Date   

Re: What else to manage pain?

Buzz
 

Hi Lavinia!
I tried to post more pics of Buzzy's RF hoof.  I am not too tech savy on this new computer!!   It is the only hoof we could get pics of.  I wanted to let you know, in case you didn't realize, the file has some pics with marks ups in it, but they were done by our trimmer.  She seems to think his hooves are not growing, which I know you said they are, just very slowly.  I think she is also afraid to trim back the toes anymore and perhaps rightfully so.  I honestly don't know!
--
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: What else to manage pain?

Buzz
 

Hi Dr. Kellon,
I have had him on Laminox for months prior to his laminitis in Dec, however that time he was only PPID.  In Jan he was dx as IR as well.  I don't know why the vet put him on the cypro. She ordered it along with the gabapentin.  Both of which he has finished the quantity ordered and I haven't refilled as I did not see any difference.  Thank you for sending the study on Insuin Wise.  I have sent it on to her and requested to please have us try getting the insulin down with metformin or invokana  I don't know which would be best for him, but something needs to be done to get him feeling better.  I am really trying to advocate for him and appreciate your help more than ever! Thank you!
--
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: What else to manage pain?

Buzz
 


--Hi Lavinia!
He was so painful today, when we finally got his boot off it was impossible to try to do any trim.  He seems to one day be better and the next not as good.  Although, he has always been difficult a doing his feet and has to really trust.   I have been super careful making sure he is not getting anything scrounging along the aisle when he is out of his stall.  Mostly today he just stood in the same place not even wanting to move.  I'm thinking we should check his insulin again and see where it is now.  I asked the vet to get the actual insulin # from Cornell and not just > 200. She said she can ask but she thought that was as high as their range reads without doing dilutions. So, I have not heard back from her regarding the actual #.  I will post pictures we took this afternoon of his R front in a few minutes. The gal who was going to take off a little toe between the trimmer coming every 4 weeks  got hesitant to rasp when she saw he was uncomfortable and said she didn't think they had grown much at all ( he was barely trimmed 2 wks. ago). Also, I have straight J herb, but have been using the Laminox.  Should I just give him the J herb without giving him the Laminox?   If so, just cut the recommended amt. to coincide with his body wt.? I can try to check his gums, but he is rather head shy too.  I'm sorry to say he has trust issues as well!  Just trying to do the best I can for this little guy!
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: Coconut oil as a taste tempter ?

Lorna Cane
 

Trisha,is pergolide encapsulated?
Inserted into peanut shell works well for some.

--

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


Re: Coconut oil as a taste tempter ?

Trisha DePietro
 

Hi Cass....no have not tried that yet. Didn't know about the granular formulation....I will check it out. Thanks!  ( trying to get her to eat all her minerals plus her compounded pergolide is the goal). 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Coconut oil as a taste tempter ?

 

Trisha, you didn't mention what you're trying to get Hope to eat. A little something or all her minerals? I stay away from oils and fats other than those that add to Omega 3 fatty acids.

Have you tried Uckele CocoSoya Granular? I've used it for years as that extra special thing that will get my mares to eat generally unpleasant things. It's the top level treat as far as they are concerned, and they'll lick it off my hand.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Coconut oil as a taste tempter ?

Trisha DePietro
 

I am still on the hunt for a taste Hope will eat....Has anyone tried using Coconut oil?  What was your experience with it?  How did you use it? Thanks.

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


Re: Adjusting pergolide when base numbers are normal

Nancy & Vinnie & Summer
 

This may be a dumb question, but how does insulin come to play in this myriad of hormones? Is it related to the elevated cortisol?

--
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: Neurogan CBDs for pain

Nancy & Vinnie & Summer
 

I love Neurogan too.  I am not sure if helps with laminitic pain, but I think it has helped Vinnie's overall comfort level.

I use it for my Summer too, she can be a little spicy sometimes and it has helped calm her brain a little.
--
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: Callisto: Sore Feet, Positive for IR, On Prascend, What Else Can I do?

Sherry Morse
 

If it makes you feel better the first time I read the name on the 2nd one I thought it had alfalfa in it and then I couldn't figure out why the report said timothy.  I'm guessing that "Wash" in this case is short for Washington state though ;-)





Neurogan CBDs for pain

TERRI JENNINGS
 

i just wanted to say thank you to whomever it was that posted about Neurogan. My 30 year old and my 29 year old are completely off of their NSAIDS and feeling better than they have in years. My 30 year old even seems to be having less trouble with his COPD despite the fact that everything is in bloom. I’m amazed with the results. I haven’t tried it fir laminitis but I was wondering if anyone has and if so did it help?

Thankd
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Re: Callisto: Sore Feet, Positive for IR, On Prascend, What Else Can I do?

 
Edited

Thanks, Sherry.  The name of the hay had ‘wash’ in it so I took that to mean it had been ‘washed’.  Sorry about that!  Both hays had similar ESCs which seemed weird to me.

eta. Just occurred to me that it probably referred to Washington State.
--
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: Adjusting pergolide when base numbers are normal

Eleanor Kellon, VMD
 
Edited

It's actually the distal lobe, pars distalis, that normally produces ACTH under the influence of CRH. CRH secretion is linked to the circulating cortisol level. In the normal, every day function of the median lobe, a tiny amount of ACTH is produced as an intermediary in other reactions https://flipper.diff.org/app/pathways/info/2863 . The median lobe is normally under the control of dopamine. When that control is lost, the levels of all its hormones is increased but ACTH is actually the lowest.

When ACTH from the median lobe shoots too high, it triggers cortisol production just like ACTH from the pars distalis. That increased cortisol then inhibits CRH and ACTH normal production.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Callisto: Sore Feet, Positive for IR, On Prascend, What Else Can I do?

Lavinia Fiscaletti
 

Hi Lara,

As has already been mentioned, there really isn't any appreciable difference in the trim from what was happening in Aug 2020 to now. Both sets of rads show really horizontally long toes, underrun heels, sinking and thin soles. The only way the soles are going to improve is if the trim gets much more aggressive with fixing these issues. The frogs are narrow and elongated, with central sulci that have split all the way up into the hairline. This is going to be painful and make it unlikely that Callisto will be able to land heel-first even if the mechanics of the trim encourage it. Treat the cracks with 50-50 ACV+water soaks, then fill the cracks with a mix of 50/50 athlete's foot cream and triple antibiotic cream that contains a pain-killing ingredient, poke some cotton into the crack to keep the medication in and keep some of the dirt out. This will help heal them while the trim works to restore healthier foot mechanisms.

If you would like mark-ups to help guide the trims, I'll need a full set of hoof photos (all four feet). Please include part of the cannon bone in the lateral views. Also need to know the date of the next farrier visit.

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


Re: What else to manage pain?

Lavinia Fiscaletti
 

Hi Marsha,

Sorry that Buzzy is still having such a tough time of it. It is definitely encouraging that he is willing to walk around by himself.

His elevated insulin is driving continued laminitis to some degree. Until that is controlled, you will have limited success getting him more comfortable. Gabapentin won't help with that. Still don't know why he has been prescribed cypro, as it has no effect on insulin and there's zero research in combining it with pergolide to treat PPID. It was an older drug used to treat PPID before pergolide was available and it was found not to be effective. Metformin or Invokana would be the way to go at this point if his insulin number isn't improving. His ACTH appears to be OK, so his pergolide dose doesn't need to be adjusted. Jiaogulan can be added to help with increasing circulation, which will also speed up foot growth. It wil also tend to mobilize any abscess material that may be trapped within the hoof capsules.

Have you had his hay analyzed and mineral balanced? OR, just use straight ODTBC, at least temporarily, so that all you need to add is salt, vit E and flax to have a safe, mineral balanced diet. As others have noted, Insulinwise has not been seen to work in most cases.

The rads showed thin soles, sinking, long toes and some slight bony column rotation. His heels are underrun. Until the trim is tightened up, it will continue to keep the soles thin as the long toes stretch the sole. The sinking adds more pressure onto the already thin soles, compounding the problem. Being a mini is a bonus, as his size means gravity isn't your worst enemy as it is in larger breeds. Make sure his boots have strong bevels added to the treads at the toes and heels to optimize the breakover for him.They usually rebound quite quickly to getting the trim corrected and insulin controlled.

Blanketing plus socks inside of his boots, along with wraps or shipping boots over his legs (I know, makes him look like a mummy) whenever the temps drop into the 40's or below will help with any cold-induced pain.

If you can post a full set of hoof photos from after yesterday's trim, with the hair secured away from his coronary bands to they are visible, I can see how the trim is evolving.

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


Re: Adjusting pergolide when base numbers are normal

Maxine McArthur
 

I see. So the anterior lobe (in a normal horse) does the everyday job of producing ACTH, while the median lobe jumps in for special occasions, so to speak? And in a PPID horse, the over-production from the median lobe drowns out (or does it actually prevent?) the normal production from anterior lobe. 

Sorry to over-simplify, I do realise other hormones are involved. Just trying to get the mechanism clear in my mind. 
--
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: Is this safe to give IR-cushings horse

Eleanor Kellon, VMD
 

Yes, it's safe.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: What else to manage pain?

Eleanor Kellon, VMD
 

Hi Marsha,

I would get him back on LaminOx, half the horse dose twice a day and make sure he has heavy socks on inside the boots.

However, getting that insulin down is critical. Re InsulinWise, please see https://ecir.groups.io/g/main/message/249832?p=,,,20,0,0,0::Created,,InsulinWise+%2B+Eleanor,20,2,0,29018987 . The study is here https://www.sciencedirect.com/science/article/pii/S0737080620300216 . No one on this group has had positive results with it and some have worsened. I would try metformin or Invokana,

Why is he on cyproheptadine?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Is this safe to give IR-cushings horse

vicky monen
 

Hi,

My last message was over looked, so  this one will be short and sweet.  

Can anyone tell me if this is safe to give my IR horse with ulcers. 

AbSucralfate Granules (Sachet)
  •  Each 7.2g sachet of film-coated granules contains sucralfate BP 5.0g.
  •  Treatment dosage of 30mg/kg (13mg/lb) of horse's bodyweight.

I have already started Ulcer treatment for my IR/cushing horse but wanted to double check  on this

Thanks, 
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: What else to manage pain?

Sherry Morse
 

Hi Marsha,

Sounds like - not surprisingly - there's been no change on the Insulinwise.  I agree with Martha that at this point metformin would be the next thing to try.  Your vet may insist on rechecking his insulin prior to writing a script.  If the result comes in over 200 again she can ask Cornell to provide an actual number for you.  I would personally not spend money on gabapentin and cypro as you have already tried both and they don't appear to be working.  I would focus on the fact that he is up and moving and that getting his insulin down and trim optimized will help him feel better.

As the trimmer didn't do very much last time Lavinia's last set of markups can probably still provide a roadmap for this trim.



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