Date   

Re: High blood glucose question

Eleanor Kellon, VMD
 

Yes, she's diabetic.
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Eleanor in PA

www.drkellon.com

EC Owner 2001


Re: Hoof radiographs uploaded

Eleanor Kellon, VMD
 

Toe is good but heels eventually have to be much lower if possible.
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Eleanor in PA

www.drkellon.com

EC Owner 2001


Re: Hoof radiographs uploaded

Eleanor Kellon, VMD
 

On Fri, Jul 29, 2016 at 03:40 pm, Stephanie Stout wrote:

Is there a specific reason why gradual lowering by slowly lowering the wedges at each reset doesn't work?

If the heels have been high for a prolonged period, especially if there is also pain involved, the tendon-muscle unit is often shortened.  When you add injury and possible scarring it's even more complicated.  Shaving a bit off the heels every few days may be easier for the horse to take than a 3 to 5 degree change every 4 to 6 weeks, although honestly there is no guarantee that would work either.

The vet also said that she would like King in Natural Balance shoes with the wedge pads - agree or disagree? Would you reset every 4 weeks? 

There is a lot we don't know about his feet and haven't even seen photos from all angles so I don't feel comfortable saying much beyond general principles.  Why does he need pads and shoes?  Has he always had long upright feet?  Any abscessing?  What is the nature of the tendon injury?  Why was he so lame recently?  A natural balance shoe without a natural balance trim is not helpful.  The heels have to come down to a normal height and P3 in about a 5 degree angle with the ground before that system can be effective.

Where would I get the Devil's Claw that is IR safe? I know the local feed store has BL Solution/Bute-Less that has Devil's Claw but it also has Yucca in it.

Phyto-Quench is now Devil's Claw based.

Should I give both Previcox and Devil's Claw at the same time?

No.

Where would I get pure H/A also?

You were getting it from My Best Horse before.

Also, he is on J-herb, and ALCAR so should I take him off the herbs? 

Jiaogulan won't work with Previcox.  The ALCar is for neuropathic pain and can be continued.

On the film, the tip of his P3 has 2-3 'tips' instead of one solid point. What are those different tips? Is that arthritis?

Movement artifact and/or remodeling. Arthritis occurs at joints.


 
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Eleanor in PA

www.drkellon.com

EC Owner 2001


Re: panting and heat and cushings

Eleanor Kellon, VMD
 

It sounds like he's panting because of anhidrosis, inability to sweat and therefore inability to cool himself normally.  Anhidrosis can be a symptom of PPID but can also occur without it.
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Eleanor in PA

www.drkellon.com

EC Owner 2001


Re: panting and heat and cushings

Donna Powell
 


Hello, have you checked for being over heated? I too live where the temps. have actually reached 100. My draft was not sweating and would pant. Also a respiratory allergy will make them pant big time, more so than being over heated. Both have happened to my horse. Start by taking his temperature calling a vet too. 
Donna, Beaufort, SC, NRCPlus0213, NRCTherapy0413
HISTORY 8-will find new link shortly

On Fri, Jul 29, 2016 at 22:44, LJ Friedman via Groups.io
<luke4275@...> wrote:
Can a horse in no work that just stays in his  breezeway stall due to blindness, pant just because of uncontrolled cushings?   ( it his hot.. 90 plus degrees in so cal.) I know cold/heat regulation is affected by cushings.. I'm not sure if panting w/o sweating can be another sign of uncontrolled ppid... ( Jesse never panted so I have no experience with lack of cushings control and panting..
--

LJ Friedman San Diego Nov 2014


Re: panting and heat and cushings

Lorna Cane
 

I can't speak to the panting,with so few details.

But I've had 2 blind horses .They were able to be out with their friends. Maybe this horse would benefit from being able to move around.

We need to  move this to Horsekeeping if  the 'blindness' issue is continued.

There are also several groups for Blind Horses.


--

Lorna in Eastern Ontario,Canada
ECIR Moderator 2002



https://ecir.groups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf



Re: High blood glucose question

Maxine McArthur
 

On Fri, Jul 29, 2016 at 02:38 pm, Eleanor Kellon, VMD wrote:

Rise in blood glucose with PPID is secondary to the insulin resistance that it causes.  If the insulin resistance is not completely compensated for by increased insulin levels, glucose will be elevated.

Although I agree this level is higher than it should be, it's not high enough to cause any panic.  In fact, the only consequence of elevated BG I've consistently noted in horses is weight loss.  If there are other hyperglycemic consequences occurring they are not being noticed but it's also worth pointing out that human diabetics can run BG considerably higher than what the horses do.  I don't recall any horses being 200 or higher.

 Thank you, Dr Kellon. I think I'm getting a glimmering of understanding about this. I very much appreciate your advice.
--

Maxine and Indy

Canberra, Australia 2010

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy

https://ecir.groups.io/g/CaseHistory/album?id=933



Re: panting and heat and cushings

LJ Friedman
 

I did a panting search on ecir.. 9 hits came up, but I didnt see any info. Plenty of info on panting and dogs. not much on the web either, related to panting and cushings
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LJ Friedman San Diego Nov 2014


panting and heat and cushings

LJ Friedman
 

Can a horse in no work that just stays in his  breezeway stall due to blindness, pant just because of uncontrolled cushings?   ( it his hot.. 90 plus degrees in so cal.) I know cold/heat regulation is affected by cushings.. I'm not sure if panting w/o sweating can be another sign of uncontrolled ppid... ( Jesse never panted so I have no experience with lack of cushings control and panting..
--

LJ Friedman San Diego Nov 2014


Re: titrating prascend : first time a horse will be receiving this

LJ Friedman
 

Looks like they  will start treatment w/o getting labs..  titrate to 1mg. wait 3weeks and then do labs




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LJ Friedman San Diego Nov 2014


Re: titrating prascend : first time a horse will be receiving this

Lorna Cane
 

For me the missing detail would be the ACTH lab numbers.


--

Lorna in Eastern Ontario,Canada
ECIR Moderator 2002



https://ecir.groups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf



titrating prascend : first time a horse will be receiving this

LJ Friedman
 

I already know the answer to my question.  Half xxx measures yield half xx results.. ( forgot the exact wording)

I'm going to assist a friend start on the pergolide wave. I'll have her follow my lead.. start with prascend at 1mg and if dose needs to be increased , change over to comp pergolide for cost savings.

The question I ask concerns the splitting of the prascend tablet. It is scored to split in half very well. I'm tempted to start at ,50 mg for 3 days  and tirtrate up to 75 for 3 days and then remain at 1mg and go back is symptoms present. How much harm will I do if I skip the .25mg level. ( I dont want to syringe 25. etc) I havent split a tablet in quarters for several years. lj friedman san diego. 
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LJ Friedman San Diego Nov 2014


Re: Hoof radiographs uploaded

Stephanie Stout
 

I just uploaded the x-ray image from the vet to his photo folder with the vet's marks on what to trim off. It is much clearer than my cell phone pictures. Thank you again. 

https://ecir.groups.io/g/CaseHistory/album?id=1402

--
Stephanie & King
October 2014
Oregon
Case History 


Re: Hoof radiographs uploaded

Stephanie Stout
 

Is there a specific reason why gradual lowering by slowly lowering the wedges at each reset doesn't work? The vet also said that she would like King in Natural Balance shoes with the wedge pads - agree or disagree? Would you reset every 4 weeks? 

Where would I get the Devil's Claw that is IR safe? I know the local feed store has BL Solution/Bute-Less that has Devil's Claw but it also has Yucca in it. Should I give both Previcox and Devil's Claw at the same time? Where would I get pure H/A also? Also, he is on J-herb, and ALCAR so should I take him off the herbs? 

On the film, the tip of his P3 has 2-3 'tips' instead of one solid point. What are those different tips? Is that arthritis?

Thank you so very much. I will post the actual x-ray image when I get it so it's clearer to see. 
--
Stephanie & King
October 2014
Oregon
Case History 


Re: New Leptin baseline from Cornell

Lisa S
 

We got a shock earlier this year when they changed the insulin assay and didn't mention it on the report! Apparently they suggest adjusting the new values slightly downward to correspond with the older values (pre-spring 2016). 

--
Lisa 2010-06

NE TX

Zippy (IR) https://ECIR.groups.io/g/CaseHistory/files/Lisa%20and%20Zippy%20-%20Bunny%20-%20Rita

Bunny, and Rita - IR




Re: ACTH went up, maybe artificially?

Lisa S
 

Thanks for this info. 

What I would now really like is for Cornell to provide a discounted fee for those paired samples! I would be very inclined to test this way when I test Zippy for the first time post-pergolide as this will be his first fall to be dosed, and I would really like to optimize its effect.

Of course I have shared about my PPID pony who lived to 40 before we knew how to manage a PPID horse. He was on a small dose of compounded product that I left out in the sun, wind, and rain, and I was hardly faithful about dosing him daily. Still, in his case, some proved better than none: despite that fact that I did everything wrong, the pergolide (and a dry lot and a grazing muzzle--I wasn't a totally bad parent!) helped him live an extra 10 years, nearly all of them laminitis free. 

I am not one to give up if I can't do things perfectly, but I now try to control what I CAN, and not worry about what I can't!

--
Lisa 2010-06

NE TX

Zippy (IR) https://ECIR.groups.io/g/CaseHistory/files/Lisa%20and%20Zippy%20-%20Bunny%20-%20Rita

Bunny, and Rita - IR




Re: Hoof radiographs uploaded

Eleanor Kellon, VMD
 

I think your vet's plan is reasonable, although the wedging and gradual lowering (at each shoeing interval) doesn't always work.  Agree with the stated trim goals.  I've seen ringbone be remodeled after correct hoof form is in place but the changes in the coffin joint are likely permanent.  That dose of Previcox is too high.  Should be half that.  NSAIDs have the potential to interfere with bone healing and circulation but have no effect on IR.  All things considered I'd say he is a candidate for Previcox but you could also try high dose Devil's Claw instead.  I'd combine that with 200 mg/day hyaluronic acid.  The coffin joint changes aren't going to stabilize though until those heels come down and no wedging.
--

Eleanor in PA

www.drkellon.com

EC Owner 2001


Re: High blood glucose question

Maxine McArthur
 

I just got the insulin result--it's only 3mU/L. Does this mean she's diabetic? She probably didn't have much in her tummy at the time and she was standing around in the sun, but it's very low. 


--

Maxine and Indy

Canberra, Australia 2010

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy

https://ecir.groups.io/g/CaseHistory/album?id=933



Re: High blood glucose question

Maxine McArthur
 

Oh thank you, Lavinia! I feel a little less panicked now. First order of the day--get diet tightened. Good to know the non-shedding coat is not necessarily an indication of a problem.

Yes, you are right that we are coming into our spring now. Everyone around me is delighted at the new green grass, while I'm secretly plotting ways to kill it all. The mares are being very tarty. 

--

Maxine and Indy

Canberra, Australia 2010

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy

https://ecir.groups.io/g/CaseHistory/album?id=933



Re: High blood glucose question

Eleanor Kellon, VMD
 

Rise in blood glucose with PPID is secondary to the insulin resistance that it causes.  If the insulin resistance is not completely compensated for by increased insulin levels, glucose will be elevated.

Although I agree this level is higher than it should be, it's not high enough to cause any panic.  In fact, the only consequence of elevated BG I've consistently noted in horses is weight loss.  If there are other hyperglycemic consequences occurring they are not being noticed but it's also worth pointing out that human diabetics can run BG considerably higher than what the horses do.  I don't recall any horses being 200 or higher.

Back in the 1980s there were a report of pergolide suppressing insulin release and elevating glucose in rats:

http://www.ncbi.nlm.nih.gov/pubmed/6147289

and another showing no effect of pergolide:

http://www.ncbi.nlm.nih.gov/pubmed/6135620

Durham et al in Equine Veterinary Journal (2009) 41 (9) 924 - 929 reported on 3 horses with type 2 DM and pancreatic beta cell dysfunction (low insulin with hyperglycemia). One horse was diagnosed with PPID and started on pergolide.  After the first dose of pergolide there was a spike in insulin to 35 uIU/L and a drop in glucose from 14.1 mmol/L to 7.5 mmol/L.  Thereafter, glucose remained around 5 and insulin progressively dropped to a high of 5 after feeding.

An abstract in  2013 JEVS found that injection of 5 mg cabergoline in a slow release vehicle in nonPPID mare did not have any effect on IR or insulin response to glucose:

http://www.j-evs.com/article/S0737-0806(13)00198-6/fulltext?mobileUi=0

These two studies suggest that low dose pergolide is not likely to reduce insulin in horses but there is still a possibility that high doses may do so, especially since this study found low dose pergolide to stimulate insulin in rat pancreas (as Durham saw) while high dose suppresses the insulin response to glucose:

http://onlinelibrary.wiley.com/doi/10.1080/15216540600687993/full


--

Eleanor in PA

www.drkellon.com

EC Owner 2001

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