Date   

Re: New member, looking for help

plentygoats@...
 

Hi Martha and Dr. Kellon, 
Thanks for your responses. I will take a look again at the test results in relation to the ACTH and get them posted with the photos this weekend. I do understand about not fasting before the blood test and this years test was done with her on hay, not fasting. I am going to consider testing for PPID and start reading those pages as well. I forgot to enter on the Case History the weight of the hay I give her so I will update that as well. She gets 14-17 lbs per day so I think I have her in the right range. I was surprised that with the weight calculator she came out as 980 lbs since weight tape said more like 925 so I will look forward to feedback on her weight once you see the photos. She has never had the characteristic fat pads, cresty neck, etc of IR so even though I suspected it three years ago, I was not encouraged to test for it because she was not obese or fat in the typical way of an IR horse. Now I understand that that is not always a symptom. I understand the value of doing hay testing but here is my question: I buy my hay about 8 bales at a time because I do not have much room for hay storage so have figured it would be cost prohibitive to have each new batch tested. Any suggestions?(besides build a bigger barn!) I have also wondered about having my pasture tested but don't know quite how to go about that - such as getting a representative sample. I did start buying from a new place recently and they did have the analysis of the low carb hay, which I will post with the photos. Once I get the photos of her hooves up I would be interested in learning more about the LaminOx or Jiaogulan treatments, which I am not familiar with. Anyway, more to come.
Thanks!
Myra 
--
Myra 
April 2020, Sonoma County, CA
Stella Case History: https://ecir.groups.io/g/CaseHistory/files/Myra%20and%20Stella  .
Photo Album:


Re: Prascend Chart

Lorna Cane
 

I typed pergolide database into Search box,and this came up.

https://ecir.groups.io/g/main/filessearch?q=Pergolide+data+base 

Scroll to last item.

Database is closed at present , awaiting roll out of new case history form.

--

Lorna  in Eastern  Ontario
2002


 


Prascend Chart

 

I have recently updated Harley's History and now need to update his Prascend dosage and I can't find where to do that.
Any help is greatly appreciated.
--
Lynn and Harley

Oct. 2010 
New Mexico, USA

Case History
Harley's Photos 


Re: URGENT - Pergolide

Melanie Pewe
 

A HUGE thank you! I do not follow this group closely and was in a near panic mode hearing I should just get Prascend .... that was not not doable at $10 a day. 

I called Pet Health and they ship to all 50 states. I contacted my vet clinic and requested they move my script over. It will actually be cheaper and they have autoship!  $1.51 for 4mg.  Whewwww

I knew I could count on you guys! 

It’s time to retest as I do spring and fall but the clinic isn’t taking routine calls currently. Thankfully my old guy is doing well, turning 26 next week.

Melanie in ND 


Re: URGENT - Pergolide

celestinefarm
 

Also, I just refilled Tipperary's Rx this morning with Wedgewood and they said it will arrive no later than....April 21. Two weeks. I"m fine right now, have enough CP to last until then, but I want to warn members that you do not want to wait until you are down to a week or so worth of CP to reorder right now. Between shipping delays and pharmacy staffing shortages with Covid 19, just in time refills will not work. 
--
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: URGENT - Pergolide

celestinefarm
 

Melanie,
I had returned last fall to using Thriving Pets, but in January, I had a real issue with their website. I was unable to get it work or reorder, had to call, and it was such a mess with messages, that I ended up having my vet call Wedgewood Pharmacy and place an Rx for Tipperary's pergolide. Then, a week later, my reorder from Thriving Pets arrived. I have zero idea how, apparently messages got through , but there was no acknowledgement, and I couldn't just assume they did.

If you do decide to use Wedgewood, be forewarned, they do not have capsules available in sizes larger than 4mgs.  In Tipperary's case, I had to order 3mg caps and 4mgs caps to get the 7mgs daily he is on. Which is really expensive, 100 caps of each ends up costing over $400. $ 4 a day is certainly well below the equivalent cost of Prascend, which would be $14 a day, but is higher than Thriving Pets was and Pet Health. 

I would go to Pet Health if possible. 

Ian Hutchings is the owner of Thriving Pets, and he is not a pharmacist. Rather, he keeps partnering his animal OTC products with pharmacies willing to compound or dispense Rx. products such as Prascend.  This will now be the third pharmacy in ten years that I know of he is been affiliated with. His original pharmacy was in Colorado and he ended up with citations from the State of Colorado on the pharmacy and himself over administrative issues at the pharmacy, which ended up closing permanently.( A search of google and the Colorado State Licensing Board can provide some details). He ended up in NJ for the past few years, now he's back in Colorado. His situation is too unreliable , IMO, and I personally will be returning to Pet Health when I complete my Rx with Wedgewood. 
--
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 .


Welcome to Herbie and his mom, Jessica, was leptin

 

Hi Jessica,
It seems as though you have been a member of the ECIR group for several years but this is your first post which triggers an official welcome from us.  You’ve got your signature and case history in place and so much of this will not be new to you but here is lots of information, with appropriate links, all in one place for you to review.  Please let us know if there are any questions you have we can help with.  If they are about Herbie, it would help if you updated your Case History to reflect the situation as it is now.  And thank you for participating!

The ECIR Group 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. 



--

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: At. My. Wits. End.

Lorna Cane
 

Sh-hhhhh, Coral.
You must whisper good, but  fragile,  news like this.
😊
--

Lorna  in Eastern  Ontario
2002


 


Re: At. My. Wits. End.

 

So I gave his food to the other 2 for 3 days and held off on giving him anything. Last night he ate his food. Fingers crossed that this lasts for a while. 
--
Coral & Po

Sept 2013

Midland, Texas

Case History: https://ecir.groups.io/g/CaseHistory/files/Coral%20and%20Poseido  .
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=107390  
**On the old forum site I had a bunch of hoof photos posted but those appear to be lost. **


Re: New blood work

Joy V
 

Kirsten, I missed something you said.  I feed soaked hay, that I buy & have at home, in the evenings for him to eat at night.

--
Joy and Willie  
(aka FLS Boxcar Willie)

Nevada County, CA - 2019


Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: New blood work

Joy V
 

Hi Kirsten,

Yes, I tried salt, and then I watered.  But it didn't kill the grass.  

The barn hay is always changing, so it's not really a help to get it tested because it will change before I even get the test back most likely.  The barn owner buys very nice (bad for my horse) hay.  I can't soak the barn hay because I don't have the time it would take to do it unfortunately (it would have to be soaked at the barn for both feedings & I'm working 3 jobs so logistically I can't make it work - I did try).  My goal is to buy the tested hay my hoof care practitioner has told me about and to feed my horse on my own and not use any of the barn hay.  My *ultimate* goal is to free feed him the tested hay in a slow feeder.  It always comes down to $$ though.  :( 

I'm going to focus on killing the grass.  I liked Lorna's idea of covering with something.  

Thank you so much for the suggestions Lorna & Kirsten both.  I appreciate it.
--
Joy and Willie  
(aka FLS Boxcar Willie)

Nevada County, CA - 2019


Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: URGENT - Pergolide

Nancy C
 

I'm sorry Melanie. 

Here is a list of pharmacies members have used successfully.

https://ecir.groups.io/g/main/wiki/ECIR-Links

To All: THIS is why Thriving Pets is not on the member recommended pharmacy list.


--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2020 NO Laminitis! Conference, October 23 - 25, Harrisburg, PA


Re: leptin

HerbiesMom
 

Hi LJ - High leptin levels demonstrate leptin resistance. You want low leptin levels. My horse had high leptin in his blood and therefore leptin resistance, and he was insatiable. He also had insulin resistance.  What I learned is that to lower leptin levels you need Forage, Freedom and Friends!  FORAGE:  He has suitable forage - low ESC + Starch hay that he never runs out of, in slow feeder hay nets of various sizes.  FREEDOM:  He is now on a grassless track system, I hang hay nets all over the track to encourage freedom.  FRIENDS:  He was kept alone. He now has a pony friend who is his best friend and they move a lot more together.  My horse's leptin levels were testing at 30+. I just had his blood work done two weeks ago and his leptin level was 9.84.  Getting the leptin resistance under control, IMO, is key to keeping the insulin resistant horse healthy.   
--
Jessica and Herbie 
November 20, 2018 
Herbie Case History: https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Herbie


Re: URGENT - Pergolide

LJ Friedman
 

What I suggest you do is call Pet Health. Sometimes they can call thriving pet and move the prescription over. I know that’s done in the human side not sure about the Animal side. But have no worry Pet Health will be fine for you
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: leptin

LJ Friedman
 

No. Thank you for checking. I was always under the impression because his appetite is voracious that his leptin was crazy high. So I will put that notion to rest
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: leptin

Sherry Morse
 

Hi LJ,

Based on what's in his CH he's right in the normal range.  Has there been a change since those last results?



Re: leptin

LJ Friedman
 

Thanks for the reply. So in corrected my statement, Jesse has high leptin levels.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: URGENT - Pergolide

Sherry Morse
 

Hi Melanie,

You may have missed this recent discussion on Thriving Pets (https://ecir.groups.io/g/main/topic/72770431#248521) but there are certainly other compounding pharmacies out there if you need to change.  Many of our members use Pet Health and are very happy with them.  
Pet Health Pharmacy, https://www.pethealthpharmacy.com/, 800 742 0516.



URGENT - Pergolide

Melanie Pewe
 

This morning I logged into my Thriving Pets account to reorder Alex's 4mg of pergolide only to find out through their chat site that I cannot reorder since they recently partnered with a new pharmacy in CO and only have permission to ship to about 5 states currently. And NOT North Dakota.  These capsules cost $1.65 each.  Their recommendation is to have my vet order Prascend.  OMG - That would cost me $10 a day - which is not in the budget at all since I am out of work.  Anyone know of other reputable online pharmacies that I might get my vet to send a new script to? THANK you.

If you care to send a personal message my email is mpewe @ srt.com

Melanie
in ND
(steward to Alex - my 26 yr old Morgan gelding with PPID)


Re: At. My. Wits. End.

Pat Gauvreau <pgauvreau@...>
 

Coral
i agree with Trisha ... LET THAT ANGRY ENERGY GO. 
Many of us have gone through this feeding problem. Go to a place of compassion instead of frustration. Try not feeding her anything but hay for a day or two, then give her a little mash of something she likes. The next day begin to “inch back” all the other stuff slowly (over a month). Just add a “pinch” of the bitter tasting supplements to something she does like. Leave it there until the next day and see if she ate it. If she did, add another pinch and so on. If she goes off it again, reduce to previous amount. Just keep doing this bit by bit. Don’t get mad at her as your negative energy is getting in your way. Play with her instead of always being the one that brings distasteful stuff to her. Give her a safe treat when you greet her to build back trust. Take the time it takes so it pays off on the end. Your horse depends on you. Remember to be kind at all times. Your emotions are picked up immediately when you arrive. Take deep slow breaths as you approach the barn, relax your mind and body, think positive thoughts and loose your anger. Please...   

--
Pat and Savannah
Vancouver Island, British Columbia, Canada
January 2018 

Case History: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Savannah
Photos: https://ecir.groups.io/g/CaseHistory/album?id=22028&p=pcreated,,,50,2,0,0

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