Date   

Re: Continued use of soaking water

Maxine McArthur
 

Hi Tori
No, you can't re-use the soaking water to soak again. The whole point of soaking is to leach out the sugars. So the sugar is in the soaking water. If you soak dry hay in sugar water, it won't leach out any more. Also, the soaking water may ferment, which is potentially dangerous. 
Please tell whoever asked that they should drain the soaking water where horses can't drink it. 

--
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

 


Continued use of soaking water

Tori & Floss
 

I have been asked if the same water for soaking hay can be safely used for a week?
I understand people sometimes need to save money and water too but is this safe to use the same water every day to soak your hay?
Thanks for your time.
--
Tori

 

December, 2016

Adelaide Australia

Case History  https://ecir.groups.io/g/CaseHistory/files/Tori%20and%20Floss 

https://ecir.groups.io/g/CaseHistory/album?id=3347

 

 

 


Stabul 1 availability

Irene Collins-Fotino
 

Thank you all for this information. I will call Randy on Monday. 
Dawn - I understand the shipping, distribution etc., costs, but interestingly enough Kim is able to get
feed shipped directly to her. 
I did speak to Randy earlier this year and he told me that for him to ship to me would be cost 
prohibitive for me. If I can't get Stabul at a decent cost, I will have to switch Logan to another 
feed - not something I want to do and I'm afraid that might not be good for him. 

I'll let you all know how my conversation goes with Randy. 

Thanks all!


--

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: Cabergoline not available—emergency—Dr. Kellon

Mary T
 

I just had a conversation with Dr. Douglas.  He said the drug has been stuck in customs 12-14 days.  He thinks it may be in NYC—it is in the US.  He mentioned some other clients were going to call their congresspeople.  I am going to do that on Monday—I have two good Senators.  Anyone else heading into a situation like ours might consider doing the same.  The description is 25 GM cabergoline for horses, the only one (any other veterinary cabergoline would be for dogs).  I am afraid with all the horrific human tragedy, animals are being forgotten or pushed aside.

Dr. Kellon, he can’t compound from Dostinex due to the fillers.  He mentioned adding Cypro to the Pergolide for synergy until I can get the cabergoline again.


Re: Stabul 1 availability

gypsylassie
 

Kim, what size bag do you get shipped directly from Randy?
Laura K Chappie & Beau over the bridge
2011 N IL


On Apr 17, 2020, at 6:31 PM, Kim Rice <kimberztaz@...> wrote:

Randy at Anderson Feed ships directly to me; call him on Monday.
--
Kim R, Lafayette, CA  2019
https://ecir.groups.io/g/CaseHistory/files/Kim%20and%20Shomee


Re: Potential PPID on a deadline

Tiffany
 

I should probably add he's not showing any signs of active laminitis currently either. His digital pulse is back to normal.
--
Tiffany
Lincoln County, MO
April 2020
Hollywood Case History: https://ecir.groups.io/g/CaseHistory/files/Tiffany%20and%20Hollywood
Hollywood Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=245376


Re: Potential PPID on a deadline

Tiffany
 

Thanks Sherry. I have reached out to the Equi-Analytical and will wait for response to complete the hay analysis. This is completely new to me as the only analysis the stable provided didn't include ESC or other horse pertinent info and I'm in unfamiliar territory sorting that aspect out also.

With regard to the metabolic panel, I will ask for these add'l blood test when we draw ACTH again which I'm hoping will be soon. I placed a call to the vet yesterday and am awaiting response. I'm very familiar with advocating on behalf of my horse which I have had to do passionately and research/educate myself a great deal these last few years. It has paid off. I do have a great vet, but my horse is a complicated case. For example, when he had ulcers all outsiders swore he didn't and were willing to bet on it, yet he had severe ulcers but not typical symptoms. Same when he was diagnosed with EPM...all my equestrian friends thought he was fine and I was jaded due to my experiences. However, with the lyme I would like to test but am still a bit hesistant. I have been told repeatedly lyme is rare here in MO and we have serious medical expenses in my family, not even considering that of my high maintenace canine and equine fur babies so sadly I'm forced to prioritize. My insurance will cover the metabolic due to the claim, but I don't feel confident they will cover the lyme. Do you by chance know what that expense would be? I just don't have any other signs that cause me to suspect lyme and the EPM is well controlled. However, I have heard of many PPID horses experiencing spooky behavior and my vet confirmed that with his experience also.

With the Outlast -- the link you included gives the NSC not the ESC which you mention I should be concerned with. I knew the NSC as I researched it and brought my concerns to my vet with that info combined with the alfalfa and molasses. Unfortunately I have not had success with keeping his tummy happy with other supplements despite my best efforts. Its further complicated by the fact that many ulcer supplements contain ingredients that will interfere with the absorption of his diclazuril/levamisole for his EPM so it has been a challenge to find something that is manageable for both the staff and his medication. This supplement has been successful for us so I feel like I'm walking a tight rope in ways.

Have you all seen PPID cases that originally had normal tests? Is it possible he still has PPID or does the last normal ACTH indicate he's ok? Are there other tests with regard to that I should be pursuing? Would body shot photos be helpful even if they're not exactly as requested? I do have some before the lockdown I could share that are recent.

I know we're a complicated case, and very much appreciate your time!
--
Tiffany
Lincoln County, MO
April 2020
Hollywood Case History: https://ecir.groups.io/g/CaseHistory/files/Tiffany%20and%20Hollywood
Hollywood Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=245376


Re: Cabergoline not available—emergency—Dr. Kellon

LJ Friedman
 

you suggest. .50 mg.   assuming every 4 days?  ( you didnt mention frequency). thanks 
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Cabergoline not available—emergency—Dr. Kellon

LJ Friedman
 

are these correct numbers?? 400 mg cp?  11 mg cabergoline?
--  i posted dr douglas is referring us to wedgewood.   
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Cabergoline not available—emergency—Dr. Kellon

Mary T
 

Thank you.  I have a call in to Dr. Douglas.  My question is whether the fillers that are in oral pills preclude their use for compounding for IV.  

thanks again!


Re: Cabergoline not available—emergency—Dr. Kellon

Eleanor Kellon, VMD
 

Did you see my post about compounding from Dostinex tablets? They aren't pure cabergoline like the base drug that is held up in Customs but they are readily available. You could contact BET to see is that is a possibility for you. I wouldn't use any other compounder because their controlled release carrier is unique to them. All things considered, I suspect, but don't know, you could go with 0.5 mg as an initial oral dose in Ally's case, test ACTH after 2-3 days and adjust accordingly. Please understand this is only a conservative estimate that probably would be safe but we are in totally uncharted territory here.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Stabul 1 availability

Kim Rice
 

Randy at Anderson Feed ships directly to me; call him on Monday.
--
Kim R, Lafayette, CA  2019
https://ecir.groups.io/g/CaseHistory/files/Kim%20and%20Shomee


Re: Potential PPID on a deadline

Sherry Morse
 

Hi Tiffany,

Then you could use the 1137 as a best guess - which means at this point he needs to lose about 50lbs.  If you contact Equi-Analytical about a hay test (we recommend the 603 Trainer) the first test will include the price of the hay probe.  

Many vets are not aware that the full metabolic panel needs to be done to truly ascertain the whole picture with regard to IR.  Even if they do all the bloodwork if a horse is in the normal ranges they'll say there isn't an issue and we have close to 30 years of experience on this group which says that's not always the case.  If you've seen a hard crest starting to develop it's very likely that Hollywood is IR.  

As far as testing for Lyme - I will tell you that my vet was pulling blood on my gelding and insisting that his spookiness had nothing to do with Lyme and everything to do with the time of year as even her 28 year old was being goofy and she was shocked (I was not) when he came back with a titer indicating chronic Lyme.  His symptoms were silly spookiness and being not quite right.  Two months treatment with Doxy and he was back to his usual goofy self.  He still will occasionally spook at nothing but he was born into my arms and I know the difference between that and what was going on when he had Lyme.  My POV was that it's my money and if I want him tested for Lyme to rule it out she should just draw the blood and send it out for testing.  Same as getting the metabolic panel done.  You need to be your horse's advocate because they can't speak for themselves and IMO it's better to get the testing done (this is for both Lyme and glucose/insulin/leptin) and rule everything out rather than playing a guessing game.

NSC is not the number you need to be concerned about - you need to look at ESC + starch.  According to Purina, Outlast (which contains alfalfa and molasses, both of which we do not recommend for an IR horse) contains 15% ESC + starch which is well over the recommended 10%.  https://ecir.groups.io/g/main/message/217233.  

And finally, many of us board and we know how difficult it can be to get a boarding stable on board with doing what's needed for these horses.  You're very lucky that you have a dry lot available so hopefully you'll be able to sort everything else out.




Re: Riosa Hoof Trim Questions

hdavis
 

Hello Cindy.

Thanks for the comments and info. I hope to attempt to do a trim with Rio tomorrow and will use your comments. As for the bar questions, that could very well be the issue but not sure and will check it out tomorrow.

I have her in cloud boots now as they finally came in and they fit much better than the old ones. She is walking around landing heel first and doing well. Will try her without the boots when I trim tomorrow and see how she is walking. She is stretching as she has stretched into my hand several times over the past few weeks which I hope is a good sign.

Thanks again!

--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa Case History
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

 Photos

https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .


Storm

Case History



photos

 
 

 




Re: Riosa Vet Appt questions

hdavis
 

Hello,

Sorry for the delay on responding. Been busy with work issues.  I have updated and uploaded Riosa's Case History.

To answer some questions:

1. Yes she has lost weight and I would say she is maybe 10 lbs over her ideal weight...I am saying that as her crest is still enlarged but all her other fat deposits have gone. Her eyes are still a bit puffy as well at times throughout the day.

2.  I have not taken her off supplements and won't but my question was are there any that she is on that will affect testing at all?  Just want to be aware in case some should be removed.

3.  One question for others - has anyone in Canada done the Domperidone test for early PPID and what was there experience?  




--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa Case History
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

 Photos

https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .


Storm

Case History



photos

 
 

 




Re: When can you tell if your horse is PPID with high insulin or is PPID/IR

Sherry Morse
 

Hi Liz,

Based on your numbers for both glucose and insulin (and thank you for updating your CH!) she's still definitely IR and needs to be treated as such.  You are probably ok with not soaking her hay as it's been tested and is under 10% ESC + starch, but she does need to be on a controlled diet, and it's not obvious if that's happening with no amount given for how much hay she's being fed in a day.




Re: Potential PPID on a deadline

Tiffany
 

I am unsure of what his ideal weight is or where to find that. However, when he was at his lowest weight of 1137 he looked the best. However, last spring on the dry lot, the vet was very happy with his body condition. I have no idea as to the amount of grass hay he eats and have no way to estimate this, nor restrict or soak this due to limitations of boarding. A stall is not an option for him as he cannot have turnout on grass since he didn't adapt to a muzzle. I will say he doesn't typically eat non-stop and seems to feel full unlike my previous laminitic mare. Its possible this has changed some but again due to lockdown and pandemic I'm relying on staff who is trying to stay on top of things and communicating observations.

I don't have the grass hay tested yet as I have been asking the stable since late Feb for help with this as I don't have a hay probe. I'm still waiting to hear if they have one. The stable is on lockdown due to the pandemic which further complicates/delays things. Currently he doesn't get any pasture turn out and is on dry lot 24/7 and will not return to pasture despite the season due to the laminitic episode and him being such an easykeeper now. My vet told me he wasn't IR due to the insulin levels and didn't recommend any other testing so I'm a bit confused as to your inquiry on the other IR testing. I did go over the diet with my vet regarding NSC levels in the vitamin balancer and the outlast as those were both concerns for me, but I was assured those levels were acceptable for him. I do plan to go over the diet more thoroughly with the vet once I can get a hay analysis completed.

He doesn't have a cresty neck per se as in a previous laminitic horse I owned,but rather a short, thick one with a small spot where a fat deposit began. I can include some pictures I have that are close to the photos requested until the lockdown is removed if that's helpful in his photo album. 

Regarding his eyes and spookiness, his eyes have been checked. He has not been tested for lyme as the dr didn't believe it was necessary. There was a time before his EPM was better controlled that I believe it may have affected his eyesight, but this feels different. Its more a general spookiness that seems to be unrelated to his EPM or vit E as he was on a higher dosage in the past but when we lowered his vit E, he seemed to go back to normal.

I have previously read through some of the recommendations, but its tricky with my boy as we're limited due to the boarding facility. They do work with us a lot, but there's a herd and management that's considered so I'm trying to work within those parameters. There are not any better locations for his needs, having my own place isn't an option, and re-homing him would be unlikely suitable for him due to his costly maintenance needs/health conditions.

I hope this clarifies things a bit. Please let me know if I can answer further questions to help with recommendations.
Thanks!

--
Tiffany
Lincoln County, MO
April 2020
Hollywood Case History: https://ecir.groups.io/g/CaseHistory/files/Tiffany%20and%20Hollywood
Hollywood Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=245376


Re: Potential PPID on a deadline

Sherry Morse
 

Hello Tiffany,

Welcome to the group! 
So before I share our general introductory information, thank you very much for getting your case history done already!  That's very helpful, but I still have questions, sorry!  First off is - what is your guy's ideal weight supposed to be?  As a 15.1 hand QH I'd expect him to be about 1100 pounds (or less) which means he's anywhere from 90 pounds to much more than that overweight at the moment.  So he definitely needs a diet change.  Grass hay is probably ok, but if you suspect he's IR it needs to be tested and until it has been tested it needs to be soaked as outlined in the diet section below.  We also need to know how MUCH hay he's eating as he needs to be eating no more than 2% of his ideal weight per day - and that includes hay and any grain.  We do not recommend free choice hay with IR horses as they often have elevated leptin levels and never actually feel 'full' so they will eat as much as you let them. We also do not recommend unlimited grass turnout as many IR horses are prone to becoming laminitic when allowed to eat grass.  For some, even little bits through a muzzle is too much.
Now, he'd be on the young side for PPID and we often see the ACTH result elevated if the horse is transported for testing (as you found) so we recommend testing at home.  We also need to see results for insulin, glucose and leptin to determine if he's IR or not (which he might well be if he has a cresty neck and a tendency to pack weight on.  His insulin result is in the normal range but for the full picture we really need the glucose and leptin run as well.  Information on those tests are in the diagnosis section below.  If he is IR the Buckeye is probably not going to be a good feed for him (see the Diet section below).  Ideally you want to have his minerals balanced to the hay he's eating and not use a commercial ration balancer as most of them don't meet our ESC + starch recommendations.  
As far as the spookiness - has he had his eyes checked and has he been tested for Lyme?  Both can be issues unrelated to IR or EPM which can cause increases in spooking.
With all that being said what follows is our standard introductory letter which you should keep for your reference.  Have a read through and let us know if you have any further questions.

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.

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 LeptinLeptin 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. 

*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. 





Re: Cabergoline not available—emergency—Dr. Kellon

gypsylassie
 

Mary, I may be out of line here, but for what it's worth,  I think if I were in your shoes I might get the prescription from my vet for the pills to have them on hand.  Talk it thru with your vet, take into account what Dr. Kellon said, remember that dosing between humans and horses is very different and doesn't have much to do with size, and be ready to give it a try when the dosage interval is up.   If she is in danger of "crashing" it's worth trying.  I'm sorry for what the two of you are going thru.   I hope she's ok.
Laura K Chappie & Beau over the bridge
2011 N IL


On Apr 16, 2020, at 8:24 PM, Mary T via groups.io <deserthorse18@...> wrote:

My vet spoke with Dr. Douglas the other day.  He had nothing for her RE oral cabergoline dosing.  My dilemma is I have NO more drug left & a fragile, highly Pergolide resistant horse.

is there any way to contact the vet in Australia?


Re: Stabul 1 at Chewy

 

Thanks, Donna. I've had that same conversation with Randy, and my experience is exactly what he describes when I bought 10 bags at a time from TSC.  My mares did NOT love it long after the smell of the flavoring was gone. I need it to be tempting to my picky eater as a treat, so Chewy delivery from a constant fresh supply has been ideal.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 

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