Date   

Re: blood work for insulin levels

JoAnne Goblet
 

Hello Kirsten,
I replied to your post, but can't seem to find if you had written back.
Thanks,
JoAnne

--
JoAnne G in PA 2020


Re: Questions about Babe on pergolide

Sherry Morse
 

Hi Anna,

Pain may have some effect on ACTH levels but as his level was taken while fasting (which lowers ACTH) and he was not in acute pain at the time of the blood draw you can probably eliminate that as a reason the ACTH level was high.

Shedding of summer coat this time of year is normal.  Both of my horses are blowing some coat as are other horses at our farm.  If you're having drastic weather changes that could account for the shivering.

TRH testing helps confirm a diagnosis in horses who are in the equivocal zone for just a regular ACTH test at baseline.  It does not measure tryptophan, but thyrotropin-releasing hormone.  A horse that is PPID will have a result far outside the expected range on the 2nd blood draw. 

Chasteberry can help with shedding in a PPID horse but will not replace the use of Pergolide.

You can use CBD but it again will only treat symptoms - to solve this particular problem you need to remove the cause which is both elevated ACTH (which is what the Pergolide treats) and correcting the trim. 

You can read a bit about Hot Hoof 2 here: https://ecir.groups.io/g/main/topic/1054053#161647

Heaves is something that can be made worse by uncontrolled PPID so getting his ACTH levels lowered may help with that as well.  No guarantee on that, but just a personal observation and we've had several horses here who have been better after their PPID is controlled.

As far as the veil - what is his current dose of pergolide and how long has he been on it?  Did you titrate him up?  Use APF?  If not you may want to back the dose down, get APF on board and then titrate him up (there's reference to this in your welcome letter - https://ecir.groups.io/g/main/message/254667)





Re: Cupcake in full wind up

Sherry Morse
 

Hi Carla,

As we're in the midst of the seasonal rise it's not surprising that her ACTH level went up since July but her elevated insulin is more concerning at this point. 




Questions about Babe on pergolide

Anna Dolly
 

Good morning,
I have written up a handful of questions and took them to the vet's clinic on Monday. I have not heard anything back, yet. I'd like y'all's input, too, please.
Babe's ACTH was 45 and he was fasting when they drew blood. He also had abscesses in both front hooves. He WAS moving some that day, so it wasn't the worst day, but he was not comfortable.
Would pain affect his ACTH levels?

We've had several mornings in the upper 30s (F) this last week. Babe has come down shivering. This is atypical weather and atypical of him to be chilled in that temp range (me, not so much, and I'm ALWAYS cold!). He is also shedding. I cannot tell if this is his normal shedding from grooming or not- my other horse is also shedding some. Babe's hair is short and glossy- maybe 1/4" long and always has been, in warm months.
Would pergolide be affecting his ability to stay warm? This is going to be a very long hard winter, if that's the case. We get between 10-20 (F) in winter.

What does a TRH test (the vet who is too far away suggested doing that in Jan, my vets haven't mentioned it) tell a vet that ACTH doesn't? All I know is it measures tryptophan levels, but not what role those play.

I've read some about chasteberry (vitex) here and other respected sites and still do not have a comprehensive grasp of what that herb could do for him if the pergolide is going to cause him issues. 

would there be any reason NOT to give him CBD? I know that it can help with pain and inflammation. 

They put him on Hot Hoof 2, but did not say whether this is for long term use or flareups? I took him off of it a few days ago, he's still a little tender, but no heat and not really limping. 
The farrier will be out as soon as he can get this way (we live in a rather remote area) to rasp his toes and I know that will help. If I had a clue what I was doing, I'd do it, but I'm not about to go make anything worse for him.

They never would check for Lyme, just told me that his bloodwork 'didn't indicate the need for it'. We live in the woods and have for 5 years. I'd be amazed if my boys hadn't been exposed. But what in the regular CBC would tell a vet that there's no need for a Lyme test? I'd like to understand.

I've had a hard time accepting that this may be what we're dealing with, unlike his heaves. That I could see for myself. This has had too many questions that I haven't gotten answers to. It may very well BE PPID. But I don't want him looking droopy and doped (I can definitely see a change after a week of pergolide) on meds that can have serious side effects if it's not certain that's what's going on.
He has a 5 year history (since we moved from the Gulf Coast and sandy soil to rocks and mud in the mountains) of occasional abscesses, and then this, a month or so ago, was the first time both fronts were affected. I didn't know about NSAIDS and antibiotics potentially prolonging abscesses and may have done him a disservice, there, as these just drug on for weeks. This is the first I know of laminitis and rotation, but also the first we've done radiographs, so I do not know if he's ever been laminitic before.
I think this is all of my questions for now...
Thanks for your help.
Anna
--
Anna Dolly
Keyser, WV
Sept. 2020
Babe's Case History
Babe's Photo Album


Re: Canadian winters and preventing winter laminitis

 

Heather, as long as you're leaving a door open so she can come and go (which is smart for ventilation), I think it would be a better investment to cover the walls with house wrap, the rolled film that is generally applied between the insulation and siding - or even plastic - to cut the wind.  You can use hay bales as insulation if you have enough to spare.  We can have temperatures as low as negative 20 F but I feel like the bigger warning is not to get things too tight.  I have a very old bank barn which holds some warmth until it doesn’t.  Last winter I had one horse fewer than usual and I could feel the difference in temperature.  On the north side of my barn, is an open enclosure, only useful in summer, with a roof and an outside wall.  This extra wall acts to block the wind from the barn.  It sounds like you’ve done a great job in situating the barn.
--
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: Canadian winters and preventing winter laminitis

Jennifer Murphy
 

I am on a tight budget and find a lot of materials on websites for buying/selling like Craigslist.  I know you have a similar site in Canada, but I can't remember the name of it.  When I was on Facebook, the local yard sale groups and marketplace were great resources for low cost or free materials.  You can always put the word out to local contractors to see if they have leftover materials that they might sell, too. 

If you get desperate, it might be a little expensive, but maybe tack up thick moving blankets on the walls and ceiling?  It would at least help a little.
--
Jennifer in NH
2020

CH - https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Flea

Photo album - https://ecir.groups.io/g/CaseHistory/album?id=251041&p=Name,,,20,1,0,0


Re: Canadian winters and preventing winter laminitis

Judy and Bugsy
 

Interesting thread for sure and horse people can sure get creative. I’m not sure if Bugsy is susceptible to winter laminitis, but I’m getting prepared regardless. 


I wonder if spray foam insulation in the shelter might be a possibility? I haven’t compared styrofoam or fibreglass insulation prices with having a spray foam installed though  


There are also those insulated tarps that they use on construction sites to cover the door opening. 


I’m going to send a straw sample away to get tested for ESC and starch. The horses don’t really eat it but they will pick at it. Since straw is hollow, I find it much warmer than shavings  


I’m looking at buying an animal dryer/blower as one of the things I am always concerned about exercising in winter is how easy the horses get sweated up and then it takes hours to dry them.  This would also help to warm up Bugsy if it’s super cold. 

I also think I’m going to set up a mini paddock paradise with electric fence poles (not electrified) in the paddock  just to get the horses moving a bit more  while they are in there.

Spring, summer and fall are sooooo easy compared to winter. 😔

 

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: Cupcake in full wind up

LJ Friedman
 

How did you titrate from 2.0 to 2.5? And why?

--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Cupcake in full wind up

 

Carla, it’s to be expected that she may well need more pergolide with time.  Some horses are lucky and don’t but needing more is a reasonable finding.  It’s possible that her current struggles are causing her to need more pergolide, not because the pergolide is less effective just that there is no longer enough to do the job.
We have a dosage database somewhere here but last I checked, I think it was being refurbished.  I have a 30 yo horse on 24 mg now.  He seems to be doing well.  I know there are some horses which don’t tolerate it well but I’ve never heard a toxic dose described before.  Maybe ask for a trial?
--
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: Canadian winters and preventing winter laminitis

hdavis
 

Thanks everyone for the feedback.  My shelter is 36 x 18 deep and is split into 3 stalls which are 16 deep and 12 wide. Right now we have half wall dividers but I am going to put a full wall divider for Rio’s stall (she is the outside stall on the south end. The shelter runs North and South with the back facing the cold west winds and the front is the east side. We have buildings to the North to block find and bush to the east as well.  From the south we don’t have much wind break but usually southern winds are water winds and few and far between in winter.

For bedding use shavings as worry about the straw as she will eat it and I don’t want to take chances with her insulin as already am having issues getting it down to anywhere near normal.  When it’s cold I make sure I have lots of bedding.  I worry about enclosing her right in as she will be alone in the stall and closed off from the other 2 horses.  I was thinking I would put a plexiglass window in the divider wall and then building a wall which was 3/4 across the front or could hang an isolated tarp across the front.

We were going to insulate her walls and roof with 2” styrofoam insulation. And then sheet it in with 3/8’s plywood.  I think not closing her entirely in would be good then she can go in and out as she pleases.

I was hoping maybe to get away without insulating it as the cost of insulation is thru the roof with covid as is lumber.  But is she needs to have an insulated stall we will build her one. Any other tips and tricks would be wonderful to hear!  Oh and she has her own personal water trough which is in an insulated box with a water heater in it.  It is in her stall as well as tucked in one corner. 

Thanks for the help!!



--
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: Bloodwork Help - PPID and IR

 

Hi. Rebecca,
Generally a trial is just that.  You plan to do a certain length of time, most frequently a month, on a low starter dosage of pergolide and then note if it has positive effects, both visually and in the bloodwork.  You need to give pergolide three weeks before testing ACTH again so a month would be the shortest test period.  At the end of that period, you and your vet can decide whether or not to continue and if an increase in dose seems advisable.  The correct dose has been described as the one that controls the symptoms so every horse starts with the lowest dose. 

There is really little risk in giving unnecessary pergolide but you do want to increase the dose from 1/4 mg to 1 mg over the course of about a week to minimize hormonal disruption resulting in a veil.  Every horse experiences the drug somewhat differently.  

Practically, you would suggest to the vet that you’d like to do a trial for whatever reason and he prescribes Prascend, the name brand version of pergolide.  Sometimes the vet stocks and will sell you the appropriate number of capsules or you can purchase it from online pharmacies, with a copy of the prescription.  ACTH, the hormone measured with testing, is not the only hormone affected by PPID so there are occasional horses with PPID that do not have elevated ACTH.  Or it might be an early stage of the condition, where the values are low but not stable.  Doing a trial is a fairly common thing to do when you’re not sure exactly where you are.
--

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: Abscesses in donkey hooves???

Philippa
 

Thank you Kirsten for your reply. Your explanation had helped. The vet has applied an animal lintex poultice which I am to replace with a new one in 2 days. After that I am to spray the area with iodine to dry it out. Then I am to regularly soak his hooves in copper sulphate to harden them and kill bugs. (In the past I have used zinc sulphate for soaking as I thought it was less harsh on healthy tissue???)

I have requested markups and will work on getting new photos with his leg hair flattened. 


Thank you for your help. 

--
Philippa New Zealand 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Philippa%20&%20Abraham  ;
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=253721 ;


Re: Cupcake in full wind up

Carla Anderson Peters
 

Martha,
She didn’t give me any reason supporting that...It was a blanket statement.  I feel that she is currently not responding to that level (2.5g) for sure.  Does pain override the efficacy of pergolide?
--
Carla

 

December 2013, WI

Cupcake and Gunnar's Case Histories 

Cupcake's Photos

Gunnar's Photos 

Ω



Re: Cupcake in full wind up

Carla Anderson Peters
 

Hello Martha,
No, she was on 2 g, then I titrated her up to 2.5 g. She has been on that for about 4 weeks, and her ACTH went up since July.
--
Carla

 

December 2013, WI

Cupcake and Gunnar's Case Histories 

Cupcake's Photos

Gunnar's Photos 

Ω



Re: Canadian winters and preventing winter laminitis

Jennifer Murphy
 

I just built a barn last fall and insulated it.  It's not a traditional style barn; just a long run in (10x18) with two stalls off of it, a narrow alley on the opposite side that serves as my feed/tack/supply room, and a hay room along the back length. The exterior of the walls are insulated (just fiberglass insulation) and the interior wall between the stalls is insulated, as well as the ceilings.  The stall near the end of the run in is closed off in winter with two 4x8 sheets of plywood, and there are wire filled gates instead of stall doors -so the barn is insulated, but not airtight.  I also made sure to position the barn so the worst storms (nor'easters) would blow against the back of the barn, where the hay room takes the brunt of it.  My vet and farrier were out in January when we were at 18*F with a blistering wind, and it was still bearable in the stalls.  We were doing radiographs, bloodwork, and my farrier was fitting Flea for clogs, so we were out there for hours.  My vet noted that it really wasn't as cold as he expected, considering it's essentially an open barn.

One thing I noticed was when I locked Flea in his stall during really cold nights, he would be crippled up the next morning.  When I just let him wander in and out of the barn as he chose, both he and the other mule will go inside to the stalls during really bad weather on their own and Flea didn't get so stiff and sore.  
 
--
Jennifer in NH
2020

CH - https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Flea

Photo album - https://ecir.groups.io/g/CaseHistory/album?id=251041&p=Name,,,20,1,0,0


Re: Cupcake in full wind up

 

Hi Carla,
Your case history states that you increased her Prascend to 1.75 mg on 2-4-17.  Is that the last increase you’ve made?  On what basis did vet describe this as toxic?  Is she responding poorly to the drug?  Normally that would not be considered a large dose.  I have a Shetland on 5 mg now and a mini on more.
--
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: Canadian winters and preventing winter laminitis

Lecia Martin
 

Hi Heather:   
We share similar weather and keeping these guys warm is a challenge to be sure.  I can share what I have done to mitigate the wind.  I took one of my shelters 10 x 16 and insulated it with R40 and covered it with plywood.  I also closed in the front, leaving a 6 foot opening.   On the floor I filled it with sandy soil, raising it up a few inches then placed rubber mats over the sand.  In summer, I use a light covering of shavings, and in the cold, deeper bedding of shavings then a layer of straw.  My guys dont bother with the straw because when its colder than -20 I feed free choice round bale in a net at nite.  This has worked fairly well, that and blankets, hoods, boots,socks  etc.   I have seen both in there when it is really nasty.  Not sure how large your shelter is but you could do that on one side.  When I boarded horses, I had two horses per shelter, 12 x 24, with a divider in the middle. Maybe it would work to close in one side.  Last winter I looked into getting an insulated wind curtain but couldn't find one in the size I needed without going custom.  Maybe you will have better luck. I hope this helps you.  


--
Lecia Flyte and Flame
Alberta, Canada


Re: Cupcake in full wind up

Carla Anderson Peters
 

My vet also said, that she is at the toxic level of Prascend.
--
Carla

 

December 2013, WI

Cupcake and Gunnar's Case Histories 

Cupcake's Photos

Gunnar's Photos 

Ω



Re: Canadian winters and preventing winter laminitis

Helen Connor
 

Hi Heather,

I've never lived in the Canadian north in winter, but with the temps you describe, yes, a closeable door would be a good idea. Insulation will be a very good idea. Just make sure a bored (even if cold) horse can't pull it out of the walls. Wind, of course, will make temps feel colder, so orienting your shelter to face away from the dominate wind is a good idea too. I would also blanket your horse for those temps and put socks and boots on Rio. Remove those every few days to make sure Rio's skin is doing okay and the blanket and socks are dry. If wet, put dry ones on. Make sure he's not losing weight due to the cold. Up his feed if necessary. Remember to warm his water somehow. Good luck!
--
Helen Connor and Blessing (IR/PPID)
Scappoose, OR
Member since May 2017
Case History:  https://ecir.groups.io/g/CaseHistory/files/Helen%20and%20Blessing
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=6847


Re: Cabergoline not working? Input from Dr. Kellon, please.

Angelika Busi
 

Thank you so much for your quick response, Dr. Kellon.

I shared your feedback with my veterinarian. We had talked about bromocriptine before and decided that we don’t like that option. Qiqi showed that she doesn’t do that well with regular injections and these would be twice each day.

I do agree that due to her reaction the cabergoline is not a long-term feasible solution for Qiqi. Even though the compounded pergolide did not get her ACTH down to the preferred, or even “normal” numbers, her numbers were never as bad as in the two recent tests with cabergoline.

 

My thinking at this point is, if she can't be fully controlled from neither cabergoline, nor pergolide, let's use the medication that's easiest on her and hope for the best.

We still have 4 ml of cabergoline left and the mare’s next shot will be due this Friday.

I am wondering if I should raise the dose to 2 more times 2 ml every 10 days and go then back to her full amount of compounded pergolide (was 21 mg), increase that slowly to 25 mg and retest 4 weeks later?

 

However, that would be a switch in the middle of October and I saw that you recommended to LJ to wait with a return to cp until December, in order to not change during the peak of the seasonal rise.  

If you think I should also do that for Qiqi, despite her adverse reactions to the injections, I will do that. In that case, should I still raise to 2 ml every time?

 

Please let me know. I am still so distraught about these numbers and so thankful about your support.

Angelika and Qiqi & Apollo
https://ecir.groups.io/g/CaseHistory/files/Angelika%20and%20Qiqi%20-%20Apollo/Quqi
https://ecir.groups.io/g/CaseHistory/files/Angelika%20and%20Qiqi%20-%20Apollo/Apollo
NE Illinois

 

September 15

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