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ECIR Group - Equine Cushings and Insulin Resistance #FACTS

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By ECIR Group - Equine Cushings and Insulin Resistance

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Re: Blood work results and confused!

Lavinia Fiscaletti
 

Hi Cheryl,

Sorry, you're right - somehow I just missed the last glucose result in the case history.

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


Re: Blood work results and confused!

Cheryl Oickle
 

Thank you sooo much again for all the feedback. I do not see any changes in Jewel ie excessive thirst etc so it’s hard to present the argument! I may just arbitrarily increase her dose by 0.5 mg thruout the rise anyhow if I can not get buy in from my vet.  I did go back to my case history and my previous blood work IS there so I’m not sure why Lavinia said there  was no glucose etc.
I am so thankful for this group! 
--

--
Cheryl and Jewel
Oct 2018

https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel

https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: Carrots ok to feed?

Eleanor Kellon, VMD
 

There's no question there have been reports of horses getting into trouble when being fed carrots. How much it takes to do that I can't tell you. More than a bite.

Let's take a look at why that might be. Carrots as fed are around 5% sugar, 2% starch (although some strains are much higher) but average 90% water so on a dry matter basis they are 50% sugar and 20% starch. By comparison, hay on a dry matter basis is 7% sugar and 1.6% starch (average for generic "grass" hay at Dairy One). If diluting the sugar and starch by water is all it takes to make something safe to eat, grass at all growth stages would be safe. We all know how that works out.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Seasonal Rise Question Based On New ACTH, Insulin And Leptin Blood Work

Lynn
 

My vet called today. He consulted with the endocrinologist about Relevante's elevated leptin and insulin. The endocrinologist agreed with what was said here on the forum regarding onset of exercise program and the seasonal rise being variables that could be affecting the numbers. He also discussed "breed" stating that he was happy with the numbers considering Relevante is a Paso Fino and to just continue with the current protocol.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Blessing: New numbers; we're losing ground

Helen Connor
 

Thank you, Dr Kellon! I'll pick up some baby peas and not use molasses. I just taped her to be sure about that weight. I recorded it incorrectly. She appears to be 835 today. Much more optimistic scenario on that front, anyway. Thanks for the caution about liquid pergo.

Helen
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847


Re: Jesse sore

LJ Friedman
 

It is updated.   What do see as missing?  Last trim notes?  Thanks 
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Blessing: New numbers; we're losing ground

Eleanor Kellon, VMD
 

It's difficult to even guess without knowing how much she has been getting. For now I think your plan is reasonable but would try something like watered down baby carrots or baby peas instead of molasses. Water is OK too.  Keep the volume as small as possible. Do not go to liquid pergolide - too unstable.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Blood work results and confused!

Eleanor Kellon, VMD
 

P.S. Another consideration here is whether you will be able to keep up the same level of exercise throughout the seasonal rise. Exercise (the more, the better) is the best tool for controlling insulin. If that drops, the effects of uncontrolled ACTH will magnify.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Blessing: New numbers; we're losing ground

Helen Connor
 

New numbers from Cornell University show Blessing's ACTH at 49.4. Last August, it was 17.3. I'm having a lot of trouble getting her to consume the compounded pergo (2.75 mg). She has become suspicious of everything. I'm afraid of the time it takes, but is getting her back on 2.75 mg/day and testing in 2 or 3 weeks the right process, or should I ask for an increase in pergo now? If so, what dosage is appropriate?

I've asked the vet to confirm Blessing's weight from her visit, but I recorded 728 lbs on Aug. 14 when the blood sample was drawn. Dr. Kellon encouraged me to keep Blessing's weight near 850 lbs a year ago (and my vet agrees), so we're lagging there too. I will increase her hay to between 18 and 20 lbs. a day until we can get back near 850 lbs.

My vet recommends using 5 cc's of molasses to dissolve the compounded pergo powder, and syringing it into Blessing's mouth. I don't like this idea because of the sugar load, but I'll do it tonight to get the medicine into her. It would seem that dissolving in water would be okay. Is it? Should I ask my vet to request liquid pergo for the future, or is dissolving the powder at the time of feeding okay?

I'm installing an updated version of her case history now. Thank you for any help and reassurance you can offer.
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847


Re: Blood work results and confused!

Eleanor Kellon, VMD
 

Hi Cheryl,

Regardless of what any of us might think, you need to get your vet on board.

It's basically impossible to compare your insulins because of different labs, different assays, different potential for cross-reactions.  ACTH units aren't always directly interconvertable either for the same reasons. My main concern would be a repeat performance of last year but you would make a stronger case for an increase if you are seeing any changes in your horse like more drinking and urination, topline wasting, belly enlarged, crest increasing. Otherwise, talk to your vet about a prophylactic increase with the possibility of weaning back down to her current dose in late winter.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Carrots ok to feed?

Nancy C
 

Hi Beth

This conversation comes up in nutrition circles a lot. First question is why does one want to feed the carrots? 

As Dr Kellon points out in this post the ECIR Group has long seen horses resolve uncomfortable feet when carrots and apples are removed. 

https://ecir.groups.io/g/main/message/166748?p=,,,100,0,0,0::Created,,posterid%3A58231+carrots+,100,2,0,1055106

https://ecir.groups.io/g/main/message/141405?p=,,,100,0,0,0::Created,,posterid%3A58231+carrots+,100,2,0,1049097

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA


Re: Jesse sore

 

LJ,
 
I think one thing that would make a huge difference, is if you would update your Case History! 

Thanks!
 

--
Ellen
Pal & Savvy
N. Alabama
Aug 2013
Case History 


Hay tests results and prascend question

kellyandbella
 

Hi everyone! I got my hay test results back from 4 different potential sources and was wondering which would be the best to choose based on sugars and nutrition. They are all posted in my photo album. #2 called “greenfield” seems to be good and so does #3 called “Barry”. The greenfield one is courser and the Barry one is very fine. Was thinking that the courser one might be a better option for my mare for more chewing? She is a wizard with the 1” net and I fear she will be able to basically inhale the finer hay through the mesh. What do you guys think based on the results, and taking the courser/finer texture into consideration? Bella is IR and packs on weight extremely easily.

She seems to be ok on the prascend... I think her fat pads look at bit better and she has had more energy. Not quite as itchy. She also has become much more spooky. She can be like this anyway, but since being on prascend she has definitely been more reactive. Is this a thing with prascend? Should I just wait it out and see if she evens out, or should I maybe try lowering the dose by splitting the pills in half? She’s tricky to ride right now as her go to move is to spin when she spooks. 

I am waiting on her bloodwork still (vet is on vacation this wk). I will update her CH again when I receive the results, and at that time will try again to change it to PDF. :) 
--
-Kelly

November 10, 2018, Grandview PEI Canada

Bella case history:  https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20Bella

Photo album: https://ecir.groups.io/g/CaseHistory/album?id=81257


Re: Blood work results and confused!

Cheryl Oickle
 

Sorry i thought my case history had baseline glucose from last year. 
Initial insulin 16.3uIU/ml range 4.5 to20
Glucose 4.7. Mmol/L range 4.2-6.4mmol/L
These were fasting last Sept
My posted result today was NOTfasting
Pergolide dose is at 1.0 mg.What would you recommend as increase. My vet doesnt think so but your site I find is much more on board

Cheryl and Jewel
Port Alberni BC Canada

--
Cheryl and Jewel
Oct 2018

https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel

https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: Mare with severe founder and blood test shows Cuchings

Deb Walker
 

Beth - I just want to chime in here, as I too found acquainting myself with all of the knowledge and information available here difficult. The case history took me days to do, as did learning the proper etiquette for posting pics, etc. It's a lot to take in when you are worried sick about your horse. But, your vet's suggestion to put down such a young horse without first trying the things that work appalls me. But I will 100% agree with the vet that it is a huge undertaking, it is going to probably be expensive (more so than you can imagine) and a lot of frustration and crying yourself to sleep at night. In the end, only you can decide if your relationship with your horse is worth it.

When Scotty had only 1 ml RF sole and 7 ml LF sole and could barely hobble, 35+ years old, he still had that sparkle in his eye and he still was eating well, expressing affection, etc. I was beyond shocked to discover the severity of his situation, and the friend who trailered us the 60+ miles to a University Vet Hospital advised me to put him down...he is old, we were going into winter, and there were no guarantees anything would save him. After a full team of vets and farriers consulted, it was decided to leave him overnight and do a venogram the next day; this is probably what your vet was suggesting. This determines if there is blood flow. If there is not sufficient blood flow, your horse cannot grow a hoof. If there is, they can grow hoof. Because of the farrier schedule at the hospital, he had temporary devices put on his front feet as he had to stay Friday-Sunday until the farriers returned on Monday if the venogram was successful.

Long story short, he had sufficient blood flow, the farriers put on a product called Ultimates which is wrapped extensively with an almost cast like material to stay on the foot. http://www.nanric.com/catalog/all-products/nanric-ultimate-pair (Scotty's were black, but this is what I am talking about.) It wasn't easy, he wasn't sound, he laid down a LOT, BUT in 8 weeks he grew 17 ml of sole!!

Life since then has not been the same. It's hard. Some days you wonder if you are crazy. You don't add up the money you are spending because it would be devastating. Scotty went back to the same hospital last year for a check ligament surgery, and has also gone back a few more times for different trimming options. But he is alive, he's well, and I've finally hit the jackpot with a farrier who I believe can rehab him the rest of the way, and for whatever days this 35++ year old horse has left, I will do my best to keep him happy and healthy. All this to say, you could easily have another 20 years with your horse.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: Blood work results and confused!

Lavinia Fiscaletti
 

Hi Cheryl,

Insulin: To convert the pmol/L results to uIU/mL: divide by 7.1. So 1422 pmol divded by 7.1 = 200.28uIU/mL

ACTH: To convert pmol/L to pg/ml: divide by .22. So 8.2pmol  divided by .22 = 37.27pg/ml

Because Jewel is a confirmed PPID horse, we have found that keeping the ACTH solidly within the low-to-middle of the range at all times works best over the long haul . As her ACTH is already above the normal range, and still climbing due to the seasonal rise influence, that indicates the pergolide dose needs to be adjusted upward to compensate. 

Insulin seems to have shot up considerably but doesn't seem to jive with Jewel's appearance. However, the previous insulins were done fasting, correct? That would give you falsely low results. Were these results also done fasting?

There are no glucose values listed in the case history - has Jewel's glucose ever been tested?

Would you please add your general location to your signature as that helps us to be more specific in answering your questions. Thanks for your help with this bit of administrative housekeeping.

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


Carrots ok to feed?

 

Could someone look at this article & give me your opinion on it? The numbers & analysis make it look like very small amounts of carrots are ok but it doesn’t “feel” right. My barn owner sent this to me but I still don’t agree. Here is the link to the article 
http://www.thelaminitissite.org/articles/who-said-stop-the-carrots
--
Beth & Flame

NV Oct 2013

Flame Case History

Flame Pictures


Blood work results and confused!

Cheryl Oickle
 

Jewel is doing fantastic! Riding over 100 miles a month her weight and demeanor amazing and the morgan crest soft and minimal.  Her diet has NOT changed per case history, although a new supply of tested hay she is now eating and will be retested, just in case.She remains dry lotted. I am struggling to update my case history so please bear with me. 
I just received blood work and although I am pleased with the ACTH but I am really surprised with her insulin levels rising. The BIG caveat here is that the lab values and lab has changed  and so have the measures of her previous insulin levels which was 36.4 uIU/ml range 4.5-20.0 at IDEXX LAB in March 2019
ACTH 8.2pmol/L  Aug to Oct  range 4.62-11.66pmol/L  Nov to July range 2.42-10.22 pmol/L   TRUE NORTH LAB
INSULIN 1422 pmol/L  range 28-330 pmol/L   TRUE NORTH LAB
I cannot measure her trends with the different labs and values, can someone help decipher this?
IF her hay test reconfirms low sugar which I anticipate it will as it is a reputable dealer <8 ESC +starch.
What else should I be doing? I'm very worried or should I be.?
--
Cheryl and Jewel
Oct 2018

https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel

https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: Mare with severe founder and blood test shows Cuchings

Kirsten Rasmussen
 

It's your decision Beth, but as Laura said you could always sell the Timothy if it tests too high, especially if otherwise it is nice hay.

--
Kirsten Rasmussen
Kitimat, BC, Canada
January 2019

Shaku's Case History: https://ecir.groups.io/g/CaseHistory/files/Kirsten%20and%20Shaku  
 

Shaku's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=82559&p=Name,,,20,1,0,0   

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