Date   

Re: Transitioning from prascend to compounded pergolide

 

Cheryl here is a link to a message with helpful info and links to more messages. https://ecir.groups.io/g/main/message/244830?p=,,,20,0,0,0::Created,,compounded+pergolide,20,2,0,69241073
When you first want more info about a subject please start by doing a search of the messages. There is a search block at the top of every page (see the top of this page) so just type something like "ordering compounded pergolide". 

Also we have excellent "Files" see the link to our files in the column on the left side of the Main Group page. If you open the files you will find the search box at the top of the page.
--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


locked Re: Upward Fixating Patella Advice?

 

Hello R.C.,
All new members receive the following detailed informational posts. You'll also receive an email with instructions for creating a case history for you horse. Please explore our web site, the link is in blue below. Any words in blue are clickable links. We also have an excellent "Wiki" which will provide you with step-by-step directions for most of what we ask our members join/create/upload etc.

Now, I've personally owned three different horse with injured stifles which resulted in the locking/slipping patella issue. So I've had more than my share of how to strengthen those medial patellar ligaments. Walk only in straight lines, keep the horse's stride short early on. NO lunging or circles. 
Avoid mud/slick footing. I found a nice gentle grassy slope with mowed grass to do this exercising. Initially we walked straight up the moderate hillside, slow shorter steps then I went downhill on a milder slope, very short steps and repeat, repeat, etc. Eventually each horse improved to the point where I could do this under saddle. We progressed to the point of walking that slope in a serpentine pattern, always using shorter strides downhill and gradually using longer and stronger strides uphill. The progression from there was to slow controlled trotting in straight lines on good footing. Two of my three horses had complete recoveries, one became an eventer the other went on to a show career. The third horse had damaged her stifle as a 2 yr old fighting with a wire fence. She could remain pretty sound as a pleasure type trail horse but slick footing was her downfall. The rehab needed is boring and slow but it works. Just have patience and do those walks!


Welcome to the group! 

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 following 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.

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. 

 

--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Transitioning from prascend to compounded pergolide

Cheryl Oickle
 

Could some one point me to the information on the above topic? Namely how the prescription should be written to assure the same dosage is being given?
Currently Jewel is on one mg of Prascend.
Thank you
--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel

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


Re: Logan Insulin increase

Amy Veatch
 

Hi Irene,
The only thing I would add (besides I'm kind of surprised his insulin has been as close as it has to normal (keeping in mind that 10-11 is the target max) in the past with his ACTH numbers--wow!  those are really high) is that I noticed he stopped receiving yummy bananas in June 2018 (apparently after an insulin result in the 80's) and that in the months afterward his insulin dropped significantly.  Is there any chance a good-intentioned but poorly-informed someone at your barn is slipping him treats without your knowledge? Just looking at those numbers and comparing his feed history, it looks like he might have snuck back on the banana train. :-)

--
Amy & Princess (12 year old KY Mtn Saddle mare) & Max (6 year old mini gelding) - both PPID/IR
Southeast TN, Joined 2019

Max:

https://ecir.groups.io/g/CaseHistory/files/Amy%20and%20Max
https://ecir.groups.io/g/CaseHistory/album?id=134444&p=Name,,,20,1,0,0

Princess:

https://ecir.groups.io/g/CaseHistory/files/Amy%20and%20Pincess

https://ecir.groups.io/g/CaseHistory/album?id=96097

 



Re: Test results after Metformin

Aurelio Henriques
 

Regarding cubes to hay equivalency, One lb of cubes are generally equivalent to about 1.25 lbs of hay. This is mostly due to the fact that
the cubes are drier than hay and that there is no wastage with cubes.
In addition, the Timothy Balance cubes do contain some beet pulp which ups the safe calories a little.
Still, I like to use the 1.25 rule of thumb as a starting point.

Aurelio
Ontario Dehy
Ontario Canada
 
Aurelio Henriques
Ontario Dehy Inc.
tel. 519-524-1063
On 01/13/2020 11:07 AM, celestinefarm wrote:

Thanks, Cindy, I just wanted to clarify because for those unfamiliar with Timothy Balance Cubes, they might not realize they contain beet pulp. Hay cubes are always marketed as to be fed equivalent to hay, and there might have been confusion.
--
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: Is anyone giving 3 Prascend?

 

My daughter's mare, Lyric is on 3 a day. If you search the files you should find a document w/ listing of the various dosages. Perhaps a mod can chime in. Nancy Reed


Re: Bloodwork and possible error

 

I’m sorry to say I’ve seen exactly the same effect in both Satra and Cayuse: reasonable in October, higher in January. And here, winter is only vaguely what people in other parts of the country think of winter. Not cold, days in the 60s. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse Case History Folder                Cayuse Photos
Diamond Case History Folder              Diamond Photos 


Re: Is anyone giving 3 Prascend?

Bonnie
 

Mine is on 24 mg compounded capsules as has done well on it for years.
--
Bonnie and Lad
North Ontario
Dec 2008
 


Re: 2nd request Metformin

Amy
 

I've searched and see that it can be only temporary , but others have kept their horses on it for a long time.  

I was just curious if it can have long time affects?  I'll be getting bloodwork probably in February and see where his insulin numbers are.  If they are still controlled then I'll have to decide if it's a good idea to take him off and retest or just keep him on it.  I feel like if its working don't change protocol,  but I also dont want to spend the money and keep using a syringe 2 times a day if I dont have to.  I already have to use a syringe to get his pergilode in as he can't be trusted to eat his grain as he only eats that a few times a week.  

I guess I'm lucky that he doesn't put a fight since I syringe 3 times a day.

Thanks 
--
- Amy 10-2016

Mooresville, Indiana 

Stormy, Case History, Photo Album

 


Re: Jiaogulan quality

celestinefarm
 

Mega, 
I had received an unused package of jiaogulan from Uckele back in October and when I opened it, it was brown. I have always used jiaogulan from My Best Horse and found it to be a bright green powder. I also had personally consumed tea made from jiaogulan leaves from online companies , Immortalitea and Majestic Tea and the leaves were a darker , but definitely green color. ( I discontinued jiaogulan tea when it seemed to make me tired, but have recently resumed using jiaogulan through Immortalitea that is in capsules. The jiaogulan in their capsules is a dark green , but definitely green color powder. Not getting the tired effect like I did with the tea)

I mentioned the brown color of the jiaogulan here back in October and it was suggested I contact Uckele, which I did. One of their service reps asked me to text her a photo of the jiaogulan, which I did, and included a photo of the bag with the batch number and dates so she could show it to one the production staff members.. I have never received any reply back as to whether it was normal, etc. I've since repurchased jiaogulan from My Best Horse, and haven't had any issues with horses liking it. 
--
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: Test results after Metformin

Sherry Morse
 

Hi Dawn,

I have no idea about the beet pulp - this is the content of the message (and groups.io seems to be back to normal now):

   The ODTB cubes can be fed as part of the diet or even the sole diet. It replaces hay at about 3:4 ratio dry weight. Meaning, rule of thumb, 3 lbs of cubes replaces 4 lbs of hay.




On Monday, January 13, 2020, 10:57:15 AM EST, celestinefarm <celestinefarm@...> wrote:


Sherry, groups i.o. is acting up for me this morning, so I can't read Aurelio's message. The reason 3 lbs of cubes equals 4 pounds of hay is because the cubes include beet pulp , which increases the caloric count? 
--
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 .


Logan Insulin increase

Irene Collins-Fotino
 

Hi Sherry and Martha,

I will put all of this into Logan's CH but for now here is what I have:

most recent blood work was sampled on 11/12/19 and finalized on 11/20 at Cornell:

glucose    103   range 71-122
lipemia     5   normal <30
hemolysis    6   normal <20
icterus    1   

ACTH  >1250
Insulin   55.47   range  10-40

Previous bloodwork is in his CH. 

His feed now - recommended by Dr. Kellon in October is:

6 pounds of ODTB cubes. These are soaked in hot water. He likes them warm
   and wet, but not sloppy wet
4 pounds of Stabul 1
4 pounds of beet pulp      These do not contain molasses. They are soaked in not water, but
   not R,S,R

The vet is usually at our barn in the morning, but he probably had his morning meal of
beet pulp, Stabul 1 and cubes piror to the blood draw.

Thank you so much,
--

Irene & Logan
NRC 2009
Hudson, NH

https://ecir.groups.io/g/CaseHistory/album?id=9598

https://ecir.groups.io/g/CaseHistory/files/Irene%20&%20Logan


Re: Jiaogulan quality

Lorna Cane
 

Mega, I should have added that both Uckele and My Best Horse sell quality products.
You can't go wrong with either company.

--

Lorna  in Eastern  Ontario
2002


 


Re: Jiaogulan quality

Lorna Cane
 

Hi Mega,

If you contact Joan,at My Best Horse, she can tell you where she sources her J-Herb, and possible reasons for its colour/aroma.

Www.mybesthorse.com


--

Lorna  in Eastern  Ontario
2002


 


Jiaogulan quality

mega
 

So, I recently bought 1 pound of Jiaogulan from mybesthorse.com and it is green with a fairly strong smell, especially, when it gets a bit wet. I usually by the Jiaogulan from Uckele and it is usually brownish and I never noticed a particular smell. Does anyone know whether there is a difference in quality, which one might be better or how what to look for? Thank you!
--
Mega
Maryland
November 2019
https://ecir.groups.io/g/CaseHistory/files/Mega%20and%20Aine 


Re: dry skin rx for dry skin with ir horse

Daisy Shepherd
 

thank you dr kellon,   he gets uckele equi hoof complex 1 scoop daily that has 20mg of biotin plus uckele equi-vm  1 scoop  should i increase to 2 scoops.  also read that you recommend chrondtin  which i do not use.   gets thyro l 2 scoops daily;  just had an acth repeated 1/2020 as you recommended  was 14.4 cornell   was 48.6 11/2019; will do blood work again late spring.  any other ideas greatly appreciated.  thank you, you are so greatly appreciated, daisy and tiko
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: dry skin rx for dry skin with ir horse

Daisy Shepherd
 

thank you bonnie;  he gets 2500 iu daily of ucekels liquid vit e; thought it was in his case hx so will check.  also wonder if using the cocasoya oil would be  better than the granular  but also wonder if the granular is more suitable  for the ir horse; i have increased the granular for winter to 2 scoops, maybe 3 is needed. ( scoop that comes with the granular ). thanks for your input, daisy and tiko 
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: Test results after Metformin

celestinefarm
 

Thanks, Cindy, I just wanted to clarify because for those unfamiliar with Timothy Balance Cubes, they might not realize they contain beet pulp. Hay cubes are always marketed as to be fed equivalent to hay, and there might have been confusion.
--
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: Test results after Metformin

Cindy Giovanetti
 

Yes, Dr. K has said that. Apparently the balance cubes are more calorie dense than hay. 


Correct me if I'm wrong, but 20#s of Balance cubes equals more than 20#s of hay, doesn't it??
_._,_._,_


Re: Is anyone giving 3 Prascend?

Sherry Morse
 

Hi Marion,

You may need to discuss the fact that there are many horses who are on more than 2mg of prascend per day with your vet. You can take a look at the Pergolide Database to get an idea of some of the dosages being used by ECIR group member horses.  It's also noted on the main ECIR page that we have horses using up to 17mg a day: https://www.ecirhorse.org/pergolide.php