Date   

Re: Searching archives and interpreting ACTH results in fall

Lavinia Fiscaletti
 
Edited

Hi Kathy,

I sure do remember you and Magic. Welcome back, sorry you find yourself in need again.

A couple of questions for you: what were the results of the insulin/glucose tests? Where was the blood work sent?

Testing during the seasonal rise is fine to check the status of an already confirmed PPID horse. Testing for the first time can be a bit of a grey area. Grayson's results are hinting at early PPID but aren't undeniably positive as older horses in general tend to have ACTH levels that are somewhat higher than young horses show. Whether to start him on pergolide or not is a bit of a judgement call at this time as seasonal rise is peaking now, with ACTH also topping out and starting to drop over the next month for non-PPID horses. If you opt to start him, definitely titrate up the dose. A small dose of pergolide is not likely to hurt even if he isn't PPID, may help, and could be stopped after the rise period in order to retest without the seasonal influence in play. Because he has had no signs of laminitis, you could probably just make sure the diet is really tight and opt not to start the perg now then plan to retest him after the rise or in April for a more definitive answer. I know, clear as mud :(

Compounded pergolide is available with a script but now that the patented, equine version Prascend is on the market, many vets don't want to prescribe the compounded. Here's the list of compounding pharmacies that members have used successfully should you go that route:

https://ecir.groups.io/g/main/wiki/ECIR-Links

He's definitely IR but without a leptin test it's unclear whether this is baseline IR or only being driven by the seasonal rise. Being a TWH makes it more likely he's baseline IR and the seasonal influence has exacerbated that tendency even without PPID. You're already working on getting the weight down. Good on stopping the Senior feed. The TC ESC+starch numbers are only averages - not a guaranteed analysis for every batch. Whether it is a good match for your hay or not is unknown unless you have an anaylsis for the hay. If the alfalfa isn't bothering his feet, no problem to keep using it as long as you are taking it into account in the mineral balancing as it is adding significant calcium to his ration (6-7g per pound). G

Crest should soften fairly quickly, esp if it is a new symptom, once the diet is tight enough and he loses the extra pounds as that is an IR symptom. Make sure the muzzle is sealed - no grass - for turnout. Be careful not to cut his hay allotment back too quickly to lose the weight as that can backfire on you by having his system go into thinking "starvation". Feed him either 2% of his ideal weight or 1.5% of his current weight in soaked hay daily - whichever amount is larger. Adjust downward as he loses weight.

HTH.

--
Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team


Re: Pet Health Pharmacy

Eva
 

As a pharmacist I'll say - you cannot write for a branded product which has no substitutions and expect to get a substitution - even if you write a note - it would need to be clarified.  Pharmacists cannot guess at the intention of the proscriber.  And you wouldnt want them to.  Your vet did not write as Jani recommended above.  "x mg of pergolide as pergolide mesylate".  Perhaps the Vets local pharmacy has worked with this vet before and knows how to clarify for legality - but by law the pharmacy cannot do what the vet wrote.  It sounds like the pharmacy tried to clarify and most likely it was a tech talking to a tech which further confused the issue.  If you are calling Laura RPH back most likely she can help clear things up for you.  Once things get ironed out you probably won't have further issues - just guessing because I don't know this pharmacy at all but IMO these things usually work out.  Vets are not used to dealing with pharmacys or the laws which must be followed.  This has caused me distress for my own animals in the past
--
Eva and Anske
October 2017 Corvallis OR
Case History Anske 9yo Friesian Mare https://ecir.groups.io/g/CaseHistory/files/Eva%20and%20Anske


Re: Deciphering hay analsis

Eva
 

msg 226667 RE ADF

When using the AS FED or AS SAMPLED analysis, a good rule of thumb is to use the 8/40/60 rule; only purchase hay that tests 8% or more crude protein (CP), with less than 40% ADF and 60% NDF.  That's a general rule - yes, there are horses that will eat hays with 65% NDF, but again, it's the whole picture. Some hays like bermuda are higher in detergent fiber, but are still nutritious. The rule of thumb will get you in the ballpark. 



The sugars looked ok.  IMHO in a pinch you can feed this if they will eat it.  I would retest thru Equi-An if buying a significant amount to get the proper results.  I think the DM % is usually about 92% so you can "assume" the numbers are actually a bit lower As Fed because it would be diluted by water content 8% or less.

You can look at my most recent hay analysis to see that the moisture content was 8.5 %.... and then the resulting differences in numbers
--
Eva and Anske
October 2017 Corvallis OR
Case History Anske 9yo Friesian Mare https://ecir.groups.io/g/CaseHistory/files/Eva%20and%20Anske


Re: What happened to photo album

 

Carol, 
Did you create the photo album in the Case History, "Photos" location? If you tried to load photos into your Horse's Case History Folder it doesn't work as that is the wrong location for photos. I do see that you already have a Photo album in the "Photos" area with some photos, xrays, etc in it.
--
Bonnie Snodgrass 07-2016

ECIR Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Re: Considerations for treatment of eye conditions for PPID/IR horses

Cassie
 

Thanks! I posted here in case of special protocol for IR/PPID horses, especially now that it is reoccurring and onset and treatment is occurring in the sensitive time of year.

The picture/original thread was from last year. Last year it was flushed, which didn't resolve the issue.  Later a mass was removed that was not identified.

This year the vet has assessed - it resembles conjunctivitis, but there is some suspect granular tissue.  We had the added fun this year of a displaced (i.e. no longer contained by her outer lid) third eyelid.  Thankfully that part resolved quickly!

She is in the Guardian mask now.


--
Cassie

March 2017

Washington

Ellie Case History: https://ecir.groups.io/g/CaseHistory/files/Cassie%20and%20Ellie
Ellie Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=10111


What happened to photo album

Carol Grubb <headmare0@...>
 

Help  I just uploaded a new photo album called sweat pattern as I have a question on if anyone has thoughts or experience  with unusual sweating occurring with no activity (other than eating).  River is high insulin but low ACTH and I have had other PPId horses that demonstrated unusual patterns like this.  In July of 2016 River had anhydrous and had to take the supplement   (A1C of AC1?) to help with that.  Now he at the extreme other end.  He began sweating excessively like this as he got worse with the laminitis and founder but he is appearing to be much more comfortable with now laying down like he was and walking around quite a bit in his dry lot paddock.  Also  now my other photo album has disappeared that had all the body and hoof pics in it???????  Aurgh$%@    
--
Carol 
Tucson AZ
2012
https://ecir.groups.io/g/CaseHistory/album?id=71740 
https://ecir.groups.io/g/CaseHistory/files/Carol%20and%20RIver


Re: need more protein

Eva
 

Thanks Cass - I am working with Gwen at Uckele and I am fairly comfortable with balancing in general.  Just wanted some additional alternatives to alfalfa cubes/pellets and I wasn't sure what other protein sources were recommended.  Also I'm not sure where you got the 15 lbs of hay from.  She gets ~ 2% body weight which is 23 lbs total hay or hay plus alfalfa.  

Thanks Everyone for your input this has been really helpful!  Likely we will end up with a blend of different proteins in addition to all the baseline supplements
--
Eva and Anske
October 2017 Corvallis OR
Case History Anske 9yo Friesian Mare https://ecir.groups.io/g/CaseHistory/files/Eva%20and%20Anske


Re: Considerations for treatment of eye conditions for PPID/IR horses

Eva
 

Probably you should post this in horsekeeping group.  You'll get more responses.

General eye care tips:

one eye means it is probably not systemic (ie related to EMS/IR).  Could be an irritant, infection, injury
keep the eye clean and dry and masked
antibiotic ointment - probably not needed unless you see signs of redness and purulent discharge
steroid ointment - I really would recommend staying away from steroids unless recommend by vet.  Steroids can make some conditions worse and in some cases cause damage.
lastly - I looked at your picture and it looks like inflammation in the lower tear duct.  You would need a vet to assess this and flush.  

My personal feeling is - I don't want a blind horse so anything that lasts longer than a few days I'd have the vet look at.

Good Luck!
--
Eva and Anske
October 2017 Corvallis OR
Case History Anske 9yo Friesian Mare https://ecir.groups.io/g/CaseHistory/files/Eva%20and%20Anske


Searching archives and interpreting ACTH results in fall

Saucier Kathy
 

Hi, I'm not new to the group but have been without an EC/IR horse for 9 years now.  But now my 19 year old is exhibiting some issues so we tested insulin, glucose and ACTH.

Trying to catch up on things since a lot of new information has come out since I was following the group so closely.  Some of the oldies on here remember Magic, my work to get ODTB cubes to TX, testing some feeds, etc.

We are in the middle of our son's wedding planning and a trip of our own to follow and have limited time to search, read and catch up or post this new case history so I'll get to the point of my question and get to the case history in a couple weeks.

I found the Liphook graph of ACTH values through the months of the year by searching on the archives.  I was surprised that isn't on the ECIR website, just info about the seasonal rise, which I knew already.

With that site, http://www.thelaminitissite.org/ppid-faq/acth-interpretation, was the more recent 2016 study and graph by Durham.  It is showing by week 37 (our test date was Sept 14) normal range could be in the upper 40's.

I know testing in fall is discouraged but we needed to find out what was going on.  Grayson tested at 58.7 (the lab showed normal range 9-35).  So he is above that upper 40 number on the graph.  I'm just wondering how off of normal this is.  Is he early stages but definitely PPID?  Vet wants us to start on Prascend.  I'm assuming Pergolide is no longer available like from Ian Hudgings? He is prescribing 1 mg/day.  Do we need to start at a lower dose and work up to the 1 mg?  That was the old knowledge that I had from 10 years ago.  If so at what do we start and how quickly do we work up?  Leaving my horse in the care of others is a little unnerving in that I can't see side effects as they begin if I'm out of town, so am also wondering how quickly we need to start this.  Like ASAP or sure wait a couple weeks.

 

Until I can fill out a case history here is what we are dealing with.

For about 3 weeks now he has had a little swelling in the tip of the sheath and his crest has gotten hard.  He was getting way too much hay as the 2" hole hay net allows way too fast of consumption and we have now rationed down to the 1.5% body weight amount  (he was consuming 25 lbs a day and now we are at 15-17 lbs a day).  Vet body scored him 7.5.

He is off the Purina Equine Sr that he had been on when we moved from the boarding facility, but still on when tested.  His G:I ratio came out to 1.46 coming off the Sr feed (1 lb a day), unlimited hay and grass.  No laminitis at this point.

We went from no grass to rain season and lots of grass so he is off the pasture and stuck in a stall and run for now.  Have ordered a grazing muzzle so he can go out and move around and 1" hole hay nets to slow his hay eating so he doesn't go long periods without.

His current diet in addition to the 15 lbs Timothy hay is 8 ounces twice a day of TC Balancer with 9.2%ESC & 1.8%starch.  He has been on a daily amount of less than a pound of alfalfa cubes which has helped prevent his impaction colics that he used to get. But the easy to soak large pellets from Dumor have molasses added so we are back to long soaking alfalfa cubes or pellets.   I really don't want to remove this bit of soaked alfalfa cubes if possible.  He also gets salt, Vit E and joint supplement which I can get amounts into the case history in a couple weeks.  Just throwing this out there because I know I will be asked.

Oh and his sheath swelling has gone down today - yay!

 

So sum it up, questions are

1. can we trust the ACTH value to show PPID when done in September?

2. whether we need to work up to the 1 mg Prascend and how much for how many days?

3. can I wait a couple weeks to start it so I can observe him for side effects or get going asap?

4. is Pergolide still available somehow?

5. how quickly will a crest soften once we have worked on the diet?  That was a symptom Magic did not have.  He had the sunken eyes (which went away on treatment), sheath swelling (especially if he got ahold of leaves), long hair coat (never went away).  From what I remember every horse is different and I have to learn what the symptoms are on this horse and what they mean for him as far as IR and C's.

Thanks,

Kathy Saucier

19 yr old TWH gelding Grayson

Texas

Restarting 2018, but with group since 2005?

 


Re: Considerations for treatment of eye conditions for PPID/IR horses

Cassie
 

Same eye, different year!  Seems to be upper third eyelid this time.  Treating with triple antibiotic/hydrocortisone eye ointment and banamine for now.  Biopsy/removal of third eyelid if it doesn't resolve.  Hoping it's not another mystery growth.


--
Cassie

March 2017

Washington

Ellie Case History: https://ecir.groups.io/g/CaseHistory/files/Cassie%20and%20Ellie
Ellie Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=10111


Re: How do I update my case history?

 

Candice,
You got me thinking about this so I went  ahead and looked at my own horse's case history. Actually, you need to go to the Case History group, search for YOUR folder, Candice and Shark. Open it your folder. You will see several blue colored symbols to the right of Shark's case History. Click the one that looks like a trash can. You will have the option to delete the case history file. The symbol with the pencil image is to edit the NAME of the file. Up of the top of the page you will see a large blue button for uploading a new file. Hope this helps. One of our moderators may have more to add.
--
Bonnie Snodgrass 07-2016

ECIR Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Dr Kellon PM

Bonnie Eddy
 

Dr Kellon I sent you a PM concerning Racham
--
Bonnie with Racham from Southern California, Nov/2016

Case History
Racham's Photos 
Ω 

 


Re: CocoHoof

Eleanor Kellon, VMD
 

CocoHoof is a hoof supplement, not a fatty acid supplement, so fed in smaller amounts and different ingredients.  The fatty acid profile in CocoHoof is similar to the CocoSun supplement.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: How do I update my case history?

Eleanor Kellon, VMD
 

Next to your file you should see a trash can icon.  That's the  delete.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Greenville NC members?

melissa gray
 

I’m in Greenville, NC!!!!!!  How can I help?  252-814-7031
--
Melissa

May 2017, Greenville, NC

Buttercup Case History: https://ecir.groups.io/g/CaseHistory/files/Melissa%20and%20Buttercup

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=31032


How do I update my case history?

Candice Piraino
 

Ok- yes most likely user error!

I have read the directions for updating the case history- but having some serious issues here. How do I delete my first case history and replace it with the updates? I do not see a delete button :(

I have Shark's lab results! UGH he is PPID positive! UGHHHHHHHHHHH!!!


--
Candice Piraino
September 2018, Summerfield, FL
Case History: https://ecir.groups.io/g/CaseHistory/files/Candice%20and%20Shark
Shark's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71507  .


New hoof photos posted for Lavinia of very sore recently barefoot horse

Dawn & Qharma
 

Hi Lavinia,

Whenever you get a chance would you please take a look at the pics I just posted?

Unfortunately, I doubted myself after the last time you reviewed them and called a barefoot trimmer guy out on 8/21.  He totally disregarded the x-rays that I offered to show him and did a very aggressive trim.  Q couldn't walk at all.  He has been in boots since we pulled the shoes on 8/8.

On 9/15 I found a different trimmer who came and did some very minor adjustments and said that he will be fine - it's just a matter of time.

I have him booted on all 4 in Easyboot Stratus with wedges.  The sole around the tip of the frog is so soft it indents with thumb pressure.

I have a feeling you are going to say that his toe still needs to come back?  This current trimmer is very experienced and I like the work that I've seen but I'm definitely not an expert at this.

Thanks for any input and I hope my pics are good quality.

--
Dawn & Qharma
December 2017, Phoenix, AZ

Case History: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Qharma  
Hay Analysis: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Qharma/Hay%20Analysis
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=66067


Re: Hay - Analysis, Growers, Sampling - some advice

ferne fedeli
 

Interesting that you mentioned that grass hay sells for less than Alfalfa in your area, Dawn.  I find the opposite to be true here in No. California the past few years.  Grass hay is quite a bit more expensive than Alfalfa.  Maybe there are more horse buyers than livestock buyers or something.  I noticed last time I was at a local feed store that the Orchard Grass was $21 a bale (we have 100lb or so bales here) and the Alfalfa was only $18...  I remember when I first had my other horse in the late 90's that Alfalfa was more expensive than grass (probably safer for us horsey types, as we weren't tempted to buy Alfalfa!!!)
--

Ferne Fedeli

No. California

Regional Members Database Coordinator

 - see who is near you

Add your contact information if you want to help out/meet ECIR members in your area.

Case History


Re: need more protein

 

Hi, Eva.
Please get in touch with a hay balancer from the ECIR list. You need to have a clear-eyed and detailed discussion with a knowledgable balancer to get a clear picture of what will be involved using this hay if you soak it.

With crude protein at 4.9% and a 1025 lb Friesian in light work fed 15 ½ pounds of hay daily, Anske will have a larger CP deficit than I've addressed. You may be better off with a combination of hays/feeds and supplements rather than just a protein supplement to make up a deficit that large. 
--
Cass for Cayuse (PPID/IR) and Diamond (IR)
Sonoma County, Calif. Oct. '12

Cayuse Case History                Cayuse Photos
Diamond Case History              Diamond Photos


Re: I need some advice..

 

Hi, K - Just as Pauline says, they can certainly come back from this. One of our members had  5 of her horses slough all of their hooves due to selenium toxicity; 4 recovered completely, one did recover but was a long, hard slog. Here is the thread:  https://ecir.groups.io/g/main/topic/3866926#204076   Note that the sole will cover the coffin bone in weeks/months, so you aren't looking at your mare lying down for a year. You should count on a full year before you ride her again, however. Similar to tendon injuries, these horses need time to re-grow and re-strengthen everything before they start work again. 

In that thread, have a look also at Druid's story: (thank you, Paige, for this): http://www.ironfreehoof.com/severe-laminitis-case-study.html     That's a severe case, but well worth reading (spoiler alert - happy ending).

In my opinion, the burn cream, poultice pad and wrap are perfect - well done, you! Others can chime in here.
--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support  https://bit.ly/2MlAtPd  

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193&p=pcreated,,,20,1,0,0 .

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