Date   

Re: Success syringing metformin

Amadadelsol@...
 

Hello,
After using some tips and tricks with Metformin and Prascend I've also come up with some things that have made the daily medicating a bit easier.

The barn staff syringes her AM and PM with Metformin/water 30 min prior to her hard food (Stabul1). They wipe her mouth afterward. I also do a dose midday. I took 500 Metformin pills and poured them into my Vitamix blender which grounded them into a fine powder. Prior to that I weighed her dose of pills and got a gram measurement. After they are in a powder I weigh a snack baggie (accounting for each baggie weighing 1 gram) with the powder. The barn staff has one baggie per dose for ease of use.

She wants nothing to do with any of her supps (Glycocemic, TriAmino, copper, zinc, salt, E, magnesium, chaste tree berry powder, flax) so I cut her pelleted supps from Uckele in half and add to Stabul1 AM to get her adjusting to them. I am hoping to increase to full amount eventually or do another feeding of supps/Stabul1 for PM feeding in the future. In with her Metformin at midday I add TriAmino, E, salt, magnesium, chaste tree powder. I mix it all with water and form a loose paste. After I shoot this in with a 60cc syringe with a big hole cut in the end, I wipe her mouth with a wet rag, put A&D ointment on her lips and mouth corner and give her some Stabul1. I mix her 1.5 tabs Prascend hidden in a size 0 veggie capsule in with the Stabul1 and she eats it up. If she were to find the veggie capsule and refuse to eat it I would use a dog pill popper and get it in her that way. After that she usually drinks. She likes the apple/banana Uckele treats and one trick I have found that helps her eat her morning Stabul1 with pelleted supps is to add a small amount of the crumbles at the bottom of the treat bag over her food. That gets her interested in her food. Often she will require more than 1 cup of Stabul1 to cover up the smell of the Uckele pelleted supps. The only supplement I haven't figured out how to get in her is the stabilized flax. She absolutely goes off everything else if I attempt that. So she has been a little stinker but I'm working on learning patience and being somewhat satisfied about getting most of her supps in. It's not easy though because I want to know that I am doing 100% of what I can to get her well. 
--
Pat and Frigga
Monkton, VT
2020
https://ecir.groups.io/g/CaseHistory/album?id=252741  

https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Frigga


Re: Riosa needs help looking forward feedback

hdavis
 

Thanks Sherry!  Yes  I saw that and I replied with a question as my horse is not lame and is sound.  What I wondered is there a time frame from when a horse had laminitis to when they can be trailered if they are sound with boots on or do you have to waist a full hoof cycle. That was what I was wondering about. My mare had laminitis at end of Feb and her insulin is currently well controlled according to her last 2 blood tests.  

Rio seems to be more herself today and I am now suspecting she perhaps got a split pea stuck in her tooth or gums as I noticed my other mare acting a bit the same today after she ate her cubes with peas and supps in it.  I’m sure it is irritating as would be like a popcorn kernel stuck in your mouth.  Think I might grind the peas maybe to help stop this in the future.

Thanks again for the help. 
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

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

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




Re: apf and veil

LJ Friedman
 

Thanks for the reply. I am now at day four of re-introducing 20 mg of compound pergolide. And so far see no problems. I will keep your horse in mind when I assume I might have to go higher than 20 mg. As a reminder I switch to Cabergoline because my vet did not want to go above 20 mg and I caved in too quickly. This time I will stand my ground and get what I need.. Thinking I probably won’t retest until January with the rise’s end,  and of course will test sooner if things indicate it is needed.  thanks.  
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: apf and veil

Angelika Busi
 

LJ,

That sounds like a good plan. Just to let you know, my mare was recently switched back from cabergoline to pergolide too and while she clearly had a veil on cabergoline, she was perky and happy with her old dose of pergolide (21mg) from the beginning. I started her on APF 3 days before giving the first capsule but will leave her on it until she is fine with her new target dose of 25 mg. Just to be on the safe side.


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


Re: chickens in horse hay/ chance for salmonella with my IR horse

 

We had a barn chicken for a few years.  She was the last of the laying flock and we thought she would be warmer over the winter in a horse stall.  She had her own box but after awhile we began letting her explore the barn and make herself at home.  She was very cute!  She made herself a nest from Logo’s hay droppings on the barn floor right outside his stall .  They didn’t share food so that wasn’t an issue.  But, when I think of all the other critters that share the barn with the horses, chickens might be the least of the problem.  Whenever there’s food around, there’s going to be company.
--
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: chickens in horse hay/ chance for salmonella with my IR horse

Daisy Shepherd
 

thank you; i read those 2 sites that you posted.  my horse is boarded so i can only voice the info;  i do rake my horse area daily where i see all the chicken feet.  thank you again, daisy and tiko
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: apf and veil

Sherry Morse
 

LJ,

That should be fine to start with but you may want to have more on hand in case you need to go past the 5 days at restart.




Re: chickens in horse hay/ chance for salmonella with my IR horse

Daisy Shepherd
 

thank you dawn.  since my horses are boarded, i have no control;  i have voiced what i know about poultry and salmonella and my past experience  but it is up to them as  it is their property. i do daily rake  the areas where little chicken feet have gone that are in my horse area but i do not know what else i can do.  thank you for your message, daisy and tiko
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: Riosa needs help looking forward feedback

Sherry Morse
 

Hi Heather,

Dr. Kellon already answered your question about trailering.  Perhaps you missed it?  https://ecir.groups.io/g/main/message/256327




Success syringing metformin

 

At Kirsten's suggestion, I'll  summarize what works for us to syringe metformin twice a day. Dr Kellon's suggestions are summarized in the metformin information in Files. I suggest starting with the right equipment before even trying to syringe. 
1. I bought a new inexpensive coffee grinder. It cost the same as good manual pill grinders and turns the hard 1000mg metformin tablets into powder much better. 
2. I bought the large size Wild Cherry Flavored Milk of Magnesia. 26 oz. lasts about a week. 
3. The missing link was reusable 60 cc catheter tip syringes with silicone O-rings. The plunger with a silicone O ring never sticks. These syringes are manufactured for feeding baby animals (Squirrel syringes) or for enteral feeding.  https://www.amazon.com/UrnConcern-Feeding-Syringe-Reusable-Silicone/dp/B081ZFZD5C/

I grind the metformin dose to a fine powder and pour the powder into 45 ml pre-measured milk of magnesia. I cover and shake a few times until the grittiness of the ground metformin is mostly gone, about 5-8 minutes. I draw half the mixture into each of two syringes. Dividing the dose allows me to comfortably position my thumb on the plunger and smoothly syringe one-handed. My horse is cooperative so long as I can syringe slowly in roughly 3 squirts per syringe. When we're done, I wipe her lips, especially the corners, with a very wet cloth. Then I rinse her mouth with a hose. I doubt this mixture of metformin and milk of magnesia causes sores, but undissolved metformin grit could, so I still rinse out her mouth. As a reward, I give my horse a tiny treat feed (about a cup of FORCO for now) to get the saliva flowing. 

Hope this helps anyone frustrated by disposable single-use syringes.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


Re: Power Of Trimming - Feedback From Chiropractor

Lynn
 

Amen Kirsten! You said it - it was an eye opener for me - I've often heard the phrase "no feet no horse" but the extent to which his feet were impacting his body just didn't penetrate until she began to exam/adjust him. She was very impressed with Lavinia's skill sets. I explained how the ECIR group works and the wonderful volunteers/experts we have. She said it's wonderful how technology has made collaboration and assistance on this level possible (regardless of distance) to the great advantage of our horses. She said in the past a vet or farrier likely would have just raised their hands with no real solution for the horse.  Relevante and I are very, very fortunate.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


apf and veil

LJ Friedman
 

i’m wondering if this strategy is correct.:
I start at apf five days before giving CP, and I’m continuing for five days while on CP for total of 10 days. Does that sound like enough if no veil is showing? Of course I will have to get more if I notice  veil signs after the five days of apf while on medicine
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: High insulin again- metformin, mare cycles

 

Thanks, Kirsten.
I can post what solved the syringing puzzle for me, if that's what you mean. I will start a new subject heading. As for exercise, yes, I plan to, as soon as temperatures drop to a point where I can tolerate being out in the sun.  Still in the 90's here much of the day, expected to continue into next week. If I get the bib clip done, that will be a start.  
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


Re: Riosa needs help looking forward feedback

hdavis
 

Thanks Lavinia for the ideas.  I do think it was something she got stuck in her mouth and each day she is getting better and better but I still want to get the vet out or trailer her to a vet. 


So I posted asking 2 questions.

1) best option for sedation if I need one keeping in mind she is on Invokana.  From my research it looks like maybe Dormasedan?  We tried Valium before and got some weird reaction so want to stay away from that.


2.) if Rio is well controlled with low insulin and glucose levels and not lame, when can she safely be trailered?  Do I have to wait until her hoof has completely grown out? 


She is doing well today with little pawing and chewing issues.  Fingers crossed we are on our way to getting the issue resolved.


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

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

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




Re: Power Of Trimming - Feedback From Chiropractor

Kirsten Rasmussen
 

Lynn, Relevante's story has been so encouraging and as if any affirmation of Lavinia's skills were needed but it's things like this that really show how valuable her advice is and how the whole body is influenced by the trim!  This makes me so happy!!

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


Re: High insulin again- metformin, mare cycles

Kirsten Rasmussen
 

Cass, I hope Dr Kellon has some advice for you.  You certainly now have mastered the dosing via syringe of Metformin!  I think you should share that with the group when you have time... 

The only suggestions I have are can you get her ACTH into the mid-teens (as others have found to be beneficial), and can you increase exercise (right now I think your CH indicates she is sedentary?).  Thank goodness she is not in pain, if you can increase exercise it might be a good time to start?  (I'm not sure what the smoke situation is there right now though)

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


Re: Very high ACTH, no symotoms

Kirsten Rasmussen
 
Edited

Bonnie,

I don't see why a high ACTH couldn't be present with no signs.  Most people don't test until there are signs of disease so maybe there are lots of horses with no signs but high ACTH out there?  There are multiple hormones involved in PPID and perhaps if the others aren't elevated as well you won't see signs of PPID.  I do still wonder if the lack of signs means there is no... 

..."hypertrophy, hyperplasia, and microadenoma formation within the pars intermedia. These conditions contribute to excessive ACTH production, and the enlarged gland places mechanical pressure on adjacent tissues, inhibiting function of the pars distalis and pars nervosa. The resultant functional changes and the excessive release of ACTH into the body result in clinical disease"
https://www.vetfolio.com/learn/article/equine-essentials-equine-cushings-syndrome-pituitary-pars-intermedia-dysfunction

If there are no signs of clinical disease other than grossly elevated ACTH, then is there still enlargement of the pars intermedia?  Perhaps there is no definitive answer to that question beyond an autopsy.  As Martha indicated in her reply to you previously  https://ecir.groups.io/g/main/message/256192
ACTH isn't the only indication that PPID is well-controlled and other hormones are involved.  Dr Kellon has also said:
https://ecir.groups.io/g/main/message/255735 : There is no direct link between ACTH  and insulin levels.  Studies have shown cortisol is often normal and much of the measured ACTH  may be inactive. However, we use ACTH as an indicator of control over the PPID.  ACTH is actually  only a small fraction of the hormones released by the intermediate lobe, and all of them can have a negative effect on insulin sensitivity.

https://www.ncbi.nlm.nih.gov/pubmed/6141515 
https://www.ncbi.nlm.nih.gov/pubmed/3035302
AND 
https://ecir.groups.io/g/main/message/215025 : Also important to note there are some PPID horses whose hormonal profile doesn't include obviously elevated ACTH.  In fact, this group founder's mare was like that! It probably shouldn't be surprising when you consider that of all the hormones put out by the pituitary in PPID, ACTH is by far at the lowest concentration. We're way past the time to switch to testing POMCs across the board or alpha-MSH instead.
So I dont think there is an obvious answer to your question about whether extremely elevated ACTH but no symptoms means the disease is present.  Maybe Joseph is in the earliest stages and early treatment will reduce the severity of his PPID (signs, such as laminitis, and hypertrophy of the PI gland) as he ages.  Is it possible there are subtle signs you may have missed?  If you notice any changes while he is on pergolide that could be an indication that what you thought was normal for him is not (similar to Martha's experience with skin conditions in her horse Logo).  Or maybe Joseph will never develop the signs of PPID and always have high ACTH, regardless of whether or not he is treated.

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


Re: Riosa needs help looking forward feedback

Lavinia Fiscaletti
 

i Heather,

Just to add another possibility to consider.

One of my boys went thru something similar: was opening and closing his mouth, twisting his head around, licking his lips and generally moving is tongue around inside his mouth. I tried flushing his mouth, examining it for something being stuck in his teeth and couldn't find anything. Called the vet, who also suspected something was stuck so came out. After examining him thoroughly, it turned out he was having some gas issues and as soon as he passed that, he was fine. It happened a few more time, on and off over a couple of months, then stopped completely. Never did figure out exactly what was causing the problem, so I'm assuming there was something about some of the hay that wasn't agreeing with him 100% as he lived on a dry lot.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Re: High ACTH no symptoms

Kirsten Rasmussen
 

Oh my goodness,  I see I've mixed up Brenda and Bonnie's 2 posts!   No wonder Brenda's case history for Stormy doesn't have the results Bonnie was sharing!  Lol

Brenda, most of what I wrote above still applies to you I think, but you can definitely disregard this comment:

Was Stormy the one with the mild symptoms and baseline ACTH of 176 more recently?  That higher baseline ACTH during seasonal rise is normally considered a positive for early PPID here.

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


Re: Higher than 10% NSC survey by Dr. Kellon

Lavinia Fiscaletti
 

Here it is, Judy:

https://ecir.groups.io/g/main/message/254507

You can also find this by opening the ECIR Group home page, then scrolling down to the bottom where it lists the top hashtags. Click on Polls.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR

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