Date   

Re: Supplies

celestinefarm
 

Karen, condolences for your Nabreez. You did what you could for him and ultimately did what was in his best interest. May he fly free. I'm sure someone will want to take you up on your offer, Where are you located, someone local may want to simply pick up the APF from you.
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History


Re: Seasonal Rise

Eleanor Kellon, VMD
 

From the trend in his numbers and what you have seen in the feet it's definitely time to get aggressive about better control. He's had PPID for a number of years now and it's not unusual to see the IR progressing along with it despite his Tb genes!  Be prepared to go up more than 50%.

According to Cornell, upper limit of normal for leptin is 10 with the current assay.  His leptin creeping up is in parallel with how IR he has become.
--
Eleanor in PA

 

www.drkellon.com 

EC Owner 2001


Re: New IR Diagnosis

LM
 

I feel for you and you have taken on a tremendous job! Size 11, HOLY COW! I hope it is ok to comment here and if it's not just toss it out. I could not do without the extra foam mats fir them to stand on while working with their feet. There is one kind I would get from the surplus store near my old farm and the horses LOVED to stand on these. I was also going to say if for some reason you go with a clog the farrier can cast it on. And if you do an easy care glue on I can tell you we have preferred the N/G because it has the frog support , you can pack it with DIM or something else but that means you can access the sole if needed and you can also leave the wall uncovered and set the shoe back further easier than with a shell if that is helpful. You also have the choice of the heel stays to make it sturdier but less flexible.

I'm not suggesting anything just giving you some of our experience to maybe help you make the best choice. Also really be sure to measure the foot right after trim. Easycare will send you three of the closest sizes if nobody near you has a fit kit.
Wishing you guys success!


--
LM
March 2013
Ohio/Colorado


Re: New IR Diagnosis

Eleanor Kellon, VMD
 

Hi Kristen,

Hard to know where to start - but that's why we have DDT!  First of all, diet is never more important than trim.  They are both very important, particularly when talking about pain.  A bad trim can mechanically undo all the good.

D - DIAGNOSIS

You have a mildly elevated insulin and normal ACTH, especially considering age and time of year. I know it's more expensive but I would seriously consider repeating the blood work at Cornell with meticulous attention to sample handling.  Nothing is more expensive than incorrect treatment. In the meantime, no harm whatsoever in continuing him on an IR safe diet and your hays look fine but you need a complete mineral profile.

I have no problem with short term Thyro-L for horses that test low when first starting treatment but realize it will suppress his own thyroid function. I'm personally not in favor of the high dose treatments that induce hyperthyroidism.  Pergolide is not indicated from information available to date.  Fine to use ALCar with the Thyro-L. In fact, in humans high thyroid function depletes ALCar.

His breeding explains how you can have both EPSM and IR. The two conditions might actually be keeping each other in check to some extent. 

The cause of his foot pain is a very complicated question because any of the existing conditions, or any combination of them, could be doing it and nerve blocks can't really separate them out well. The sinking he has could easily be mechanical and he has no true rotation. Maybe the new films will provide some helpful information. Definitely need new hoof pictures.

D: DIET

ESC + starch looks fine but need mineral details. This is very important for hoof quality.  You might consider adding Jiaogulan.  If there is active laminitis pain it should help. Will also improve hoof growth and it's good for tendon issues.

T:  Trim

Pending new photos.
--
Eleanor in PA

 

www.drkellon.com 

EC Owner 2001


Re: Chaste Tree Berries

 

Hi Kathy

I don't stop chastetree berry.  My horses still get their winter coat and they don't resemble a hairy Yak.  I do blanket when the temperatures are 45 or below.

--
Jean and Amber (over the bridge)

 

South Carolina

August 2004

NRCPlus 0412; CIR 0813, 1211; NAT 0612

https://ecir.groups.io/g/CaseHistory/files/Gloria%20and%20Amber


Chaste Tree Berries

Kathy Thomas
 

I have been giving Donna chaste tree berries to help with shedding, and it worked well.  My question is, with fall just around the corner and the coat naturally getting fuzzier, when should I stop with the CTB?  Thanks!
--
Kathy 2017 and Donna

 

Harrowsmith, Ontario

https://ecir.groups.io/g/CaseHistory/files/Kathy%20and%20Donna


Re: New IR Diagnosis

Jane Fletcher
 

Oh dear, poor fella that sounds pretty sore. Lucky he has you to advocate for him. It's often not easy so best wishes.

Jane

Sent from my iPad

--
Jane, South East Western Australia
Nov 2016
Garnet and Bill


Re: New IR Diagnosis

Jane Fletcher
 

Can't believe how many years it has taken me to think of using mats!!

Jane

Sent from my iPad


--
Jane, South East Western Australia
Nov 2016
Garnet and Bill


Re: Seasonal Rise

Tara Sullivan
 

I am following this thread...very timely for Elf.  I recently posted about increasing his pergolide because his insulin is very high and acth is almost double what it was the year before.  And I deliberately checked before the expected seasonal rise.
As explained in another post...his diet could be tighter, but as long as his acth is high we will never experience a good insulin level.  He is not prone to laminitis...BUT...I just trimmed his feet and see a very slight disturbance at the white lines.  This pony has always had super strong laminar connections...and there is ever so slight a stretch.  RED FLAG!!  WARNING WARNING....

I am scheduled to run labs tomorrow....He is in week 4 on a tighter diet and increasing his pergolide by 50%.  So if I have interpreted correctly the advice of this thread....We should target an acth of 20 or better.  And if insulin is still high....keep tweaking diet. 
Question about the IR calculator...it doesn't seem to tell me anything when I plug in leptin. 

Thanks guys!! 
Tara And Elf 2015

https://ecir.groups.io/g/CaseHistory/files/Tara%20and%20Elf


can't open case history file

millionairess1989
 

I need to do a new case history for Mill, but I can't get the file to open. I click on open or open and save but nothing works. Help please! I'm not sure where our old case history was. 

Jennifer & Mill
Middle TN
~2010


What made you test for PPID in the first place?

Casey76
 

I've had a tough year horse-wise.  My vet thinks I'm a bit of a paranoid hypochondriac.

When Blitz had his first major episode of laminitis - which I'm still convinced was precipitated by the trim he was given - I asked my vet if he could check the ACTH, and he refused, saying B was far too young, and isn't exhibiting any symptoms.  I'm just wondering, what if the symptoms are very subtle?

He doesn't have any fat pads, but conversely, he has always had filled supraorbital fossas (not puffy, but not indented either).  He doesn't have a "fatty" sheath, but he produces an extreme amount of smegma, and he has a tendency to get a swollen sheath. Despite being barefoot all of his life, he has always been tender footed, especially after being trimmed, and has likely had subclinical laminitis for a long time even though he has never had access to much grass.

It has just been confirmed that B has PSSM/EPSM though he is virtually asymptomatic at present (high resting muscle enzymes and slight muscle atrophy despite correct training are the only signs at present).

I know that it is the prime time to test for ACTH anomalies at the moment, and I really want to get to the bottom of B's ongoing foot soreness.  Would I be completely mad to ask for him to be tested?  Blitz is 6yrs and 2 months old.
--
Katrina

 

Mar 2017, Alsace, France

Tartine Case History: https://ecir.groups.io/g/CaseHistory/files/Katrina%20and%20Tartine

Tartine Photos: https://ecir.groups.io/g/CaseHistory/album?id=4725

Blitz (non-IR) foot photos https://ecir.groups.io/g/Hoof/album?id=4743&p=Name,,,50,2,0,0 



Volunteers Needed!, Mon, 8/28/17 #cal-notice

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

Volunteers Needed!

When:
Monday, 28 August 2017

Where:
At your computer

Description:

Everything you learn from the ECIR outreach groups is the result of many hardworking people from all backgrounds who share the passion for our special horses. The ECIR group is made up of veterinarians, farriers, nutritionists, and medical doctors. There are those of us who do not have scientific backgrounds, but are everyday horse owners who found our way to ECIR when we didn’t know where to turn.

ECIR Group is over 9,000 international members on Groups.io outreach alone.  By collecting histories and laboratory data from thousands of horses with PPID and IR, we have been able to carefully monitor responses to treatment and management changes, both good and bad. This is real life, in-the-barn, research at its best. It is also the largest field trial in the world.  No one else has what the ECIR Group has.

There is much more to come. This work can not be done without the help of a growing group of passionate volunteers, many of whom you have never seen. We are all educators who make our world a better place by sharing the knowledge we gain from our experiences and our skill sets. 


If you have the time and passion to give back to the ECIR Group,

we want to hear from you!

Please fill out the Volunteer Form


Time commitment will vary from ongoing projects and tasks to specific short-term needs. 



Re: New IR Diagnosis

Kristen Singh
 

Hi Lavinia,

No thyroid test was done. The vet wanted to trial the Thyroid L to help with insulin. The horse does have a cresty neck so he mentioned weight loss as well.

The other vet that drew labs wants to trial Pergolide. Both vets agree the horse has insulin dysregulation.

This horse has always had lameness issues since purchase over 3 years ago particularly in the RF. He is on and off lame all year with bouts of laminitis at least once a year. He has not been shod always barefoot or booted with me. 

I just sent an email to Dairy One asking for the additional trainer 603 test on my recent sample. I will let you know the outcome.

Thank you Jane for the tip on padding! I have a cushy stall mat in the barn but I made the mistake of taking both mac boots off last Sunday to air them out and wash them and the poor guy was too sore to get them back on both feet. He has been so sore that even wearing boots, he can't lift the "good foot" to stand on the bad one if that makes sense.

Today, I was so relieved that I got both off and on so I can check and double pad the macs. He is better tonite than he has been which is a relief.

Lavinia,
I am very wary about the clogs which is why I'm glad you responded to my comment about it. I am capable of trimming but I feel inferior to deal with the magnitude of issues in his right foot. I guess I don't want to make it worse. Perhaps, my trim is causing some of this. Would a glue on clog or synthetic be better? Like an easy boot shell? I don't want to affix something at all like ashoe or clog tbh. I'm needing expert assistance with the trim at this point. This is a big boy and these macs are not going to hold up long (size11).

Thank you for the links. I'm going to read them now. I hope I answered all your questions. I'm interested in hearing Dr. Kellon's take on this case. I'm determined to get this under control. And I'm perplexed now about icing. The vet said to ice all I want and it is the only thing that helps laminitis and not to do bute. As soon as xrays are available, I'll be adding to his CH file and I'll let you know.




--


Kristen 06/10

AZ

Thor

Case History


Thor's Photos

 


Supplies

karen larson
 

Some of you may remember my frantic messages from several weeks ago about my gelding Nabreez.  He started having balance problems after increasing his pergolide dose and unfortunately it continued to get worse.  After having him go down several times and being unable to get up, I had him euthanized on the 9th.  So, I don't know if this is allowed or not, but I have nearly a full bottle of APF Pro - I think he had 4 or 5 eight ml. doses and this is a 12 oz. bottle.  I will sell at a good price if someone needs it.  Just email me privately or if this post is not permitted, my apologies..


Re: New IR Diagnosis

Lavinia Fiscaletti
 

Great idea, Jane.

You can use any kind of padding you may have available - anti fatigue mats, a piece of carpet, garden kneeling pads, a folded up saddle pad are other ideas.
--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team


Re: New IR Diagnosis

Lavinia Fiscaletti
 

Hi Kristen,

You are an angel for having taken this boy on and he is lucky to have you as his caretaker.

Will need to have Dr. Kellon take a look at the blood work and address the PSSM and IR issues for you. In the meanwhile, can you please clarify a couple of things:

There do not appear to be any thyroid test results in the blood work - were these done? If not, why is Thyro-L being started? It may help in jump starting a sluggish metabolism temporarily to increase weight loss but the effect is temporary as the body will then down-regulate natural production of thyroid hormones to compensate. It is not a treatment for IR as IR is not caused by thyroid issues. Even IF the thyroid hormones were low, this is generally secondary to other issues as primary hypothyroidism is extremely rare in horses. Dietary mineral imbalances - esp deficiencies of iodine and selenium which will affect the thyroid - are very common. Fix the diet and the thyroid will then fix itself.

The hay analysis is only a partial one. It doesn't have magnesium or any of the trace minerals included so it is not comprehensive enough for mineral balancing. As you just had this run, could you call EA and ask them to run the rest of the # 603 Trainer test so you have a more complete profile?

Pergolide is used to treat PPID. It can secondarily help manage IR if the PPID is the driving factor behind insulin levels that won't come down but is not a treatment for IR in and of itself.

Is the current lameness in the RF a new development or worsening of a previous problem? Is he lame regularly to some degree or does he have periods of soundness mixed in? It sounds as if he goes lame at the same time each year rather than being lame at all times.

Diet and trim are both legs on the same stool - either one can make the stool wobble if it isn't the right height. Fixing the diet won't overcome any mechanical problems while addressing the trim won't eliminate any dietary issues. You'll need to cover both to get the best outcome.

NSAIDs usually have little to no effect on laminitis pain as it comes from a different type of cellular reaction than what the NSAIDs can control. See Dr. Kellon's Endothelin-1 in Laminitis from the No Laminitis Conference Proceedings 2013  for more info:

https://www.ecirhorse.org/proceedings-2013.php

Take a look here for alternatives to try:

https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives

If you are dealing with laminitis, icing is not recommended. More info in the above file.

How well are the Old Macs doing in keeping Thor comfortable? Generally, we don't recommend appliances for laminitic feet as they make it difficult to do the frequent trim adjustments that are needed to keep the hoof capsule at it's optimum shape. Unfortunately, many times clogs get applied instead of putting a realigning trim in place so they can make the situation worse. There are times, however, when an appliance may be appropriate. Will need to see the latest xrays and pix to really be able to make recommendations in this case.

Hang in there.
--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team


Re: Jesse and return to work allowed??

LJ Friedman
 

Here are the other videos of  that session

https://youtu.be/c5Px0jTUQjs


-- https://youtu.be/VyPlRb0kbrs

Jesse has been worked without boots as well.,typically alternating boots on and boots off.. . Will film that next time he goes w/o boots.. 

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: New IR Diagnosis

Jane Fletcher
 

Just a comment to sneak in! My two horses are sore when doing their feet. I know you can leave a boot on the foot you aren't trimming but I like to swap between the two front feet. I have started putting 2 camping type mats ( we get them at camping stores in Australia that people stand on when they shower) under their front feet. It has made a huge difference to how long they hold their foot up. Plus they are putting it down on a clean surface. I always let them take their foot back when they choose but they now take it back gentler and hold it up longer. Obviously our first consideration is safety so don't do if you think your horse would be scared etc. best wishes.

Jane

Sent from my iPad

--
Jane, South East Western Australia
Nov 2016
Garnet and Bill


Re: new hoof photos for smokey and regina

regina bruno
 


Re: Adding herbs etc to a forever hi insulin horse? in a do no harm fashon.. suggestions please

LJ Friedman
 

YES
--  willl get that done..  

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

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