Date   

Re: Is there an App for that?

Eleanor Kellon, VMD
 

There are spread sheets and software programs and I've seen more errors come out of them than I can count. Some are entry errors, others were unexplained errors. If you don't have the knowledge to have a rough idea of what the answer should be, you'll miss them. There are also situations which are judgement calls that can't be easily incorporated into an app. The math isn't the problem. If you can use a calculator you can do it - if you have the knowledge.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Can I Mix These Uckele Products With Minerals In Bulk 30-Day Supplement Recipe?

Eleanor Kellon, VMD
 

I have two concerns with this method. The usual way multiingredient supplements are mixed is more like mixing cement - a drum that rolls at a low speed. I honestly don't know if a high speed blender like this would do the same job. At the very least I would suggest testing a sample of the final product. even if just for one major and one trace mineral, to make sure the numbers are what they should be. My second concern is that taurine and lysine are heat sensitive. There may not be enough heat generated by the blades and motor to make a difference but I couldn't guarantee it. A tool like this that's used with a drill https://www.homedepot.com/p/ANVIL-Eggbeater-Mixer-57485/300960444?MERCH=REC-_-NavPLPHorizontal1_rr-_-NA-_-300960444-_-N or grout mixing paddle or a bread dough kneading attachment on a standing mixer would be more like it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Is there an App for that?

Debra
 

Curious if anyone knows if there's some sort of App or some "calculator" that exists that will allow users to figure out how to make adjustments to feeds while maintaining proper ratios? It's all math after all...isn't it?
--
Debra Doerfler
San Marcos (San Diego County), California
Lady Sierra Snarf n' Snort AKA "Sierra"
2009 TB rescue mare, adopted 2017
Member since March 2019
https://ecir.groups.io/g/CaseHistory/files/Debra%20and%20Sierra

https://ecir.groups.io/g/CaseHistory/album?id=91011


Intakes of beet pulp above 30 to 40% of dry matter intake may suppress appetite?!

Debra
 

I was reading one of the many file articles and ran across this statement, ..."-intakes of beet pulp above 30 to 40% of dry matter intake may suppress appetite to the point they don't eat enough hay."

So would intake of beet pulp in the 20-25% of dry matter range potentially suppress appetite SOME so that Sierra isn't always ravenous? She's got a belly on her but I don't dare not have grass hay in front of her 7/24 lest her stomach ulcers flare.

--
Debra Doerfler
San Marcos (San Diego County), California
Lady Sierra Snarf n' Snort AKA "Sierra"
2009 TB rescue mare, adopted 2017
Member since March 2019
https://ecir.groups.io/g/CaseHistory/files/Debra%20and%20Sierra

https://ecir.groups.io/g/CaseHistory/album?id=91011


Re: When to retest after starting prascend trial

jmc
 

Thanks all. I have an excellent relationship with my vet, I think I'll sched the test for 3 weeks after he hit 1mg, then discuss if we are chasing the rise. He is doing well atm, this is my plan unless he starts leaving ponds again (ah, the joy of !ules teaching !y horse to pee in the same places, every time. Mule ponds, made by a horse with a gigantic bladder...
--
Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386


Re: Arizona 7 year old laminitic mare due in March

 
Edited

Hi, Sarah, and welcome to the group! I am sorry your mare has had an episode, but glad she is feeling better.  Good work with the Soft-Rides - many horses just love them.

Great work on your case history - many thanks for that!

Pulling the Total Equine was a good decision. I am sure it has been a player here. As Dr. Kellon says, pregnancy can induce a degree of IR, and until you know for sure what you are dealing with, it is best to treat her as IR.

NRF2 is most likely a waste of money; there are better supplements to use as anti-oxidants. Here are Dr. Gustafson's and Dr. Kellon's posts about Protandim (NRF2)
 https://ecir.groups.io/g/main/message/237520   
 https://ecir.groups.io/g/main/message/235716  

Heiro is most certainly a waste of money - some more information in the files here:  https://ecir.groups.io/g/main/files/8%20Commercial%20Items%20Targeting%20IR%20and%20PPID  They sure have good marketing, though! :)

Here is a list of safe bagged feeds, and also acceptable ration balancers: (also found at these links in the files https://ecir.groups.io/g/main/files/5%20Core%20Diet and https://ecir.groups.io/g/main/files/6%20Diet%20Balancing  )

SAFE BAGGED FEEDS

Rinsed/soaked/rinsed beet pulp

 Soy hull pellets

Ontario Dehy Timothy Balance Cubes  http://www.ontariodehy.com/tab02-07.htm  

 Nuzu Stabul 1 http://stabul1.com/stabul-1/   

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

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

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

Acceptable Ration Balancers (but very much second best to hay analysis and custom mix). These all have no added iron, a very important consideration for our metabolically challenged equines.


Uckele U-Balance Foundation
https://uckele.com/u-balance-foundation.html  (some horses don’t like the taste)

 

California Trace Plus  https://californiatrace.com/about/california-trace-plus/  (will need to add magnesium)

 

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

 

 

Colorado Se Mix https://horsetech.com/equine-supplements/custom-non-stock-products/colorado-se-mix (will need to add magnesium)

 

 

VermontBlend   https://customequinenutrition.com/products/vermont-blend

 

  VifArgen Le Cheval au Naturel http://lechevalaunaturel.blogspot.com/p/blog-page_13.html 

 

Mad Barn AminoTrace+  https://www.madbarn.com/ca/product/aminotrace-pellet/

 

  For areas where added manganese is necessary:

Mad Barn Omneity Powder  https://www.madbarn.com/ca/product/omneity-equine-premix/

Mad Barn Omneity Pellet  https://www.madbarn.com/ca/product/omneity-equine-mineral-and-vitamin-pellet/

Mad Barn Trace Mineral Pack  https://www.madbarn.com/ca/product/madbarn-trace-mineral-pak/

Equi-VM  https://uckele.com/equi-vm-7lbs.html

 

Sport Horse Grass  https://uckele.com/sport-horse-grass-pellets-15lbs.html

Equi-Base Grass  https://uckele.com/equi-base-grass-pellets.html

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

 

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


Here is the full, official welcome letter - there is a ton of information in it, so take your time and don't feel overwhelmed! (most of us were overwhelmed at first, but it all gets easier).  You can just zip over the PPID information - I will eat my hat if that is a confounding factor here, but I left it in because there can be confusion about which disorder is relevant.

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.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you follow the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know 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.

If you have any technical difficulties, please let us know so we can help you.

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

 

--
Jaini 
Merlin and Maggie (over the bridge), Gypsy, Ranger
ECIR mod/support, Smithers, BC 09

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193  
https://ecir.groups.io/g/CaseHistory/album?id=39711


Re: Can I Mix These Uckele Products With Minerals In Bulk 30-Day Supplement Recipe?

Lynn
 


Re: Can I Mix These Uckele Products With Minerals In Bulk 30-Day Supplement Recipe?

Eleanor Kellon, VMD
 

What kind of blender?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Protein ?

celestinefarm
 
Edited

Holly,
Dr. Kellon suggested you add Tri Amino to her diet to ensure the essential amino acids( protein) are covered. Tri Amino from Uckele is a amino acid blend that provides essential amino acids, the one's she cannot manufacture herself. 
See the following link for an explanation of what essential amino acids are and why they are needed and Dr. Kellon's post below with the link to Uckele.

https://equimed.com/news/products/dr-kellon-s-guidelines-the-science-of-feeding-your-horse-for-healthy-muscle
 

Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Can I Mix These Uckele Products With Minerals In Bulk 30-Day Supplement Recipe?

Lynn
 

My hay balancer schooled me last night on how to create a bulk 30-day supplement recipe for Relevante based on his latest hay balancing analysis. The minerals are monosodium phosphate, magnesium oxide, copper and zinc sulfate. I found out from Joan at MyBestHorse this morning that i can add Mov-Ease, Jiaogulan and ALCAR to the mineral mix without fear of the minerals affecting the efficacy of these products. I want to know if i can also add these Uckele amino acid products to the above mix without concern that they will lose efficacy or go "bad." : Taurine, L-Leucine and Tri-Amino. I then plan to throw the whole lot in the blender. 
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Tetanus shots

Eleanor Kellon, VMD
 

You can't find anything because there isn't anything! There are rapid titer test kits available in Europe, but as far as I know not here https://en.fassisi.at/products/large-livestock/horses-fassisi-tetacheck/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Arizona 7 year old laminitic mare due in March

Eleanor Kellon, VMD
 

If she has had EMS since before the pregnancy there will be evidence of changes in her feet (the horn lamellar zone). I'm actually also looking for evidence of something else to explain the pain - like the poor digital cushion development and flat to negative palmar angle that is so prevalent in QHs.  No harm in testing her after she foals and is weaned.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Arizona 7 year old laminitic mare due in March

Lavinia Fiscaletti
 

Hi Sarah,

Good to hear she is feeling better.

You need to test her now to know what is happening at this time so you can manage her appropriately thru the pregnancy and foaling.

Afterwards, you can retest to determine her "normal" status just to be safe going forward.

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


Re: Pergolide dosing -

Eleanor Kellon, VMD
 

The three most important things to remember about that study

- none of those findings are new
- ACTH fluctuations did not correlate with metabolism of pergolide
- there was ZERO evidence of any kind that twice daily dosing/split dosing would be superior - none - while studies that actually follow ACTH for 24 hours find it is not elevated over the level present at the prior dose 24 hours ago
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: When to retest after starting prascend trial

Lavinia Fiscaletti
 

Yankee was positively diagnosed with PPID in Feb but medication was not started until July - which puts you squarely in the position of "chasing the rise" to attempt to gain control of the increasing ACTH. There is no mention in the case history of why there was a delay in starting the meds.

Always need to discuss prescribed medication doses with your vet. No one here can prescribe for another member's horse but those with experience can relate those experiences as examples of what might need to happen. Those who have been on this PPID merry-go-round for a longer time, and have good working relationships and the consent of their vets, may have more leeway in making dosing changes more rapidly as needed.

Lack of consistent symptom control: ongoing flat feet and sensitivity plus lack of energy (possible sub-clinical laminitis), fluctuating PU/PD are red flags for lack of good control of the PPID, which would necessitate an increase in the dose of pergolide to correct. Based on the experiences of members here, it can take double, triple the non-seasonal dose of pergolide to maintain good control of the ACTH thru the seasonal rise period and keep the risk of laminitis to a minimum. That 2mg dose is an example of what it may take to get a handle on the situation with Yankee so that Jodi has information to use in a conversation with her vet.

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


Re: Pergolide dosing -

Sherry Morse
 

This has already been addressed - you can read the messages here: https://ecir.groups.io/g/main/message/239018



Re: When to retest after starting prascend trial

Sherry Morse
 

Tanna,

One of the reasons for recommending a higher dose is that she's 'chasing the rise' right now and where he may have been controlled if he'd started on 1mg earlier this year now that we're into the seasonal rise period his ACTH may be increasing faster than the 1mg can control.  Dawn already addressed the BI marketing campaign that 1mg fits all needs which we've found to not be the case with so many horses here.

It's definitely a bit of a balancing act and one of the options is getting him on 1mg and then retesting after 3 weeks and assessing his numbers then.  Depending on symptoms I might opt to do that but would continue with a bump up (assuming the vet is wiling) unless that lab result showed him solidly in the middle of the reference range.  If the results came back as he was controlled in the midst of the rise on 1mg that would be wonderful and he could stay there rather than continuing up to 2mg.  



Re: Pergolide dosing -

LJ Friedman
 

Any thoughts on the twice daily dosing.  I know the study is small.  Might this be something to consider?  More studies to show once a day is fine?
--
LJ Friedman  Nov 2014  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: When to retest after starting prascend trial

celestinefarm
 

Hi Tanna,
Whether Jodi consults with her vet depends on the understanding she had with her vet regarding dosages for Yankee with Prascend was prescribed. There are many vets who understand the physiological reasons for a horse to become affected with PPID and there are some who do not. Members here have had to deal with vets who think because BI advertises that a "tablet' will control their horse's PPID , indicating that is a lifetime dose, that raising dosages higher is somehow out of standard practice, can cause liability issues, and also offends their position as appearing more knowledgeable than their client, since they are the licensed vet. 
It's a tough position to be in, and one that requires some finesse to manage. I don't know for certain what category her vet is in.
If I were Jodi, I would report to her vet what symptoms have been improved and what haven't, and that she wants to slowly increase the Prascend to 2mgs, if necessary, to see if the additional symptoms are improved.  If the vet balks, then she knows she has a problem and will have to address it accordingly.
I haven't looked at Yankee's ACTH testing to see what lab she used. MSU 's endocrinologists, for the past couple of years, have written in their interpretations of results I've received for my own horses, a lengthy encouragement to provide pergolide at dosages that control symptoms and to NOT simply treat by numbers. I would think they are not the only endocrinologists to encourage vets and clients to do so. If there are such notes, I would use that as backup for my position to increase Prascend.

To answer your question after that lengthy non answer, LOL, yes, those of us who are more experienced with PPID are often quicker to recognize symptoms and get an pergolide increase BEFORE a more serious symptom rears it's ugly head such as laminitis.  Unfortunately, that experience often came from missing symptoms early. It's why the group encourages members to keep a journal of symptoms, observations, etc on their horse, including the degree to which the symptoms are expressed, weather, stabling and turnout time, etc.  so they are more likely to see something early. Not everything is caused by PPID, but PPID and IR early signs are often assigned to other causes and can be mentally discounted as one off's ,etc. when they really are signs of increasing dysfunction. Those of us with experience are trying to help those with less not make the same mistake.
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Re: Arizona 7 year old laminitic mare due in March

Sarah Radachy
 

I’ll get pictures today but vet thinks it is highly unlikely anything will show up in xrays. She is completely sound after 2 days in soft stall and soft rides.  

You think I should test her after she foals and weans to be safe? 
--
Sarah G'Lynn Radachy
Bachelors in Dairy Science from Iowa State  University 
Phone: 623.262.4341

--
Sarah Radachy

46361 - 46380 of 282395