedback on the 4 pics added.


Best Regards,
 

Connie & Falki

Manitoba Canada

Aug 2013


 https://groups.yahoo.com/neo/groups/echistory7/files/Connie%20P/


 https://groups.yahoo.com/neo/groups/echistory7/photos/albums/2003166298


 

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


Tender footed without boots but walks briskly with his boots on. We have been trying to go for a 30 minute walk daily.



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


You've done a great job in regaining control of the toes, which are backed up nicely, with dorsal walls following the dorsal edge of the coffin bone. Soles are thin, coffin bones ground parallel. The hoof-pastern axis is slightly broken back in both. This is in part due to the sinking but also need to allow the rear of the foot to gain some height in relation to the front. Also need to gain a bit more overall hoof capsule height as his bony column is sitting lower inside than is optimal.

How is he doing?

Lavinia, Dante, George Too and Peanut
 



Re: Jasper's Lyme Results

Nancy C
 

IME, hungry all day is part of uncontrolled IR.

You need to do what you need to do to avoid choke. 

Some members have used large rocks in the feed pan/bucket to slow them down. Psyllium previously mentioned.

Nancy C in NH
ECIR Moderator 2003
Join us at the 2015 NO Laminitis! Conference, Georgetown TX, November 6-8, 2015
 
www.nolaminitis.com




---In EquineCushings@..., <sassafrass45@...> wrote :



With no hay in diet i feel like i need to give more then 22 lbs of cubes,i know i run the risk of him getting to fat,i don't know what else to do other then feed 30 lbs a day.He hungry all the time...


Re: Metabarol for IR?

Eleanor Kellon, VMD
 

I'll try to get a dialogue going with Dr. Adams.  Time short this week though so please send me an e-mail next Monday and remind me.

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


Re: Jasper's Lyme Results

Eleanor Kellon, VMD
 


---In EquineCushings@..., <sassafrass45@...> wrote :

I called cornell and blood for lyme test was more then likely missed handled to get the results jasper had. I then called vet clinic and talked to them,and the blood samples were not taken care of in a timely fashion.

= = = = = =

Could you be more specific?  Exactly how was the sample mishandled?  What is "taken care of in a timely fashion"?  What effect did these sample handling errors have on the results?

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


Re: Metabarol for IR?

 

Sorry for the partial earlier post.


Dr Kellon, would you consider going direct with the president of the company, who responded to my questions this morning, to ask for the study data? I can provide his email address, and his phone is shown below. Or get the study data from the researchers? The lead researcher in the AQHA financed study was Amanda A. Adams, contact details at http://www2.ca.uky.edu/gluck/AdamsAA.asp   I’m out of my depth with the statistical details, recognizing only that this is a very small study of a short duration.


Answers: No, there were no diet changes, all horses were dry-lotted on hay, and no, neither metformin nor levothyroxine were administered. Control horses received only the yeast as a placebo. The study duration was 45 days in the autumn. The reduction in insulin levels in EMS horses administered Metabarol daily (45 day study duration), versus placebo, was statistically significant at the alpha = 0.05 level. 


In any event I'm unwilling to cut Satra's hay from 1 ¾ %/BW to 1 ½ %. Her grass hay diet hasn't changed significantly since I recognized she was PPID in 2012 or has only become more strict, so the doubling of her insulin within the past 6 months is independent of diet changes. We're working on getting new blood tests done at the same time of day as earlier tests to remove that variable  from the equation.


I take the liberty of copying the email.

----------------------------

Hello Cass,


Thank you for your interest in Metabarol. One thing I would like to point out is that the researchers performing this study used the Scientific Method in designing and executing this study. In keeping with the Scientific Method, the study was designed such that as few variables as possible were modified or changed before and during the study such that there is maximal statistical power in determining if there indeed is a significant effect of an independent variable, which in this case is whether or not an EMS horse received Metabarol or placebo. The dependent variable in this study is the insulin level of the horse or concentration of inflammatory mediators present in the blood. Please see answers to your specific questions below.


Were the diets of the two groups identical before & during the study? 


Yes, the diets of the horses were identical before and during the study. All horses were maintained on a dry lot and fed only hay. The control group also received placebo (yeast, Sacharromyces cerevisiae, carrier in Metabarol) daily, while the treatment group received Metabarol daily. 


Were there diet changes during the study? What time of year? Were Metformin or levothyroxine administered?


The diets were not changed during the study. Changing the diet during the study would introduce a confounding variable. Metformin NOR levoythyroxine were not administered to control or treatment group horses.  The study was designed to determine if Metabarol administration reduced insulin levels in EMS horses. Therefore, there would be no reason to administer Metformin or Levothyroxine. The study was performed in Autumn.


The demonstrated capability of Metabarol to reduce insulin levels in EMS horses IS INDEPENDENT OF DIET. The reduction in insulin levels in EMS horses administered Metabarol daily (45 day study duration), versus placebo, was statistically significant at the alpha = 0.05 level. 


Thanks again for your interest in Metabarol. Have a great day!



Patrick Lawless PhD

President

Biological Prospects LLC


Office

449 Lewis Hargett Circle, Suite 190

Lexington, Kentucky 40503

(P) 866.721.1412

(F) 866.415.6808


Laboratory

University of Kentucky

ASTeCC Building

Room A346

145 Graham Avenue

Lexington, KY 40506-0286

89461 - 89480 of 282393