Date   

Re: Severe laminitis case

Rose Miller <Rosemiller@...>
 

I personally would love to hear your foot trimming ideas. thanks in advance. 
--
Rose Miller in Arizona 2020


Re: Senior Feed sugar starch levels

Sherry Morse
 

Hi Kandace,

Information in the CH that would help us would be an ideal weight for J as well as a current weight.  That would help give a definite total amount of intake per day that she can have.  If she's a 6 at about 1000 pounds she probably should be closer to 900 as an ideal which would give you an intake of 18 pounds of day for her to get back to her ideal weight.  Looking at your CH she's not getting anywhere near that much so something isn't adding up there if she's not losing weight on the very restricted diet and that would make me wonder if she's IR as well as PPID.  If she's IR as well as PPID I would be more careful about what I fed her in terms of grain.  If she's just PPID you have a bit more leeway in grains but it's still best to err on the side of low ESC+starch.  Many senior feeds have rates that are in the high teens to high 20% range and those I would try to avoid if at all possible. 

Are you weighing hay out for both mares and just dividing the totals out for the CH info?  Looking at your other mare I see you have her listed as eating 20 pounds of hay a day so I'm finding that a bit confusing.



Re: Lavinia is there ever a right time for corrective shoes?

Jeanne Q
 

Update:
After chatting with my farrier we both came to the conclusion that metal on her feet at this time of year is probably not the best idea.  In his experience the composites get very brittle in our serious cold temps here in northern MN.  Also, the cold temps dont work with the glue.  So he is going to research some more about possibilities.

Lavinia if you or anyone has some innovative ideas on how to increase her comfort level at this time it would be greatly appreciated.  Has anyone ever used the velco shoes?  They are a European thing but really seem like they could help.  
--
Jeanne Q MN 2020
https://ecir.groups.io/g/CaseHistory/files/Jeanne%20&%20Glory
https://ecir.groups.io/g/CaseHistory/album?id=241360


Re: Senior Feed sugar starch levels

Kandace Krause
 

Kirsten, again thanks.  Seems your my person here.
J has never had laminitis.  She is only just now not getting much exercise as the two horses have become so bonded since K's diagnosis.  Also an hour seems to be as long as a ride and her old arthritic joints can take.
Yesterday, day two of five minutes handwalking, both horses were acting dangerously while just one out a a time.  Seems more work needed there, lol.
I have not requested insulin test on J, the vet just took blood for follow-up so I thought that more expense could wait until her PPID is established as high outside of seasonal rise.  I should see those results by weeks end.  
As she has not had laminitis, I don't understand what is missing in CH?  
As she did fall back hard at onset of winter two seasons back, I have "fattened her up for winter" so my fault she is at 6 BCS.
Since I can't be certain what she eats for hay I am uncertain how much to bump up cubes and BP.  I have been waiting to see if she appears to be winning or loosing at holding weight.
--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K


Re: Acute laminitis - unable to control pain

Shannon and Postina <shannon.behmann@...>
 

Thanks so much Tracy!  Feels good to connect with another Paso person.  I am so happy to have found this group.  I really appreciate all the information because I feel so helpless as I watch my horse struggle. Just an awful place to be right now.  But this group gives me direction and actions to take. Today we will trim her feet and hope for some pain relief. 
--
Shannon B in Ontario 2020


Re: Acute laminitis - unable to control pain

Tracy
 

Hi Shannon - 
I am another Paso member here, there are several of us with Pasos.

Keep us posted- this group is a wealth of info and has helped many horses and their humans. You are in the right place!
If you hit information overload don’t forget to just breathe. 


Tracy

--
Tracy and Salsa (1999 model year Paso Fino)
Middle TN USA, September 2019
Case History  https://ecir.groups.io/g/CaseHistory/files/Tracy%20and%20Salsa
Photos https://ecir.groups.io/g/CaseHistory/album?id=95827


Re: Riosa Rads would like feedback please

hdavis
 

Thanks Kirsten!  I thought I had read the message string but clearly missed some of the info as it does state it will interfere with insulin.

I also noticed we should stop Biotin supplementation 6 days before labs and had a question regarding this. My biotin is added into my custom mineral mix from madbarn and not something I can take out manually. So to stop the biotin would one just stop giving the minerals totally and then just give those they we give for the emergency diet?
Thoughts?

I really hope this doesn’t sku my numbers too badly.  Madbarn has been adding biotin to my horse’s custom blends for about 2 years now at least so I guess all the bloods I have been checking with my 2 horses over that time period would have been affected. 

Another learning moment for me on how much you need to stay tuned into the posts on ECIR and how things can change when dealing with managing our equine friends. 
--
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: Riosa Rads would like feedback please

Kirsten Rasmussen
 

Biotin will affect the insulin.   It's hard to say how much, but hopefully the results of the bloodwork will still be helpful.  Did you read through this message thread and look at the link to the study? 

https://ecir.groups.io/g/main/topic/77731380#256718

Good to see her hooves are looking so good, well done, Heather!

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


Re: suggestions in getting insulin down

Kirsten Rasmussen
 

Whichever you decide to do, whether it's increasing Prascend or trying Metformin, I would do only 1 thing at a time so you can see which one helped.

How do we know what to increase it to? 
What am I looking for with the dose increase? 
Will the lameness stop when we get to the correct dose? 
Since the ACTH is always in normal range,  Do I just keep retesting the Insulin and once the correct dose is met the insulin will finally come down? 

How do you know if the dose is too much? What are the signs to look for if its too much? 
Your vet's suggestion to 2 mg Prascend is reasonable.

You are looking for lower insulin, better appetite, reduction in crest/goopy eyes/insulin, etc.

No way to know if it will help with lameness.

Yes, keep retesting insulin and watch for a drop.

There is no harm in giving too much Prascend, except to your pocketbook or if you have a horse that really struggles with the veil it can be hard on both of you increasing the dose.  See this post by Sherry about an accidental overdose (100x!!) case study:
https://ecir.groups.io/g/main/message/258702


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


Re: Case Hx folder is Empty

Kirsten Rasmussen
 

Hi Shawn,

I have a little house keeping task for you.  Could you add the link to your photo album to your signature please?

Here is the link to Candy's album:  https://ecir.groups.io/g/CaseHistory/album?id=258140

This is where you go to update your signature:  https://ecir.groups.io/g/main/editsub
Don't forget to hit "Save" at the bottom after you edit it!

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


Re: Riosa Rads would like feedback please

hdavis
 

One more question as I just noticed the messages about biotin and testing.  Does it affect insulin or glucose as Rio has biotin in her customs mineral mix.  I hope not or else I just wasted money on bloods by missing this!  Ooops!!
--
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: Riosa Rads would like feedback please

hdavis
 

Oops that was sent without a message!  Sorry!

Thanks Dr. Kellon.  Hopefully her blood work comes back with good results as well!  Great to hear we are on track with the trim. My vet was very pleased with the rads and mentioned the same as you regarding the bony column alignment and sole depth.  She also mentioned I had about 6 weeks she figured left to regrow out the hoof capsule.  


I was wondering what your thoughts were on getting her back to work based on these rads.  So far we have been working in hand or online in the fields and arena focusing on big squares and straight lines.  At times we do have to do smaller squares as she can be full of beans.  But so far no issues with soundness that I can see.

Would you think we continue with the ground work and increase the duration of trot and canter? Would you wait a full year from her initial episode (end of Feb 2019) to do ridden work or wait longer to when her insulin dropped from addition of Invokana (started end of May and dropped to 200 when tested in July). Thoughts and comments?

-- 

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: Riosa Rads would like feedback please

hdavis
 


Re: Acute laminitis - unable to control pain

Shannon and Postina <shannon.behmann@...>
 

Thank-you.  I put stall wraps on this morning.  I will wean her off the bute and gabapentin.  And draw some blood for the blood test that you recommended for PPID.  She is on the emergency diet  

I will also work on filling out the case history to give more info.  
--
Shannon B in Ontario 2020


Re: Acute laminitis - unable to control pain

Candice Piraino
 

Hi Shannon!

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/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 Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/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 EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating". 

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*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: EMS 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 EMS/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 EMS/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 EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR 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 

PHCP Barefoot Trimmer @ www.arkhavenfarm.com

 


Re: ivermectin vs mixi

LJ Friedman
 

thank you for the reply and thank you for setting things straight with my worming knowledge 
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Case Hx folder is Empty

Shawn Gould
 

Hello Dr. Kellon,

I sent the hay sheets to the above address. I also just uploaded Candy's most recent X-rays in Photos. She has been trimmed since then with specific attention to lowering heels and she is scheduled for another trim 12/14.

Unfortunately, Candy is off her feed. I can only assume she has some kind of ulcer situation going after all these months on NSAIDs. She is off them now, but only for a few days. Argh. Gave 3/4 tube dose of Ulcergard and will start treatment. I saw that I need to give it 2 hours before or after j herb, I beleive. I am trying to stay calm. She is on phyto-quench, but she is not as comfortable as I would like. She continues to tread. And is not walking as well as she was yesterday, so my plan is to start Jiaogulan tonight. I will be syringing that with the mov-ease 2 x a day and drop the phyto-quench. As I understand it interferes with the Jiaogulan, however if I should continue for comfort and give it at some staggered time I will do that. Please advise. I also ordered PEA, so its on its way if she needs that. Maybe, I will see her get more comfortable quickly on the J herb. My biggest concern is keeping her eating now. My feed store has the sample hay bags so I grabbed alfalfa and timothy. Of course  they have not been tested, but I was hoping to grease the wheels in the appetite dept. I am not sure what to do. She has always had a very strong appetite, but now has lost interest in her safe Teff hay and Timothy balanced cubes. She has rejected soaked grass hay in the past. I really should not be soaking hay because of my arthritic hands, but will do so in this emergency. I did giver her a pound of timonthy hay and 2 # of alfalfa which she ate. Any advise on this. I think she would eat soaked alfalfa, not sure about the timothy hay. Or should I just feed her as usual tonight and see what happens overnight with the one dose of ulcergard on board or should I give soaked alfalfa? I am not clear on what poses a bigger threat to her.

Thanks for any input.



--
Shawn
Dec 2020, Santa Cruz, CA
Candy Case History:  https://ecir.groups.io/g/CaseHistory/files/Shawn%20and%20Candy


Re: ivermectin vs mixi

Eleanor Kellon, VMD
 

If you do monthly ivermectin you won't have encysted forms.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Acute laminitis - unable to control pain

Eleanor Kellon, VMD
 

Pain doesn't interfere with PPID testing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459856/ .

Gabapentin is worthless is my experience, and bute may be making things worse.

She needs leg wraps and socks on her feet inside the boots. More details coming soon.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Riosa Rads would like feedback please

Eleanor Kellon, VMD
 

Alignment is good on the films. Good sole depth.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

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