Date   

Re: Iron overload and IR/PPID - peer reviewed studies?

Joy V
 

Thank you so much!  I cannot believe people are arguing that iron overload is rare and hardly happens.  Some are saying that the iron in dirt & water is not "bio-available" and horses aren't affected by it?

--
Joy and Willie  
(aka FLS Boxcar Willie)

Nevada County, CA - 2019


Re: Scooter's Hooves ready for 1st markup - with X-rays (!!)

Leah Bartel
 

Hi Lavinia,

How do you know the frog and soles are being heavily over-trimmed? What should they look like instead? I was always told to just remove the "junk" sole (flaky, crumbly looking) and leave the "live" sole (smooth). I also have been mostly leaving the soles alone, except for the bar area and have been blending the bars into the natural sole. The frog Ive always been told to trim so that it is passive to the heels, meaning just slightly shorter than the heels. Please let me know if any of these frames of reference that I've been using to trim are incorrect or need to be changed in Scooter's case.

The hind foot shots have been uploaded as well so I'd love to get the markups soon! Thanks!
--
Leah
Ohio
2019

Scooter's Case History: https://ecir.groups.io/g/CaseHistory/files/Leah%20and%20Scooter
Scooter's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=240467


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

Deb Walker
 

Sandra - Scotty was started on a liquid compounded pergolide in May of 2017. He foundered severely that late summer/fall. Little did I know that the liquid concentration cannot be guaranteed to hold it's potency. From there switched to Prascend, but like you, when dosage needed to go up, I went with chewable pergolide from Wedgewood. Again, live and learn. His symptoms were not being controlled with even the higher dosage, and after several conversations with pharmacists at WW, including the head of the department, it was determined they do not test shelf life of that particular product and they refunded my money to me.

Since then he has been on 4 mg pergolide mesylate from Pet Health Pharmacy (which they did tell me is more like 3.3 mg Prascend) and he is doing much better.

Having been through this, and now knowing Scotty was not getting the help he needed from very expensive medications, I would never use the liquid or chewables again. If my vet would not prescribe it, I would find a different vet.
--
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


Invokana doses

Kim Rice
 

I have had my horse on prascend 4m for over a couple of months but he has been dealing with Cushings for a year.  

on 12/13/19 his blood work came back with ACTH 35.4 down from 59 but his insulin over 200; started on metformin 14x2 1/11/20 then blood work on 1/29/20 ACTH 35.7 and insulin over 200.  Feel metformin isn't working so looking into trying Invokana.

How much do you dose a 1,000 pound horse?

Please help Dr. Kellon.
--
Kim R, Lafayette, CA  2019


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

 

Thank you!  The fault was me.  Trying to do two things at once.

I didn't know there was a signature wizard! Yeah!  I will go do that now.

Sandi and Cody from WV
2007


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

Lorna Cane
 

Hi Sandra,

I wonder if you have a signature gremlin ? Your last 2 messages didn't come through with a signature, but others have. If you are making a signature manually for your messages, we can put you out of your agony, and make it automatic .
Just go to Subscription, put your signature into the signature box, scroll down to hit SAVE.  Bob's your uncle. 😉

OTOH, if you actually have made an automatic sig., and a gremlin is at work, I have no clue how to help. Sorry.

Lorna  in Eastern  Ontario
2002


 


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

 

Thanks Dr. Kellon. I will make sure to request that.   


Re: New Member - Need Trim/Balance Mark up if possible by 2/25/2020 #understandingtrim

Eleanor Kellon, VMD
 

The main reason for another test is to see if her dose of pergolide (if she's even on it now??) is adequate.

Has she ever been tested for Lyme disease? How painful was she in 2014?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Iron overload and IR/PPID - peer reviewed studies?

Eleanor Kellon, VMD
 

Here you go - and also the references at the end.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971364/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

Eleanor Kellon, VMD
 

There doesn't have to be any conversion issue if your prescription reads:

            x mg of pergolide, as pergolide mesylate

instead of just x mg of pergolide or x mg of pergolide mesylate.

The legality question comes up repeatedly. It is not illegal to write a prescription for pergolide in any compounded form. What the FDA says is illegal is using bulk drug instead of crushed up pergolide to make it. However, federal district courts have disagreed in similar cases. The legality is not cut and dried but in any case it does not involve the prescribing veterinarian.

 

Read the threads here: https://ecir.groups.io/g/main/search?q=%23legalityofpergolide&ct=1


--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Iron overload and IR/PPID - peer reviewed studies?

Joy V
 

This is probably mainly directed at Dr. Kellon.  I'm in a hoof group online (offshoot of Pete Ramey's) and there is a very interesting thread going about commercial feeds/grains with iron added.  One of the things that keeps coming up is people say they want to see peer reviewed studies because they don't believe iron is bad for a PPID/IR horse.  I have shared what I know and given links to Pete's website (where he quotes Dr. Kellon).  But I wondered if any of these "peer reviewed" studies exists?  

(am working on my case study, I apologize.  This weekend I'll get it posted, I swear)

Thanks in advance!
--
Joy and Willie  
(aka FLS Boxcar Willie)

Nevada County, CA - 2019


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

 

Thank you.  I had not realized that conversion factor when switching. You are right, there would be very little increase going from 2.6 (2 prascend) and 3 CP.


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

 

Hi Sandi,  

I used a pergolide/oil suspension for years while I had a local compounding pharmacy formulating it for me.  Once I learned that encapsulated powder was available from Pet Health Pharmacy, with greater stability, I switched over to those.  I bought 60 days of oil at a time and my horse’s response seemed appropriate.  By the time Prascend hit the market, I was already using well over their recommended dose.  I used a combination of Prascend and compounded pergolide in my horse’s later years because invariably a new vet would ask if I’d tried Prascend.

I would suggest the liquid over granules because it goes directly into the mouth without any ‘discussion’.  They can flavor it, which can be helpful.  I had mine formulated initially at 1mg/ml and eventually increased it to 10 mg/ml, when I bought some a few years ago to aid in dose titration.  Keep in mind that, if you switch from two Prascend to 3 mg of compounded, your effective dose will have changed very little as each Prascend is equivalent to 1.3 mg of compounded.  Others do it differently but I would plan to titrate your way up to 4 mg of compounded pergolide (the equivalent of 3.08 Prascend) and then just ignore the conversion factor for any future increases.
--

Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

 

That is exactly it.  He says he can't prescribe the compounded since there is an FDA approved drug unless I can come up with a reason.  He said he is required to use the FDA approved drug unless there is a reason the horse won't take it, so he can prescribe an alternate format but would not accept capsules as being that different from tablets. He is based in Ohio so I don't know if state laws come into play. I also tried the justification of needing a in between dose such as 2.75 mg for getting the capsules.   

I saw the storage concerns about the powder/granules in addition to concern about dosing discrepancies.  If I had to go to this method I would definitely figure out a way to divide and seal in smaller containers.  But of course that is exposing it to air .......

Sandi and Cody in WV
2007

https://ecir.groups.io/g/CaseHistory/files/Cody%20aka%20Quite%20Appealing%20from%20WV


Re: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

celestinefarm
 

Sandy, 
I can't look it up right now, but there was a discussion a while back about Wedgewoods pergolide granules. Wedgewood has not outside tested the granules for stability and a concern is that pergolide itself is fairly fragile. A jar of granules will expose the pergolide to air every time it is opened, and may allow for faster degradation of pergolide. 
The reason Prascend has the longest shelf life is because it is packaged in sealed, foil blister packs that keep all light and air out of exposure to the tablets. Next longest stability are capsules, for the exact same reason. Pet Health Pharmacy also has done stability tests on the capsules and found they are stable for six months. Again, because the pergolide is not exposed to light and air( every capsule of pergolide I've ever gotten has been opaque white.)  As you noted, liquid is only stable for 90 days, and that is questionable. Also, liquid can be more difficult to get in a horse and to measure accurately. 

Why does you vet only want to prescribe liquid or paste?  Is he thinking that there is some legal issue with capsules because of Prascend? ( We are very aware that many vets are under the mistaken idea that Rx compounded pergolide is illegal, which is hilarious when you consider that nationally accredited and known veterinary compounding pharmacies provide compounded pergolide in various forms. That's what compounding is, creating a form of an approved drug that allows it to be easier administered to animals, or in the case of humans, because of an adjunct ingredient in the drug that the person is allergic , etc.)  

Hopefully one of the mods can come up with the research file on stability of capsules.  Also, many of us open the capsules and put the powdered pergolide directly onto a carrier, as our horses will not eat a capsule.( that's my situation).  But at least they are stable until being given.
--
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: New Member - Cushings diagnosis and laminitis

Maxine McArthur
 

Hi Diana
Just a quick follow up to the welcome message—you may not be able to get leptin done, but definitely also do insulin and glucose. Not sure where you are in NSW, but my vet uses the lab at Charles Sturt Uni in Wagga. They are quite a bit cheaper (at least for ACTH, insulin is similar at all the labs) than Idexx or Vetnostics. Might be worth a mention. Also, make sure the vet emails you a copy of the actual results. 

Please also check the link in the welcome message about getting accurate xrays. In particular, make sure you mark the dorsal wall. I usually bring a small piece of wire (or a farrier nail) and some blu-tack, in case the vet is unprepared.

The soaked teff is fine for the moment, and Carols minerals are good too.  Let us know when you get the test results and X-rays. 

Keep breathing! Each step takes you closer to helping Prince feel better. 

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Re: New Member - Need Trim/Balance Mark up if possible by 2/25/2020 #understandingtrim

celestinefarm
 

Mel,
APF stands for the Auburn Labs product, Advanced Protection Formula. It's an adaptogenic herbal supplement that helps to counteract the side effect of initial administration of pergolide, which is lethargy, off feed, etc.  The side effects don't last long, but having a horse go off feed, etc. is never a great idea, especially if you can avoid it. APF is available not only from Auburn Labs , but online in most equine catalogs also. Here is the link
https://www.auburnlabs.com/product/equine-apf-the-original/
Please note that it is relatively expensive . A bottle doesn't seem too costly, but you have to give most horses 10 or more ml  once or twice a day to be effective, so it drains a bottle quickly. An alternative to APF is to give Jiaogulan, which is a vine type of plant from SE Asia that is also a great adaptogen.   Jiaogulan is best given 20 minutes prior to a bucket meal, and the dosage is to effect. Start with one tsp of powdered Jiaogulan and titrate up from there until desired effects are noticed.( usually pink gums, but in the case of pergolide veil, until horse brightens up, begins eating and drinking normally, moves around more, etc.) Many here give Jiaogulan permanently, my stallion get's two tablespoons per day. 

If dosing 20 minutes prior is not feasible, then give in the bucket meal, but plan on giving a higher dose.

It can be purchased online and is far less costly than APF. Members also will switch to it from APF once their horse seems to adapt to pergolide well.  Two sources are Uckele and My Best Horse. 
https://uckele.com/jiaogulan-powder-1lb-bag.html
http://www.mybesthorse.com/productsorderhere.html


--
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: Pergolide - Vet only prescribing paste or liquid - feedback needed on options

LJ Friedman
 

wedgewood so odd with their bs policy of no price given before they receive an rx
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: New Member - Need Trim/Balance Mark up if possible by 2/25/2020 #understandingtrim

Lorna Cane
 

On Tue, Feb 25, 2020 at 01:03 PM, Mel V wrote:
I don't recognize the APF acronym yet.  I'll go looking for it. 
Hi Mel,

For a valuable list go to our Files, click on Start Here, and scroll down to fith entry, Commonly Used Abbreviations...

 
--

Lorna  in Eastern  Ontario
2002


 


Re: New Member - Need Trim/Balance Mark up if possible by 2/25/2020 #understandingtrim

Mel V
 

Eleanor,

I don't recognize the APF acronym yet.  I'll go looking for it. 

Bali is rather bright eyed and cheerful this week, just foot sore.  I'm willing to believe that her long toes are contributing.  That's getting addressed tomorrow.  Hopefully my farrier can get her feet balanced tomorrow.  And, Bali tested negative for IR a few years back(probably 2014), which my vet contributed to my controlling her diet.  I did not get lab reports and would need to call the office to see if they have them online still.

How important is it to send an ACTH test off to Cornell? I should check how much that one costs.  Like most, I have to be smart with my vet budget and decide what I should spend my money on.   If my vet needs to run back to the clinic after my farm, I need to make sure he knows so he can adjust his schedule on the 6th. I already stagger her vaccinations.

I do have a few blood chemistries from the Aug 27 - Sep 3, 2019 time frame.  I can upload those into a blood work sub-folder to her Case File?(if I understand the instructions correctly.) 

Off to re-read which folders get which files, then I can put blood work reports there, although they were all pulled when she was non-weight bearing.  A couple of the vets (and not the new graduates) said she was one of the most painful horses they'd ever seen.  She blew through the nerve block in 2 hours.  We truly thought we might have to put her down until the surgeon came up with trying ketamine on an 8 hour schedule, since I did not have a 3 day weekend hospitalization budget.  It worked.

Thanks again,
--
Mel & Bali
Joined ECIR 2/23/2020
Purcellville, Virginia, USA
Case History: https://ecir.groups.io/g/CaseHistory/files/Mel%20and%20Bali
Photos: https://ecir.groups.io/g/CaseHistory/album?id=241764

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