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Re: Needing a better long-term solution for my mini with uncontrollable IR levels

amyscrivanich
 

I also uploaded some radiographs from 2019 as well as a picture from her trimming from last week (that was 7 weeks of growth!!)  

https://ecir.groups.io/g/CaseHistory/album?id=264439

Thank you !!

--
Amy Scrivanich
Charlotte, NC
Nov 2004 (my original PPID horse passed in 2015)


Re: Laminitis and Mare Hormonal Relationship?

Jackie W
 

Sherry, thanks for the additional info and the references.  I just talked with our vet, but the info she had limited the dosage to 50 mg/Kg/day, so I'll send her your references as well as this one I found from Tufts for 30mg/Kg, up to 3x a day: https://sites.tufts.edu/equineendogroup/files/2016/11/2016-11-2-EMS-EEG-Final.pdf, p9.  Didn't know the part about 30 min before feeding, so will do that as well tonight.

I'll cut back on the hay; lately I've been away unfinished hay, anyway, so she's probably closer to 16 lbs of forage.  As a Fjord, she's pretty big boned, so the 900 lbs is more of a guess. This time, her blood work showed leptin about a tenth of what it used to be and she also not guzzling hay like she used to. I recently added Glycocemic EQ and I'm wondering if there's something in it that affected the leptin (in a good way!).
 
Thanks! Jackie
--
Jackie and Megan
Palm Bay, FL
Joined March 2018

https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Megan
https://ecir.groups.io/g/CaseHistory/album?id=264114


Needing a better long-term solution for my mini with uncontrollable IR levels

amyscrivanich
 

I have been mainly a lurker on this group for a long time.  I joined initially for my PPID horse in 2006.  He passed away in 2015 and then in 2018 my mini pony (Mater) had been diagnosed with IR.   I thought I was going to lose her when I couldn’t get control of her pain.    The metformin seem to somewhat lower her IR levels, but the only thing that helped from the onset (for pain) was Thyroid-L.   I didn’t want to keep her on it long term, so after months of doing well, I started to back off her dose to only find that she was starting to get uncomfortable.   So it’s been over 2.5 years and she has still been taking Metformin & Thyroid L.  All was going well, until I routinely did her annual ATCH & Insulin test beginning of May-2021 and her Insulin level was what is was from the first time I tested her back in 2018 ( >200)   She wasn’t showing an physical signs of being uncomfortable, but I took her off of her dry lot (that has some sprigs of weeds coming up) and put her in the padded stall.   Her feet have been trimmed regularly every 7-8 weeks and this time I noticed her feet (all 4) had grown more than her usual 1/4“ (they have always grown fast ever since her bad episode in 2018) and this included her hind feet which seemed to grow normally from 2019 on.   

I have been watching her like a hawk since her bloodwork gave me a heads up that something is wrong.  And she is walking a bit slower and laying down a bit more than usual, but still not too painful with very slight intermittent pulses in her front feet.   The farrier trimmed her up nicely(last week) and I put her cushy soft ride boots(that she wore 24/7 back in 2018) on her feet (more as precautionary since she just got trimmed).   So now I am dumfounded as to what to do.  The vet said just increase her thyroid-L then retest her.   I don’t want her to have another bout of founder as I do not think she would survive it.  She is 19 yrs old and her weight is perfect, and she is only eating ODTB (3-4 x’s a day)   I am not even giving her soaked hay since the IR bloodwork results.    

She doesn’t seem too painful, but her bloodwork will be an indicator that she may go that direction. I do not want to continue to use these meds long-term what are other options??   Please help me come up with a game plan!  

--
Amy Scrivanich and Mater
Charlotte, NC
Nov 2004 (my original PPID horse passed in 2015)

https://ecir.groups.io/g/CaseHistory/files/Amy%20and%20Mater%20May%202021.pdf


Re: Laminitis and Mare Hormonal Relationship?

Lavinia Fiscaletti
 

Hi Jackie,

Per those rads, there was NO heel that needed to come down - her bony column was in good alignment at that time. Her heels appear to have been somewhat underrun, but that is a different issue and there was no vertical height available at that time to bring them back. Her toes needed to comeback a bit and her soles were quite thin, so I hope there has been absolutely NO removal of any sole of any kind since then.

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


Re: Laminitis and Mare Hormonal Relationship?

Sherry Morse
 

Hi Jackie,

A couple of things for you to consider regarding feeding.  If Megan's ideal weight is truly 900lbs (I suspect that at 13.3 it may be less) she should be eating no more than 18lbs a day TOTAL.  Most of that should be forage with just enough of a carrier to get her supplements in to her.   If she's not losing weight on that amount of feed you may want to cut back a bit more on her hay intake but that's a fine balance as cutting back too much can cause other problems.  As the Coolstance is higher in fat than we want an IR horse to have I would use the minimum amount you need and you may need to experiment with other carriers to get her to eat her supplements without the stuff that's not good for her.

Re: Metformin, I totally goofed on that because I forgot the KG conversion but she was definitely still not being dosed enough (My corrected calculations come out to 12,791mg/2x a day).  References for your vet:

I would wait for the 2nd blood draw to see if the metformin has any effect but others may jump in to say if 3 doses is enough to see a difference.

To add the photo album link to your signature:

1) Go to this link to amend your auto-signature: https://ecir.groups.io/g/main/editsub

2) Look at the bottom of that page for the window hat has your signature in it

3) Add the link to your photo album (https://ecir.groups.io/g/CaseHistory/album?id=264114) below your CH link. You may need to add a space to make the link live.

4) IMPORTANT: Scroll to the bottom and hit SAVE!








I will add more photos to her file and change my signature.  The rads in there now are from March this year.  I don't know if her feet have changed since then; they look the same on the outside, but Megan's trimmer is working to slowly bring the heels back down.  https://ecir.groups.io/g/CaseHistory/album?id=264114

Thank you, again.  Jackie
--
Jackie and Megan
Palm Bay, FL
Joined March 2018

https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Megan


Re: Laminitis and Mare Hormonal Relationship?

Jackie W
 

Sherry, thanks for your reply! Today, Megan is slightly overweight at about 940 lbs, probably around a BCS of 6 (I'd need to go through it thoroughly). I've cut her alfalfa slowly back the last couple of weeks so that she was down to a handful and now none for the past couple of days and she continued to go downhill. I seem to have more problems with orchard grass than with alfalfa as far as relating anything to her feet over the years, but I can't fault whether it's the orchard grass or just the sugar content. I started a half flake (~2 lbs max) at dinner probably about 10 years ago, because she used to open her mouth on the top of the stall boards after she was eating, and the little bit of alfalfa seemed to calm that activity down (not cribbing but similar action).

Unfortunately, the cool stance is my saving grace for getting her to finish her feed, so she gets about a kitchen cup (1/4 pound) each meal. I've tried other things like Stabul 1, crushed up treat, cocosoya, etc., but nothing is as effective, and I've even tried cutting it back, but then she doesn't finish. I'll look around to see if there's another carrier I can use. I put the balancer cubes in, but she really doesn't like those either.

OK, so it looks like I'm mixed up and only giving half the amount recommended here for the Metformin. Megan weighs 426 Kg, and my vet prescribed 14g/day, which works out to 32 mg/Kg per day instead of twice a day. I will talk to my vet about doubling the dosage. Is there a reference that I could provide to her vet when I ask to increase it? I think the current amount has reduced her fat pads slightly, but not her hoof pain. The vet is coming on Wednesday to draw blood for the hormones and do a uterine ultrasound. If I get the Metformin upped this evening, would it be worthwhile to do another metabolic panel on Wed to see if it worked? I only ask because they're really expensive.  The vet will be here again in 2 weeks to draw the second blood for the hormones.

Additionally, as of today I have temporarily discontinued the Laminox and I've added 2500 mg of Devil's Claw (from the local health food store) to see if that makes a difference. She doesn't have a bounding pulse, but she is now laying down an abnormal amount. 

I will add more photos to her file and change my signature.  The rads in there now are from March this year.  I don't know if her feet have changed since then; they look the same on the outside, but Megan's trimmer is working to slowly bring the heels back down.  https://ecir.groups.io/g/CaseHistory/album?id=264114

Thank you, again.  Jackie
--
Jackie and Megan
Palm Bay, FL
Joined March 2018

https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Megan


Re: Hay sampling and Maximum acceptable starch levels

celestinefarm
 

Cheryl,
My understanding from the group's general experience that you want to keep starch at 4% or less.  Some horses can tolerate 6 % some cannot handle 4% . Try to find hay that is native grass, bluegrass,timothy, orchard grass, with as little rye or clover as possible. Until you have an analysis, none of that is guaranteed, especially if there has been a drought or temps below 40 F at night, but you won't spend money on an analysis to find high SS on hay that is most likely to be over the limit if you cancel out high rye or clover hay. ( Rye is often touted for cattle and guys that plant hay specifically for the cattle market will seed a significant percentage of rye in their hayfields).
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Re: URGENT: Laminitis suspected, possible abscess too? Already on ER diet ... what next?

Laura and Ero
 

Agree on the approach and greatly appreciate the perspectives on moving. My gut says the same thing and initially he'd be stalled with a solo turnout available. It's more of a sandy base so hopefully that offers more cushion as well. Because he's EMS with high leptin, we're not sure about turnout with another horse just yet either (mostly as he'll eat everyone's food). Today his DP is normalizing. It's still present, but not bounding. In addition to the boots, heavy bedding and driving slow, my trimmer proposed casting his feet for additional support (and then boot over them). Any experience or thoughts on casting?

I also had a pre-scheduled baseline Glucose/Insulin and Vit E re-test for tomorrow, but given he's stressed and has bute in his system, I'm going to hold off. Will reschedule once at the new place for a few weeks. 

I've not gone through this before, so trying to understand what's next, what to watch for, expect. How long to wait until he's ready for walking, turn-out, (who knows on riding). I'm not pushing him, but he also needs to move as he has SI flexion and contracted muscles in his hind-end (working with an osteopath). This issue is the priority thought so I'm curious to see if he presents an event line in his hooves and am expecting he'll be 'rested' for several weeks, possibly for a full hoof grow cycle (9-12 months)? 


--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Re: URGENT: Laminitis suspected, possible abscess too? Already on ER diet ... what next?

Sherry Morse
 

Hi Laura,

If he's up more than he's down I'd plan on moving him and making sure he has his boots on and take the drive slowly so as not to throw him off balance.  I would not hand walk him unless you know exactly what you're dealing with (and at this point you don't).




Re: Laminitis and Mare Hormonal Relationship?

Sherry Morse
 

Hi Jackie,

Looking at your CH Megan is still overweight, is that correct? Is she still being fed alfalfa and Coolstance now?  Given her elevated insulin numbers if she is still being fed both of those they need to come out of her diet as they could be contributing to her issues (both in terms of not losing weight and foot pain). 

Otherwise she's certainly a candidate for Metformin - the dose would be 28,140mg 2x a day which is four times the dose you have listed in her CH and why you may not have seen any improvement with that dose.

If you have current hoof pictures we can advise you if she needs alterations to her current trim to help her feel better as well.

If you could add the link to your photo album (https://ecir.groups.io/g/CaseHistory/album?id=264114) to your signature that will help us find it easily.  If you need directions on how to do that just let us know.




Re: URGENT: Laminitis suspected, possible abscess too? Already on ER diet ... what next?

Kirsten Rasmussen
 

That's a tough question, I hope you'll hear from others on it, too.  If he was mine, as soon as the digital pulses normalized, I'd move him.  In padded boots.  One hour is not long and you can drive slow on corners and brake softly.  He will likely want to run around his new area so keep the padded boots on and confine him to a small SAFE pen where he can see the other horses (hopefully they are near enough that he doesn't feel alone in a strange place) but can't gallop around.  And continue to soak hay and use padded boots when you arrive until he settles in, at least.  He might need the padded boots when he is eventually integrated with the herd, too.  Just use your best judgment and common sense.

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


Hay sampling and Maximum acceptable starch levels

Cheryl Oickle
 

Good day all:
As new hay is being cut here already, a question.  What would be the MAXIMUM acceptable starch level in hay with an ESC and starch combined at 10% or less.  I believe I read some where 2% or less for IR Cushings horses. I know some horses are more likely to be more sensitive than others, but curious all the same. 
--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel
https://ecir.groups.io/g/CaseHistory/album?id=81063


Re: URGENT: Laminitis suspected, possible abscess too? Already on ER diet ... what next?

Laura and Ero
 

Unfortunately, I’ve asked about the hot wire and/or another fencing type already, but it’s not been met with much interest — hence the plan to move. It’s hard to find a place with a large enough dry lot for adequate turnout in my area. I finally did find a place, but I’ve had to compromise on distance and price. Is he safe to travel an hour away in his current condition? He’s up more than down in his stall. Should I start hand-walking or stick to stall rest? I don’t want to aggravate the laminae, and get a more rapid DP again do I?

Ero was on a balanced diet, but with new hay coming in every other month I couldn’t keep up with testing so was advised here to continue soaking my hay. 

And as of about a month ago, Ero refused to eat his Equi-VM (including anything I added to it, hay too). Uckele sent a new batch and still straight refusal. The plan was to get to a new barn, test hay and rebalance, but continue to feed Flax, E, Salt, magnesium with soaked hay for now. I was able to get a sample of Vermont Blend Pro to try, but with this episode I’m hesitant. 

Can remove the bute/UG. Not getting strong support from area vets re: that protocol, and it’s hard to continue to go down this road alone. 

--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Re: Experience with drowsiness/sedation from Benadryl given with vaccination?

Joy V
 

Hi Donna,  I have always been told by my horse's vets, even the current one, to dose him 20 - 22 pills 2x per day.  So that's probably where you got the higher number.  

--
Joy and Willie (PPID/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: Laminitis and Mare Hormonal Relationship?

Jackie W
 

Dr Kellon, Looks like her prescription amount is good.

I've looked at Megan's history and for May 2021, she is still sore but on the recovering side of a bad bout of laminitis the week before (103 uIU/mL), April 2019 was not active laminitis, but she looked like the Michelin man, lumpy everywhere (202), and June 2018 was recovering from founder/sinking in January (98) and walking well in boots, and Dec 2017 was recovering from founder/sinking in Aug but doing quite well before the bottom fell out again the next month (94, fasted).

Thanks, again, for your help and support. 
--
Jackie and Megan
Palm Bay, FL
Joined March 2018

https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Megan


Re: Just can't get my numbers down

Lorna Cane
 

Hi Dr. Sink,

We can't receive attachments here.
But if you join the Case History sub group you can create a folder for lab results, and post them there. 
....... join our case history sub-group.
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.

If you can create a case history the details will help with accuracy of advice  given.
It's also a good place for lab results,keeping everything in one place for easy review.

Hope this helps.
--

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


Re: PPID Haircoat and Shedding

 

Hi, Jennifer.
Addressing the hair coat question, some horses can have very well controlled ACTH and still not shed out well. This varies with the individual. My horse sheds best around this time of year if her ACTH is in the low 20's pg/ml range. Once you have your labs done, it should be clearer whether a dosage increase may help with shedding. 

As for what you're seeing, please post a photo in your Photo Album. Normal shedding, Cushings or not, leaves a horse slick. I never wait for shedding once the weather gets warm. I have been body clipping horses with PPID for as long as I've had them. If it's spring with some days are warm and cool nights, I start with a bib clip. Often the coats starts to regrow the minute it's clipped off. You'll find lots information about body clipping horses over at EC Horsekeeping: https://ecir.groups.io/g/Horsekeeping/messages 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Blood work updated, Radiographs of R fore - lameness - Dr Kellon?

rozaniloc@...
 

Thank you so much Dr Kellon - that does look similar. I have forwarded this to my vet. I really appreciate your knowledge & experience! 
--
Rozanne & Sunday
July 02 2019  Larimer County, Colorado
case history:  https://ecir.groups.io/g/CaseHistory/files/Rozanne%20&%20Sunday 
photos:  https://ecir.groups.io/g/CaseHistory/album?id=93586  


PPID Haircoat and Shedding

jennigrossi.jg@...
 

My PPID horse was not on enough Prascend and had a very high ACTH when I did bloodwork in early April. He was shedding at the time (despite the to low dose and uncontrolled ACTH) and continued to shed as I increased his Prascend from 1 mg to 1.5 mg. I had a gut feeling that the 1.5 mg was still not enough and since he did well with the increase and is a big horse, I decided to go ahead and increase him to 2 mg. Unfortunately, he stopped shedding a while ago and neither dose increase has caused him to completely shed out (I think?). Other symptoms seem to be markedly improved (pot belly, poor appetite, lack of energy, unbalanced hoof growth, thrush), but his haircoat is still long (I'm not sure if it's actually dense hair or just long hair). My questions are:

1. I plan to retest bloodwork in a couple of weeks. If his ACTH is within normal limits, but his haircoat still doesn't look like a normal horse, should I increase him to 2.5 mg based solely on that symptom?

2. It's very hard to tell if his haircoat is actually denser than a normal horse or if it's just longer hair than a normal horse. So, if his hair was allowed to grow extra long and dense during the uncontrolled ACTH episode, is it possible that he did shed out the density and what is remaining is simply long hair that's left over from his high ACTH winter? Do I clip him to try to help him regain a normal length coat? For comfort?

Thank you for your help.
--
Jennifer Grossi
Charlevoix, Michigan
2018
https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Firestorm
https://ecir.groups.io/g/CaseHistory/album?id=262822


Just can't get my numbers down

dsink@...
 

I have attached three sets of lab results for this patient, Wes Rittner, and I cannot seem to get the ACTH and other numbers down any further.  We put Wes on Jiaogulan and metformin (when available) and they just didn't seem to make a difference.  Any suggestions out there???  He definitely looks better and has not had any resent bouts of laminitis, but I am still concerned with his lab results.

Dr. Sink

--
Deborah K. Sink, DVM, IL, 2020

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