Date   

Re: ER EMERGENCY EXPERIENCE

Maggie
 

What a nightmare Sharon!  I'm so glad that you are home and doing well and hope you continue to do well and have no long term effects.  When/if you feel up to it, you should contact the patient advocate at that hospital and talk over your ER experience.  
--
Maggie, Chancey and Spiral in VA
March 2011
ECIR Moderator/Primary Response


Red and Poppet- loop paddock, using Round Up to kill grass

jonno17@...
 

Red and Poppet are doing amazingly well and they're ready well actually more than ready to come out of their big yard and go in to a loop type track system, we have built that for them, the track starts from one end of their yard and goes inside the perimeter of the paddock their yard is in right back to the other end of their yard, as it is Summer here the grass has dried right off but in some places there was too much there for them to consume so we have gone around it with Round Up over the whole track, we did this over a week ago, I'm not familiar with having to kill every blade of grass, I was planning on letting them on to it in a couple of days, obviously the now killed grass is still there, is that a hazard to them or will I have to completely get rid of the dead grass that is there? I'm not sure how all this works, are they likely to eat the killed grass? A silly question but will it still have sugar/starch in it even though it has been killed? We've had a very dry Summer and the grass would be very stressed from very little rainfall and it is very short.
--
Clarissa
November 2018-Red, Poppet
Tasmania, Australia 
https://ecir.groups.io/g/CaseHistory/files/Clarissa%20and%20Red_Poppet
https://ecir.groups.io/g/CaseHistory/album?id=79540


Re: Treats to hide Prascend tablet in

Lynn
 

Hi Cassie, 

Yes, the Beet-e-Bites 30 count peppermint Equipockets are 28.95. That's what i pay...I feel your pain.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Help for Swa - PPID treatment, feed management and vet check up

ananja@...
 

Paula and Maria, thank you very much for your answers!

I am going to read through the information again, this time more detailed.

I didn't know about APF yet, it sounds promising. I have discovered there is one supplier in the Netherlands (https://www.pardoes-aurora.nl/contents/nl/p443_APF_adaptogene_kruiden.html). So APF is given in addition to Prascend to reduce its side effects and not on its own without giving Prascend?

I also see the APF is quite costly, could it be given daily or maybe less often to reduce costs a little?

I asked my vet about APF. She didn't know it yet and said after reading through the information that it may work for some horses but not for others. So I will discuss with her what to do on Tuesday. Any recommendations concering doing new blood tests? Is this recommendable?


--
Ananja

August 2018, The Netherlands
Swa Case History: https://ecir.groups.io/g/CaseHistory/files/Ananja%20and%20Swa
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=78425


Re: ER EMERGENCY EXPERIENCE

Maxine McArthur
 

I'm so sorry you had this awful experience, Sharon, but thank you for sharing. It is a timely reminder indeed. 
--
Maxine and Indy (PPID)

Canberra, Australia 2010

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

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

 


Re: Prascend

Paula Hancock
 

On Fri, Feb 8, 2019 at 09:01 AM, Meg Burden wrote:
What do you recommend about Vitex in conjunction with Prascend? Any other suggestions would be appreciated and open to comments. I want this gelding to be pain-free and our goal is to go back to what he loves to do most--moving cows?
Hi Meg.
Welcome to you and Burns!  It sounds like you have done a number of things to help him, which is great.  There are likely more things you can do to achieve your goals for him, which you can find in the information in the general summary below.
Just a couple of quick comments on current diet (because it's time to go feed my own horses...)
Alfalfa may or may not be okay, it depends on the horse.  It makes some IR horses footsore for unknown reasons.  It also makes mineral balancing an extra consideration.  Harmany OB Formula contains some things you don't want, some that you probably don't need and unknown amounts of all.  There are probably simpler, more helpful and more cost-effective options for several of the supplements you are using.  Does he need the Relyn for gut issues or for joints?  If his Glucose/insulin ratio indicates that his IR is not under control, body issues and joint stiffness may improve markedly just by addressing that.  Uncontrolled or under-controlled PPID (Cushing's) can push the insulin higher and cause laminitis, as well as muscle wasting, ligament and bone weakness and immune issues, to name a few.  Vitex (Chaste tree berry) can help with hair coat, but unfortunately does not control the progression of the disease.  Pergolide, either compounded or Prascend, is the only to do that.  Some of us use CTB in the spring to help with shedding, and some keep their horses on it year round.  One of mine gets kind of schizo on CTB, so I only use to help with shedding and have to be careful around him until I take him off.
In general we recommend increasing the pergolide dose slowly to avoid lethargy, loss of appetite, etc that some horses experience.  Normal dose escalation is 025 mg for three to four days, then 0.5 mg for three or four days, then 0.75 mg, then up to 1 mg.  Retesting three weeks after reaching the target dose will help you determine if 1 mg is sufficient or not.
Please read through the information below to find more ways that you can help your boy.  There is a lot of great information and handy links, so it's useful to keep a copy for reference.  Please let us know where you need help.

The ECIR provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

In order to help you and your equine quickly and effectively, we need you to explain your equine's situation by following the instructions you were sent upon joining. Your completed case history form and ECIR Signature will save days of back and forth questions. If you haven't done so yet, please join our case history sub-group. Follow the uploading instructions so your folder is properly set up and then upload your case history. If you have any trouble, just post a message or email the case history group explaining specifically where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

 

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

 

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

We ask all members to sign their first name, general location, date of joining and link to the case history and photo album every time they post. It helps us to find your info faster to answer your questions better. You can set up an automatic signature so you don't have to remember to do it. 

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.
If you have any technical difficulties, please let us know so we can help you. 

 
--
Paula with Cory (IR & PPID?and Onyx (IR/PPID)

  and Remy (?)

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx

 


Re: Updating Case History

Paula Hancock
 

Hi Stuart,
Yes, please use the new case history form for her.  If you are having a crisis and need immediate help, please just add current information to the new case history and let us know where you need help. Include a link to her case history in your signature:
https://ecir.groups.io/g/CaseHistory/files/Stuart%20and%20Promise
You can go back to fill in the old information later.  Your old case history was uploaded by one of the moderators so one of us will probably need to delete that before you can upload your new one.  I don't want to delete unless you have a copy of that saved on your computer first.
In the meantime, the following is a general summary of the protocol we use.  Things have been updated since you first joined, so it would be good to go through it to see what you can do now to help your mare.  There are lots of links to helpful information, so it's good to keep a copy handy for reference.

The ECIR provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

In order to help you and your equine quickly and effectively, we need you to explain your equine's situation by following the instructions you were sent upon joining. Your completed case history form and ECIR Signature will save days of back and forth questions. If you haven't done so yet, please join our case history sub-group. Follow the uploading instructions so your folder is properly set up and then upload your case history. If you have any trouble, just post a message or email the case history group explaining specifically where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

 

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

 

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

We ask all members to sign their first name, general location, date of joining and link to the case history and photo album every time they post. It helps us to find your info faster to answer your questions better. You can set up an automatic signature so you don't have to remember to do it. 

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.
If you have any technical difficulties, please let us know so we can help you. 

--
Paula with Cory (IR & PPID?and Onyx (IR/PPID)

  and Remy (?)

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx

 


Re: Prascend in the water bucket?

Paula Hancock
 

On Fri, Feb 8, 2019 at 07:29 AM, <h2obury@...> wrote:
Two questions.  Has anyone tried dissolving the tablets in the water bucket and what are your thoughts about it?  Has anyone tried the Medi-Melt pergolide tablets from https://www.wedgewoodpetrx.com/pet-and-horse-owners/medi-melts.html  I'd hate to invest in yet another method and find it rejected like the dozens of others.
Hi Joy,
Well, that's the first time I have heard of someone using two gallons of water to dose pergolide!  It might sort of work, but there are so many variables and unknowns, it would be better to find another solution. Prascend appears to taste worse than the compounded pergolide and if you are using the Prascend, you can try putting the Prascend in an empty capsule to reduce the likelihood of tasting it.  Eva's discussion thread would be worth looking at for other ideas:
 
The Medi-melts are geared towards dogs and cats, so likely your girl will not like chicken flavor, but they also have Medi-mints.  You would want to know if sugar is used or not.  I get my compounded pergolide from Wedgewood, but haven't tried any special delivery.  I have more trouble with Prascend, so if your vet is willing to prescribe compounded pergolide, that would be my first choice.  Some people core a small piece of carrot and put the pergolide inside, but highly recommend putting Prascend in a capsule before putting in the carrot.  It sounds like your lucky and very smart girl is already suspicious of attempts to medicate her.
Thanks for working on her case history. Let us know if you run into difficulties with that or have other questions.  Meanwhile, I am including a general summary of the protocol we use here to help IR and PPID horses regain/maintain their best health.  It contains lots of good information and useful links, so it's handy to keep a copy for reference.

The ECIR provides the best, most up to date information on Cushing's (PPID) and Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

In order to help you and your equine quickly and effectively, we need you to explain your equine's situation by following the instructions you were sent upon joining. Your completed case history form and ECIR Signature will save days of back and forth questions. If you haven't done so yet, please join our case history sub-group. Follow the uploading instructions so your folder is properly set up and then upload your case history. If you have any trouble, just post a message or email the case history group explaining specifically where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: IR is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

 

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

 

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

We ask all members to sign their first name, general location, date of joining and link to the case history and photo album every time they post. It helps us to find your info faster to answer your questions better. You can set up an automatic signature so you don't have to remember to do it. 

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.
If you have any technical difficulties, please let us know so we can help you. 

 
--
Paula with Cory (IR & PPID?and Onyx (IR/PPID)

  and Remy (?)

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx

 


Re: ER EMERGENCY EXPERIENCE

Shevawn Romine
 

Sharon,   What a horrifying experience – I have thought of that very thing when preparing pill into capsule in kitchen,   where I take my meds or if grandkids/granddogs  are around and I drop one.    Folks with other health issues certainly may not have survived this – so glad you did!   But it makes me have to wonder how it makes my horses feel?    


--
Cassie and Shevawn
03/2015   Gordon, TX
CH folder:  https://ecir.groups.io/g/CaseHistory/files/Shevawn%20and%20Cassie 
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=76832 


Prascend

Meg Burden <whburden@...>
 

I just started Prascend yesterday. My 16 year old QH, Burns, is on 1/2 tablet for 2 weeks then 1 tab, Before starting the Prascend I was using Hilton Herb's Vitex Gold Plus and was having good results as evidenced by him playing and engaging with other 2 geldings. Now that we are on Prascend, I would still like to continue the Vitex. What recommendations would y'all give us? Has anyone used Prascend in conjunction with Vitex with good results? Hoping to be able to keep Prascend dose at 1/2 tab with support of Vitex.

History:  He had a first and only bout of fall laminitis and I used ice boots for 40 minutes twice that day and heat and digital pulse stopped,  2 episodes this past summer of sweating around neck when other 2 geldings were fine, has a hay gut, no IR according to test, stim test pre-draw was normal and post was 187 in November, after 1 month of Vitex we did our first ACTH last month and it was normal, no crest, overweight but only in belly, he also has Navicular and shoes were pulled July 2018 when Vet recommended to go from 3 to 4 degree pads and I didn't want to do that because his heels were already way contracted. Wish I had pulled shoes years before, but did when I first got him 4 years ago and he was painfully lame--was easier this time with hinds having a 6 month head start. He is getting concavity. He had heel first landing upon front shoe removal. He is in Cloud boots when ground is hard, which here in Maine all ground freezes at night this time of year--during the day he is without the hoof boots.

Diet:   free choice orchard grass hay in Porta-Grazer and hay pillows, 2 handfuls of soaked Speedibeet as carrier, Arizona Copper Complete, sea salt, 1/4  of a flake of 3 string bale alfalfa ( Vet okayed alfalfa )-- in am/pm, hempseed oil, CoQ 10, sprinkle of kelp, Dr. Joyce Harman's OB Formula, MagRestore, MSM, Hagyard Pharmacy Relyne GI, Vitex Gold Plus 11ML am/pm, 1 oz fresh ground flaxseed, Vitamin C and free choice Rush Creek minerals. I also some salad greens in pm to feed. I saw a big difference when I added the hempseed oil and CoQ 10. And he started playing again when I added Vitex Gold Plus.

What do you recommend about Vitex in conjunction with Prascend? Any other suggestions would be appreciated and open to comments. I want this gelding to be pain-free and our goal is to go back to what he loves to do most--moving cows?


Re: Treats to hide Prascend tablet in

Shevawn Romine
 

Saw this Beet-e-bites conversation and went right to their website to purchase ,  but they showed up as $1 a piece,   i.e. $30 for a bag of 30.     Does that sound like the right price folks are paying?    I can’t do that.   


--
Cassie and Shevawn
03/2015   Gordon, TX
CH folder:  https://ecir.groups.io/g/CaseHistory/files/Shevawn%20and%20Cassie 
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=76832 


Re: ER EMERGENCY EXPERIENCE

Eleanor Kellon, VMD
 

OMG Sharon. Thank goodness you're OK. That's a hefty dose even for a human.

[If you do have anything residual I hope you can sue the pants off the jerk in the ER.]
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Are commercial “IR” treats safe?

Barb
 

That’s great! I will have to try those.

Thank you!
--
Barb

January 2019, Omemee, Ontario, Canada

Lily's Case History: https://ecir.groups.io/g/CaseHistory/files/Barb%20and%20Lily  .
Lily's Hoof Photos: https://ecir.groups.io/g/CaseHistory/album?id=83890


Re: 2nd try Racham's mental and physical state

 

I'm very concerned with her mental state. It doesn't correlate with her tenderness. She has not been the same since the Cabergoline. She was strong, having good long rides in July. 
-----------------------------------
Bonnie, have you checked her eye sight? At least do a test to confirm she perceives your hand waving near her eye, one at a time? Blindness can creep up, especially when the lens becomes clouded. I was surprised to find my age RMH was almost blind in one eye and detected only a little light through the other. At night I'm pretty sure she saw nothing. The symptoms were that she would inadvertently touch me when we were in close quarters, not her manner at all as a very well broke mare. Eventually it be come much worse.

--
Cass for Cayuse (PPID/IR) and Diamond (IR)
Sonoma County, Calif. Oct. '12

Cayuse Case History                Cayuse Photos
Diamond Case History              Diamond Photos


Re: ER EMERGENCY EXPERIENCE

Lavinia Fiscaletti
 

Oh Sharon,

How awful. Thank goodness you were able to remain relatively clear headed thru this experience as it no doubt saved your life.

Thank-you for sharing and reminding all of us to remain vigilant when handling all meds as I'm sure anyone could find themselves in a similar situation on one of those days when life gets just too hectic.

Healing thoughts for a quick and full recovery.

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


ECIR Group - Equine Cushings and Insulin Resistance #FACTS

main@ECIR.groups.io Integration <main@...>
 

By ECIR Group - Equine Cushings and Insulin Resistance

PPID is a disease. EMS is not. Read about the differences (and similarities) between the two and about effective treatment here: https://bit.ly/2LqGEjO


Updating Case History

Stuart Wilson
 

Hi,
I have an old case history and need to update it and get my mare some help. Do I transfer old info into new case history first?
Stuart and Promise
Washington


Prascend in the water bucket?

joyh2obury@...
 

Hi all, 
I'm a new member.  Still working on completing the case history for my new equine partner, a 15 year-old QH Mare I affectionately refer to as my "Mid-Life Crisis".

I purchased Emmy in November, 2018, she was already on 1 mg of Prascend since July and had been dx'd with PPID.  (Yes I knew all about her condition before I purchased her. No I'm not insane.)

It's been a struggle to get her to take her Prascend like a good girl.  She's super smart, independent and confident.  She can smell Prascend a mile away no matter how I try to sneak it in.  Dissolving, syringing, hiding in treats, mixing in food, etc, she might ingest it once, but never again.  Even turning her nose up at her food completely if she suspects it's in there.  Same with syringing into her mouth, the only thing I accomplished was making her refuse all syringes in her mouth, including paste-wormer.  With each failed attempt her mistrust of me grew, which strained our relationship.

Finally, I dissolved the pill in her water bucket in about 2 gallons of water. She usually gets it down in a couple hours without even noticing.  The vet doesn't like that idea and thinks the medication loses its potency and she's not getting the full strength.  And yet with all the things we have to do to get Prascend into our horses, I'd be surprised if anyone is getting the full potency of the drug into their animal,   Emmy's begun shedding, which has not happened in a couple years according to her previous owner, so she must be getting some benefit.

Two questions.  Has anyone tried dissolving the tablets in the water bucket and what are your thoughts about it?  Has anyone tried the Medi-Melt pergolide tablets from https://www.wedgewoodpetrx.com/pet-and-horse-owners/medi-melts.html  I'd hate to invest in yet another method and find it rejected like the dozens of others.

Thanks for your help.

Joy


ER EMERGENCY EXPERIENCE

Sharon Manning
 

cautionary tail/ pergiloid
 
Hi all,
I haven’t been here in a long time because I haven’t needed to. Knock on Wood.
I have spent the last few days in the hospital in the MCI after arriving via ambulance.
After mistakingly taking my horses pergiloid of 16mg. Its amazing that I am alive, and I wanted to share my experience with you all as a reminder of the serious drug we all are handling daily for our precious PPID horses. My mistake came close to taking my life but my knowledge (because mainly of this group) of the drug and fast action saved my life.
 
Understandably the poison control nor the ER doctor had any experience with this drug and overdosing of such.This drug has been off the market for humans for a long time and NO one would take it recrecationally or for suicide attempts. 
 
How did something like this happen? By any chance do some you multi task? Do any of you push to meet deadlines and take care of others? Well, I was pushing too hard one morning getting my husband off to go out of town, fixing the horses feed, steaming hay, making my protein drink which I used to take a few supplements. I also was working a problem over the phone about my daughters birthday present. I fix my horses feed in our mud room off the laundry and kitchen. Walking back and forth drinking my smoothie popping my supplements I took the pergiloid out of the frig just like I have every morning for years. Walking to the mud room to add it to the feed the phone rang.  I held that capsule in my hand sat down my smoothie and answered the phone. After handling that problem I picked up my drink to down the last bit and mindlessly I pop that pergiloid cap in my mouth and down it went. As I put my empty glass down into the sink its as if I was in slow motion. Looking into that glass I thought oh dear God what did I just do? I quickly checked the horse feed for the capsule and back to the kitchen looking all over the counters around where I picked up the phone. Nope not there.I got the bottle out of the frig and sure enough the count proved me to be in serious trouble.
 
I pull up the poison control number on my computer and called. After dealing with the agent and repeating the same information over and over, realizing this was a waste of my time, I hung up as in just these few minutes symptoms were starting. Trembling and shaking with increased respiratory rate. I tired to tell myself it was just me being scared. I called 911 and going through the same repetition of answering the same questions over and over I held on trying to convince the agent the serious nature I want I had done. Trembling and starting to sweat profusely I pick up my keys, turned every thing off and headed out to the front yard begging the 911 agent to send the EMTs. She finally told me they were already on the way and I sat on the swing to wait. I was feeling a little spacey but still thinking clearly. I can only guess but at the time the EMTs arrived it was about 15 minutes total. The ambulance was right behind them.They didn’t have a clue what to do for me. So I asked to be taken to the ER. As the ambulance arrived I got up to walk and was totally unable to control my muscles and began having what I was told later wasTurrets. As I was being strapped in I began to feel as if I could not breath. They started oxygen and then the projectial vomiting all the way to the hospital. In the ER I was left to the side because according the the attending physician I was uncooperative to his questions and directions. The Turrets was causing verbalizations other that what I was trying to say. I was being treated as a drug addict and or a suicide. The ER doc told the EMT that he would draw my blood and see what I really had taken and then give me something for nausea get someone from social services and send me home. While left in the care of the ER nurse my Turrets continued to become more animated. Hyper sensitiviey to light and sound started and through the fog of what I was later told was spacial schizophrenia I watched the ER doc studying me and then question the nurse about my behavior and verbalizations sense she had been taking care of me. He then did administer a drug for nausea which helped but didn’t completely stop it. A internal medicine doc was brought in and he realized something different was being experienced then the typical OD. My husband was there by this time (two hours later) and a neurologist was brought in. The neurologist new exactly what he was seeing because he new all about the drug. He however had no experience with a overdose of the drug but he acted quickly with a drug that had a counter effect of pergolide, stopped the nausea and took over my case, emitted me to treat symptoms as they showed. At this point they were expecting hallucinations  and seizures and I was put in the MCI. He told us this would be a hit and miss in treatment and possibly some long term issues. If I need to be put on anti psychotics  for a while.
 
Looks like the vomiting removed most of the drug from my stomach and there is no way to know just how much I did absorb into my system. I am at home recuperating and doing well.
 
Im only sharing my humilating mistake to ask you all to rethink and as a reminder how you handle this medication. Feeding becomes a automatic function after a while and if there are other animals or children around I employ you to treat this drug like a loaded gun.
 
I hope is helpful.
 
Sharon
Cushing/IR 05
NRC+11/08
NAT 2/09
CIR12/09
DEW 08/10
COH 04/11
BRR 2015
AAL 2015
 
Sharon
E TN
2005
 
 


Re: Treats to hide Prascend tablet in

ferne fedeli
 

My guys really like Stabul 1 also.  The big problem for us in this area of Northern California, is finding a TSC that will carry it.  One store agreed to carry and then was told by his upper management to not order any more as shipping was too expensive!!!  Such a pain!
--

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

49281 - 49300 of 278138