Date   

Re: LAVINIA/ MARKUPS/ need additional help

Daisy Shepherd
 

lavinia and /or dr kellon, about 9 weeks ago my vet, who is not on the ecir page, saw tiko for my concern with right hind soreness/stiffness, she recommended hind shoes for support ( he has not had hind shoes for about 6 years, he came to me 2017 no hind shoes since about 2014 ) also the drug ? equinox; did the shoes not the drug. he usually works out of the stiffness, recently does not, noted with walking that when he steps under with right hind collapses on that side with quick recovery, does about 3x in a one hour ride.  will the markups for changing his toes and heels help with this?  my farrier due 5/27 may want to consult for this.  should i give a supplement for discomfort, if so what, he gets hylarin 1 scoop for joints.  i am sorry if i sent this before , typed up before but could not find that i had sent. xrays in photos 4/2021  does not include right hind as vet clinic so far cannot find although i know it was done.   thank you daisy and tiko
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: LAVINIA/ MARKUPS/ need additional help

Daisy Shepherd
 

lavinia or dr kellon,  i mentioned  about
2months ago of tiko and some possible stifle discomfort, vet recommended hind shoes which he has not had for many years[ before he came to me]  , he has now had 2 shoeings with these shoes due for third 5/27, vet also recommended  ? analgesic [? equinox ], did shoes did not start RX;  before would work out of discomfort  today did not. he also when walking and steps under with right hind collapses on that hind
 not every step but every ride about 3x rides of about an hour.  i  do not know the best to do for him as far as rx for discomfort,  ; when lavinia does markups and my farrier begins those changes will that help? can you please suggest what is best. my vet is not on the ecir page,   I think my farrier will be, he may want to consult with you.  i just do not know what to do and need your help. thank you daisy and tiko
--
-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0


Re: Vitex/Chasteberry study #Vitex_CHB_Chasteberry

Sherry Morse
 

Hi Sue,

PPID is a progressive disease and the treatment for it is pergolide.  CTB has not - to my recollection - ever been proven to do anything beyond helping PPID horses shed out.  I would ask the person who said this where they got that information.




Re: Vitex/Chasteberry study #Vitex_CHB_Chasteberry

 

Hi, Sue. 
I'm not scientifically oriented either. I do use the combination, or I should say, I have used both pergolide and vitex/ CTB, until today! I've seen no evidence vitex/ CTB surpresses the adenoma. That's not my belief, and that was never the reason for my use of vitex/CTB and pergolide. The best evidence I've seen is that dosing our horses with sufficient pergolide to keep ACTH in the high teens is the optimal management of PPID over the long term.

You can read in detail about the use of vitex in treating PPID at ECIRhorse.org, about half way down the page, under Alternative Therapies.
https://www.ecirhorse.org/treatment-ppid.php  Short version: in early PPID, vitex may offer some relief of symptoms, but vitex doesn't reliably control abnormal hormones produced by the pituitary adenoma or the growth of the adenoma itself. In fact, the evidence is that vitex/ CTB does not suppress the adenoma.

Many members here with PPID horses use both pergolide and vitex/ CTB when pergolide alone doesn't facilitate shedding of the Cushings coat. For Cayuse, the combination facilitates some shedding but more specifically, stops the regrowth of her Cushings coat until I stop vitex/CTB in the fall. Now that I've read the article, I won't risk the possibility of higher ACTH for the convenience of not needing to body clip my PPID horse several times a year.  I'm not going to bet against Dr Kellon's caution that vitex might interfere or interact with pergolide.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Wonder if I've done something incorrect.

Sherry Morse
 

Hi Carrie,

It may be that we all just missed your message (as I know I did).  Has Lillie lost any weight with the diet changes you instituted?  Has she been started on pergolide or Prascend in light of the elevated ACTH result?

Since she did test above the acceptable range for this time of year I'm not sure I'd be willing to wait until the fall rise to retest and confirm the diagnosis as starting medication at that point has you 'chasing the rise' and it's very hard to get ahead of it. 




Re: NEW CASE HISTORY ASSIST

Sue Ring
 

Hey Sherry,

Thanks for your response.  I am between phones and will get a new full body shot of Shifty for reference as soon as I can.  The bloodwork was NOT a fasting test, it was Cornell's Plasma (Insulin Baseline Equine) and TRH Response:  ACTH.  He is on Equioxx (same thing) and I think I had the dog's Previcox on my mind.  He does have some arthritis (he is an OTTB) at age 20 but I actually have been trying to lower his dosage in an attempt to wean him off, IF I can possibly do it comfortably.  I was also concerned about any of the herbs for his allergies and uveitis conflicting with the tweeking I am trying to do with his diet due to the recent diagnosis.  Hay testing is very difficult for me as I must buy it as I can get it, sometimes it comes from out-of-state, not in large batches....but I know the preferred way to balance is to the hay on hand.  Does anyone have a good method of balancing when they run into a problem like this...or am I just not thinking clearly.  I plan to take Dr Kellon's ECIR and NRC Plus courses to gain the knowledge.  Also, I have been keeping Shifty (for now) off of pasture, or just turning him out for no more than an hour while I tidy his stall and paddock area, to run an get a good roll.  I hate to do that to him and have another horse boarding with me that has no ECIR issues and actually can go out per the usual, but his buddy stays close now that my horse is on lockdown.  Will I ever be able to have him safely graze with the other horses?  Alot to sort out and I am trying to be very judicious and informed about all I do, but I have never had to deal with Cushing's...as I know many have not

Thank you so much for your time and expertise...you make it seem like there is a definite light at the end of this confusing tunnel!!
--
Sue R in NC 2021

CASE HISTORY:  https://ecir.groups.io/g/CaseHistory/files/Sue%20and%20Shifty


 


Wonder if I've done something incorrect.

Carrie
 

Hi Moderators, 
I sent a message a short while ago about my updated Case History & Photos requesting some advice regarding test outcomes & have not heard from anyone up till now.  Maybe I have done something incorrectly.
If all is correct , it's no problem you are all busy, I'll wait to hear when you are able to advise . 
Many thanks 
Carrie 

--
Carrie 
March 2021
UK



Re: Update on Cadet, relapse of foot sensitivity--second try

Lavinia Fiscaletti
 

Sounds encouraging regarding the trim, Aunna. When you have a moment, seeing pix from after the trim would be great.

How long has he been tender footed this last round? Unfortunately, it does seem like he is straddling that proverbial fence. How long this may set him back will depend on how long the tenderness lasts and how well his trim is supporting him now.

Frustrating for sure.

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


Re: Vitex/Chasteberry study #Vitex_CHB_Chasteberry

Sue Ring
 

Hey Cass,

I am not very "scientifically" oriented, but after reading this article (and have you also say you are using the vitex/Pergolide combo) are you getting better results with the combination??  Someone recently recommended I add 1/2 - 1 tbsp of the herb to my horse's daily ration, along with his prescribed Pergolide.  They said it gives added support to suppressing the tumor.  Thanks for any additional information you can give!!
--
Sue R in NC 2021

CASE HISTORY:  https://ecir.groups.io/g/CaseHistory/files/Sue%20and%20Shifty


 


Re: Jiji's Blood Test Results

 

Nope. The only clinic nearby has only one large animal vet and he is extremely busy. I've been calling probably once a month and leaving my name and phone number with the receptionist but I've never gotten a call back.
I will reply to this thread as soon as I get her bloodwork results.
Thanks
--
-Olivia
May 2021, Bemidji, Minnesota
Jiji's Case History
Photo Album


Re: Re-addressing fructan level #Fructans

 

Sherry,

It always comes back to the fundamental, NO Laminitis!

If it's too late, then you treat the cause and support the hoof.

You don't treat laminitis with diet. You treat hyperinsulinemia with diet. You prevent hyperinsulinemia with diet. You treat PPID with Pergolide, (sorry - no prevention for PPID). Because these are the most common causes of laminitis, this is where our focus goes. But, I could go on:

You prevent fructan induced laminitis by not delivering 8 lbs of artichoke-derived fructan through a naso-gastric tube (to date, the only documented cases of fructan-induced laminitis).
You prevent grain induced laminitis by locking the door to the feed room.
Then there are the causes of laminitis like concussive, support-limb, placental retention, Lyme disease and on and on. Laminitis is always secondary and without understanding the root cause, can never be adequately dealt with.

--

Kathleen (KFG in KCMO)

Director and Research Advisor, ECIR Group Inc.

Missouri, USA, 2005

https://scholar.google.com/citations?hl=en&user=3-I7UI0AAAAJ 

 


Re: Hydroxizine?

 

Hi again, Lisa.
If you head over to EC Horsekeeping, you will find two documents on the use of spirulina in Files. One describes its use with chondroitin for Culicoid sensitivity.
https://ecir.groups.io/g/Horsekeeping/files/-What%20to%20do%20about%20Culicoid%20Sensitivity.pdf 
The other describes spirulina for respiratory issues. 
https://ecir.groups.io/g/Horsekeeping/files/EK%7CWinter%20Respiratory%20Health%20for%20Your%20Horse.pdf 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Hydroxizine?

Anthie Booras
 

I get mine from mybesthorse.com. I believe the bags have a recommended amount on them. Mine currently gets 1/2 tablespoon chondroitin once a day and a tablespoon of spirulina twice a day. When she was really bad I was doing two tablespoons spirulina twice a day. 
--
- Anthie

Northern California
August 2015

Erin's case history: 
https://ecir.groups.io/g/CaseHistory/files/Anthie%20and%20Erin/


Update on Cadet, relapse of foot sensitivity--second try

riggslippert@...
 

Hello,

Cadet's case report has been updated.

After Lavinia expressed concerns about Cadet's trim (https://ecir.groups.io/g/main/topic/82163413#264044), he was seen by a new farrier, who seemed very approachable and took back his toes quite a bit.  He also requested a look at Cadet's most recent radiographs.  There was no lameness after the trim.  Cadet is scheduled for a second trim with the new farrier 3 weeks after the first.  I plan to post new hoof pix after that.

I had rechecked lab work just before the trim.  The temperature had been above 50 F for most of the 48 hrs before, although it was 47 F at the time of the sample.  His insulin remains elevated (Cornell 87.36 mIU/mL), although it is better than the last time.  Triglycerides 66 mg/dL (RI 10-90).  He had no access to grass and I think his diet is as tight as I can make it.  His weight hasn't changed significantly with the calculator, but he looks much leaner, no crest or supraorbital fat, and I can feel his ribs better.  I have to assume this is the lowest I will be able to get his insulin without increasing his exercise.  I was about to extend his hand walking and maybe consider starting to ride him until...he had access to grass clippings blown into his dry lot by the neighbor mowing his lawn.  This happened after I had left the boarding facility for the day and he probably nibbled on them overnight.  Now his feet are slightly tender, with no increase in pulses.  He is reluctant to walk on gravel, walks normally in his dry lot and on sand, but refuses to trot.  

This appears to illustrate how much of a metabolic tightrope he is walking.  Does this relapse mean his timetable to being ridden is reset to zero (ie 6 plus months)?  

Thank you in advance for any comments or suggestions.
--
Aunna
October 2018
Oakland County, Michigan, USA
Cadet Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Cadet
Ruger Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Ruger

Cadet Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=84102




Re: Re-addressing fructan level #Fructans

Sherry Morse
 

Thank you so much for filling in more information Kathleen.  I too have a huge issue with some of the misinformation out there about IR and PPID (particularly when I hear it coming from a vet) but this is a great summary of this particular topic. 





Re: Jiji's Blood Test Results

Sherry Morse
 

Hi Olivia,

Frankly we'll be better able to answer your questions once we see the actual numbers for ACTH, insulin and glucose.  She may just be overweight and have bad feet.  Has she had any x-rays done on her feet? 




Re: Re-addressing fructan level #Fructans

 

In addition to Sherry's excellent and accurate response, a reminder to go full circle with "diagnosis."

First and foremost, what is the cause of the laminitis? We often forget that laminitis is a secondary outcome. Treating laminitis is like trying to get the cows back in the barn - how did they get out in the first place?

If the horse has or had documented high insulin and that is the known cause of the laminitis, the question should be, "Did the diet change result in a reduction of insulin?" If yes, then the diet is effective and the source of the current symptoms need to be investigated. Other things to consider - does the horse have unmanaged PPID? Does the horse have abscesses brewing from post-laminitic damage? Is the trim/hoof support adequate? Is there an underlying infection?

If fructan is an issue related to laminitis, then the mechanism is through endotoxemia or "sepsis-induced laminitis." In that case (which, BTW, has never been documented on pasture and certainly not hay), then there would be symptoms accompanying or preceding the laminitis, like a gut upset. 

In the experiments where researchers triggered sepsis-induced laminitis using rapid induction of inulin fructan, they needed a minimum of 5 lbs to trigger laminitis in 30% of animals and 8 lbs in 100%. That's pure fructan, delivered to the gut all at once. If this horse is eating hay (slowly) with 4.64% estimated fructan, fed at 2% bodyweight per day, that's about 1 lb of fructan, and a different form of fructan than that derived from artichokes, delivered over the course of the day. I would be more than happy - thrilled actually - if someone could explain to me how that would trigger sepsis-induced laminitis. Even the unproven theory that there is a release of fructose/glucose molecules as the fructan is being fermented and that somehow results in hyperinsulinemia is squishy in this case because even if you use NSC (WSC+starch), it's barely above 10%. So... where's the logic?

Sorry - don't mean to shoot the messenger and you were absolutely correct to ask. It's just that, after over 10 years of illogical argument with no data to support it, it gets annoying. Take this quote for example,

"Although laminitis has yet to be induced experimentally by feeding fructan-rich pasture or a fructan-rich extract, there are anecdotal reports of clinical laminitis occurring when diets are below 10% ESC+starch but high in NSC." Again... what is the cause of the laminitis? Notice that it doesn't say, "there are reports of hyperinsulinemia..." again (and again) pointing to the outcome, not the cause. The paragraph concludes with, "Until specific research data are available, horse and pony owners would be well advised to avoid feeding high-NSC pasture and hays,... to soak... to use grazing muzzles."

As a scientist and advisor to this group, I find this completely illogical. It basically says, "There is no proof, but let's put the burden on the horse owner." Not only is there no proof, there's no physiologic basis for the rationale. Fructans are pre-biotic and are likely more beneficial than not. They certainly don't have a role in glucose or insulin production unless the horse is a species unlike all other mammals. 

Argh... sorry - it's not you - it's this topic!
--

Kathleen (KFG in KCMO)

Director and Research Advisor, ECIR Group Inc.

Missouri, USA, 2005

https://scholar.google.com/citations?hl=en&user=3-I7UI0AAAAJ 

 


Re: Vitex/Chasteberry study #Vitex_CHB_Chasteberry

 

This link to the article,  Use of the Chasteberry Preparation Corticosal® for the Treatment of Pituitary Pars Intermedia Dysfunction in Horses,  works for me. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: New Bloodwork Results in updated Case History- Please Review

Sherry Morse
 


Hi Leigh,

Looks like you are definitely heading in the right direction so that's wonderful news.  If May is comfortable enough to get back to work you may find that brings her insulin down even more.




Re: Vitex/Chasteberry study #Vitex_CHB_Chasteberry

chemelle
 

Thank you for this!
I recently added the chasteberry (evitex) to improve shedding and I think Andy already has a very pronounced seasonal rise.
--
Chemelle
Hillsboro, OR
2019
https://ecir.groups.io/g/CaseHistory/files/Chemelle%20and%20Andy 

https://ecir.groups.io/g/CaseHistory/album?id=94380

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