Date   

Mule diagnosed with PPID. Questions

Sherrie Yuschak
 

Hi,

I have a 10yr old mare TWH mule diagnosed last week w/ PPID. 
Cornell: 
ACTH = 124
Glucose = 70
Insulin not evaluated.
She was not fasted (pasture and hay pellets prior blood draw)
She has been losing topline and has a hay belly. The loss of topline has been since winter but it has gotten worse over the summer. No laminitis. I will be moving her home within the next month, putting her on a grassless track system with hay and starting Prescend.
  • My question is regarding grass and diet. I so often see PPID combined with IR and recommendations all lean toward managing the IR. How strict do I need to manage her diet once she is in a good range with Presecend? No grass? No weeds? No fruit or starchy vegetable treats? OR are these ok to give in limited amounts since she doesn't have IR?
  • Also, must I have my hay tested? I planning on timothy (shipped in) or coastal is local. 

I recognize in a perfect world it's helpful to manage most horses as if they have IR and that traditional horse feeding isn't healthy. However, I don't want to worry myself sick about things that aren't critical as that steals joy.

Wishing I didn't need to be part of this group but so thankful for everyone's support and knowledge!

Thanks,

Sherrie

--
Sherrie Yuschak in NC 2020


Willow x-rays loaded to album

Pat
 

Vet on Saturday says episode is over, recovery was quick.
Evidence of previous episode about 8 months ago. (While at different barn, wearing shoes, in January, with no grazing, lameness not detected at the time.)
X-rays loaded to our album.
Farrier is coming tomorrow.
--
Pat
August 2020
Metro Vancouver BC Canada
Case: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Willow
Photos: https://ecir.groups.io/g/CaseHistory/album?id=253325


Re: Squamous Cell Carcinoma

Allison
 

Just got off the phone with the surgeon. He also strongly feels amputation is the only option besides euthanasia, since the tip of his penis is basically rotting at this point. So that's where I'm at. He feels his age is not a concern since he's otherwise in good shape, and commented that they often do this sort of surgery on horses in their 20s, since that's when these types of issues arise. I am going to try contacting the University of Guelph Hospital to get their input also tomorrow.
--
Allison in Ontario 2020

Case History: https://ecir.groups.io/g/CaseHistory/files/Allison%20and%20Sonseeahray
Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=254641


Re: Squamous Cell Carcinoma

Allison
 

Nancy and Carol, thank you!! I'm including these in my list of questions when I call my vet. I'm going to keep trying to get him interested in treating my horse, and am going to see if he will consult with the hospital at Guelph. I am also waiting to hear back from the surgeon I was referred to so I can ask some questions. I'm very concerned with the impact of surgery on a horse his age. 
--
Allison in Ontario 2020

Case History: https://ecir.groups.io/g/CaseHistory/files/Allison%20and%20Sonseeahray
Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=254641


Re: Squamous Cell Carcinoma

Carol
 

It's been a while since I've commented since my Cushings horse passed on years ago but this caught my attention. My thoughts are with you.  

 When I had a bone infection and was scheduled for amputation because the antibiotics weren't killing the infection, I found some research on silver killing stubborn infections and dosed myself that night. Infection was gone next morning and MRI showed proof and we did not have to amputate. I still have my foot 5 years later. Vets can prescribe silver in a compound with sulfer. Or you can get colloidal silver online or even at some stores like wal-mart. My vet prescribed silver sulfadiazine for one of my horses when she tore up her knee and had a mess of a wound. The other antibiotics had poor results. The silver got the results for us. 
Also IP-6 has shown results against cancer. IP-6 is a form of inositol, a natural sweetener found in grains. 

On Tue, Oct 6, 2020 at 9:52 PM Allison <morningstar_acres@...> wrote:
Yes I will ask for a different antibiotic.
--
Allison in Ontario 2020


Re: New Bloodwork & question on feed while exercising

V F
 

Eleanor,

His urination & drinking has been very consistent for a year & a half. Ten gallons water per day while getting soaked hay, summer & winter. The last month I have been feeding mostly dry hay in bags & yes, his water intake went way up. Doesn't seem to be urinating any more but it's hard to tell with new stall/bedding arrangement. What I have noticed is that out on our walks his urine is much clearer (not cloudy as it has consistently been). I'll take a sample jar & strip next time we're out so I can sample it there.

He only seemed hot to the point of a little damp sweat a couple of days all summer. (He sweats moderately hard on our walks, but so do I - it's been hot.)

He gets 1 1/2 oz, of NaCl twice per day in his BP & ODT, so a total of 3 oz.

For the last week he has had intermittent cowpies, which is the only time I've seen his manure off at all.

Symptomatically, when he was on  300mg dose, he just seemed to run out of gas on our walks & wanted to stop & kept gently nickering at me to tell me something. He has much better exercise tolerance now. Could have been due to being non-exercising for so long. I could try upping the Invokana again & see what occurs. Looking for better exercise tolerance & more urination.?

I don't think he's metabolic at baseline, either, so it's my management that has to improve. Will go back to soaking hay - sigh...

By the way, the Invokana I ordered arrived here in 5 business days - coming from England!
Thanks for all the ideas.
--
Virginia F, Lily, Jasuur, Cache, Haat & Spiritt in the sky, in South Central Oregon
ECIR 2010
Jasuur case history and bloodwork folder:  https://ecir.groups.io/g/CaseHistory/files/VirginiaF%20and%20Jasuur
https://ecir.groups.io/g/CaseHistory/album?id=147028


Re: Squamous Cell Carcinoma

NANCY BOTTE
 

Hi Allison - 
I have a Fjord that years ago started bleeding when he urinated.
Longs story short - he has a mass in his urethrae - we tried many
methods to get the bleeding to stop. But finally a vet said to
try Cytoxan. It worked! He was on it for years and it didn't
seem to bother him.  I wonder if something like that would
help?
We got the drug from Canada - way cheaper...
Thinking of you!
Nancy B 




--
Nancy B
NH
2020

https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Twister 


Re: ACTH/glucose high on second blood test

Sherry Morse
 

Hi Mary Ann,

1 - can you please update your CH with the current bloodwork numbers?
2 - If this was my horse and she was that elevated I'd titrate her up to 2mg daily and then retest after 3 weeks to see if that's brought her down into the lab's range.  At 240 even 2mgs may not be enough to control her PPID and you may need to bump her up again.

As we always say, the right dose of Prascend is the one that control the ACTH in your horse and 1mg was obviously not enough for Rosie.




On Tuesday, October 6, 2020, 6:34:48 PM EDT, Mary Ann <horsehead64@...> wrote:


I finally received the results from my mare's second blood test. Her ACTH and glucose are still very high. Her insulin was low and my vet does not consider her to be IR. She did increase her Prascend from 1 mg to 1.25 mg and monitor her for lethargy or appetite suppression. Her dose was increased starting October 2nd. After 5 days on the slightly increased dose, her appetite remains good and she is still quite energetic. My vet was going to confirm with other colleagues who specialize in PPID as to what her dose should be and whether or not she should remain on the increased dose during the seasonal rise. 

I'm looking for input from the group on questions I should be asking my vet regarding her current level of Prascend. Can I increase her a further .25 mg for another 4 days to get up to 1.50 mg. What is considered a safe dose to administer with ACTH and glucose that high? 


Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Re: feed question post laminitis

Kirsten Rasmussen
 

Cherie, when I look at everything you've posted I'm thinking this is more of a trim and minerals issue rather than EMS, especially as her ACTH was not elevated.  A few more details though would be helpful: was ACTH done fasted (hopefully not, but even if it was it still looks normal for this time of year), and did you get insulin and glucose done, too?  If not, I don't think it's necessary right now, but if you did please add the results including your ACTH to your Case History.

I personally would get an analysis of the hay you are planning to feed this winter (the 603 package from Equi-analytical is ideal), and then have a mineral supplement balanced to that hay (one of our balancers can do that for you for a 1-time fee).  This should help with tightening up her hoof growth and growing unflared walls over the winter (from the photos you provided, I can see her hoof walls are flared quite high up her hoof capsule , so you can expect this to take 6-9 months minimum).  The trim is also critically important, too, but I'll leave that for someone more experienced to comment further on.

I think her body condition looks quite good for going in to winter, not fat and no ribs obviously visible.

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


Re: Squamous Cell Carcinoma

Allison
 

Message received this morning from vet #2:

"Your next step is surgical intervention or humane euthanasia. The ultimate reality is that regardless of whether we can get the infection under control or not, if you don't go the next step with amputation then we are wasting our time. As we discussed, the idea of treating to reduce the swelling and try to control the infection is only a short term fix at best. The infection is the secondary problem. Without fixing the primary problem the end result will not change. Sonny is in significant discomfort and will stay that way and only get worse until the primary problem is resolved.....even if we can get the infection under control. It is very obvious that you care deeply for sonny but we really need to consider quality of life. Please take emotions off the table,and make a decision that puts Sonny's best interest in mind whether that is surgical intervention or humane euthanasia. He is suffering and it will only get worse. "
----
Allison in Ontario 2020

Case History: https://ecir.groups.io/g/CaseHistory/files/Allison%20and%20Sonseeahray
Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=254641


Re: Squamous Cell Carcinoma

Allison
 

Thank you so much Nancy. Your words comfort me a little. My mind is racing constantly over this, it's hard not to become obsessive.

Last night was the first night he tried to kick out when I was messing around with him down there. I don't blame him poor boy. After our lunge/cold water hoseout/lunge/wash with soap/cold water hose out...I put him in his stall for a couple of hours to eat and chill. Then tried rinsing him out again with just plain water to make sure I got all the soap. That's when the kicking out started. He'd had enough. Then I applied Special Formula 17900 in there as best I could. I have 2 tubes of it left so I'm going to stick with it until the end of this round of antibiotics and then switch to the frankincense oil mix. This is the ingredients list of the SF:

MEDICINAL INGREDIENTS: Penicillin G Procaine 100 000 I.U., Dihydrostreptomycin (as dihydrostreptomycin sulfate) 100 mg, Novobiocin (as novobiocin sodium) 150 mg, Polymyxin B Sulfate 50 000 I.U., Hydrocortisone Acetate 20 mg, Hydrocortisone Sodium Succinate 12.5 mg., per 10 mL.

--
Allison in Ontario 2020

Case History: https://ecir.groups.io/g/CaseHistory/files/Allison%20and%20Sonseeahray
Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=254641


Re: Squamous Cell Carcinoma

Nancy Kitchen
 

Allison
I am only a member here but I wanted to reach out to you and say, breathe.  I can only imagine your frustration level at this point.  Try very hard not to feel lost just because you don't have a supporting vet to tell you what the next step should be.  Many people here have had to improvise, overcome and adapt in order to help our equine friends.  I think you are on the right track to help your horse.  I have a couple long stories of being in your shoes and going thru many many many vets.  I have no experience in penile cancers etc, tho. There are many here that have good information and are all good people wanting to help you.  They were here when I needed support and I still have my horse because of this group. All I can offer is an ear but if you listen to your horse, he'll tell you what you need to know.   All the very best to you and your best friend.
--
Nancy K
Smoke and Tucky
November 2018, Southeast, MA

Smoke Case History:  https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Smoke
Smoke Photo Album:    https://ecir.groups.io/g/CaseHistory/album?id=94122
Tucky Case History:  https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Tuck 
Tucky Photo Album:


Re: Hay v. Haylage

Saskia Visser
 

Did you get your haylage tested in the end?  Interested to know what you decided on and how it worked out.

Regards,
--
Saskia V in CH 2020

https://ecir.groups.io/g/CaseHistory/files/Saskia%20and%20Skipper


Re: hay analysis and balancing minerals

Kirsten Rasmussen
 

Renee,

Here is the direct link to the pdf. 

https://ecir.groups.io/g/main/files/6%20Diet%20Balancing/HAY%20BALANCING.pdf

Hope it works for you! 

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


Re: Squamous Cell Carcinoma

Allison
 

Yes I will ask for a different antibiotic.

Got him lunged cold hosed and washed tonight and brought the swelling way down again. 2 hrs later it was back at 50% 😔 
--
Allison in Ontario 2020

Case History: https://ecir.groups.io/g/CaseHistory/files/Allison%20and%20Sonseeahray
Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=254641


Re: Progress after 1 1/2 years !

Candice Piraino
 

Renee! Wow amazing results and you should be proud! She looks great! Yay!!!
--

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 

PHCP Barefoot Trimmer @ www.arkhavenfarm.com

 


Re: ACTH/glucose high on second blood test

Candice Piraino
 

Hi Mary Ann,

yes continue to increase her Prascend until
her ACTH numbers are in the “normal”
range. In order to do this, increase slowly to avoid the pergolide veil. After you reach your next dose, such as 1.5mg, keep at that dosage for 3-4 weeks and then retest to ensure the numbers are down. Once you reach your targeted normal range- you can keep that dosage. It is of course best to test 2 x year (at the same time for consistency) to ensure that dosage is still adequate for the horse. Some horses have needed as much as 22+ mg a day!

I input your numbers in the calculator, and even though your mare is definitely PPID, it doesn’t look like she is IR.  If the blood work shows elevated glucose then you have a diabetic condition, which is the next step up from IR. When both values are elevated it means the body has ramped up insulin production as much as it can but it still isn't moving the glucose from the blood into the cells.
The next step could be that the insulin level starts to drop because the pancreas is basically exhausted and can't keep putting out that level of insulin. The glucose will still be high but the insulin level could read much lower - a bad scenario. Make sense?
--

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 

PHCP Barefoot Trimmer @ www.arkhavenfarm.com

 


Re: ACTH/glucose high on second blood test

Lorna Cane
 

Oh,ok  Mary Ann. Thanks.
I can't open it with my tablet, so will  have to get to my PC.( love technology)

But may we ask that you add your blood work to the appropriate section of your CH, so that it is all in one place,for easy perusal /comparison ?


--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Re: ACTH/glucose high on second blood test

Mary Ann
 

If you look at the "Blood Work" folder in my CH, there should be two files now. I labelled the newest one Rosie_Massey 2nd blood draw Sept 2020.
--
Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Re: urgent Test results back for Rio and says not IR

hdavis
 

Thanks Renee.  I am so happy Rio’s insulin is down so much as she has been very hard to control. So happy the Invokana is working!  
--
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  .


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