Date   

Re: Case History

Anette
 

Yes I have but will look again.
--
Anette P and Jaywalker
Boomer, NC
Sep.9 2018
https://ecir.groups.io/g/CaseHistory/files/Anette%20and%20Jaywalker


Bullitt - Body condition and Hoof Questions

Sarah Orlofske
 

Hello All, 

Thank you to everyone who has helped Bullitt and I in his laminitis recovery. I really could not have done it without you all! 

Bullitt has been doing really well, but I have been trying to increase his exercise to see if that helps get his insulin under control but he is reluctant to walk with me. I check for heat and pulses and there aren't any. He does not act lame like he did with his laminitis episode last year. What I have noticed is that he is walking very narrow in the back (legs close to the middle of his body) and that his hind hooves are very uneven. He is walking on the outside of the hooves and there is a noticeable difference between the sides viewed from the sole plane. Is this a result of his laminitis episode last year? Is there some other joint or hoof issue that we are just now seeing because his hooves are now nearly grown out from his laminitis episode last Aug-Sept? Is this uneven growth enough to explain why he is not enjoying his walks like he used to a few months ago? He also seems to wear the front of his hind toes off flat like he is dragging them. Does that mean his toes are still too long? Other than the walking issues he honestly seems to be in the best shape of his life. I am sorry if these are silly questions, but I only have Bullitt and his sister Kate and they are my only two horses and my only experience is with minis so I am still learning about all the hoof issues in particular. I have posted all new hoof photos in case someone is willing to give them a look and provide some insight. Any thoughts would be greatly appreciated. Farrier is coming next week. They are in need of a trim, but I have been dealing with my own health issues and about a week behind schedule. 

Bullitt's case history is also updated. I would also like some opinions on his weight and body condition. I used the ECIR weight calculator and he came out at 363 but body condition-wise he still looks like a 5.5 to me. I am really bad at this since I was conditioned to think that minis are healthy when in fact they are fat. I thought an ideal weight for him would be around 375, but at less than that he still looks a little heavy? The pictures I posted don't show ribs, but I do see them when he moves and they are easy to feel. I think he looks slightly thinner than the photos make it look but he does have a little tough on the spine and a little fat behind the shoulders. Any thoughts about his weight and body condition would be greatly appreciated as well. We have made some diet changes so I want to make sure he is still on target. 

Finally, vet is scheduled on July 24th for new blood work for Bullitt and Kate. I hope this will work to keep us ahead of the seasonal rise. 

Thank you again for your help and support. 
Sarah 
--
Sarah O. 
Rudolph, WI
2020


Re: ECIR Group 2021 NO Laminitis! Conference -- UPDATE 07.05.21

Nancy C
 

Hi Kim

I've checked our records an you are there, registered and paid.  I have privately sent you a copy of registration.

Thanks!
--
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: Jalila almost managed?

Sherry Morse
 

Hi Nancy,

In addition to all the advice you've already received from Lavinia, is there any reason that you can't remove the alfalfa from her diet now?  She may well be one of those horses who can't tolerate alfalfa and that's one easy area where you can tighten up her diet which could help with both her insulin numbers and possibly her foot soreness.  Are you soaking the current hay ration?  If not, this may be another area that can be tightened up as well. 

There are a number of imbalances in the hooves that need to be corrected or the problems you're seeing (flares, thin soles, long toes, underrun heels) will continue to be an issue.  There is no such thing as 'good growth will continue and the repair will complete' without the trim being tight.  If left as it is there will continue to be problems as the new hoof comes down to the ground.  If your farrier is willing to work on the trim I would suggest submitting a full set of hoof pictures for mark ups (directions here: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help). 



Re: best time to test acth and insulin

Sherry Morse
 

Hi Vicky,

The seasonal rise starts with the summer solstice but has its most noticeable effect from August>October.  You can read more about this as well as see a weekly chart here: https://liphookequinehospital.co.uk/wp-content/uploads/Seasonal-Changes-in-ACTH-Secretion2.pdf.

You need to wait 3 weeks after a dosage change to recheck ACTH.

It doesn't look like you've ever used a TRH stim test on Samson, is that correct?  That might help you with checking to see if his dose is controlling his ACTH although there are no reference ranges for testing a horse on Prascend using the TRH test.  You may need to continue to rely on observation of symptoms with him.  Is he currently getting all of his Prascend in a single dose?




Re: Supplements and conflicting information

Kirsten Rasmussen
 

Hi Kandace, 

I'm not sure if your iodized salt would be stable, and if it is stable whether it contains enough iodine to meet your horse's needs.  Ideally you would also feed a supplement containing some iodine, or feed kelp flakes.   I'm sure you saw all that in your ECIR rabbit hole search though.

I usually come back to this post, which shows why we recommend 2-3 oz ground flaxseed (because 3 oz provides about 19 mg Omega-3 FA, which meets/exceeds what horses on pasture get).
https://ecir.groups.io/g/main/message/226573?p=,,,20,0,0,0::Created,,Flax+seed+to+Flax+Oil+Conversion,20,2,0,25707499
Here is another useful article that recommends 4.5 oz ground flaxseed/day:
https://drkhorsesense.wordpress.com/2021/05/24/flax-to-mimic-pasture/
This one is also interesting and explains why we recommend flax over other O-3 sources:
https://drkhorsesense.wordpress.com/2021/03/08/omega-3-fatty-acids-in-equine-and-canine-nutrition/

Some house-keeping: can you add the year you joined ECIR to your signature please?

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


Re: best time to test acth and insulin

vicky monen
 

HI,

Seasonal rise is considered what months exactly? Aug through Dec? 

and how long after a dose increase should I recheck ACTH?

He is currently showing no symptoms, but obviously I need to test to make sure.  Also he never had high ACTH, only symptoms that suggested early cushings.  I usually have to go by symptoms since ACTH is always normal. Any other suggestions for dosage increase for these early cushings horses that test normal?  Currently the only cushings symptoms he is showing is long guard hairs and his coat grew in thick and fast after clipping in March 2021.  Otherwise he is looking great on the current dosage.  

Thanks so much,
--
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

https://ecir.groups.io/g/CaseHistory/album?id=1226

https://ecir.groups.io/g/CaseHistory/files/Vicky%20and%20Samson


Re: Case History

Eleanor Kellon, VMD
 

Anette,

If you mean LibreOffice you don't need Microsoft. When you save a document click on the drop down arrow on the "save as" line and you will see an option to save as Microsoft Word document.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Case History

Nancy C
 

Hi Deb

I'd like to point you again to the messages you have received to help you get started.  Not clear from previous communication you have seen them. 

https://ecir.groups.io/g/main/topic/83692247#265880

There is a lot of info in the four responses to your first "I need help" post that might help point you to get started. These messages include links to our Wiki and to the Case History subgroup. These are "rooms" off of our main discussion room. Bookmarking the pages helps to find them again if you get lost. You can also find them in the header of each page on the groups.io. so for example, go here to the groups discussion on the web and scroll to the header at the top of the page.  https://ecir.groups.io/g/main/message/266251

Like any software program, Groups.io takes getting used to how it operates, but with the help of ECIR volunteers and individual practice, the vast majority of folks find it can be done. Please let use know by posting here, where you are getting stuck.  Volunteers want to help you. We've not seen any more info form you other than this post and the link above, so please feel free to tell us a bit about your horse. It would be very helpful to know, at least, what device you are on.

Thanks in advance for helping us help you and your horse.
--
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: Lavinia would you advise the new Xrays please

Carrie
 

Apologies all photos in original file now. 
Added label in description box for each photo as couldn't find another way of labelling them this time .. feel so useless !! It's not hard.. but dhh !
Includes LF & RF X-Rays plus lateral photos as requested.
NB. half of the resin remains on RF - from front toe to medial side. The hoof has area where it was trimmed for Seedy toe & smaller holes made for resin to anchor & stay on better.
Thank you Lavinia
--
Carrie 
March 2021
UK


Re: Case History

debost@...
 

No kidding!  I find it impossibly complicated and difficult.  I've given up, at least temporarily.  This website is like a house that has been added to over the years and makes no sense as a unit.  Simplifying the instructions or starting over with the process of posting case studies would help a lot more people and horses.
--
Deborah Ostrofsky
Year of joining: 2021
Location: Northwestern Pa


Re: Jalila almost managed?

Lavinia Fiscaletti
 

Hi Nancy,

The 2021-07-05 photos are from after the trim that was done once you had the radiographs to look at - correct?

Toes are still miles too long on all four and that hole is located in the excess toe length - remove the toe length and that hole will also be gone: it's likely that dark gap you can see at ground level in the toe of the LF lateral radiograph.
Hind heels are severely underrun. Soles are thin, which isn't surprising with the toe length and wall flaring that is also present. Much of the damage that is visible is due to the mechanics that are still aggravating the situation. Trim needs to be tightened up considerably. If she is heel landing at the trot, that is a good thing but being "off" is not. If she isn't sound, she should be wearing padded boots - which will be difficult to fit with the excess toe length. Sand will tend to abrade the soles so she should be booted any time she is moving in sand.

The March blood work results are pretty similar to the latest blood work done on June 27th. The anomaly is the June 25th blood work, where her insulin was >200 and her glucose put her in the diabetic range. Are you sure (meaning vet, Cornell) that there wasn't a mix-up in that sample with some other horse? Not doing the ACTH and T4 had nothing to do with the result, as the insulin and glucose testing would be the same.

Good that she has lost weight. Feeding anywhere from 1.5%-2% of her ideal weight is generally the formula, which will be influenced by the calorie content of the hay as well as the metabolism of the horse eating it. What hay are you feeding - there are four listed in the case history. When do you get the new hay? Yes, you should get a custom supplement to match whatever hay you are feeding, as all of the hays have a serious calcium-phos imbalance, which the CA Trace won't address. This would take iron content into account as well. It would be a good idea to discuss the overall situation with one of the Hay Balancing people listed in the files:

https://ecir.groups.io/g/main/files/6%20Diet%20Balancing/HAY%20BALANCING-1.pdf

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


Jalila almost managed?

Nancy K.
 

I redid Jalila's case history document and added detail, while maintaining the integrity of what was previously in the Apple Pages debacle. It's now in the Word/PDF format so it should be readable. I also added a new blood work report, front foot x-rays, and photos of feet and body to our Case History and Photo Album files.
I have some questions and need help understanding where Jalila and I stand in the process of managing this EMS/IR.
X-rays & Feet & Exercise
Jalila's x-rays are not as bad as I expected. My farrier was able to be with us when the vet came to do them and he trimmed her immediately after. It looks like she has good attachment between her bony column and hoof wall to a little over half way down. That's where the changes in the hoof show from post-laminitis and switching to the EVIR Emergency Diet, which added minerals, Vitamin E, and flax. My understanding is that if we keep the flares from leveraging the "good" growth will continue and repair will complete.
On her 2021-07-05 LF Sole shot, there is a little hole/pocket. It showed up post trim. Is that an old abscess pocket or is it showing separation at the toe? She is mobile and sound at the walk. her soles are thin and she is definitely off and heel landing if she trots. Should she be exercising? (Hand walking on level ground in sand arena) In the next three weeks or so, she will be totally off alfalfa, which I understand might contribute to foot soreness. How does iron figure into this? Will a custom mineral balance for my new crop of hay regulate that possible factor?
EMS/IR Calculator & Diet
Could someone please walk me through what those numbers mean? It appears she is a bad case. The March numbers were possible skewed by the fact that she was still laminitic and, likely, abscessing when we drew the blood sample. The blood work report from June 25 showed an extreme insulin level (>200) My vet and the lab at Cornell insist Jalila must have had a carbo load just prior to the draw. That is highly unlikely. I timed her breakfast, 6 lbs. of hay in a nibble net, so she would finish 45 minutes to an hour before the vet arrived and there is nothing else to eat in her dry lot. Whatever, since the June 25 test (blood was drawn on the 21st) was not the same as the March test, and lacked the T4 & ACTH numbers, we reran a test with a blood draw on the 27th (Test result on the 29th).  Do I need to get onto the grass hay, get a custom mineral mix and give her some time before I panic?
She has lost a lot of weight, but her weight loss has slowed and she needs to lose more. I cut a pound of hay from her rations, went from 18 lbs. to 17 lbs., about 3 weeks ago. Should I wait to adjust again until after the grass hay arrives or cut another pound now?
Finally, thanks to everyone for being so supportive and helpful.
--

-Nancy K. with Jalila & Shiraz

March 2021, Blaine county Idaho

Case Histories: https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Jalila

Jalila’s Photos: https://ecir.groups.io/g/CaseHistory/album?id=262313
Shiraz's Photos: 
https://ecir.groups.io/g/CaseHistory/album?id=262467 

 


Re: Case History

Sherry Morse
 

Hi Annette,

Let's start with step 1 - knowing where your current case history is located on your device.  Do you know where the file is? 

If yes - is the information in the file current or does it need to be updated?

If current - make a note of where the file is located and open your case history folder.  Click on the "+NewUpload" button and then click on "Upload file" in the drop down menu.  From there you will need to navigate to the file location on your device and upload.

I suspect from what you've written you do NOT have a current case history file on your device.  If that's the case you need to start from scratch and include both the old information from your case history as well as any updated information.  Once you have all the information entered into the document you need to save it as 'Horse's Name_Case History_Date completed', note where it's saved on your device and then save it as a PDF (either by going to File>Print>Print to PDF) or using an online file converter.

Once that's done you would then follow the steps outlined above to upload the PDF file to your case history folder.  If you run into a problem you need to let us know what stop in the process you are having an issue with.  If you need to download the pages form again you can go here to get it: https://ecir.groups.io/g/main/files/Case%20History%20Tools/Case%20History%20Form.pages




Re: Case History

 

Anette,
Have you opened our Wiki to find and follow the Case History directions? The Wiki is located on the left side of this page, bottom item . Open that then proceed to Case History help.
--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album Deceased


Re: Lavinia would you advise the new Xrays please

Lavinia Fiscaletti
 
Edited

Hi Carrie,

Would you please combine all the pix and rads into the album that is in your signature, rather than having multiple albums. Here's the link to the new album:

https://ecir.groups.io/g/CaseHistory/album?id=265767

Would you be able to get a lateral shot of that RF as well? Is there only a rad of the RF? Could use to see pix of the LF too.

Thanks.

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


Re: thyroid help

 

Kandace, I don’t think there is any reason to delay your test as long as it’s 3-4 weeks since your last dosage increase.  I’m sorry if my post confused you.  You want to test before you get too far into the rise so you can make any adjustments early.  The test you did last February indicated more pergolide was needed.  You’ve increased the dose by 0.5mg since then but have not tested.  If the test indicates still more is needed for control, you want to make that change as soon as possible.  Are you saying you want to test during the rise?   What do you hope to learn from that?
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Seasonal Rise

 
Edited

Kandace,
Are you using prescription medication "Prascend" or using a generic version of pergolide?
https://ecir.groups.io/g/main/files/3%20Cushings%20Disease%20-%20PPID/Cushings%20Disease%20Treatments/Pergolide/3.%20Prascend

--
Bonnie Snodgrass 07-2016

ECIR Group Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album Deceased


Case History

Anette
 

I need " How to upload Case History for Dummies"! I have tried several times to upload one, had the info filled out and lost it! Today I even made an account so I could use the Microsoft Office for free thing to fill out the form and it won't or I don't know how to get the document there. I use Libra for other documents I make so Don't have Microsoft on the computer. I have an Ipad and tried doing it from there up to no avail,help please!
--
Anette P and Jaywalker
Boomer, NC
Sep.9 2018
https://ecir.groups.io/g/CaseHistory/files/Anette%20and%20Jaywalker


Re: Seasonal Rise

Maxine McArthur
 

On Tue, Jun 29, 2021 at 06:59 AM, Kandace Krause wrote:
I know I have asked this before, I cannot seem to be able to find all my messages to track the answer down.  I have, in the past, found all my messages by typing my name into search bar.
Hi Kandace
To address this part of your question—below the window with any of your messages, on the right-hand side, you should see the word ‘more’ with three little bars. On my phone it is in blue. If you click on this, it should give you the option ‘see all messages by this member’. 
 
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

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