Date   

Re: Help with assessing Hoof Pics Lavinia

Maxine McArthur
 

Hi Marsha
I’m sure Lavinia will have trim advice for you shortly, but just wanted to mention that Easyboot Clouds and Equine Fusions are also good rehab options. Both companies do mini sizes, although I’m not sure if the actual Clouds are in mini. You may be able to get hold of some sooner than waiting for the Soft Rides.
Hang in there.

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Re: Uncompensated IR for second winter in a row - is this a seasonal thing? Should I be concerned?

Eleanor Kellon, VMD
 

Cold weather is a stress on the body. It takes considerable calories to keep body temperature normal. The stress response in general aims to preserve precious glucose resources for the vital organs like heart and brain. Heart and brain don't need insulin to take up sugar so by inducing insulin resistance the glucose supplies get shifted away from skeletal muscle which does rely on insulin for part of its glucose uptake
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Nitrates in water

Maxine McArthur
 

Hi Philippa
Have you had the water tested? What was the result? I found this message in our sister group on nitrates in equine forages (you can join to view the files here: https://groups.io/g/Equinenitrates

“Evaluation of Water Quality and Nutrition for Dairy Cattle
https://msu.edu/~beede/dairycattlewaterandnutrition.pdf  

See the discussion and Table 5 on page 9.
Is it shown as
Nitrate (NO3) 
or Nitrate-nitrogen (NO3-N)?  which has a lower threshold.

Either way, the 19 ppm would be considered safe for ruminants and cows are considered to be more susceptible.
If in doubt (i.e. untested hay, hay/pasture irrigated with processed water) double the NRC level of iodine. “

If you’re concerned about nitrates I recommend joining that group, there is a lot of good information there.

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Help with assessing Hoof Pics Lavinia

Buzz
 

Hi Lavinia! Rather than do a 2nd try with a previous thread, I thought best to start anew.  Buzzy is really not improving much after a month of being in pain.  He is on equiox and gabapentin.  I did get Soft rides for his front and now trying to get for the hind.  Initially the vet didn't feel a pulse in the hind, but apparently that changed!  He is standing more and doing somewhat better since the boots, but I am still terribly concerned about him.  I think the trimmer thinks this is not going to be a positive outcome.  Can you please take a look at the pics I have posted.  He is not a trusting little guy and is very difficult to get good pictures.  We have done our best and I have posted multiple ones in an attempt to cover it the best we can.  I have an ordered in for soft ride boots for his hind but at this time they are on back order.  I've tried a couple vet school podiatry offices and am awaiting a call back on Monday from them.  Any suggestions or comments are so welcomed to attempt to save this little guy.  I am totally willing to help him wherever I can to recover.  Thank you in advance for your compassion and knowledge!
--
Marsha and Dame - Buzzy TN 2019

https://ecir.groups.io/g/CaseHistory/files/Marsha%20and%20Dame%20-%20Buzzy
https://ecir.groups.io/g/CaseHistory/album?id=258797


Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

 

Hi Jenny,
I’m so sorry about your friend.  We’ll still be here should you need to take a break from this for a bit.

No one knows the reason behind the alfalfa sensitivity, just that it affects some horses and not others.  My PPID horse was not sensitive but he was also not IR.  It’s wise to avoid it unless Dewi has been eating it without issues, which would be hard to tell in his case.

I wondered why your vet chose to do a TRH test as the previous testing was apparently not.  Was he thinking Dewi might be PPID?  That also crossed my mind as his laminitis seems so closely related to the fall rise.  You could try him on some pergolide to see if that gives him any relief.  He is obviously IR, even not being PPID, as his symptoms began at a younger age than most PPID horses exhibit symptoms.

With respect to pain relief, there really isn’t anything available which would control laminitis pain except for addressing the cause.  In a way that’s a good thing because a good number of us would avail ourselves of it and lose focus on correcting the cause, which as Sherry states is probably related to the high insulin and inappropriate trim.  As you seem to be paying attention to his diet, it may be time to look into metformin (again) or invokana.  You can search the messages for invokana for more information.  There’s been a lot of discussion about it recently so there’s lots to read.  It doesn’t go back very far as it’s a fairly new application.
--
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: NEW MEMBER - urgent advice needed for IR pony in constant pain

jenny.comish@...
 

Hi Sherry,

thank you for your very thorough response, which I will go through with a fine toothed comb and will check out all of the links. But just one question, if he is continuing to have elevated insulin levels but his diet is low sugar and starch, why might that be, and what can be done to control it? (On the basis that metformin may or may not work).

Thanks very much.

Jenny
--
Jenny Comish
England, UK
Dewi Case History: https://ecir.groups.io/g/CaseHistory/files/Jenny%20Dewi
Dewi Photos: https://ecir.groups.io/g/CaseHistory/album?id=257833


Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

Sherry Morse
 

Hi Jenny,

The short answer on alfalfa is that while it's usually lower than 10% ESC+starch some horses just can't tolerate it.  Much like while we use 10% ESC+starch as our cutoff for safe hay some horses need much lower than that or they have issues.  Even random bits of grass may be too much for some, but others might be ok in the same situation.

It's very much something that isn't cut and dry so if you have a horse that's known to be very sensitive it's just best to avoid things that might set them off. 




Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

Sherry Morse
 

Hi Jenny,

So sorry to read about your friend.  That kind of puts everything else on the back burner so no worries on not responding. 

As far as the metformin - got it.  The next time you do a CH update you may just want to put a note in on the line with it that it was only for a short time and not current. When he was on the metformin is that when he had the change in insulin from 485 to 4.1?  If so you may want to trial it again.  We have many members here who are using it and they administer it by syringe but you do need to be careful to rinse their mouths after to avoid mouth ulcers, so that's not without issues.  You can read more about it here: https://ecir.groups.io/g/main/files/4%20Insulin%20Resistance/Metformin

Danilon (known as bute here in the US) is a problem - if he's still in pain while on it I'd say that's a good indication it's not working for him.  We have some members using paracetamol (Tylenol here in the US) with limited success but again it's meant for short term use. 

I'm hoping some of our other UK members will chime in with suggestions for you but if you can source Devil's Claw (we usually recommend Uckele PhytoQuench pellets but again, I'm not sure if they're available in the UK) you can substitute that for bute.  I just did a bit of a search and found this: https://www.equineanswers.co.uk/bute-substitute-powder/p25 which has MSM in it as well which can be tricky with some IR horses (you can read more on that here: https://ecir.groups.io/g/main/files/Joint%20Supplements/Glucosamine,%20MSM,%20Yucca,%20HA.pdf).  We have another recent member here whose horse has been on bute since last March I believe and she's now weaned him off of it and he's on the Phytoquench pellets and she said he looks better than he has in quite a while - this is a snippet of that conversation: https://ecir.groups.io/g/main/message/259786)

This is the general guidance for tapering off NSAIDS: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf  My suggestion would be to stop one of the 2 doses for 2 days and then start stretching out the time between doses as outlined in that document. You need to do the tapering slowly because there is a NSAID rebound effect that can be seen if you stop quickly, especially after so long a period of time on the drug.

His pain level can certainly be due to the trim and lack of sole depth as well as possibly (probably) elevated insulin levels.  It's all part of what needs to be brought under control to get him feeling better.  Using bute to control pain (which it doesn't seem to be doing at this point) is putting a band aid on the problem but to get him feeling better you need to remove the triggers which is what we focus on here.

Is your vet thinking that Dewi needs to lose weight so his feet feel better?  Or is to help with his insulin levels or ???  For me, although it's hard to tell with the winter coat, he looks to be at a good weight for his size.  We recommend feeding 2% of ideal weight in hay+concentrates per day, which would be about 5.8kg for him.  So you may want to cut his hay ration down a bit and make sure you're weighing what he's eating. 

I know there have been a bunch of studies on soaking hay for extended periods of time(we have a few here: https://ecir.groups.io/g/main/files/5%20Core%20Diet/1.%20Hay%20Information/Hay%20Soaking) but the short answer is you then lose a bunch of minerals as well as the protein and sugar content and that creates other issues.  For the purposes of lowering the sugar content you're really ok with just an hour if the water is cold

Yes to getting insulin and glucose tested again - definitely NO for the karo test, especially in a horse with known high insulin and already having laminitic issue that's playing with fire.  I know it's hard but you are his advocate and you need to do what's right for him and don't let the vets cow you into thinking they know best because they often don't. 

Can you get the actual test results for the TRH test from your vet? That should list the pre-test number as well as the 112 post test result.  For example when we did a TRH test on my gelding in 2019 the lab report lists:

TRH Response ACTH: Pre: 20.9pg/ml (range 9 - 35)
                                Post: 69.5pg/ml (range 9-110)

For a horse that's early PPID the pre-test result might be in range but the post number will be out of the range, but for one that the post-result is equivocal (like Dewy) we might be able to glean some information from what his pre-test number was.

Hopefully that makes sense!




Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

jenny.comish@...
 

Thanks for your support Francine. I’ve read a number of times that alfalfa is not great for IR horses but I am not clear as to why - as so long as the sugar and starch are low enough it seems a bit strange. There must be a reason out there - I need to do more reading! 


Thanks again.

Jenny
--
Jenny Comish
England, UK
Dewi Case History: https://ecir.groups.io/g/CaseHistory/files/Jenny%20Dewi
Dewi Photos: https://ecir.groups.io/g/CaseHistory/album?id=257833


Re: Uncompensated IR for second winter in a row - is this a seasonal thing? Should I be concerned?

jessica skene
 

Hi dre.Kellon

 

I always wondered why does winter cause such change in insulin level? it seems like many hormones do change a lot in winter... why is this?
--
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


Re: Uncompensated IR for second winter in a row - is this a seasonal thing? Should I be concerned?

Megan and Reign
 

Thanks so much for your input, Dr. Kellon!
--
-Megan
 
2019, Gig Harbor, Washington
 
 


Re: Hoof Evaluation 1st time and UPDATE/HELP

Tamara Gonsor
 


Re: Gavis rads today need help getting them up please

Kathy Ladendecker
 

I actually took breakover back with a bevel all the way through the visible toe callus, about 1 cm on each front hoof.  He has rotated severely and the old toe callus was no longer a point of reference.  I took heels down as far as I could per collateral groove depths kissing into live sole at the seat of corn.  

Awaiting review to take breakover back any farther with the bone loss and remodeling.
--
Kathy in MA
December 2017
Barefoot Trimmer


safe(r) anti-inflammatories for uveitis

Maxine McArthur
 

I'm looking for advice on anti-inflammatory support for uveitis. 

CH is up to date [most recent entries highlighted in yellow], but in summary: 
In 2018 Indy had a slow-healing corneal ulcer, which was finally debrided and healed after approx. 4 months. She has had no issues with that eye until spring this year. We had a mild, wet winter, with an explosion of grasses and pollen this spring, and now going into a milder, more humid summer than usual. My vet feels that the weather and pollen may be a trigger for the eye irritation. Last summer we had drought, thick bushfire smoke, gale-force dust-filled winds and soaring temperatures--but the eye was fine.
Bloods done 8 Dec 2020. ACTH: 20.5pg/mL; insulin: 4 mU/L; glucose: 4.2 mMol/L. The vet also pulled blood on 12 Jan to check protein and we did a CBC too, all normal (they haven't emailed me the actual numbers yet). Pergolide raised from 3.25mg to 3.5mg on 24 Dec in preparation for seasonal rise. 
I also consulted another vet who specialises in opthamology  (she is the one who debrided the ulcer in 2018), and she examined the eye carefully and said she could see nothing of major concern, but to make sure I continue the anti-inflammatories for at least two weeks after the eye looks better as there may still be inflammation lurking there. 

Anti-histamine (Zyrtec) made no difference. Previcox made no difference. Flunixin (oral, 8ml/day) did the job but it took two weeks, and she is now being weaned off it (on half dose now). My vet wants her off the NSAID, but also says she will probably continue to get flare-ups and we'll have to periodically use the flunixin. She has also been on omeprazole. I added N-acetyl-cysteine 2-3 weeks ago as well.

Tonight after two days on the half dose of flunixin I am concerned that the eye might be starting to look a bit sore again (slightly less open than the other eye, lashes slightly droopier).  

I am thinking I should continue some kind of safe anti-inflammatory support until the weather dries out and cools down (probably around May-June). The alternative seems to be waiting for a flare-up and doing on-and-off flunixin, which is obviously not ideal--or have I got this wrong? Happy to be corrected.
  
Questions:
1. Is Devil's Claw likely to be effective with eye inflammation? 1a. Are there any other non-NSAID anti-inflammatories recommended for eyes?
2. If Devils Claw is worth trying, how long should I leave between stopping flunixin and starting? 
3. If it appears ineffective, should I increase the dose? By how much? (Indy's est. BW is 380-390kg) If it seems ineffective at what point should I give up?
4. I have copied below the forms of Devils Claw that are available to me. I would like to avoid large amounts of powder as I will have to syringe it, and she already gets two large syringes daily with her spirulina and CTB and trace minerals, plus one small syringe with her pergolide. If the powder is the best option, I'll use it, but would prefer something else. 
DEVILS CLAW - Country Park (powder, granules, cut root)
Devil's Claw Powder 1kg – Mane Event Equestrian Supplies
Devils Claw Root | Greenpet (powder)
Joint and Mobility Support Horses - Devil's Claw Flex (herdz.com.au) 
Pain Relief for horses - Brookby Herbs Devils Claw Plus for Horses (herdz.com.au) 
Not Bute Herbal Anti Inflammatory Control Pain In Horses Dog Naturally 100Ml | Catch.com.au

Also, out of interest, does the herb Eyebright {Euphrasia officinalis] help with eye issues? It kinda sounds like it should! EYEBRIGHT - Country Park
(FWIW, I get my chastetree berry powder and a couple of other things such as beetroot powder from Country Park and have found them to be a reliable source.)

I have searched the archived messages and it does appear that what works for one horse with uveitis does not necessarily work for another in different circumstances. However, any tips from members with a similar issue very welcome. Another sticky point is that my vet does not want me to exercise her beyond handwalking while the eye is sore, and this is really making it hard for me to control her weight. Although the other vet said she didn't think light work (short trots, walking up hills) would be a problem. Her muscles, joints, feet and attitude are always better when she's in regular work, even if light, so I'd like to get back to it if possible.

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Do PPID horses get constipated or is this age related gut issues or sand colic?

Stepht
 

Lately Katie has been losing topline and acting a little lethargic.  Over the last 10 days as I hand walk her, she will stop and defecate a little then several minutes later she will stop again and pass gas then poop a little more. The appearance of the manure is normal shape and color and not dry or mucous coated. Her gut sounds in all quadrants are good and her appetite is very good.  She does not seem to be in any discomfort.
 
I have not yet updated her CH as I said I would with my eye question 3 weeks ago (shame on me), but in a nutshell;  her blood work has been good with ACTH falling in the high teens and low 20's for the last 2 years. Last test was 10/5/2020 - 18.0 pg/mL from Cornell.  She is on 10 mg. compounded pergolide.  Her ration is Timothy Balance Cubes at 15 lbs per day and, at this point 5 lbs of TC Sr. (this was slowly increased from 2 lbs for flavoring her cubes about 3 weeks ago....the vet wanted to try increasing to see if it helped her topline.  It has helped her a little.)

About 2 months ago, she was moved to a different lot that has more dirt than her other lot (she wore a grazing muzzle in the first lot)  She tries to graze on the tiny clumps of dead grass around the fence line.  Our soil here is mostly clay, but has some sand in it.  I also suspect that hay blows into this lot from another and so she is eating small amounts.

To clarify the timeline:  She was moved into the new lot around Nov 16th.  She noticeably was dropping topline and muscle in her hindquarters after Thanksgiving.  Vet looked at her Dec 10th and we slowly increased TC Sr. from 2 lbs to 5 lbs.  Around January 4th she started having the "constipation" symptoms.

Does this sound like a constipation issue or simply age related gut issue? Could it be a mild sand colic issue? Or does this sound like her PPID is falling out of control in the last few months and I need to retest?

I thought about adding psyllium so I read the recent posts regarding adding it to the ration and Dr. Kellon's post on her blog about all senior horses needing psyllium daily.  I also think I would like to add a probiotic because of her age.  Should I try this:

1). Uckele psyllium husk pellets mixed with her Balance Cubes - can someone please comment on amount? What amount should I give on an ongoing, daily basis?
2). Uckele GUT pellets or Absorb-all - please comment on which one would be a better choice to start
3). Electrolytes in water to help increase water consumption or adding loose salt (I do have to be easy with the loose salt in her cubes.  Too much and she refuses to eat)
4). Omit the TC Sr. and replace with Stable 1 if we need to keep the amount higher in order to help her maintain weight.

Thank you!


--
Stephanie Thomson August 2, 2016

 

Liberty, Missouri

Katie Case History

Katie Photo Album  https://ecir.groups.io/g/CaseHistory/album?id=6072

Katie Lab Values Folder  https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Katie 


Nitrates in water

Philippa
 

Just wondering if anyone knows if high nitrate levels in drinking water can cause laminitis?

Thanks.

--
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: Hoof Evaluation 1st time and UPDATE/HELP

Sherry Morse
 

Hi Tamara,

I'll leave it to Lavinia to give you specific trim advice but what jumps out at me is that he has no sole to spare, but it looks like your trimmer is still dressing the sole.  Until he has more sole it's very important to not touch it at all unless there's something Lavinia specifically has asked you to do with it.  Both of his front feet need a large trim adjustment with the right front being worse than the left.

Bloodwork - you want to make sure if possible you do the blood draw on a day when the temperature is over 50 and non-fasting - meaning 4 hours after being fed hay for the first time in the day if he's not allowed free access to hay overnight. 

Martha's already addressed the timing on the blood draw as well as your concern about the amount of pergolide per dose.  The veil effects every horse differently and some do experience a veil with each dose increase while others do not.  There is - as Martha mentioned - the possibility that PPID or pain could be effecting his appetite as well.  Which it is can be hard to figure out.   Were he mine I wouldn't do any more adjustment to pergolide dose without a test to see where he's at with his current dosage.

If you're asking about kidney function being affected by pergolide I don't think that's been found to be an issue with the majority of horses on pergolide - even at dosages much, much higher than were you are right now.

As far as the ribiness but still looking round from the front - I'd expect that's more due to lack of conditioning right now.




Re: jesse foot sore. equiciser

LJ Friedman
 

I took some more additional pictures of some lateral views and some down on the ground views. Let me know if anything else is needed. And thoughts on the beautiful photos.?  Many thanks to Nancy for helping me load them to my ch.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

jenny.comish@...
 

Hi Sherry,

thanks so much for your response. I think I have caused confusion over the metformin, he’s not on metformin. He was years ago but I stopped using it on agreement with my vet as we weren’t convinced it was doing anything and it was really hard to get him to eat it. But if you think it could be worth another go I’m happy to try. I’ve not heard of Invokana, I will have to look it up. 

As regards the Danilon, yes he’s still on this - on advice of my vet it has been reduced a little more to 2 thirds of a sachet per day - I give him one third in the morning and another third in the evening. My vet also suggested he could have 8 paracetamol per day, 4 in the morning and 4 in the evening. I did that for a few days, but stopped as I thought I can’t carry it on long-term - or can I? Dewi is absolutely crippled, so he needs some pain relief. What else can I do if he’s not on Danilon? I just don’t understand why he is in so much pain. Do you think it’s all down to a bad trim and thin soles? 

As regards how long I soak the hay, I’ve only been soaking it for 12 hours for a short amount of time - usually I only soak it for an hour, but my vet said an hour was not long enough, and as I have been so worried about him, against my better judgement I listened to my vet as I am desperate to make his pain go away. But the 12 hour soaking has made no difference to his pain. Also a well- known UK nutritionist suggested a 12 hour soak would reduce the calorie content of it so would help with weight loss. My vet thinks it would be helpful if he lost more weight. 

Do you think I should I get his insulin tested again? I know my vet will want to do the post Karo light syrup test - and I know you don’t recommend that. I will have to be very insistent with them that I don’t want that done. 

As for the TRH stimulation test, the guidance I read from Liphook Equine Hospital in the UK, who are supposed to be an authority on laminitis, is that it’s fine to do it in December (and my vet said it is). It was quite expensive so I can’t afford to get it done again any time soon. If it is imperative that I get it re-done to save Dewi’s life then I will of course and would get into debt to do it. I’ll be honest though, and this is not a dig at ECIR, just a general gripe after years of having a laminitic, I am getting really weary of all the contradictory advice on laminitis and I don’t know who is right and who is wrong. I don’t know the pre TRH number - sorry if this is a daft question, but when you say ‘number’,  what number do you mean and should my vet have it? 


I will definitely do a post about hoof advice. Thanks so much for looking at my case history and starting the process of helping Dewi and I. 😊


Jenny
--
Jenny Comish
England, UK
Dewi Case History: https://ecir.groups.io/g/CaseHistory/files/Jenny%20Dewi
Dewi Photos: https://ecir.groups.io/g/CaseHistory/album?id=257833


Re: NEW MEMBER - urgent advice needed for IR pony in constant pain

jenny.comish@...
 

Thanks for the quick reply Martha, and sorry for my slow reply. I’ve had some bad news this week as a good friend of mine has died, so I have not had time to look on here. 

I don’t think I made my case history clear about the metformin. He was only on metformin for a few weeks years and years ago. He’s not been on it since, I was never sure it was doing anything and it was very hard to get him to eat it as it came in huge tablets that clearly taste awful. What he has been on many times is Danilon. He is on it now and has been on it since June. He’s in terrible pain, so whilst I understand that long-term use is not good, my vet keeps prescribing it and I don’t know what else to give him. She did also suggest giving him 8 paracetamol per day, which I did for a short time, but stopped as was worried it wasn’t a good idea to carry on for too long. Any other pain relief advice would be really appreciated. 

Thanks for sending me the welcome info, I will look through it in detail.

Jenny 
--
Jenny Comish
England, UK
Dewi Case History: https://ecir.groups.io/g/CaseHistory/files/Jenny%20Dewi
Dewi Photos: https://ecir.groups.io/g/CaseHistory/album?id=257833

25741 - 25760 of 282164