Date   

Re: Boarding in San Diego area?

coffincomplex@...
 

Thanks, LJ. I won't have a place to live picked out until I know where the horses will live (priorities you know...). Just trying to stay as close to La Jolla as possible.

I've posted on a couple of Facebook groups, including that one, and gotten a few recommendations but so far none of them have panned out. Hoping to keep beating the bushes until the right fit appears.
--
Alanna
May 2018
Los Angeles, CA
Buster's case history: https://ecir.groups.io/g/CaseHistory/files/Alanna%20and%20Buster  .


Re: Free feeding tested hay

Sara Gooch
 

 Bobbi,
With the Abler granules, make sure you follow the protocol of not getting the granules wet by feeding in any sort of a mash.  Best results by dosing with any omeprazole first thing in the morning with the smallest amount of carrier you can, and on an empty stomach, then withhold their breakfast for I think it is 30-40 minutes, maybe an hour, I forget, but do some research on the timing. This ulcer discussion should be on Horsekeeping, so if you have more questions, ask there ☺.
Good luck,
Sara, 2011, Northeast California


Re: Peg / 9YO PREG MARE / Cohuna VIC AUS

Cindy Q
 

Hello Katie

Welcome to the group and I'm very sorry that you have a mare in crisis. I think Peg is her name?

I'm going to share our official welcome letter below. The Emergency Diet is linked below (you can find it at the bottom of the linked page). You asked about supplements. In Australia, Carol Layton is recommended and she helps teach a portion of Dr Kellon's NRC Plus course, her website is 
https://balancedequine.com.au/ and she sells a few premixes that are safe (very affordable, no fillers, best guess but can be started quickly or in the interim - I ship them from Australia all the time) and also offers paid custom feeding plan advice in line with the recommendations of this group (customised to your tested hay is the top recommendation here for feeding). In Australia, Hygain also makes Micrbeet which is unmolassed quick-soaking beet flakes which also make a safe carrier if fed rinse-soaked-rinsed (to remove surface iron) and can help to provide more calories (beet is mentioned in the Emergency Diet) - see Dr Kellon's posts here on feeding laminitic pregnant mares https://ecir.groups.io/g/main/message/254788 and https://ecir.groups.io/g/main/message/233869

Sorry, I'm not experienced with pregnant mares but I am sure other volunteers and members will chime in. In the meantime, read through the welcome letter carefully and the details of the Emergency Diet. You mentioned your latest hay was tested, if it is not below 10% ESC and starch combined, you would want to be soak it for an hour and drain the water away well before feeding.

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. 

 

--
Cindy and Glow - Sep 2017, Singapore
ECIR Primary Response





Re: Recent bloodwork concerns

Michele Goldberg <ladipus@...>
 

Hi Sherry ...my vet just advised me to increase my horses dose from 2 1/2 mg to 3mg...he’s suggesting that I do not give it all at once ..he’s suggesting 1.5 twice/day 
--
Michele Goldberg
Bernville, Pa 
joined 5/19/2016


Re: early ppid question

LJ Friedman
 

Is it OK to test now or is it a benefit to wait for June July? Thank you
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Re: Free feeding tested hay

gypsylassie
 

Hi Pat, one thing you can do to help her is to give her a small meal of hay before you ride or exercise her.   That will help the part of the stomach that doesn't have protection from acid splashing up when a horse trots and canters.   
Laura K Chappie & Beau over the bridge
2011 N IL 


Re: Riosa and Invokana dose

Nancy & Vinnie & Summer
 

We just started Vinnie back in 1/8th (cutting the pill 8 ways) of the original dose (300mg) we are pulling blood tomorrow to see where the insulin and triglycerides are with this low dose.

Vinnies triglycerides have come down to 71 and it was only because insulin was going up (49 then 68 two weeks apart) that we decided to restart the meds. I am working directly with my vet at the moment until Dr Kellon has a moment to check in.

Thanks Nancy :)
--
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: early ppid question

Nancy C
 

Hi LJ

Agree with Sherry.

--
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: Riosa and Invokana dose

Nancy C
 

Hi Folks

Dr Kellon is keeping an eye on all of the Invokana horses. Make sure your lab tests are in your CH . Stay in contact with your vet.

If your vet feels that Triglycerides are too high and a role back is in order, based on previous reports, personally I would follow that guidance.

If you feel signs are showing things you have not seen before, discuss testing with your vet.

--
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: Riosa and Invokana dose

Lecia Martin
 

Hi Heather:   I have been following with great interest, especially after Nancy's journey with Vinnie. I, too have noticed a lack of energy,  and unwillingness to move forward. Discussed it with my vet on Friday as a matter of fact.  Flyte's bloods showed increased liver enzymes and slightly elevated triglycerides. Currently he is on 2/3 of a tab,  but I am wondering about cutting it to half a tab.  We will be testing again first week of May. I have struggled this winter with his weight as well.  On the plus side his feet are good and moves well when he wants to.  I am hoping Dr. Kellon will weigh in at some point for feedback.
Lecia Flyte and Flame
Alberta, Canada


Re: early ppid question

Sherry Morse
 

Hi LJ,

I'd retest in June or July at the latest so if you need to update his dose prior to the rise you have time to do that (and you would just need the basal ACTH test, not TRH stim).




Re: Riosa and Invokana dose

hdavis
 

Yes I totally agree we are the experimental herd and lots of unknowns but I do know that this drug is what has saved us so far. I am thinking maybe she just needs more energy in her diet maybe, even if she isn’t loosing weight. Hopefully Dr. Kellon can respond but in the meantime we will carry on as is and I know lots of others have questions they posted they would like help with too and I don’t think we are in dire straights yet so can wait.

So appreciative of this group and the support and sharing of all the info and experiences!
--
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: early ppid question

LJ Friedman
 

The reason why I’m confident in the diagnosis is because he was having problems with his tendons that cleared up almost immediately after starting pergolide. Recapping, when should I test and which test should I get?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Re: Free feeding tested hay

Sara Gooch
 

Thanks Cass regarding the Abler omeprazole.  I had success with the Abler granules too. I was just curious if maybe there was another effective omeprazole product besides the Abler.  And sorry, I mistakenly thought that this post was on the Horsekeeping page--

Sara,  2011, NE California


Re: early ppid question

Sherry Morse
 

Hi LJ,

Was the test in 2019 the last one Majestic had?  If so, since the TRH stim test was done during the seasonal rise when we don't have an accurate scale for post-TRH results I would take that result with a large grain of salt and perhaps think of checking him this year just to see how he compares to the 2019 test.




Re: Riosa and Invokana dose

Sherry Morse
 

Hi Heather,

Obviously I'm not a vet but I think that at this point we may just not know all the answers to these questions as Invokana use is so new and the horses on this group are basically the 'experimental herd'. I think Dr. Kellon may be keeping track of who's on what dose at this point and what possible side effects are being seen but I'm not sure if anybody else has mentioned lack of energy.  Hopefully one of the other Invokana users will see this and be able to let you know if it's something they've seen in or not. 



Re: Recent bloodwork concerns

Sherry Morse
 

Hi Jennifer,

You can titrate up by .5 so do 1.5 for 3 or 4 days (all in one dose) and then go to the 2mg in one dose.  If you think you're seeing signs of the veil you can slow the titration rate but going by halves is easiest.  As far as once a day vs. twice a day dosing, there's been some research into it that says it may be effective but from the experiences on the group here 1x is most effective and if people have gone to 2x a day dosing it's usually something like 2mg at one time and then another 1mg to keep the therapeutic level in the blood up.  As you noted, even the vet at BI said dividing the dose in 2 would be for horses with a good level of ACTH and that's not where Firestorm is now.

Hope that helps answer your questions.





Re: Boarding in San Diego area?

LJ Friedman
 

facebook “socal horse community “
you can post a “ looking for”
After you’ve selected a few, I can get the inside scoop from others in the area
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Re: Boarding in San Diego area?

LJ Friedman
 

Can you be specific as to where you will be living. What area?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


early ppid question

LJ Friedman
 

Is there amount of time,months, years etc. where in early PPID horse that only showed with a TRH stim test, can move over to ACTH with good confidence?  Majestic is doing quite well though I don’t test him perhaps as often as I should.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

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