Date   

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

amyscrivanich
 

I think I’ve updated everything to be more clear.  
I totally agree about the Thy-L, but the vet of course doesn’t agree regarding the T4 level; very frustrating and that’s why I’m hoping I can get some better advice here.     So I’ve kept her meds the same since 2019:  Thy-L dose 1 tsp 2x’s daily.  4000 mg Metformin 2x’s daily.   I do not have current radiographs.  The ones we took in 2019 were when she was feeling better.   I have uploaded current picture of her body and her feet.    Since I struggle to keep weight on her, I give her as much as she will eat of the ODTC (Leftovers are given to my other horses so there is no waste ) 

My goal is to find something besides the Thy-L and Metformin to keep her comfortable long term.  

Thank you !

 



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

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

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

 


Re: Laminitis and Mare Hormonal Relationship?

Kirsten Rasmussen
 

Hi Jackie,

Here is the 2020 update on that file you'd like to share with your vet (your link goes to the 2016 version but 2020 has more info).

https://sites.tufts.edu/equineendogroup/files/2020/09/200592_EMS_Recommendations_Bro-FINAL.pdf

In addition to providing the dose, 30 mg/kg up to 3x a day (and up to 50 mg/kg), it also says to recheck insulin after 7 days on it.

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


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

Kirsten Rasmussen
 

Casting would definitely add an extra layer of support. 

As far as exercise, as soon as he is off pain meds you can evaluate how comfortable he is walking.  If he doesn't need any encouragement to walk beside you then handwalking is fine.  Putting off turnout with other horses is a good idea since you have that option.  After 6 months of healthy hoof growth (when the event line is in the bottom quarter of the hoof, approx) he should be ready for reintroduction to regular work.

If you add jiaogulan to his diet his hooves will grow out faster, but they will need to be trimmed more often.  It is also an adaptogen that could relieve some of the pain.

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


Re: Hay sampling and Maximum acceptable starch levels

Kirsten Rasmussen
 

Hi Cheryl,

I would not purchase a hay with more than about 2% starch for a sensitive horse (even 2% would be pushing it for me) .  4% starch has the same effect as 8% ESC, and starch cannot be soaked out.  And of course you still have the effect from the ESC in the hay added to the starch.

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


Re: Blood work questions

mucksal@...
 

Thank you. We will do the complete metabolic panel with Cornell. I will look into the Rescue Remedy. Thanks 
--
Alison KY 2019
https://ecir.groups.io/g/CaseHistory/files/Alison%20and%20Jazzy/Alison%20and%20Jazzy


Re: Blood work questions

mucksal@...
 

Thank you. The vet will be taking more blook & we will do the full metabolic panel. Thanks again
--
Alison KY 2019
https://ecir.groups.io/g/CaseHistory/files/Alison%20and%20Jazzy/Alison%20and%20Jazzy


Re: PPID Haircoat and Shedding

jennigrossi.jg@...
 

Cass,

Great information. Thank you so much!
--
Jennifer Grossi
Charlevoix, Michigan
2018
https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Firestorm
https://ecir.groups.io/g/CaseHistory/album?id=262822


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

Sherry Morse
 

Hi Amy,

Could you please add your photo link to your signature? https://ecir.groups.io/g/CaseHistory/album?id=264439 (if you need help with that please let us know). If you can add pictures of her feet currently (directions in the Wiki here: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help) as well as pictures of our body it will help us help you. Looking at her old x-rays we can see where she started but not where she is now. 

Thyro-L is not a pain treatment, so any improvement you've seen was more likely due to changes in management or trimming.  Given that her current T-4 level is now elevated, if anything the amount should be decreased, not increased.

Metformin stops working for many horses and Mater may be in that category now.  However, we don't know what her current dose is, nor if it's the right amount for her weight so it would be very helpful for us if you could provide both her current weight and the actual dose she's receiving.  

Feeding needs to be based on weight so that's another reason we need to know her current weight.  Are you weighing out the amount of cubes she's being fed now?




--


Re: LAVINIA/ MARKUPS for tiko

Lavinia Fiscaletti
 

Hi Daisy,

I've added the mark-ups to Tiko's album:

https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Created,,,20,2,0,0

Unfortunately, there have been no changes made to the trim since the reads were done back in Nov 2019. Although the sole depth has increased slightly, the coffin bones are still ground parallel, with the HPAs remaining significantly broken back. Tiko's heels are underrun and his toes are too long horizontally. The feet have basically squished down, with the entire hoof capsule pushing forward out from under the leg and the heel bulbs have dropped down and been compressed out behind the heels. The goal of the trims needs to be to get the toes backed up while working to encourage the heels to stand up straighter so that the entire hoof capsule can settle back in under the leg and support the horse correctly.

LF dorsal: The green line follows the angle of the new growth to the ground. The blue area is some slight lateral wall flaring that can be removed entirely.

https://www.hoofrehab.com/WallCracks.html

LF lateral composite: On the radiograph, the pink line shows how the bony column should be lining up - where it ends is where the sole depth should be. There should be no hoof at ground level beyond this point. The purple line follows the actual bony column alignment - note how it drops back and away from the pink line = broken back hoof-pastern axis (HPA). The green line running down the dorsal wall is only a visual marker - NOT a trim line. Once the bony column is properly lined up, this line will run parallel to the pink line. Blue line at the toe is where the toe needs to backed up to, with the blue X being the excess horizontal toe length. Red line denotes where the bottom of the hoof should be if there was a proper amount of sole depth. The lime line at the back of the foot shows how the heel bulbs would be if they hadn't squished out behind due to the heels collapsing forward.
In the photo: the green line is the same as the one on the rad. Blue area corresponds to the blue X on the rad. The orange line shows where the heels should be located over time.

LF sole: Due to the shoe, you can''t see most of the bottom of the foot. The blue hashed lines correspond to the blue area on the lateral rad and photo. This line is likely behind where the "white line" appears to be at ground level. Need to remember that the white line is a seam that stretches along with the sole and rest of the foot, so it's distorted as well. Please have a read here for more specifics:

https://www.hoofrehab.com/Breakover.html

https://www.hoofrehab.com/HorsesSole.html

Even tho they need to be moved back, the heels need to be left alone for now as there is no extra vertical height available to work with. Rather, they need to be encouraged to stand up straighter over time. Frogs and sole should be left alone. Only lightly address any areas along the leading edges of the bars that are crumbling or already detaching. More specifics here:

https://www.hoofrehab.com/HeelHeight.html

See esp. figures 2 and 3.

RF lateral composite: Same discussion as the LF.

RF sole: Follow the discussion for the LF.

LH lateral composite: Similar to the fronts but there is a bit more sole depth. On the rad, the blue X is the extra toe length that needs to be removed. Because the foot was pulled a bit forward when the view was shot, the HPA looks a tad better aligned, so the pink and purple lines appear more closely aligned. If you pushed that foot back so he was standing squarely on it, the HPA would be worse.

LH sole:  Same idea as the fronts - shorten the toe horizontally at ground level (blue hashed area).

RH dorsal: Green line follows the angle of the new growth. Blue area is the slight amount of lateral wall flare that can be removed. The maroon line highlights the medial wall being a tad longer than the lateral one. comparing both of the collateral groove depths at their deepest points will help to double check this:

https://www.hoofrehab.com/Balance.html

RH lateral: Blue area is the excess toe length. Orange line shows where the heels should eventually align. Green line is only a visual marker.

RH sole: Follow the discussion for the other three feet.

While putting on shoes will physically lift the soles off the ground, it creates the clearance at the expense of hanging the horse entirely from its lamina by removing the soles and frogs from doing their share of the load bearing. Shoes will also apply constant pressure to the already crushed under heels, never allowing them to relax down and stand up. Padded boots will allow for support across the entire bottom of the feet, while providing pressure-and-release that stimulates sole growth and increases overall foot function.

--
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?

Jackie W
 

Lavinia, thank you so much for your input! I thought for sure because her palmar angle was so high that the toe of the coffin bone was poking and hurting.  Glad to hear that is not the case and we can leave well enough alone! Trimmer was reluctant to do much, so now she can relax on that front. (And, no, our trimmer doesn't take sole off.)  Early on our trimmer was able to get some input from Pete Ramey, and she has really done a nice job keeping Megan comfortable. These photos were taken 3 weeks after the last trim. I will try to post more photos soon and regular hoof shots. Thanks, again!
--
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


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.



18381 - 18400 of 279935