Date   
Re: Laminitis Triggers

ironic_acres@...
 

Sherry,
Those numbers are current. Migo should weigh approximately 1,000 pounds. He was at 1,250 but has already dropped weight since being on the Thyro L. He is now about 1,200. Based on his desired weight he gets 15 pounds of hay. I started soaking this week. Additionally he gets his 1 pound TCBC with his minerals balanced to hay analysis. This has been his diet since 2013 with small changes here and there. Surprisingly, he is not a big eater.
The lameness exam was pretty encompassing. He was cleared of Kissing Spine and complications with his SI joint injury. Hoofs and legs were clean.
His current trim is a work in progress as in March, when this round of 'things' started happening, he began laying down a lot of hoof. I mean, a lot. I could take off 1/2 a week and never get a head of the curve. His chestnuts, ergots, mane and tail have been on overdrive as well. He shed just fine and coat is normal, shiny as can be.
I am working on getting photos and xrays. Lynn (an expert picture taker here on ECIR) is going to help me. I want the photos to be on the same day as the xrays and am trying to get that scheduled.

Thank you,
Tracy and Migo
--
Tracy and Migo
Ohio, USA
February 2013

Case History
Migo's Photo Album 
Ω

Poor Hoof Integrity & Bounding Pulses Without Being IR?

 

Hi Everybody!

I have been working closely with the amazing Carol Layton to formulate a suitable nutrition plan for my OOTB, Con! She has inspired me to reach out to you all (As well as try to engage Dr. Kellon) in respect of Con's recent and first laminitis episode since owning him. 

Background Info: 

During February / March this year we experienced significant rain fall after an extremely dry summer. Naturally we had an influx of lush green grass as well as terribly soft and mushy hooves. Con pulled up lame in his right front hoof on the 16th of March 2020. During this time there had been no other significant change to routine or diet other than the rain and he was also not in work at this time therefore unlikely to be a work related injury (Photos of his mushy hooves during this are in my album along with his current condition at that time). I also feel it important to note that he had been grazing in the same 20 acre paddock everyday for 10 - 12 hours a day for over six months before his first laminitis episode. 

Con was seen by our vet on the 19th of March 2020. During her visit she found a lot of heat in all feet, a bounding digital pulse in all feet (however primarily stronger in the front), he was reluctant to move whatsoever and obviously very lame in his front right hoof. He also had that typical laminitis stance (leaning back into the hind end to remove weight from the front feet). Based on this, our vet diagnosed Con with laminitis noting the green lush grass as the cause. The treatment plan given to us was to put him in a dry paddock for one week with no access to grass and only to only feed him grassy hay during the day then be stabled at night with two biscuits of hay and his normal hard feed. We were also instructed to give him Bute twice a day (morning and night for a week). 

She then returned on the 26th of March to perform x-rays to check for any rotation of the coffin bone (x-rays also in my album). As you can see from the x-rays, there was minimal rotation with the only concern from her being his thin soles and minor navicular changes. You can also see that he rotates inwards quite a bit which she advised is unlikely able to be treated due to his age (15 years old). Her treatment plan post x-rays was to have Con shod in order to support his thin soles as well as muzzle him at all times when turned out onto grass to graze. She advised that Con did not meet the typical criteria of an IR horse and advised against blood tests. 

We actually ended up moving Con to a new agistment facility on the 29th of March where he is turned out 24 hours a day. We have since managed his laminitis from this time by utilising a grazing muzzle (for at least 22 hours of the day) however have not been using a muzzle since the 25th of May 2020 due to him having his two front incisors removed due to an unrelated dental issue exacerbated by muzzle use.

Going Forward:
Con has not displayed any lameness since his initial laminitis episode during the middle of March. The only way we have been able to monitor the recurrence of his laminitis is through his digital pulse. When wearing a grazing muzzle, Con usually only has a very mild pulse (sometimes not even palpable). When he is not wearing a muzzle his digital pulse varies greatly each day.He currently shares an 18 acre paddock between four horses. During the day they are kept in the top half of the paddock which has relatively dry grass grazing as well as access to a Rhodes grass round bale and at night they have access to the bottom part of the paddock which is still green and lush due to being rested over the summer. His digital pulse sometimes feels non-existent in the morning, then they're bounding by the afternoon then the next day he may only have a slight pulse in the front right foot and then nothing by the afternoon. There doesn't seem to be any consistency. There also isn't ever any heat or reluctance to move around. 

My two questions are:

  1. Is a raised digital pulse (with no other obvious laminitis like symptoms) an accurate way to judge if your horse is having a laminitis episode and can you have bounding pulses in a horse who is not IR?
  2. Could this one episode all boil down to his hoof integrity at the time? As stated above, I have uploaded photos into our album of his mushy hooves post rain (sorry I only have one photo) as well as photos of him post trim taken today for comparison purposes. You will see that we are still trying to grow out the damage done back in March. Important to note: I am not ruling out that Con is not IR as we haven't had a blood test done yet (however we are having one done in the next fortnight to rule this out for sure as well as having pasture tested). What I would like to know in the meantime is if bounding pulses are a common symptom if the cause of laminitis is hoof integrity vs IR
  3. I am also wondering if this more had to do with the nitrates / mycotoxins in the grass post heavy rain after an extended drought period as opposed to the sugar content of the grass.


Thank you so much for taking the time to read my message. Look forward to hearing all of your thoughts on this!

--
Anjelica Robertson
Brisbane, Australia 
(Joined 2020)

Con's Photos

Re: Fescue vs legume in grass hay

Eleanor Kellon, VMD
 

 Unless I'm mistaken, those are types of fine  fescue, not tall fescue, so shouldn't have an endophyte problem - but check with your grower to be sure.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Re: Monty's Blood Work

Eleanor Kellon, VMD
 

The calculator makes sharp cutoffs but this insulin is normal by the ranges found in the VA Polytechnic field study.

It fits with his radiographs showing no evidence of laminitis - and with the very low leptin.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Monty's Blood Work

Collaeyn Hazen
 

 
Hi! I just got Monty's bloodwork back.

ACTH    20.8 pg/ml  (range says 9-35)
Insulin    12.91   (range 10-40)
Leptin  4.08   (range 1-10)

The IR Calculator says that his Insulin is "compensated IR", is this true even though it falls in the normal range? Apparently Glucose wasn't tested.  Thoughts? 

His other results:
Sodium   132  (says low)
Potassium 3.8
Chloride 93 (says low)
Bicorbonate 27
Anion Gap 16
Calcium 11.6
Phosphate 2.9
Magnesium 1.6
Lipemia 9  (says no lipemia if < 30 units)
Hemolysis 14  (says no hemolysis if < 20 units)
Icterus 2 
Iron   115 
Selenium  14.84 
Copper   1.03 
Vitamin E   143 (low) 

I can easily add more sodium and vitamin E to his diet, but what about Chloride?

Everything else seems within the normal ranges, based on the reference intervals.


--
Collaeyn Hazen
Sewell, NJ
Joined 6/17/2020
https://ecir.groups.io/g/CaseHistory/files/Collaeyn%20and%20Monty
https://ecir.groups.io/g/CaseHistory/album?id=248978

Re: Hoof evaluations

Judy and Bugsy
 

Thank you for your replies. I have been packing/cream in the collateral grooves for the fronts along with the central sulci for 3 weeks now but will now soak once per week and see how he does.  I have not been soaking the backs as I did not think there was a need but I can start if necessary.  

I’m not really sure what it is I’m looking for improvement wise. How do I know if his frogs are improving?

He is no longer in boots in his paddock. He is booted when we go for a ride outdoors. 

Thanks
--

 

Judy and Bugsy

Regina, Saskatchewan, Canada

Feb. 25, 2020

https://ecir.groups.io/g/CaseHistory/files/Judy%20and%20Bugsy
https://ecir.groups.io/g/CaseHistory/album?id=243358

 



Re: Dietary effect on insulin and glucose: instant or cumulative?

Kirsten Rasmussen
 

Thanks Amy, I will read it through more carefully!

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   

Fescue vs legume in grass hay

Kirsten Rasmussen
 

I have spoken to my new hay supplier.  He supplies an all grass hay (timothy, brome and orchard mixed) but he said there is "a little bit" of creeping fescue and red/purple top fescue in it, which he adds to increase the protein a bit.  He emphasized it is very little fescue  I did not ask if its an endophyte-free variety but having read a bit more I think I better call him back to ask.  He also grows a grass-legume mix hay (unfortunately I don't have the details on how much or what type of legumes). He appears to be a very conscientious grower who tries to produce quality hay, and he knows I am looking for low sugar so will point me to the part of the field that was cut earliest in the day.  Any input on which is the safest for an IR horse?  I don't know if Shaku is sensitive to legumes or not; he's certainly eaten a LOT of legume-rich hay in the years I've had him, until last year.  But I'm thinking the grass with small amounts of fescue is still the best choice?  If the fescue doesn't make up a large portion of the hay, then is it safe(r)?

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   

Re: Horses and Safe Limit of Nitrates from Dairy One, Was Grass Hay with High Protein

Candice
 

HI Debbie,

I am just hoping on here to say way to go above and beyond!!!! I love the enthusiasm and of course you spreading your news. This is so important to do, because many horse people (owners, vets, farriers alike) do not 1. do this and 2. do not KNOW how it can affect a horse! So kudos to you! You are helping us all learn a little something that we can take with us, to hopefully help another horse wether you know it or not. 
PS- Glad you won't be buying that hay!
--

~ Candice 

Primary Response Team

September 2018, Summerfield, FL

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

Shark's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71507 

 

Re: Acute Laminitis / Hay Analysis / Bloodwork

 

I’m stopping the Metformin because her mouth is so inflamed and irritated ...the bute was to help with her immediate discomfort from her laminitis which was triggered by the steroids...we are weaning off the bute and are down to just 1 gram once per day for 1 more day ...the Pentoxifylline and the Ace were also given initially all to help reduce pain...I’ve stopped the Ace and I’m contemplating stopping the Pentoxifylline because she is so over having anything syringed into her sore mouth at this point...her bloodwork revealed high insulin (63) cortisol and acth normal ...she’s been off pasture , on stall rest , now eating tested low sugar Timothy, and I’ve stopped feeding the Gro N Win...so I’m hoping with just those diet changes alone her insulin will come down.
Michele & Schimpie


--
Michele Goldberg
Bernville, Pa
joined 5/19/2016

Re: jesse mouth issues

Eleanor Kellon, VMD
 

LJ,

I had the same thought (your regular vet) although the dentist may be better equipped to do a full exam.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Re: Acute Laminitis / Hay Analysis / Bloodwork

Eleanor Kellon, VMD
 

Michele,

Compounding won't help.  Are you feeding immediately after giving it?  That should help. You could also try mixing it in Milk of Magnesia to reduce irritation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Re: Connamera Sm .Horse Laminitis

Kirsten Rasmussen
 

Hi BJ,  I'll just add to your welcome letter that you can turn her out longer (in her padded boots) if you block off the hole in the muzzle so Cricket can't eat ANYTHING.  This will allow her more exercise or stall relief, safely.  Bring her in and remove the muzzle for her meals.  If she has 10 deg rotation I would make sure she doesn't get ANY green stuff, including weeds, because it's only going to slow the healing and possibly continue to trigger her laminitis until it's removed from her diet.

Also, you'll want to make sure her 3 meals are providing her with enough calories.  We recommend feeding hay weighing 2% of the horse's body weight (before soaking).  Unless the horse needs to lose weight, in which case feed either 2% of her ideal body weight, or 1.5% of her current body weight....whichever is greater.  This will allow for slow but safe weight loss.  Also read up on the emergency diet in your welcome letter, which in addition to soaked hay includes salt, ground flax, and vitamin E.

Candice's recommendation to have your hay tested is important, you need to know what you are feeding.  Make sure you pay a couple dollars more for the "wet chemistry" analysis as it is much more accurate.

Please do get your Case History posted with all your lab numbers in it, and her medication doses.

We are here to answer any questions you have after you've had a read through your welcome letter.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   

Re: Connamera Sm .Horse Laminitis

Candice
 

Hello BJ!

Welcome to the group! 

A quick answer until you can complete your case history so we can give you more adequate and custom advice for Cricket: the degree of rotation causes concern to me and if you have radiographs, please upload them. We can give you more precise advice with radiograph views, hoof photos, and a case history. She should be on the emergency diet asap and if you can get a hay analysis on your hay that would be best. Soaking hay only makes it safer NOT SAFE, especially since we are unsure of the numbers. It is best to turn out in the late evening and left out at night, since the starch/sugars in grass are lower during that time. Dr. Kellon and the others can correct me if I am wrong and also will add their input. Also, in regards to trimming, it is best to remove any extra leverage that can be causing Cricket more pain. Please post as soon as you can and let us know if you have any issues uploading. 

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. 

 

 

--

~ Candice 

Primary Response Team

September 2018, Summerfield, FL

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

Shark's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71507 

 

Re: Horses and Safe Limit of Nitrates from Dairy One, Was Grass Hay with High Protein

Eleanor Kellon, VMD
 

Those levels (which are NOT backed by formal research) refer to acute toxicity -   i.e. animals dropping dead, aborting, etc. Effects of lower level intake have not been studied in horses. Of particular interest to us is effects on thyroid function and laminitis. For many years Fescue endophyte was said not to affect horses' feet - until it was actually studied and found that it does.  Nitrate intake has also been reported to cause hoof pain, but not officially "proven".
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Re: Laminitis Triggers

 

Hi, Tracy. 
Is Migo lying down to sleep? A long shot... but when my sleep-deprived Paint (used to be called narcoleptic) starts falling asleep on her feet, especially if she isn't on level ground, she looks like she's having balance problems, crosses over in front, looks uncoordinated and neurologic. She also drops her head. It all means she's about to fall asleep on her feet. I doubt you'd miss that but thought I'd ask.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 

Connamera Sm .Horse Laminitis

B.J. Korol <hobhol@...>
 

Hi ,My 12 year old Small horse  Cricket developed Laminitis with 10degree coffin bone rotation 4 weeks ago . She has been on stall rest the first 2 weeks with Soft Ride boots but is now in stall without boots in thick shavings . She started out on 2 grams of Bute daily and is now completely off it and is getting Metformin and Metabarol daily . She had been on Metabarol since April since she had been diagnosed with Insulin resistance last year . She is walking much better now ,initially extremely uncomfortable ,the typical Laminitis walk . Her lab work showed normal ACTH but sugar level was  40 . I have been soaking her grass hay and limiting her intake to 3 feedings a day, which is not making her very happy ! I have a very small paddock area with very little grass and have been turning her out at 6AM with a muzzle ,I love her out for an hour and than back in her stall till next AM with a short walk in the PM for a little exercise and stall relief . My farrier has checked her once since initial attack and trimmed her toe slightly ,my vet is coming back this Thursday for re-exam and most likely more X-rays , the farrier will also be there and I am hoping we can do some corrective shoeing soon so I can get her back in a small amount of work to reduce her sugar levels . 
I 'm sending this history to you in hopes you would have any advice for me to follow to help with Cricket's rehabilitation .
Thank you 
-- BJKorol
BJ Korol

Re: How to evaluate body score when parts of body look so different

Eleanor Kellon, VMD
 

Her topline muscle loss complicates scoring a bit but I would put her at a solid 4.5.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Re: Horses and Safe Limit of Nitrates from Dairy One, Was Grass Hay with High Protein

 

Hi, Debbie.
Thanks for the follow-up. 

So we know a couple of things from these results. First, the "high protein" isn't really all crude protein, whether tested by NIR or wet chemistry. Crude protein testing is registering the high nitrate. I have a formula somewhere -- I won't torture you with it-- that deducts nitrates from the crude protein to arrive at an closer estimate of the real crude protein. 
 
Second, yes, horses do consume hay with high nitrates. Sometimes that's the only hay available, it looks nice, and no one is the wiser. Here one local feed store that does no testing on their hay sells high nitrate hay all winter long. What "high" means isn't black and white. Does it mean equines that eat it aren't adversely affected? We'd love to see scientific evidence of that. One thing that's reported in this area every year is spring abscesses in non-IR/non-PPID horses. It's a mystery blamed on wet and muddy conditions. Or could it be a winter of eating hay with nitrate levels like those in your sample? We don't know.

The best way to answer your last question is to call Dairy One and ask customer service if they would please give you the research supporting their claim. They are usually very helpful. 

--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 

Re: jesse mouth issues

LJ Friedman
 

thanks for the reply about the pockets. I will have an exam for with.  Do you agree that a dental vet( The one that did his big surgery) should have eyes on him? Or would  a general vet also be OK
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos