Date   

Re: New & Updated Case History help please

Nancy C
 
Edited

One more bit about diet effects, since it appears Liz and Onyx are having the same issue.

If your hay (Feb 2021?) was tested via NIR vs wet chem, your ESC and Starch may be higher than what is reported. Since it was in the 8%+ range, this would concern me. Some members have found as much as a 30% difference between the tests.  If I have these details correct, I would retest the hay. I may have missed something, bouncing between folders.

I am not seeing any listing of the major minerals for Cricket.  I would review those with your diet balancer and bring the calcium;magnesium ratio to 1.5:1 if it is not already there.

I would also want to make sure the trace minerals are tight at 3:1:3 - Iron:copper:zinc. Zinc is a really important aid for insulin sensitivity.
--
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: Liz & Onyx - New Results 2021

Sherry Morse
 

Hi Elizabeth,

Issues with contamination usually result in lower results, not higher ones.  We would need to know the circumstances under which the blood was drawn to be able to answer if it's higher as a result of a meal or temperature; would you remember that information?  If Onyx has been on Metformin for 2 years now I'd venture a guess that - depending on those answers - it's no longer working for him.  In that case you need to look at if his diet is tight enough to help get his insulin level down and to help with that we really need to know what his current weight is.  If you could post current pictures of his trim we'll be able to help with that as well.




Re: Liz & Onyx - New Results 2021

 

Elizabeth, I went through Onyx’s case history, looking for clues to his high insulin.  His testing was done in March.  Do you have any recollection of what the temperature was then?  Also, I saw an entry for metformin in 2019 and another one recently.  Did you stop the metformin and restart it recently or did you just want to bring it to our attention?  His hay might benefit from soaking as the ESC might be making it too high for him but, it he’s sound, it would be hard to know without retesting him.  Could Onyx be provided with more exercise?
--
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


 
 


Fw: Re: [ECIR] Cushings horse losing her hair

Sherry Morse
 

Forwarding this for Daune :



Hi Vikki,   I have a horse on the exact same meds.   He was shedding out nicely until i started the prascend.   Then it came to a screeching halt.    Which admittedly is better than hair falling out to leave bald patches.   The vet said i would probably need to clip whatever need be to keep him cool this summer.    He is not an Arab.   His coat is awful!   It is so coarse and he is sensitive to touch now.  All of this because of prascend.   Its a tough drug.   Good luck with the bald spots .   Maybe its something else.    Maybe they just have to get used to prascend.   There is much help here on this site maybe its happened to others.    When did you start with prascend?  

--
Daune and Monty
Southeastern Massachusetts 
2021


Re: Liz & Onyx - New Results 2021

 

Hi Elizabeth,
There have been a number of questions about the EMS calculator recently.  Nancy’s recent post should answer some of your questions.   There is a discussion of MIRG in the files but I have no experience using it.  You might try a further search on MIRG in the messages and files to see what you can find.  There is lots more.  Someone with more experience with that calculation might step up to clarify.  
--
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: Question for Dr. Kellon and Invokana dose for Riosa

 
Edited

Hi, Heather.
Not Dr Kellon, and I can't address any of your questions about Invokana.
I need to update my comments on glucometers based on my recent experience. Initially, I had no problems using a glucometer to check a drop of Cayuse's blood drawn by my vet. Starting last fall, I started getting error codes every single time. It works fine with my blood, so there's nothing wrong with the glucometer. I've tried new test strips, calibrated it, changed the battery. Error codes keep on coming with Cayuse's blood. 
After some reading about humans and veterinary glucometers, I found there are factors that will make your glucometer refuse to read the glucose in the blood or provide inaccurate results:
https://www.fda.gov/medical-devices/in-vitro-diagnostics/blood-glucose-monitoring-devices 
1. Low temperature. The blood must be and remain fresh and warm! A cold day can cause problems.
2. Hematocrit outside the usual parameters for humans
3. Finicky test strips that you buy by the dozen but use a few times a year.
4. Impact of drugs or vitamins that confound the results. 
There are probably more. In short, while my glucometer worked well initially, it no longer works consistently with Cayuse's blood. 
There's another issue we need to think about. Even working perfectly, glucometer accuracy isn't fantastic. It can be working perfectly within the specifications required by the FDA, and it can still give results that are plus or minus 15mg/dl of the actual blood glucose.  Cayuse's results, when the glucometer worked for her, were about plus or minus 5 mg/dl of lab results.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Liz & Onyx - New Results 2021

Elizabeth Kuzma
 

Hello Dr. Kellon and group, 

I just had my Tennessee Walkers results done recently and his values, especially the Insulin level seems extremely high.  I can't figure out the meaning of the results on the EMS calculator since there seems to have been a change to that.  I have never had the MIRG ratio be negative as they are for these new results.  Please help!  Could this be a contamination or mistake, should I get a redraw?  The vet said that she is having many horses test with high Insulin levels right now.  However it has me worried.  He does not seem to be showing any specific different symptoms or foot sensitivity right now.  The only change since this winter has been a hoof crack that seems to never grow out. 

The EMS calculations are below:

G/I Ratio:  0.88
RISQI Calculation: 0.091
MIRG Calculation:  -9.8
--
Elizabeth
Member since Aug. 2019, Patchogue, NY
Case History: https://ecir.groups.io/g/CaseHistory/files/Elizabeth%20and%20Onyx
Onyx's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=94258
Hay analysis: https://ecir.groups.io/g/CaseHistory/files/Elizabeth%20and%20Onyx/Dairy%20One%20Hay%20analysis


Re: Question for Dr. Kellon and Invokana dose for Riosa

hdavis
 

I don’t think she is foot sore at all as went out last evening and took her out into the arena and we had a little play on the ground and she was full of beans. Not soggy at all and very forward and playful. Looking forward to hear back from Dr. kellon and will need to get on buying a glucometer. 
--
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: New & Updated Case History help please

Nancy C
 
Edited

Jeannean

(EDIT) Sorry -- I need more coffee. Meant to include these links and explanation. Deleted by mistake.

Have a look in the message archives as Donkey variable has been discussed on several occasions.  Hoping owners will also chime in. It is primarily the ACTH.

https://ecir.groups.io/g/main/search?q=posterid%3A58231++%2Bdonkey+%2BACTH
https://ecir.groups.io/g/main/message/165442

At a minimum I might suggest you retest Cricket in July. What prompted me to test Skip (my QH) in 2019 was the ever-so-slight loss of fullness at the withers. He was 19 at the time. I think many folks would call it a protein issue, but it was not. He was only just above lab reference range @ ~40.
--
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: New & Updated Case History help please

~NeanPiggy~
 

Hmm, OK.  So I am slowly figuring this out, haha.

So you are suggesting Cricket start Pergolide (Prascend)?  His feet are drop dead gorgeous.  The only time he had a hoof issue was when he was on the DEX.  And that presented itself with chipping walls that took a few months to grow out, no pain.  Nicole S, has balanced his diet for me :)  I don't notice any other physical signs of PPID but I want to be pro-active.  I am trying hard to avoid the rabbit hole because I am fully aware it can strike like lightening.  I am off today, I can try to get updated photos of him.  He is not fully shed out so he looks a bit ratty, maybe I can bathe him today and blow out as much hair as possible with the shop vac???   He might be thinner than I expect since his exercise has greatly increased so he just may need a little more hay for his "athletic" calorie needs.  I was so hoping that all of our hiking would have helped his numbers as well as his weight :( 

The vet suggested insulinwise.  I did my reading and see it is effective only about 50% of the time.   Honestly I'd rather soak hay in the warmer temps if we think that would help with the ESC than put him on a drug.  I cannot soak in the winter, did that many years ago for my pony and it's just too cold here in the winter.  They don't have a real barn that maintains temps above 0c. 

So how do I find out about the donkey, Chispa?  Without knowing about how his numbers look I don't know if there is anything better I can do for him.  He lives with Cricket.  The only time they are separate is when he goes in his stall to eat his Stable 1/Vitamins,  Cricket can't fit under the railing.



THANK YOU SO MUCH :) 




--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


Re: Stabul 1

 

Hi, Linda,
Information about the emergency diet was included in the welcome letter you got back in late October or early November. Here's the link:
https://ecir.groups.io/g/main/message/256967
The Emergency Diet is a temporary diet for new members while they get a feeding plan in place that includes only safe forage and bagged feeds. The goal is to immediately remove any potential dietary triggers for laminitis.

My horses ate LMF Low NSC Stage 1 as a carrier. I didn't mix it with Stabul1, another carrier. Neither carrier will balance your horses' diet: that takes the right minerals in the right amounts. Minerals are fed with a safe carrier like ODTBC, Stabul1, RSR Beet pulp and the others on the list.  

 My horses will eat just about anything in a handful of Stabul1, including many meds. If you want to try different flavors (fenugreek and banana are favorites here), check out the Stabul1 website. They will send small samples. They also sell 20 pound bags to try so you're not stuck with a 50 bag of something your horses won't eat. Once you know their flavor, you can order from Chewy.com.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Commercial Feed Analysis Library - Thu, 04/08/2021 #cal-notice

main@ECIR.groups.io Calendar <noreply@...>
 

Commercial Feed Analysis Library

When:
Thursday, 8 April 2021

Description:

Commercial Feed Analysis Library

Over the years individual ECIR Group members have sent various commercial feeds to be tested then generously shared the information. The Commercial Feed Analysis Library is a new term for an old file folder where any member can go and view unbiased analyses of commercial feeds. These analyses are a valuable part of the science that the ECIR uses to help our IR and PPID horses and are valuable tools used to prevent laminitis. 

If you have an analysis of a commercial feed please, instead of uploading it to your own folder, please consider sharing it with the entire group by by notifying us here.

View the Commercial Feed Analysis Library 

Thanks for your help and cooperation.

- ECIR Group Owners and Support Team


Re: Question for Dr. Kellon and Invokana dose for Riosa

hdavis
 

Was just thinking could adding the oats/ODTB cubes mixture have perhaps caused her to be a bit doggy due to being foot sore. Adding in oats to her feed is somewhat terrifying for me as she had been such a struggle to get her insulin under control so was just thinking shoot did I maybe cause this!?!? 
--
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: New & Updated Case History help please

Nancy C
 

Hi Jeannean

The further you go down the scale for G/I  or RISQI the closer to laminitis risk you are.

For G/I the lower the ratio, the higher the laminitis risk. Cricket's is 2.80.  Ideal G/I is 10:1

MIRG measures insulin sensitivity and to my mind really comes into play when a patient becomes diabetic. A high MIRG = EMS.  A low MIRG means you have passed into diabetes. You have a high MIRG.

Cricket's RISQI is 0.17.  "A RISQI of less than 0.2 indicate severe IR and the horse is at high risk of laminitis." Your RISQI is 0.17

So let's look at DDT+E as a road map.  I would want to see Cricket's ACTH lower than 30 in April.  MY QH's is very similar to where you are.  I was cautiously leaving things alone but will test again in July to make sure PPID is controlled, but am second guessing myself. Not fully shed and looking gaunt. He's on 3 mg of pergolide.

I took a quick look at Cricket's Diet. The ESC may be too high, but balancing can help with insulin sensitivity.

Hope this 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


Question for Dr. Kellon and Invokana dose for Riosa

hdavis
 

Hello Dr. kellon.

I am awaiting Riosa’s blood results for her insulin, glucose and triglycerides and hoping we will have them maybe this week.  I was wondering should I be reducing her Invokana dose until they come back?

I have been feeding her about 1:1 lbs of Ontario Dehy Balance Cubes and oats within an hour after working her but noticed she seems a bit laggy in our hikes, lunging sessions and am wondering is this maybe a sign her glucose levels are low. She seems to have lost some of her spunk and forward was but doesn’t appear foot sore at all just a bit draggy and slow energy. Or should I feed her some hay before her workouts to help maybe?  Or ideas?
Thanks in advance.
--
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: Question for Lavinia regarding heel issue

hdavis
 


Re: Question for Lavinia regarding heel issue

Lavinia Fiscaletti
 
Edited

Hi Heather,

No, I have't had a chance to look yet but it's at the top of my list for tomorrow.

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


Re: Question for Lavinia regarding heel issue

hdavis
 

Hello Lavinia,

just checking in to see if you had a chance to review my hoof pics and had any feedback for me.

thanks!
--
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: New & Updated Case History help please

~NeanPiggy~
 

Thank you Nancy, I actually found that later after posting.  So if I am understanding this correctly I ran my numbers and basically had to look up the results on my own instead of the box next to the values.    Cricket (horse) has compensated IR or Severe IR??    He is a high laminitis risk.  I do not understand the MIRG, it doesn't give ranges .  It just states High or Low.  The reason I ask is simply to see if changing anything in my management can help.  For example I'm feeding steamed tested hay (8.1 + 7)  but should I soak it on top of that?   Steamed for asthma/allergies - I know it does nothing for sugars but it has helped immensely with breathing.


--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


Re: Lavinia Request for Mark Ups Please

Lavinia Fiscaletti
 

Hi Lynn,

It's all pretty basic changes, so could easily be done in one trim. At most, two should do it.

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

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