Date   

Re: New Hay - results. Does his current diet align to this new hay well enough?

Kirsten Rasmussen
 

Hi Laura,
I'm wondering if there are people willing to be a tutor
I'd be happy to guide you through the calculations and check your numbers if you are trying to work through it on your own.  I have done the course, passed the competency exam, and balanced a few hays for myself and others.  In the meantime though, you could ask for Dr Kellon to balance with Uckele supplements for now so there's no delay for Ero's minerals when he starts the new hay.

One thing: do this on paper, like how Carol requires it in the course!  It's less overwhelming.  The spreadsheet hides all the background work and makes it hard to see how you've done something (especially if you are coming back to it 6 months later!) and VERY easy for mistakes to be made.  If you do it on paper and 'show your work', you can refer back to it every time you have a new hay to balance and follow the same steps to work through it again with new hay numbers...it only takes 30 or so minutes with a new hay if you have your process laid out in front of you.  I only use a spreadsheet AFTER I've balanced the hay and figured out what I need to add to correct deficiencies and ratios...then, with the spreadsheet I can plug in the numbers for any extras I am already feeding for a carrier (beet pulp/soy hulls/ODTBC/extruded pellets/etc) and for any pre-made mineral mixes (if I'm not doing a custom mix) to see if it fills the gaps and doesn't throw off the mineral ratios.  But I spend so much time checking the spreadsheet for errors that I'm not sure it's any quicker than a pencil and paper!

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


TC Safe Starch Forage

eleison
 

I've been following the thread re. TC Timothy Cubes and wondered if the TC Safe Starch Forage is an option for horse with Cushings/IR?  The profile of the forage on the TC website is within the acceptable range (ESC +Starch below 10% and starch below 4%) but it is not included on your list of safe feeds.  Is there something I am missing about the Safe Starch Forage, which if I decide to use, would go into a Savvy box with small openings in the grate. If it is ok to use it, do you feed it on 1:1 ratio with regular hay or do you alter it as with the Timothy cubes?  Thank you.  
--
Sara D in NC 2021


Re: Bloodwork, PPID, EMS Invokana and Pergolide

 

I’d give maximum dose APF twice a day whenever possible. If it’s not possible every day, do it when you can. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


IR and ulcer treatment along with other health challenges

vicky monen
 

Hi,

Need to pick your brains here for some information regarding Samson and ulcers.  We have had alot of health issues ongoing for some time now. 
He was diagnosed Insulin resistant/Cushings/EPM, allergies.  

Most recently he was dealing with low grade fever and unidentified reasons for such.  I have updated my case history with details listed and CBS-Chem panel.

Basically, I believe he has been dealing with undiagnosed ulcers for a very long time., with the most recent bout the last two weeks.  I have just started him on omeprozole at the treatment dose.  He significantly showed signs of improvement after a few days of this treatment.  I will be adding the sulcrafate once I get it in.  My question is,  I understand that giving alfalfa during ulcer treatment is helpful.  Is there a safe amount I could give him, through alfalfa pellets?  Also, do you have any other suggestion for feeding and supplementation during ulcer treatment?   What about light exercise, or do they need to be off completely from any light work?  

My other questions are,  do hind gut ulcers cause low back pain and can it manifest into other mechanical issues? 
Can ulcers affect Insulin levels due to stress from pain? 
I have recently increased his prascend to 2mg per day, because I was struggled to get his insulin back down.  Also he is constantly lame, which was thought to be possibly due to chronic laminitis. Can the increased prascend affect his gut or exacerbate ulcers?  He continues to be put on Decoquinate powder for preventative & relapses of EPM and would this contribute to ulcers?  As well as he is now on a permanent low dose of aspirin for the chronic laminitis. How do any of these drugs affect his gut and or ulcers?  Vet also believes he has polynuritis but the treatment conflicts with the IR, as it requires levimisole with DEX for several months.  Is there any other thing that can be given in place of DEX to go with the levimisole for polynuritis treatment?

He is a complicated case with many variables. 

Thank you so much for any suggestions in regards to our ongoing challenges. 
--
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

https://ecir.groups.io/g/CaseHistory/album?id=1226

https://ecir.groups.io/g/CaseHistory/files/Vicky%20and%20Samson


Re: Appetitie aid

Eleanor Kellon, VMD
 

You would need to know if there is sugar in the base. The licorice is not safe unless deglycyrrhized. It has ulcer soothing ingredients similar to GUT https://uckele.com/g-u-t-2lbs.html .
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Testing for high Iron

Eleanor Kellon, VMD
 

As far as blood letting (aka venisection, phlebotomy), which I know sounds positively medieval, it is an established therapy in both humans and animals with iron overload https://pubmed.ncbi.nlm.nih.gov/19601742/. It is effective more quickly than mineral balancing but still takes quite a few sessions, 7 to 14  days apart, to make progress.  PCV and hemoglobin have to monitored to make sure you don't get too low. It takes around 1 gallon per blood draw to make any headway in a horse and would probably have to be repeated.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Testing for high Iron

Eleanor Kellon, VMD
 

 Nancy and Cass gave you good links to start reading. Here is a link to our latest paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971364/ . Also see https://www.horsetalk.co.nz/2019/10/24/iron-overload-horses-insulin/ .

The bottom line is that iron is a risk factor for IR but iron overload alone won't cause it, and correcting iron overload won't cure it. IR is genetic. It's a physiological body chemistry type. Many things can affect that physiology and it's looking like iron overload is one of them.

Ferritin is the part of the iron screen that only KSU can do.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Dewi - latest blood test results - high resting insulin - what to do next?

Eleanor Kellon, VMD
 

This new study from AU has some good information on seasonal TRH results (table 2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7848300/ . I would  start him on Prascend but he clearly had EMS long before this.

If you can already easily feel his ribs I wouldn't recommend further weight loss. Definitely retest your hay for ESC and DE. DE can lower substantially so you need to feed more.

I don't think you need any further insulin testing.

As far as I know, Invokana is available in UK. If you want to try metformin again first, Begin with a short trial and retest in 6 days. If it's not doing a good job then it never will. However, after reading your last experience with it I would probably go directly to Invokana. I will need to send directly to your vet so please send me his e-mail at drkellon @ gmail.com.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Testing for high Iron

Nancy & Vinnie & Summer
 

I am very interested in all of this..innfact just had a brief text conversation with my vet about testing for iron overload in Vinnie.

I am going to sign up for the 2021 conference too. I am very excited!
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: Dewi - latest blood test results - high resting insulin - what to do next?

jenny.comish@...
 

Thank you all so much for your massively helpful responses. It is such a comfort having this group - I finally feel I am starting to make small steps in seeing if there is light at the end of the tunnel for Dewi. And the vet I’m using seems much more motivated to try to help Dewi than my last vet practice who had no interest in taking more bloods and made no further suggestions for what could be done for him. 


My vet is not sure he sees much benefit in following the advice from Liphook to take blood after a 2 hour fast and then a 6 hour fast. He has said he will call Andy Durham at Liphook on Monday to discuss it. But of course my vet thinks I had already fasted! But in a sense Dewi had blood taken after a 2 hour fast due to slowness of vet so the 6 hour fast would be the only thing that had not been done.

Dr Kellon - thank you for confirming that you think my blood tests are ok to be counted as non-fasting. I imagine it was less than 2 hours before I arrived that Dewi had run out of hay as usually he does have a little left and I was a bit late that morning. Do you think Liphook’s advice is worth following with the 6 hr fast? The way I see it Dewi has a massive problem and his insulin is going to be abnormal no matter what test we do.  But would appreciate your thoughts on this.

My vet agrees Metformin in worth another go. But if it only works short term it’s where I go from there?

I got my hay analysis results back today - ESC is 6.3%, starch is 1.60%, WSC 14.5%. Protein is better than past hay - 9.10%. Do you think it could be worth me sending another hay sample off for analysis that has been soaked for an hour to see how much it brings down the ESC? I was just thinking that maybe 7.9% combined ESC and starch could be borderline for Dewi? But I already always soak it for a min of one hour before feeding. 


Thanks for the advice on diet Sherry. I find it so hard cutting his hay ration as I hate to think of him stood for long periods with no food. But if you think it could further help his insulin I will do it. I can feel his ribs easily.  But my vet still thinks losing a bit more weight would be helpful. I will do anything to get him out of this mess! 


As regards his ACTH, my vet agrees this is elevated. I do wonder if past samples have not been handled correctly by my previous vet.... My new vet has suggested I put Dewi on a product called Equilife Vitex. But I’ve looked up chasteberry on here and it doesn’t sound like it will do much for Dewi as I have only read that it helps with shedding and Dewi doesn’t have an issue with that. And thanks for the tip about trying pergolide before the seasonal rise. 


Dr Kellon - do you think Dewi ought to be on pergolide now? Also would it be possible to send me/my vet information on Invokana? If so, my email address is jenny.comish@...

And as for the x-rays, I’m still waiting on those - my vet has been busy lambing and calving all week. Bit frustrating as I want to get them on here. But I am VERY lucky as Sarah Braithwaite from Forage Plus has offered to come and take a look at Dewi’s feet next Wednesday for me. We’ve been corresponding about Dewi for sometime. I’m not local to Sarah but she is making a special trip 😊.

Once again, thank you all so much for the huge support. It’s heart warming to think there are people the other side of the globe all trying to help get Dewi better 😊.

Jenny (oh and I will add my hay analysis to my files and also I forgot to add my TRH stimulation test results to my case history! Post TRH he was 123). 
--
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: Bloodwork drawn once yearly?

Sherry Morse
 

Hi Patricia,

I agree with Lorna as far as the timing of the testing.  Of the three of them Dancer is the one I'd be most concerned with as her insulin is elevated, even with the metformin.  Is there a reason that the metformin was stopped and was her insulin checked after it was stopped to see if it stayed down or went up when she was no longer on it?




Re: Bloodwork, PPID, EMS Invokana and Pergolide

Nancy & Vinnie & Summer
 


Re: Bloodwork drawn once yearly?

Lorna Cane
 

Hi Patricia,

If she were mine,because there are numbers for last June,and because at that time of year ,at least the ACTH should be in good range, I would draw again in June this year.
My thinking is that if I wait til September, there being numbers for then,too,and numbers are high I'm at more of a disadvantage than if I find numbers out of line in June.
I can see how others may disagree with this, but without more details this would be my approach.

--

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


Bloodwork drawn once yearly?

Patricia Evans
 

Hi all,
I know it's best to draw bloodwork a minimum of twice yearly, but financial challenges are making life difficult for me as well as everyone. My particular problem is when to draw bloodwork if I can only afford to do it once a year? It was last drawn in September of 2020 (and no, my case histories are not up to date :( , sorry). I know I should have drawn labs on my three PPID horses already this year, but so far I have not been able to get it done. The vet charges me $485 for ACTH and insulin plus a farm fee, and right now it's not within my reach. All three are doing well, but I did need to put Dancer on metformin to get her insulin down last year. The repeat blood draw showed that her insulin did respond well, but no other labs have been drawn since then. 6/15/20 her insulin was 62.72 and after almost 3 months on metformin it was down to 40.80. She is now off it, but it seemed to be a big deal to my vet to get the prescription, since her insulin wasn't in the 100's. Since she has had laminitis twice in her life, I was able to finally talk the vet into giving it to me. 

I did look in the files and messages, but could not find anything about once yearly bloodwork timing. Any answers are much appreciated!
--

Patricia 

North central Florida

July 7 2018

https://ecir.groups.io/g/CaseHistory/files/Patricia%20and%20Dancer%20and%20Nathan
Dancer:  https://ecir.groups.io/g/CaseHistory/album?id=66069

Nathan:  https://ecir.groups.io/g/CaseHistory/album?id=94152
Snickers 
https://ecir.groups.io/g/CaseHistory/album?id=241740 


Re: Purina Outlast

 

Ok ..that makes sense ..thank you!


--
Michele Goldberg
Bernville, Pa
joined 5/19/2016


Re: Bloodwork, PPID, EMS Invokana and Pergolide

Sherry Morse
 

Hi Nancy,

We usually recommend titrating up 3 days at a time so you can up the dose now.




Re: Bloodwork, PPID, EMS Invokana and Pergolide

Nancy & Vinnie & Summer
 

Hi, again.. a little crisis mode today trying not to panic. Vinnie is pretty sore, farrier coming back to see if we can figure out of there is a collection. We opted to hold on doing anything to see if starting prascend helped.  It seemed to help a bit, but of course I am titrating up.

So being as Vinnie is as sore as he is with pulses in all four.. should I throw caution to.the wind and up his dose of prascend now to .50? Today is day 3.  He on in APF 10mls am.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: It’s Giving Tuesday....Here’s how you can help the ECIR Group!

Nancy C
 

Yes, Shirley.  Thank you very much.

There is also a service called iGive.

https://www.igive.com/welcome/lp16/cr64a.cfm

Every little bit helps.

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room


Re: It’s Giving Tuesday....Here’s how you can help the ECIR Group!

Shirley J.
 

Thank you for reposting (awhile ago) about the AmazonSmile option – I signed up and made a point to order what I could through Amazon to help support the group!  It wasn’t much, but every little bit helps, right?  Glad to hear you met the goal 😊


--
Shirley J. in Michigan
Joined 2020 (because what else could go wrong?)


Re: Omega Alpha Supplements

Sherry Morse
 

Hi Michele,

MSM can be problematic for some IR horses (see message https://ecir.groups.io/g/main/message/259636).  Glucosamine can also be an issue (see message https://ecir.groups.io/g/main/message/257235) You may want to try PhytoQuench with Devil's Claw or MoveEase from My Best Horse if you need a joint supplement. 

As far as the Adren Fx and the Respiration one - there's nothing that jumps out as harmful but if you do decide to use either one I'd definitely make notes to see they makes any difference before deciding to use them long term and to confirm the effects are due to the supplement I wouldn't change anything else at the same time.



 


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