Date   

Re: Prasend affect on immune system? Success of chewable flavored pergolide

 

Hi, Joan - I just want to chime in and agree with what Lorna and Maggie have said.  Sonny is so very clearly PPID (Cushing's) that taking him off pergolide would be exactly the same as removing insulin injections from a Type 1 Diabetic, or preventing a clinically depressed person from having their anti-depressants. The outcome could not possibly be good. Pergolide side-effects in the horse are pretty minimal, and usually restricted to the first week or so (lethargy, lack of appetite, etc). The heart-valve dysfunction that happened to some humans on pergolide has been shown to be dose-dependent, and even horses at the highest doses in our data base don't come close to the mg per kg body weight that some humans were taking.

The side effects of PPID, on the other hand, are very well documented, and can be truly terrible, including persistent infection (due to suppressed immune system); laminitis; and feeling lousy. There is muscle loss, weight loss, and weakness. Some of them show depressed appetites. There have been a small number of horses seen on this list who died from infection after the owner stopped using pergolide because of an inaccurate perception that using drugs was bad, or that pergolide might be "toxic".

BI, that manufactures Prascend, has had a very aggressive marketing scheme aimed at vets, including letters saying that compounded pergolide is illegal, unethical, and much like boiling babies. Their marketing is impressive, I will say. However, compounding pharmacies that have butted heads with the FDA have won. If your vet is concerned, all he or she needs to do is write a script for "pergolide", instead of for "Prascend". You then take it to the pharmacy, or the vet's office faxes it to the pharmacy, and the vet is totally in the clear. If the vet's office were to try to sell compounded pergolide, that would definitely be illegal (for a variety of reasons). However, providing a script is perfectly safe.

Hang in there.
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Re: Jesse,, new cornell labs just reported

LJ Friedman
 

I asked pethealth to fax my vet to get 16.0mg..  I got this response from the vet:


Jesse's last test came back and was quite normal.  I realize you consult with another veterinarian on this.  I feel his dose is right where it should be and I do not feel we should increase it at this time
I replied back:
 

I would like to increase to 16 mg now and retest in July
I got back jesses labs today. His ACTH was 26.0 . (Normal values  are 9 to 35 ) Because of  this value,  I will be raising his pergolide   He is currently on 14 mg and I will increase him to 16 Mg   )The reason is the month of June has the lowest pressure on ACTH   Dr. kellon  likes to see readings in the teens  to low 20s. At all times. A Reading of 26.0  on 14 mg  in june, would never remain that low for jesse  in October , when most laminitis   occurs as that is the time of year when there is most pressure on ACTH levels    
  (this reply I sent my vet was a copy/paste of  an email that I sent to a vet friend who I am helping with her ppid horse.. I didnt want to tell her that she needs to increase her pergolide,, so I offered info pn what and why I was doing  and she agreed it made sense)

 My vets reply was reasonable..I will see if he ok's the rx increase after he reads my reply, and will let the group know

MY QUESTION.
If he doesnt send in the increase and Jesse remains on 14mg, when should I re test to show the presumed increase in acth?
He's a nice vet.. and one cant argue with his response. 
I posted this just so others can see how I communicate with  my  local vets. 
--

LJ Friedman  Nov 2014  San Diego, CA

 

 

https://ecir.groups.io/g/CaseHistory/album?id=2117 

.https://ecir.groups.io/g/CaseHistory/files/LJ%20and%20Jesse


Re: Missing a dose of Pergolide and other Pergolide questions

 

It all depends on when you noticed that you missed the dose. If it is within 12 to 15 hours of the next dose, then just wait and do the next dose. If it is more than 12 hours, then dose, and do the regular dose at the regular time. Note: if your horse is new to pergolide, or very sensitive to changes in the dose, then just skip, and do the regular next dose.

It is fine to dissolve the tablet in water. Mixing with food works great if the bowl is licked clean.
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Re: Does Cornell do lab work for other labs?

 

All labs will outsource blood if they don't have the equipment to do certain tests, so you can get the blood pulled, and then either direct send to Cornell (serum and plasma well frozen, and lots of ice in the package); or send to the regular lab and request a forward to Cornell. The extra step to the local lab leaves more potential for mess-ups, regarding the blood getting thawed and then re-frozen; going through two labs is always more expensive for the actual blood work; sending direct to Cornell from your area will cost more for the courier. 
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Re: Pergolide dose prior to blood draw??

 

Hi, Sara - such good questions!  And, of course, we need lots more research in order to pin down firm answers to these questions. 

If you draw blood before the first pergolide dose of the day, you will be getting the "trough" results for pergolide, and the "peak" results for ACTH.  Pulling blood somewhere between 5 and 12 hours after the pergolide dose will give ACTH results that likely reflect what is going on for most of the day.  So..... if you pull blood before giving the pergolide, and the ACTH is in a nice range (low- to mid-normal), then all is well. If it is a hair higher, then you might still be okay. If it is high-end normal or above normal, you at least know for sure that you have got to increase the pergolide.  For blood pulled 5 to 12 hours after the pergolide dose, aim for ACTH 20 ng/mL or below.

In an ideal world, you would give your pergolide at the usual time of 7:30 am or so, then get the blood pulled sometime after 1 pm.  If this were me, I would give the pergolide at 6:30 (6:00 would be even better), and then keep the vet chatting for a half hour or so before the blood pull.
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Re: gas colic due to Prascend?

 

Hi, Mary, and welcome to the list!  Great job on the case history - thank you so much.
 
For your first concern with the pergolide veil: Booker would appear to be very early PPID (Cushing's), and so may be more reactive to the sudden starting of 1 mg pergolide (Prascend). It is so nice to see people being pro-active, and testing yearly.  The gassiness may be due to the change in his eating habits, or it could be due to the Prascend. Also, some horses get gassy on yeast, which is in the Cur-Ost Total Support. If the gas is new, however, it is likely not due to that.
 
If Booker were mine, I would cut the Prascend dose to 0.25 mg daily to start with, and also order APF or APF Pro  https://www.biostarus.com/products/optimum-eq-senior?variant=19273093126  This is the safest time of year to reduce the Prascend dose and then start to increase again, as this is the time of year when horses have the lowest levels of ACTH.
 
You can achieve the 0.25 mg of Prascend by cutting the tablet in half. Then dissolve the half in, say, 5 cc's of water (measured with a syringe). Suck up 2.5 cc's in one syringe, and put it in the fridge.  Suck up the other 2.5 cc's of mixed Prascend and water, and that is his daily dose. 
 
Since he seems quite sensitive to the Prascend, I would keep him on that 0.25 mg daily until the APF arrives. Giving APF or APF Pro has been shown to reduce or eliminate the pergolide veil.
 
Once the APF arrives, start administering that daily (directions are on the Valley Vet website, although that is not the only place to buy it).  Give Booker 0.5 mg of Prascend daily (MUCH easier, as that is half a tablet). Do that for a week or 8 days, then increase to 0.75 mg daily (half a tab  plus a syringe with 0.25 mg in it). If that goes well, you only need do that for 4 days. Then go to the 1 mg.
 
If at any time he looks "off" again, reduce to the dose he tolerates well. NB, you will more than likely have to increase to at least 1 mg for the seasonal rise, which should begin in early September (for normal and early Cushing's horses; full-blown Cushing's horses will often start ramping up the ACTH in July).  Since he is testing as very early Cushing's, he may even only need pergolide from August through April.
 
The list philosophy is Diagnosis, Diet, Trim and Exercise. This provides a nice systematic way to approach metabolic/endocrine problems, and laminitis.
 
May I ask, was the blood pulled after an overnight fast?  If he was fasted for the blood pull, then the insulin number is falsely low, and he is likely rather more IR than those most recent numbers suggest.  I believe it would be prudent to treat him as fully IR, rather than compensated IR, for now, until evidence suggests otherwise.   Here is the protocol for blood pulling:  Blood should be pulled from a non-fasting horse (or pony) in a quiet barn; blood spun, separated, and frozen or chilled asap, then sent to the lab at Cornell on ice; or to University of Guelph if in Canada. Ask for insulin, glucose, and leptin, and ACTH. The blood for the ACTH goes into purple-topped tubes; for the other analytes it goes into red-topped tubes.  

 

More information at these locations: 

https://ecir.groups.io/g/main/files/2%20DDT%20-%20%20The%20Diet%20Diagnosis%20and%20Trim%20Protocol/DDT%20Diagnosis.pdf 

https://ecir.groups.io/g/main/files/4%20Insulin%20Resistance/2%20Diagnosing%20Insulin%20Resistance%202012.pdf 

https://ecir.groups.io/g/main/files/Blood%20Testing%20for%20IR%20and%20PPID

In cases where horses have had Lyme disease before, or where they live in Lyme endemic areas (and the New England states are pretty much Lyme Central), it is prudent to check Lyme status once a year via the Multi-Plex Lyme panel from Cornell.

Diet is supremely important, in some ways more for what is not fed: no pasture, sweet feeds, oats/grain, carrots, apples, iron-containing supplements.  Diet consists of grass hay or haylage, with ESC (soluble sugars) and starch of less than 10%, plus minerals balanced to the forage, plus vitamin E, salt, and flaxseed or flaxseed oil.  One can use a carrier of beet pulp (rinsed, soaked, and rinsed) as a safe feed to get the supplements in.   The Temporary Emergency Diet uses hay soaked for 1 hour in cold water, or 30 minutes in hot water, with the water drained where the horses can't get at it; plus vitamin E, salt, and ground flaxseed in a safe carrier such as beet pulp (rinsed, soaked, rinsed).  More info on Temporary Emergency Diet here: 

https://ecir.groups.io/g/main/files/2%20DDT%20-%20%20The%20Diet%20Diagnosis%20and%20Trim%20Protocol/DDT%20Diet.pdf 

 Here is where we can do some tightening up.  Once you have been reading posts from other members, and dipping into the files, you will find your antennae for detecting products that are not good for IR horses  become finely tuned.

HIlton Herballs:  http://thehealingbarn.com/hilton-herbs-herballs-2/  I am pretty sure I managed to find the sugar and starch content of these once, but it was a struggle. However, the ingredients will tell you that these are in no way suitable for an IR horse:   Alfalfa, Wheat Flour and Linseed, mixed with generous quantities of Garlic, Mint, Oregano, and Rosemary with no sugar added!  Starch packs a bigger punch that sucrose, because starch can be broken down into 100% glucose. Wheat flour is chock full of starch.  You may be tempted to think that such a tiny amount of the Herballs couldn't make a difference, but I have personally seen just an apple or a few carrots a day cause continued foot pain in an IR horse, and this has been noted by other members of the list time and time again.

Biostar Optimum EQ Senior: https://www.biostarus.com/products/optimum-eq-senior?variant=19273093126   Well.......  it provides stuff you don't really need at all, and which could be detrimental (oranges, carrots, apples, etc), and doesn't provide much of what you really do need. There isn't enough copper, zinc, selenium or iodine  in there to keep a gnat alive. Complete waste of money. Nice marketing, though.

Cur-Ost EQ Adapt and Calm: I have no issues with that, but Ashwaganda can be purchased from Herbalcom.com at http://www.herbalcom.com/store.php3?list=cats&session=29e6a64de82648084874071bc3f233ef  for $9.20 per pound, a considerable savings. 

Same comment for the EQ Stomach. Probably very helpful, but might be cheaper to buy the ingredients elsewhere.

Regarding Cur-Ost Total Support, https://www.nouvelleresearch.com/index.php/products/equine-formulas/cur-ost-eq-total-support  I am always very skeptical of products that promise lots:  All in one formula that also targets conditions associated with poor digestive health including laminitis, COPD, allergies and eye conditions.   And I am a bit toe-curled by the mushroom inclusions. This product, if it is helping, is doing so via the cucurmin.

Good, optimal, immune function starts with providing the minerals and vitamins necessary for the body to manufacture the enzymes and hormones needed to keep the body working; ditto to make good skin and coat to provide a barrier to external insults; and not giving stuff that might compromise function (like iron).  To this end, balancing vitamins and minerals to your hay is the best solution.  All hays are deficient in copper, zinc and iodine (except those grown where there is sea spray - they may have sufficient iodine). Many hays are deficient in selenium, magnesium and phosphorus. Some hays are deficient in manganese.  Most hays have too much iron, which interferes with the absorption of copper and zinc.  Below is a list of acceptable ration balancers that will do nothing but good (but are still not as good as a hay analysis and balance)These have no added iron.:

Uckele U-Balance Foundation  http://equine.uckele.com/vitamin-mineral/u-balance-foundation.html

 

California Trace Plus  http://www.californiatrace.com/catraceplus.html

 

Colorado Mix  (no selenium) https://horsetech.com/equine-supplements/custom-non-stock-products/colorado-mix

 

Colorado Se Mix https://horsetech.com/equine-supplements/custom-non-stock-products/colorado-se-mix

  

VermontBlend   https://customequinenutrition.com/collections/supplements/products/local-blend

 

  For areas where added manganese is necessary:

 

Equi-VM  http://equine.uckele.com/vitamin-mineral/equi-vm.html

 

Sport Horse Grass  http://equine.uckele.com/vitamin-mineral/sport-horse-grass.html

 

Equi-Base Grass  http://equine.uckele.com/vitamin-mineral/equi-base-grass.html

 

Arizona Copper Complete (contains manganese)  https://horsetech.com/equine-supplements/custom-non-stock-products/arizona-copper-complete

 

Note that one should find out if one is in an area needing selenium, or if you are in a selenium-rich area; the same applies to manganese. Your agricultural extension office should be able to tell you.

 

Now, regarding treats and carriers to put the vitamins and minerals in, here is a list of safe bagged feeds. Excepting the beet pulp and soy hull pellets (which need to be soaked, and are fine as carriers but too messy as treats), any can be safely used as treats.

 

Rinsed/soaked/rinsed non-molassed beet pulp pellets  (various)

 

Soy hull pellets (various)

 

 Nuzu Stabul 1 (available at Tractor Supply)  http://stabul1.com/stabul-1/

 

ODTB cubes = TC Naturals Timothy Balance cubes http://www.ontariodehy.com/tab02-07.htm

 

LMF Low NSC Stage 1  http://lmffeeds.com/low-nsc-stage-1/ 

 

LMF Low NSC Complete http://lmffeeds.com/low-nsc-complete/  

 

(LMF Senior Low Carb: fat too high at 8%)

 

Haystack Low Carb/Low Fat Pellets  http://haystackfeeds.com/?page_id=69 

 

What you are looking for in safe feeds is an ESC + starch of less than 10%, with the starch content being less than 4%, and no added iron (which often hides under the name "ferrous" : ferrous sulfate, etc)

 

Trim is also a very important component, and often overlooked. When you get a chance, take some photos of Booker's body condition (side shot, neck shot, behind shot); and the hooves. Info on good hoof and body photos can be found on the Wiki page:  https://ecir.groups.io/g/main/wiki/home#Photos-and-Hoof-Evaluation-Help       

 

Exercise is a great insulin buster, but with Booker you obviously have to be careful due to his previous tendon issues.

 

Ask any and all questions, and, again, welcome!

 

 

 

 

 

 

 

 

 
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Update Your Information PLEASE!, Wed, 6/7/17 #cal-notice

main@ECIR.groups.io Calendar <noreply@...>
 

Update Your Information PLEASE!

When:
Wednesday, 7 June 2017

Description:

Case histories not only aid in monitoring and effectively managing your equine but a well documented and up to date case history is invaluable in an emergency. It also demonstrates to any veterinary or hoof care professional viewing it online or live at the stable, that you are dedicated to an evidence-based health program for your equine’s welfare.  Changes in food amounts, medication, dosages, supplements, over time show not just that you are serious about your equine's health but patterns that confirm or deny the ECIR protocols.  


Please don't wait until you need help, update your case history today so if an emergency crops up next week, you can get support quickly and need only concentrate on helping your horse.  


While you are thinking about updating don't forget the databases:

Pergolide Dosage Database 

Enter your informationUpdate your entry, View your entry (you may need to request access) or View the statistics.   


Regional Members Database  

Enter your contact information, Update your entry or View the database. 


CTB Database

Enter your informationUpdate your entry or View the database (you may need to request access).


International Safe Feed Sources 

Enter your local storeUpdate an entry, or View the International Safe Feeds Sources.


Thank you for your cooperation.

 

Owners, Moderators & Primary Response Team of the Equine Cushings List


gas colic due to Prascend?

M.D. Stephenson
 

 Hi- I recently joined the ECIR group as my horse last month was diagnosed with Cushings and put on Prascend, 1 mgm.
The Prescend was given every other day for the first week and the daily since for the last 4 weeks.

I have not yet entered all my data and entered pictures.  I will be getting his hay analyzed next week and had planned on doing the postings after the analysis came back.  
My case history is under Booker and Mary.

Booker has shown pergolide veil signs, lack of appetite and lethargy.   
Tonight it is colder here with rain and over the past few days a low pressure front has dropped the barometric pressure.
Tonight he  showed signs of gas colic.

I am wondering if the 1 mgm dose is too much or if the two are related or if anyone else has had gas colics occur.

Thank you in advance for seeing that this question gets where it should and I look forward to your response. You are a wonderful group of people. 

Mary Stephenson --  Fairfield CT

Horse:  Booker
https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Booker/Bookers%20Case%20History%20Form.pdf


Pergolide dose prior to blood draw??

Sara Gooch
 

I have blood draws tomorrow that will be sent to Cornell to see if current dosage of pergolide is still keeping ACTH levels in the low to  mid- range. Blood draw is at 10:30 a.m.  I know the feeding protocol, but my vet and I are wondering if current dose of pergolide should be given at regular time around 7:30 or 8:00 a.m., prior to the blood draw at 10:30 a.m.?   Would giving the current pergolide dose as usual prior to the blood draw make an artificial temporary ACTH spike in the blood-draw sample? Should I give the pergolide earlier, when I first give the hay around 6:30 a.m.?  Or Should I wait to give the pergolide until after the blood draw?  My vet wasn't sure. I'm lucky in that my vet has great respect and gratitude for this group and what it stands for.  Thanks from both of  us.    

Sara,  2011, Northeast California 


Re: chasteberry in a multiple herb formula

Lorna Cane
 

Sure,that would be fine.

I Googled Chaste tree berry supplier Canada,and came up with this:
https://www.botanicplanet.ca/chaste-berry-powder-2328

There are more entries, in case you haven't already ordered from Apple.

--

Lorna in Eastern Ontario, Canada
ECIR Moderator 2002

 

 


Re: chasteberry in a multiple herb formula

Karen Warne
 
Edited


Re: Digest not working?

Sandy Carr
 

Heh-heh...I guess it "heard" me.
--
Sandy

 

March 2017, Corona, New Mexico, USA

Case History:  https://ecir.groups.io/g/CaseHistory/files/Sandy%20and%20Andy . 
                        https://ecir.groups.io/g/CaseHistory/album?id=6171 .


Re: Cresty, lumpy neck

Sandy Carr
 

Dawn....agree!  I've been looking at the mess of a job of trimming my EX-trimmer has been doing for 4 years. Now looking at a correct trim I am amazed.  Of course, the EX-trimmer says the horse never presented her with the opportunity to build depth in his sole or grow enough toe to back it up --- in 4 years.  Wow, it's the horse's fault? Sad.
--
Sandy

 

March 2017, Corona, New Mexico, USA

Case History:  https://ecir.groups.io/g/CaseHistory/files/Sandy%20and%20Andy . 
                        https://ecir.groups.io/g/CaseHistory/album?id=6171 .


Does Cornell do lab work for other labs?

Sandy Carr
 

I'm trying to get my vet to be set up for a blood draw for ACTH, glucose, insulin AND leptin prior to the seasonal rise.  She said maybe her lab (name unknown) sends those tests to Cornell, or would.  (We live in New Mexico.) Is that a possibility or should I encourage her to just "git 'er done" now?

Thank you!
--
Sandy

 

March 2017, Corona, New Mexico, USA

Case History:  https://ecir.groups.io/g/CaseHistory/files/Sandy%20and%20Andy . 
                        https://ecir.groups.io/g/CaseHistory/album?id=6171 .


Digest not working?

Sandy Carr
 

Just curious.  I see up to 10 messages since midnight last night and have not received a digest today at all.  Usually by mid-afternoon I've had two or so.  In case something is wrong I thought I'd mention it.  I can always go to the running list of course...thanks!
--
Sandy

 

March 2017, Corona, New Mexico, USA

Case History:  https://ecir.groups.io/g/CaseHistory/files/Sandy%20and%20Andy . 
                        https://ecir.groups.io/g/CaseHistory/album?id=6171 .


Re: Jesse,, new cornell labs just reported

 

I agree with you: slow increase, aim at 16 mg.

Jesse is a lucky guy to have you!
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 


Re: chasteberry in a multiple herb formula

Alexandra Wilz
 

thanks unfortunately the chasteberry in the Apple Saddlery is solde out at the moment , that's why I wondered to continue to give the combination  Feistymare:
7.5gr of chasteberry, 7.5g lemon balm, 9 gr chamomile, 3 gr Thyme, 3,0gr Aniseed-- even if I give only 15g per day for the moment till I get the chastebeery pure!

Alexandra Wilz

 

May 2017 

Québec , Canada
https://ecir.groups.io/g/CaseHistory/album?id=6014

https://ecir.groups.io/g/CaseHistory/files/Alexandra%20and%20Perla


Re: Jesse,, new cornell labs just reported

LJ Friedman
 


Missing a dose of Pergolide and other Pergolide questions

Lynnae Englund
 
Edited

If you miss a dose of Pergolide should you give as soon as you can, then the next dose at regular time? Or just give the next dose as usual?
I am melting the tablet in a couple teaspoons of water then mixing with the beet shreds. All is eaten. Is it ok to melt the tablet? It is used within 5 or 10 minutes. 

Thank you.
--
Lynnae

Stormy

May 2017

https://ecir.groups.io/g/CaseHistory/filessearch?q=Lynnae

 


Re: Cresty, lumpy neck

celestinefarm
 

I saw a great before and after photo yesterday of a horse's crest and fat neck on the Vermont Blend website that was linked here yesterday. I think sometimes, if all you see is fat horses or incorrectly trimmed feet, your eye becomes adjusted to that look and it's difficult to discern what is correct and what isn't. These photos on the testimonial page are a great eye trainer of what should be. https://customequinenutrition.com/pages/testamonials
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

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