Date   

Re: Diet - Is it okay to start the diet changes before hay analysis

Sherry Morse
 

Hi Jess,

Without a case history it's going to be difficult to answer any of your questions.  Based on the bloodwork you posted Clover is a titch over the normal range for insulin as well as being PPID which would make me VERY hesitant to feed him that particular grain as it is high fat and high starch (15% starch is well above our recommended 10% of below ESC+starch guideline) and both rice bran and Coolstance are no gos for an IR horse. 

Not sure what else you're feeding him now or what you are wanting to change but if you don't have an analysis for the hay and as the pony has allergy issues anyway it's a good idea to soak the hay prior to feeding so follow the emergency diet guidelines found at https://www.ecirhorse.org/DDT+E-diet.php




Re: Cabergoline vs Prascend

Eleanor Kellon, VMD
 

Most people go to cabergoline when they have been steadily increasing pergolide without good effect and the cost of cabergoline becomes appealing.  Since you are only at 3 mg at this point, I'd consider bumping it up some more. I'd try 5 mg. For comparison, at 1 mL (5 mg) cabergoline every 10 days a vial will last you 40 days for a cost of $6.25/day.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Cabergoline vs Prascend

Juliehillard@...
 

I am looking for information on transitioning a 20 year old GWB mare from 3 mg Prascend to Cabergoline. ACTH 104, IR 44, testing once a year. 2020 values were 75 and 40. Hoping to head off another June bout of cellulitis and see if a different drug might bring her values in normal range. Relatively easy to manage her symptoms and condition, quality of life is priority. Are we better off just upping her Prascend dose and waiting out the Arizona summer temps or make the switch now? Is Cabergoline only recommended when Prascend stops working all together or is it reasonable to give it a try? Thank you
--
JAH AZ


Diet - Is it okay to start the diet changes before hay analysis

Jess R
 

Hi everyone,

I am potentially looking to move my pony because his current facility is seeming a little problematic with his asthma. Is it okay to start other parts to the nutritional diet prior to doing the hay analysis? I've moved him off commercial grains but I was trying Manna Pro renew gold? He's dealing with ulcers right now and was a picky eater prior so he seems to be not wanting to finish anything from his feed bucket. (Had his teeth done this past month)

--
Jess in New Jersey 2020
https://ecir.groups.io/g/CaseHistory/album?id=263154


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

Eleanor Kellon, VMD
 

Amy,

If you are interested in Invokana I have information to send to your vet.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: LAVINIA/ MARKUPS for tiko/ NOW NEED COMPUTER HELP PLEASE

Daisy Shepherd
 

thank you to lynn and nancy c.;  got it done. you guys are all awesome.  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: Recent Blood work for Flyte

Eleanor Kellon, VMD
 

Hi Lecia,

You started Invokana in 2019, not 2018.  As far as I could find,this was the first triglyceride test (correct?). As the lab report noted, this elevation is very mild and entirely consistent with having EMS. In other words, he may have had this for years.

His GGT and AST were actually higher in 10/18, before Invokana, than they were in 11/19 and 3/21 on Invokana, In any case the elevations are all very minimal and common in horses with EMS.

It's your decision of course, but I wouldn't stop Invokana and risk a return of laminitis. This can probably be managed by diet change and adjustment in frequency of dosing. If you and your vet want to try that, contact me privately.

It's important to realize this is not a direct effect of the drug on the liver. The loss of glucose in the urine causes an energy shortage and the body responds by increasing triglyceride release. There are metabolic and free radical stress consequences with the elevated triglycerides and this causes the liver enzyme elevation and often muscle as well (Flyte's CK was only 7 units above upper normal range). Correct the energy crisis and the problem is solved.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Are there any photos and x-rays that show a good case - what we should be striving for? #photo

Starshine Ranch
 

A good case of what?  If you are talking about body condition (?) Equus magazine has a fabulous set of photos showing all the body scores/conditions in picture form in the most recent edition... Spring 2021    Issue 204     Page 31
--
Linda in CA  2020  Midnight and Ostara
https://ecir.groups.io/g/CaseHistory/files/Linda%20Midnight%20OStara


Re: Are there any photos and x-rays that show a good case - what we should be striving for? #photo

Sherry Morse
 

Hi Pat,

Are you asking about photos and x-rays of a normal hoof or one that has recovered from laminitis?  If so you may find Relevante's photo album useful (and there is always the Google): https://ecir.groups.io/g/CaseHistory/album?id=36909




Re: Energy

Sherry Morse
 

Hi Christi,

How many pounds of cubes is he getting in addition to the hay?  If his ideal is 950 he should be eating no more than 19lbs a day total.  Even if you don't think the weight tape is accurate it will give you a general idea of where he is now and you can always use the weight calculator as well: https://ecir.groups.io/g/main/files/5%20Core%20Diet/Weights%20and%20Measures/How%20to%20Find%20Ideal%20Body%20Weight.pdf

I've treated with oral Doxy in the past but I might do IV under the right circumstances.



Recent Blood work for Flyte

Lecia Martin
 

Good morning all.   For all of you on the Invokana journery I received Flyte's latest blood results and the numbers are alarming.   His case history is up to date.  In a nutshell,  He has been on Invokana since August 2018, been sound, doing generally well.   After Nancy's experience with Vinnie we started testing tryglycerides, along with liver values.  These last numbers are concerning, so much so that my vet and I have decided to take him off  it completely and re test in a month.   Important numbers are as follows:
triglycerides   2.25 mmol/l
ggt   82 u/l
gldh  35  u/l
ast   627 u/l
ck    446  u/l
 
I have pm Dr. Kellon and am waiting to hear back.   Any feedback would be greatly appreciated.  




--
Lecia Flyte and Flame
Alberta, Canada


Re: Energy

Christi Lyon
 

Hi Sherry,

It was hard to be completely clear in one post... I never thought it was magnesium. I always have to relearn how to get stuff in my case history! I can’t even see my photo album at this point, I’ll try to get back up to speed and get the pics uploaded.  I don’t have current xrays at this point. At the second incident of fever and swelling I thought more anaplasmosis also. The current vet feels that Lyme is more likely (not sure why).  Her current plan is to get back to totally tested hay and retest insulin in a few months. Whatever is causing his problem has been happening for a loooong time. 

I currently have him at 16 lbs of hay daily and he gets no concentrate only soaked Triple Crown Timothy balancer cubes, Equi-VM, biotin, salt and 200IU vit E.  I know weight tapes are pretty unreliable so I’m not sure of his exact weight. I think his ideal weight is probably 950. 

Did you do oral doxycycline or IV Oxytetracycline for treatment? I have a friend who did 60days on oral doxy and no improvement but improved on IV Oxytetracycline. 

--
Christi Lyon
Feb 2017
Aiken,SC
Case History https://ecir.groups.io/g/CaseHistory/files/Christi%20and%20Wentworth .

Photos https://ecir.groups.io/g/CaseHistory/album?id=8510


Re: Hay belly question

Kirsten Rasmussen
 

Hi Beth,

I agree with Sherry that Flame looks great!  I could be convinced, however, when comparing his October side profiles to the ones you just posted that his topline has dropped a little, which could be why the belly might seem a bit bigger to you?  My guess is he's out of condition due to a quiet winter?  Another possibility is that his pergolide needs to be increased, although his Feb result looks good so it doesn't seem as likely.

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


Re: Energy

Sherry Morse
 

Hi Christi,

Without current hoof/body pictures and an up to date Case History it's going to be very hard to answer any of your questions.  However, lack of energy is unlikely to be due to magnesium. It could be due to hoof pain and with an insulin of 71 you're not quite in the danger zone for laminitis, but it's close enough that there could be issues going on with his feet - this is where having current trim pictures and x-rays available would be helpful for us. 

How much hay is he currently being fed?  How much does he currently weigh? Is he being fed any concentrates? If so, what are they and how much is he being fed?

Fever and leg swelling could be a sign of anaplasmosis but without bloodwork we obviously don't know for sure.  As far as your vet saying it's pointless to test for Lyme without a fever, well, fever is a sign of anaplasmosis more often than it is with Lyme.  Lyme horses can be lame, can be spooky, can lack energy and just in general act not quite right.  If you want to pay for the Lyme test the vet should do the Lyme test for you, no matter what he believes.  I've been down this same road with my vet who was drawing blood from my horse and telling me that even her 28 year old was spooky and it was nothing.  He was positive for Lyme in spite of that thought and was much better post-treatment.  I had him rechecked again this past December because I again didn't think he was quite right and he was again positive and needed to be treated.  So you might need to be a little more insistent with your vet and ask them to humor you because again - it's your money and your horse and you need to advocate for him.




Re: LAVINIA/ MARKUPS for tiko

Lavinia Fiscaletti
 

Hi Daisy,

Glad you have the mark-ups. I sent you a private reply on contacting me.

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


Re: Hay belly question

Sherry Morse
 

Hi Beth,

I don't see any pot belly on Flame in the newest pictures.  He looks like he's a decent weight right now.




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

Sherry Morse
 

Hi Amy,

Invokana would replace the metformin.




Energy

Christi Lyon
 

Hi,

Just read a recent post about energy vs hoof pain. Since a 2016 bout of laminitis and joining this group and managing my horse accordingly I have struggled with his energy level. He was always VERY forward but thought mostly due to anxiety. After he was placed on drylot and diet controlled I consulted vet about his lack of energy and was told it was pro due to the high amount of magnesium I was feeding. (Balance done by Dr. Kellon and later Uckele) so I just wasn’t accepting that. Over the years it has gone up and down but has been an issue. I had not had his blood done until this spring as I was doing all I can do diet wise. I thought that his ACTH was going to be high and that we were going the way of PPID. (I will upload new blood ASAP to case file) I was surprised that ACTH was 15.2.  I was disappointed that his insulin however was 71.19. The lowest I have gotten it was 49. I had asked for insulin, glucose and ACTH but we didn’t get glucose. I have changed vets so I’m navigating the new practice/vet. After reading the aforementioned post and info on taking the glucose with a glucometer I am wondering if I shouldn’t have been doing that years ago. My horse was a little better in colder weather but still energy diminished i.e. he used to offer to trot up hills and had not been doing so. I had mostly been walking for the last couple of years as I was suspicious about cushings and didn’t want to push him. He had put on a little weight and has slight fat pads on shoulder and rear so I cut his hay back and have been exercising him more before the blood work. He is better the day after a rest day. He gets no grazing but does pick a little on the trail. I also have some untested hay that historically has always been under 10 ESC+starch. It was only 15 bales and I’m feeding only 2 meals a day out of 5. I wondered if that could be why his insulin is high? Still the energy issues have been predominant for a LOONG time now and really no help from the vet. He had had a couple episodes of fever/swelling in legs/joints 6 mos apart that made me suspect a tick borne illness but vet suspected viral. Totally disagreed but he did not test for Lyme or other tick borne. It feels like a blood sugar issue to me...I had never considered feeding him anything more than hay and Tim balancer cubes to get minerals in him as him since he was maintaining weight. Especially now that I am trying to reduce weight a little. The vet was concerned about fat pads. Even at his thinnest he still seems to keep slight fat pads.  I was also trying to understand exactly what Dr Kellons statement of “changing what you feed is an energy issue”. 

I clearly understand the first part of the statement which was “the need to feed more calories in general when working is determined by body condition score”  which is why even with the low/worsening energy that he has exhibited in the past few years I did not consider adding oats for energy. I am really feeling down. Something isn’t right. I have described the worst days as driving a car with the brake on.  I feel like I’m torturing him some days. He has not been footsore since his recovery from laminitis in 2017. At this point I would almost prefer to think he has Lyme (which even current vet said it would be pointless to test for unless he is exhibiting fever) than he has had glucose issues and I’ve been continuing to ride!!! This has been a difficult road mentally, physically, emotionally, technologically and financially and I want to do what is best for my horse. At this point I’m not sure what that is...

I have also lobbied for the vet or the practice to attend the NoLaminitis conference but I just don’t know if they are going to. 

 


Thanks to this group I know my struggles are understood.


--
Christi Lyon
Feb 2017
Aiken,SC
Case History https://ecir.groups.io/g/CaseHistory/files/Christi%20and%20Wentworth .

Photos https://ecir.groups.io/g/CaseHistory/album?id=8510


Re: LAVINIA/ MARKUPS for tiko/ NOW NEED COMPUTER HELP PLEASE

Lynn
 

Hi Daisy...Nancy's options are cleaner. I hope this doesn't complicate things but I like to go into my album from my phone. I'm able to select each image Lavinia marked up and save it to my phone. Then I can go to those photos on my phone, open the image of the marked up foot my farrier is working on and hold it for him to refer to while he works. Once he thinks he is finished, he can compare what he has done to the markup to see if he needs to make any tweaks.  
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: LAVINIA/ MARKUPS for tiko/ NOW NEED COMPUTER HELP PLEASE

Nancy C
 

Hi Daisy

Two choices, I think.

He needs to join the ECIR main group https://ecir.groups.io/g/main
and then join the CH group to see your pics https://ecir.groups.io/g/CaseHistory

Alternatively, you can download Lavinia's mark ups to your computer and then forward to your farrier.

You can do this. Hang in there.

--
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

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