Date   

Re: Relevante trim mark-ups

Bobbie Day
 

I read something the other day which makes total sense and not sure why it didn’t occur to me! Someone suggested after a fresh trim on a laminitic horse (frequent trim anyway) to mark the toe and heel if need be with nail polish and watch it, as soon as it moves up you’ll know when to trim. Is this just too simple to make sense?
I’m going to try it though, I guess it wouldn’t work for the rest of the hoof but it would be helpful to keep the toes back.
Merry Christmas everyone 🎁🌲⛄️


--
Bobbie and Desi
NRC March 2020
Utah, Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi

https://ecir.groups.io/g/CaseHistory/album?id=78821


Re: Antech document footnote re winter insulin levels

Sherry Morse
 

Hi Francis,

Dr. Kellon can address this better but yes, insulin levels do go up when the weather is colder.  This was actually just mentioned in a message the other day: https://ecir.groups.io/g/main/message/259022.  It's also one of the reasons we recommend doing insulin testing when the temperature is 50 or above if possible and we ask for the air temperature to be reported along with the time of day of testing.  See this message from Nancy as an example of what can happen otherwise: https://ecir.groups.io/g/main/message/246486




Re: EMERGENCY - Farriers

 

Anne,
Here are some names of experienced farriers. I met two of them at a clinic. They are all in the general Lansing area. Kim Powers has extensive experience with Laminitis.

Kim Powers (517) 581-9415
Amelia DiStefano (269) 876-8364
Janelle Wild (517) 294-0892

But if you need to correct that diet. Follow the emergency diet protocols!!!  
--

Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


Antech document footnote re winter insulin levels

Frances C.
 

In a footnote from Antech giving results of requested blood work is this statement:
"Evidence is mounting that insulin concentrations are affected by season with higher concentrations detected in December, January and February in the northern hemisphere, suggesting a winter-assocciated exacerbation of ID."
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


Re: uploading case history - begging for help

Sherry Morse
 

Hi Frances,

Step 1 - create a new CH folder by going to https://ecir.groups.io/g/CaseHistory/files
  • Click on the "+New" button at the top
  • Select the "New Folder" option
  • In the pop-up window name the new folder "Frances and Phoenix"
  • Click the blue "Add" button at the bottom right corner of that window
Step 2 - navigate to the new folder you just created.
  • I find the easiest way to do a search using the name of the folder "Frances and Phoenix"
  • Click on the folder in the search results to open it
Step 3 - upload your file
  • Click on the "+New" button once you are in your folder
  • Select "Upload File" from the drop down
  • In the pop up box click on the "Browse" button and navigate to the file you want to upload
    • We prefer if you upload the PDF so anybody can open it regardless of the device they're using
  • Once you have selected the appropriate file click the open button in that pop up window
    • That will bring you back to the file upload window
  • In the file upload window click blue "Add" button in the bottom right corner
If you have the files on your desktop you should be able to find them easily.  If you run into a problem please let us know where you're having an issue.

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 



uploading case history - begging for help

Frances C.
 

Geez! Anticipating a $600 stimulus check  (bad mistake) I had the vet out to do a complete work up: ATCH, insulin, glucose. thyroid, CBC and panel and got the results in an email yesterday. So it was time to update phoenix case history form with all the new data. That is now done, Problem is I don't remember how to upload it. In my attempt I deleted my folder "frances and phoenix" (another bad mistake) On my windows desktop I have the new version as docx and also a pdf version which is what I was attempting to upload. When I try to upload CHROME gives me an available list from the desktop but does not include the case history documents
-- 
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


excell spreadsheet of online herbs etc. due to covid shortage in USA

Frances C.
 

I created a spreadsheet of online sources for common herbs etc that we use giving prices, amounts, shipping data. If any member would like a copy just "reply to sender" and I will forward it to you. I am finding that some things are hard to get.
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


Re: Mule with laminitis

Jennifer Murphy
 

Hi Renee, I have nothing to add except I'm a mule owner, too, and my mini mule is PPID/IR.  I've been following ECIR protocol for a few years now, and even my big mule who is healthy has benefited from this program.  You're definitely in the right place! 
--
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: Invokana side effects - how common are they?

Jennifer Murphy
 

When my vet and I first discussed Invokana, I had done a search here for pharmacies.  The link I sent her was shot down, because the drug was coming from India and she said you couldn't trust the medications that came from there, but is there any truth to that?  I think someone on here had posted a link to a Canadian pharmacy that she would be more comfortable ordering from, but it was a little more expensive.
--
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: Invokana side effects - how common are they?

LJ Friedman
 

I recently ordered from pricepropharmacy.com and went /  the cost was three dollars and the pills came from England, it arrived in California in less than six days
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Steglatro trial

LJ Friedman
 

I can’t seem to find the study I read almost a year ago, but it showed that BI was testing  a two drug med   for laminitis,  and I think???  that Invokana wasnt included in the combo.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Steglatro trial

LJ Friedman
 

reminder: invokana costs $3.00-,300mg at Canadian pharmacies. I used to pay $2.00 each thru mexico at san diego border
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Relevante trim mark-ups

Lynn
 

Cass! I think that is brilliant. And, in fact, I was thinking he was getting rather shaggy and I should probably trim that hair. But i completely agree with you. I just finally moved back into my house two weeks ago after the tornado in 2019. I think i can find the clippers...LOL - thank you for the verification!
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Relevante trim mark-ups

 

Hi, Lynn.

As someone who struggles with a horse with long toes and underrun heels, I have a silly suggestion that helps me better visualize the trim and the real length of the toes.

I try to keep the hair all around the coronary band trimmed even in winter. It’s so much easier to see the shape and length of the hoof that way. I just did it this week because Cayuse was clicking with every step as she overreaches behind. I was shocked how long her toes have gotten. The breakover of her front hooves (and the hinds!) needs a major adjustment. I don’t have Lavinia’s X-ray vision. I need all the props I can come up with.

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


Re: Mule with laminitis

Trisha DePietro
 

Hi Renee. Welcome to our group. You are definitely in the right place! I have attached our welcome letter that is chock full of information for you to review. It has links in each section of the letter that will take you deeper into more information. After reviewing the information ( its alot to read at first)....feel free to ask questions. 


Hello 

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. 

--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Request from Dr Kellon for feedback on Riosa's blood - should I be concerned

hdavis
 

Thanks for the comment Kirsten. Glad to know we are on track.  I wasn’t sure the levels as my tests are always done in pmol/L for insulin and I used a different IR calculator this time which wasn’t as clear to me as the one I used before.

Fingers crossed we can stay on track!  It is suppose to get down to - 40C tonight with windchill. Without w/c -30C. Brrrr.  Hope we don’t get wind over night as that is chilly!!! Lol.
--
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: Steglatro trial

Alicia Harlov
 

Thanks Loreto! That's really hopeful. This is for a client that's super painful right now. Hoping we can get him comfy, nothing else has worked. His laminitic episode started with SIRS, but now liver numbers are normal but insulin is very high. 
--
-Alicia Harlov in South Hamilton, MA 
PHCP hoofcare provider, The Humble Hoof podcast


Amino Acids

suzy zarek
 

Which amino acids can trigger an insulin response?
--
Suzy. Nebraska. 2019
Case history https://ecir.groups.io/g/CaseHistory/files/suzy%20and%20%20thor


Re: Relevante trim mark-ups

Lynn
 

Hi Lavinia,
We spent considerable time attempting to adhere to your directions above. Particularly...
Blue hashed areas around the entire perimeter can be rolled, with the most aggressive roll at the toe after it is brought back a bit more. Yellow hashes are the leading edges of the bars and sole sole that appears to be letting loose around the tip of the frog. Lightly remove what is ready to go but be careful not to get too aggressive with this. Leave the rest of the sole alone. Orange circles are where to set up the heel buttresses to maintain the current heel height while encouraging the heels to stand up straighter
I took photos [or tried] during the trim and we tried to compare with the markups. I have had the feeling more than once this fall that at the time of trim  it “looks” like we’ve achieved the goal of those particular markups but then when I see the next set I know we still didn't do quite enough. It is amazing to me each time how much he has “grown out” since the previous trim. Do you feel we should go to 3 weeks for now instead of 4? Are we are chasing ourselves a bit because we just aren’t being quite aggressive enough?
I threw up LH and RH laterals immediately following the trim just to compare. I'll get more later this week. He was actually sore after we were done so I spent the time finishing deep cleaning his stall and putting in some deep bedding with pellets. [He is fine now].
Thanks again so much - don't know what we would do without you.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


post anesthesia founder

jessica skene
 

Hi all,

 

I am trying to help a friend, many people do not speak english in my area and I try to help them as I can

The hors is 15 yrs old

gray qh of 16h 2

No history of EMS or IR but he is navicular

He had to pass a MRI at the vet hospital, he spent 5h under general anesthesia and when he woke up, he panniqued so they injected him a lots of tranquilizer.
Well, he had a bad reaction after the anesthesia and he started a myopathy... all his system wrecked after that and he foundered... left not that bad right is worst
I know a lot about IR and EMS but less about this form of laminitis.

Is everything is the same or not? the cold seem to have worsened the symptom, he is now unshod and on boots which helps... I will help her with the trim, I saw picture, too much toe and we will look into the nutrition part as well but can you tell me a bit more about this form of founder?

I suppose it's the myopathy that produced toxin which affected the feet?
--
Jessica Skene  - Abitibi, Québec, Canada
Sonara => Canadian X QH mare , 14 years old, historic of founder and Laminitis, IR / EMS

october 2017

Link to case history: https://ecir.groups.io/g/CaseHistory/files/Jessica%20Skene%20and%20Sonara/SonaraCaseHistory2019.pdf
Link to album: https://ecir.groups.io/g/CaseHistory/album?id=10295&p=Name,,,20,1,0,0
Link to hay analysis: https://ecir.groups.io/g/CaseHistory/files/Jessica%20Skene%20and%20Sonara/analysedefoin.pdf

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