Date   

Re: Conflicting information on peripheral loading

 

Hi Anna,
I can’t really comment on what the laminitis trimmer is expressing as I’m just learning about this topic myself.  Two things I’ve read here repeatedly are ‘don’t let the trimmer touch the bottom of the horse’s feet’ and ‘don’t hesitate to rasp down the toes yourself between trims’.  I know that eventually you will need to address the hoof bottoms but you’ll be safer not to touch them too soon.  To rasp off the toes a bit, it would be helpful to put the foot on a block but it sounds like you have some experience here.

To make the hoof wall thinner, I would think the wall would need be rasped around the outside, rather than off the edge, which I don’t really see, but that may be a misunderstanding on my part due our language difference.  I’m sure Lavinia will be along at some point to offer better guidance.
--
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


 
 


Conflicting information on peripheral loading

Anna Kulginova
 

I have been receiving quite conflicted information regarding if my pony should be weight bearing on her hoof walls or not.
I am quite worried for her since she is recovering/still sore from laminitis (the acute laminitis was about 8 weeks ago and want to check with you so that I do not proceed with her in the wrong way and make matters worse for her.

My temporary laminitis trimmer is an expert farrier that has been working and researching laminitis for a really long time, they go around the country to visit and help 20-30 laminitic horses each week, so they are seeing a ton of mild to really bad cases all the time.
Their diagnosis was that my pony could have had too much hoof wall removed/rasped away at a previous trim and that this is why she in not recovering as quickly as expected despite following vet advice and local laminitis protocols (I have also been following the protocols from ECIR).
That the hoof wall is now too thin to bear her weight and needs to grow back for her to get better.
I on the other hand have been under the impression that peripheral loading is not good for the horse and weight should be distributed between sole, frogs etc and only a small amount should be carried by the hoof walls.
Especially for horses with long toes, creating leverage that is not wanted.

I am really unsure about the information I have received now, since I have been working with my usual barefoot trimmer towards a better hoof shape, shortening the toes to follow the coffin bone and trying to adjust her broken back angles.
And now it feels like I have been told that that trim was not optimal for my pony :(.

My pony has been shod for almost all of her life as far as I know (have owned her 5 years, she is 13).
Could the trimmer be meaning that we have tried changing the hoof shape too quickly or in a way that my pony has had a hard time handling/adjusting to?

I am really worried about the fact that I now have had to leave her already very long hooves just getting longer for almost 2 trim cycles, per the laminitis trimmers directions.
They were out a while back (it was 5 weeks after a regular trim), cut off a bit of toe and said that they would come back after 5 weeks more and do a corrective trim.
it will be 10 weeks since the latest trim when the trimmer comes back.

After I received the trimmers diagnosis I decided to cast her hooves with flexible wrap and just trim off a bit of bar and clean the frog a bit since they were starting to look quite bad after the long pause in trimming and her feet really needed a rest from her boots.
After casting and the small clean up her step became slightly quicker but she comes up quite lame on LF after standing still on hard surfaces, she is still apparently quite sore on all hooves.
LF is also the one that looks the worst on the Xrays.
If it were her hoof walls that were the problem; shouldn't her gait and pain levels have improved quite a bit after casting (I have learned that casting mainly helps with thin hoof walls)?

I am at quite a loss at who to listen to and how to continue treating my pony right now.
Hoof images including last time the trimmer was out and the last trim from my usual trimmer can be found here.
--
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: Diva laminitis, help and hoof evaluation

Anna Kulginova
 

I am aware that my pony has excess weight and am trying to adress this.
She is eating 1,5 % of her body weight in dry matter (her haylage is 66% persent dry matter) and has been losing weight quite steadily since she started her stall rest (now stall rest with a tiny square of dry lot turnout).
I was under the impression that it is not good for a horse to be fed less than 1.5 % of their weight in dry matter?

I am now waiting for the laminitis trimmer to come out again in 2 weeks time, she has been off of Metacam a while now.
I have sadly not had anyone that could help me film her while walking out at the barn, she is still walking quite strangely.
Diva has been improving quite steadily and has been wearing her boots almost 24/7 the last 1,5 months.
Her soles and frogs have now been peeling and flaking quite badly and her feet, despite airing them every day, regular washings and cleanings of the boots etc have been quite chafy because of the hot and humid weather.
This week I decided to trim down her bars and clean up her soles a bit and then cast her with flexible hoof wraps to still give her hooves some support so she could have a rest from her chafy boots.
I thought that this would help her but she responded with being able to walk a bit quicker and instead coming up lame on LF after standing on any hard surface.
I will try and update her case file to todays status shortly.

--
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: Frodo - Radiographs, Iron Panel Results - in Flare-Up

Kirsten Rasmussen
 

Re: picky eaters.  They are more likely to eat their supplement if they are hungry...so 24/7 access to hay probably means stuffed full stomachs 24/7.   I'm not suggesting starving them for extended periods, but limiting hay intake for few hours (4?) before offering supplements might help with finishing their minerals before they go back to the "buffet".  Can you block them off from the round bale for a few hours once a day?

I do sympathize.  Dealing with picky eaters is frustrating.  :(

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


Re: ECIR Group 2021 NO Laminitis! Conference -- Early Bird Expires TOMORROW

Nancy C
 

Hi Donna

Yes, all lectures will be available on-demand, once the recordings are processed and uploaded. You will have access for six months.
--
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: Frodo - Radiographs, Iron Panel Results - in Flare-Up

Kirsten Rasmussen
 

Hi Becky,

The only calc to do is Transferrin Index:
(Serum Fe ÷ TIBC) × 100

For information on iron overload, see this link:
https://ecir.groups.io/g/main/files/Iron,%20Iron%20Testing,%20Iron%20Overload/Iron%20-%20Dr.%20Kellon%20on%20Iron%20Overload.pdf

Specifically this message on normal ranges:
The tests in an iron screen are:
1. Serum iron - the amount of iron circulating in the blood. This primarily reflects the amount the horse is absorbing from his diet. Upper normal is between 150 and 190 for most labs.
2. TIBC - Total iron binding capacity. This is a measure of transferrin, a protein in the blood that binds and carries iron. Free iron is very damaging to the tissues. TIBC normally increases as serum iron increases. Like serum iron, it can't be used as a measure of body iron load. KSU has reported seeing them as high as 455, but I have several higher than that, in both the normal and the IR group. Think of it as a "reaction" to the presence of iron in theblood, like insulin going up is a "reaction" to blood glucose.
3. TSI - Transferrin saturation index. This is a calculation, iron divided by TIBC x 100, that shows how much of the transferrin protein is saturated with iron. TSI does correlate with body iron burden, and also with how much iron is being absorbed. Upper normal is somewhere in the low 40s.
4. Ferritin - This is the protein that binds iron in the tissues and has been proven in horses to correlate very well with body iron burden. It can also be elevated with inflammation, malignancy, severe trauma, etc. but in that case the serum iron and TIBC go down. Horses in the IR study that were actively laminitic and showed the pattern of high ferritin but low iron and TIBC were not included so that there would be no false elevation of ferritin values. Serum ferritin of normal horses in Dr. Smith's study showed a mean of 152 with a standard deviation of 54.6, which means 152 was the average and most (95%) of the horses fell within a range of 97.4 to 206.6. My normals were similar, 139 plus or minus 43.9.
If the supplement contributed to this laminitis, you might have to do more than just remove it.  To stabilize Frodo again,  try separating him and soaking his hay for a few weeks.  My experience has been that after a laminitic flare-up I have to do more than just remove the apparent trigger for my horse.  Perhaps this is because my horse's 7% hay was borderline for him when fed dry, so soaking it makes the biggest difference.

I would separate and soak anyways if Frodo is still in pain.  All it takes is an electrified string and some push-in posts (or wood posts in buckets of solidified concrete) between him and his buddies, or some round pen panels if you have them. 

Also, following up on the ACTH testing.  Generalization: most IR horses are ravenous and not picky eaters.  If he is being picky then maybe that's another sign of PPID having a role in this.  Interesting that the rest of the herd is picky, too!

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


Re: Dr. Kellon - request for clarification of diabetes and pancreatic dysfunction in lab results

Eleanor Kellon, VMD
 

Nancy has answered the majority of your questions. I want to first focus on the sedation. It is well known that this drug causes a rise in glucose and insulin suppression and after two hours or so that reverses. Either way, you cannot get accurate results in the sedated horse. This is the most recent study: https://www.sciencedirect.com/science/article/pii/S1090023321000058?via%3Dihub .

As for excitement causing an ACTH increase, it doesn't. Taking blood does not cause a rise in ACTH regardless of excitement level https://pubmed.ncbi.nlm.nih.gov/26246396/ .  Response to stressors like a twitch or an injection of epinephrine only lasts 5 to 10 minutes. https://www.sciencedirect.com/science/article/pii/S0737080618307366

As for diabetes in horses, you may not need that information after all but if your vet does a basic PubMed search she will find several papers. I just posted two recently where they were also hypertriglyceridemic.

Pergolide dose is highly individual. The animal should get the dose that controls the ACTH.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Saraphina insulin test results

 


 Hi Cyndi,

I use Phyto-quench with Devil’s Claw with good results.  I believed I mentioned that in a pm.  Can you describe her soreness a bit?  Is it in her feet and you notice it when she walks or something else?  Does she favor one foot?  Does she lie down?  You’ve mentioned it a lot and I know it bothers you.  Have you searched the messages for ‘pain’?  You may get some good tips there as most people have the same concern with their horses at this stage in the process.  CBD comes to mind.  There may be an abscess brewing.

If she’s eating her hay well, and her minerals are eaten with the hay, what else are you feeding her that she won’t eat?  I still think any fussiness about eating might well be related to her need for more pergolide.  Is she getting 1 tube of UlcerGard or GastroGard daily?  

I don’t think you should be concerned with the T-4 as it’s described to be in the normal range, I think.  Someone else might have a different opinion.  I think Sherry might have reorganized your case history folder for you - it looks good to me now, so the only need there is to add data to your case history form/file.
--
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


 
 


How many hours is safe to go between "meals"

 


I wanted to reach out to those who have successfully have their horses lose weight by changing their feeding schedule. Here is my issue. Akira was raised on a round bale with a nibble net hay net and nibble net hay net in her stall at night since she came to me as a rescue nurse mare foal at 8 weeks. For the now 8yrs she has been with me I have had a round bale with a nibble net on it in the covered area at the back of the barn that leads to the dry lot. I haven't been able to change my routine for her by day because of the manner in which the herd has been managed and previous lack of sufficient pasture turnout for the other 3. She is out approx 12 hrs by day and in a stall 12hrs by night adjusted for extreme weather/temps. At 4 she was taped at 1270lbs. We have been stuck at 1130 or so for quite some time. Only being able to weigh her hay at night and cut back a bit at the night time feeding knowing she is probably consuming way more than 10lbs during the day obviously is the issue for us. There has been a change in herd management now with sufficient pasture and the unfortunate loss of my young gelding so she now has the bale to herself and the dry lot. She is near the end of the current round bale and I wanted to start weighing out her day time hay and portion it out in smaller nibble hay nets since I have plenty. So my question is....how long can they safely go without food in between portioned out hay. I did an experiment when she was and stall bound for a few days to see how fast she goes through her "10lbs of night time hay" and she blew through it in about 3 hours. That is double netted 1" holes. I weighed out 10lbs of hay and divided it into 4 nets for the day and thought oh my word she will be done with 2 nets in an hour or 2 with only 2 more to hang in that 12 hr day. Days where the weather is nice we are riding for about an hour and a half each day trying to work up to longer rides. But my back cannot sustain the 30 minutes of a sustained trot and her canter is pathetic. Riding a jack hammer would be more comfortable and my back is a hot mess. So my goal is to get her fit and fix her wonky gaits and to get her to the point of long trail rides which wotoaving her out for hours on end with no food since she has been living at the buffet for 8yrs...what does that do to her insulin and stress levels. I need to find a routine where I can put out meals for her during the day. I am home most days so that isn't a problem having to make frequent trips to her. 

I will say her golf balls above her eyes are no longer there but it is just flat now and not a well. But she has re developed palm sized fat pads behind the shoulder since last fall when those were gone. So clearly not where we need to be still. 

Thank you,
Sent with ProtonMail Secure Email.


--
Nancy and Akira
3/20/2018  Burkesville KY

Case History: https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Akira


Re: Dr. Kellon - request for clarification of diabetes and pancreatic dysfunction in lab results

Kirsten Rasmussen
 

https://ecir.groups.io/g/main/filessearch?p=name%2C%2C%2C20%2C1%2C0%2C0&q=Dormosedan
This us a summary of known effects of sedatives on insulin, glucose and ACTH.

I wonder if the use of the dorm is affecting Rosie's insulin and glucose results?  Could you ask your vet to try sedating with Valium before her appointment?  It is the least likely to affect insulin, glucose and ACTH.

I too tested my soaked hay.  I dried it in the oven on the lowest setting ("warming") I have before mailing it.  It should be dry for the lab.

While in Canada the recommended upper dose for Prascend is 2mg, in the US, the package insert says Prascend can be increased to 3mg, and in the UK it say it can be increased to 5 mg.  It is a regulatory issue, not a safety issue.

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


Re: ECIR Group 2021 NO Laminitis! Conference -- Early Bird Expires TOMORROW

Donna Hedicke
 

I would have to miss Friday, due to my work schedule.  But if I register for the conference, will all of Friday be on video to watch so I don't miss anything?
I am not concerned about CLE, just want to hear the information.
Donna Hedicke
You'll never plow a field by turning it over in your mind.


On Fri, Jul 30, 2021 at 8:05 AM Nancy C <threecatfarm@...> wrote:
Early Bird pricing expires tomorrow Saturday, 07.31.21, midnight EDT (New York USA). Registration closes August 6, 2021, midnight EDT (New York USA).

RECORDINGS!!!! Recordings will be available to attendees, once processed and uploaded, for on-demand viewing on a dedicated link.

Don’t forget, Conference Orientation hour from your hosts, Cindy and Sherry, on Thursday night, August 12, 5:30pm - 6:30pm. Meet hosts Cindy McGinley and Sherry Morse, who will walk you through how this remote conference will unfold, and help you have the best conference possible.

Full schedule here:  https://www.nolaminitis.org/conference-schedule.php

When: The weekend of August 13 - 15, 2021.
Where: ECIR Virtual Conference Room at the location of your choice.

Registration: https://www.nolaminitis.org/registration.php
Who should attend: Anyone with equines in their care.

Thanks to all who have registered already! It is a joy to see your response. You are coming from all all over the globe, and it makes this volunteer very happy.

As always, many thanks to our generous Benefactors who strongly support the needs of the ECIR Group members.

DIAMOND 
California Trace
Soft-Ride Equine Comfort Boots
Auburn Laboratories, Inc. - APF
ForagePlus
Uckele
Mad Barn
Custom Equine Nutrition - VT Blend
HorseTech

PLATINUM 
Black Horse Spirit, LLC
Progressive Hoof Care Providers

GOLD 
Anderson Feed - NuZu Feed
Omega Fields
Equi-Analytical
My Best Horse
Hay Chix
Island Pharmacy
Beet-E-Bites
Triple Crown
Pure Sole
Ontario Dehy

SILVER 
Sox for Horses

BRONZE
New England Equine Balance
Yank Gulch Equine
Great Plains Forage Balance
Ration Plus

On behalf of your hosts,
Cindy McGinley and Sherry Morse,

and

the 2021 NO Laminitis! Conference Committee.

--
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: Dr. Kellon - request for clarification of diabetes and pancreatic dysfunction in lab results

Nancy C
 

Hi Mary Ann

Not Dr Kellon, but I had a diabetic gelding.  I can offer some info for you.

PubMed quite a few studies on diabetes in horses. https://www.google.com/search?client=firefox-b-1-d&q=equine+diabetes+pubmed

While not the majority of horses, there are many that have been reported here.  Searching on diabetes in the case history sub group brings up a number of case histories that mention diabetes.  https://ecir.groups.io/g/CaseHistory/filessearch?p=name%2C%2C%2C100%2C1%2C0%2C0&q=diabetes

Your horse is IR as well as PPID. The ingredients in the senior feeds can make the IR worse, specifically fat, inverted omega 3 and 6, iron and manganese. The use of ground wheat as the starch would give me pause. As far as I can tell they do not list the starch guarantee. Here are a couple of links to explain other aspects of your questions.
https://ecir.groups.io/g/main/message/259023
https://ecir.groups.io/g/main/message/245266
https://ecir.groups.io/g/main/message/188289
https://ecir.groups.io/g/main/message/15496

Soaking hay originated here in 2002 or so. Retesting a hay crop what will be soaked long term is the recommendation. You would need to resample the soaked/dried hay and send to the lab. In 2012, I found major reduction in ESC, potassium and iron.  All good news which allowed me to more correctly and tightly balance my rations.

We have many horses on pergolide at doses higher than the label. My gelding got as high as 14 mg. Here is a link to some of the ECIR historical data. https://ecir.groups.io/g/main/wiki/1484

Dr Kellon will be reviewing current and potential medications in two of her presentations at the NO Laminitis! Conference. in two weeks. AAVSB RACE approved veterinary credits are available.  www.nolaminitis.org

I can't speak to pancreatic exhaustion specifically but I suspect the goal would still be to make the insulin sensitivity as good as possible, with diet as a core element.

Hope this helps.
--
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: Saraphina insulin test results

CYNDI CARLSON
 

Hi Sherry,
thank you for the information and link for the devils claw.I will read up on it, as Saraphina is very sore. I’m concerned about her pain level since she will only eat her soaked hay, with trace minerals added, she’s being very picky.
I will work on updated my case history !
thank you!
--
Cyndi Carlson in Colorado 2021


Re: Saraphina insulin test results

Sherry Morse
 

Hi Cyndi,

You want the pellets as they have Devils Claw: https://uckele.com/phyto-quench-pellet.html.  Use code ECIR for a 5% discount.  Then you can read about switching from a NSAID to Phyto-quench here: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/Pain%20control,%20switching%20from%20Bute%20to%20Phyto-Quench.pdf

Just FYI - Equioxx is a NSAID just like bute so doubling up on the NSAIDs is not a good idea IMO.  Also, if she's still sore on Equioxx IME it's probably not actually helping.  If you decide to stop the NSAIDs and not replace them with something else please make sure you taper off slowly.  You can read more about that here: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf

And finally, when you have a chance can you please update your case history with the current medications she is on?




Re: Saraphina insulin test results

CYNDI CARLSON
 

Martha, ok will work on cleaning up my files!

Should I be concerned about the T-4 results? The vet commented that she believed it is high due to thryo-L
which I have weaned Saraphina off.
--
Cyndi Carlson in Colorado 2021


Re: Saraphina insulin test results

CYNDI CARLSON
 

Hi Sherry, no I have not checked into Phytoquench with devils claw, can you suggest where I can find this?
I have her on Equioxx , she got laser treatment for pain last, boy that helped her getting another treatment Monday.
I like this new vet, she highly regards the group!
--
Cyndi Carlson in Colorado 2021


Re: Hay Tested, Results I have no idea what this means. Could use any help. We are now soaking her hay before feeding.

Lavinia Fiscaletti
 

Hi Melanie,

Not Dr. Kellon here, but that means to have it mineral balanced based on the analysis. For a list of people who can help you with that, please see here:

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


Re: Hay Tested, Results I have no idea what this means. Could use any help. We are now soaking her hay before feeding.

mel7198@...
 

Dr.Kellon, 
Thanks for the info. ? What did you mean when you said to get it balanced,?
--
Melanie Lemoine VT 2021  
Case History
https://ecir.groups.io/g/CaseHistory/files/Melanie%20April


Re: Help with Hoof Evaluation Response to Lavinia.

Lavinia Fiscaletti
 

Hi Rachel,

I've added some mark-ups to Ty's album:

https://ecir.groups.io/g/CaseHistory/album?id=266434

Unlike a lot of the trims we see here, Ty's looks fairly good. Toes are a bit too long horizontally, but nothing monstrous. The biggest problem is that all of his heels are seriously underrun, with the central sulcus splitting up into the heel bulbs. The heel bulbs have been puled down and forward so he is walking on them instead of his heels. This means the digital cushion are squished out behind his foot instead of being stacked over the frog and heels. This sets up the coffin bones to be ground parallel or even negative plane. The older rads from 2017 showed that this was the case in the fronts at that time. It may have improved a bit in the fronts since then but the bull nosed dorsal walls on the hind feet are a good indication that the hinds are still having a problem. Toes need to be brought back more on all four feet and the heels need to be allowed to add vertical height. This is about small, targeted changes which leave the soles, frogs and most of the bars untouched.

LF dorsal: Green line follows the angle of the new growth down toward the ground. There is a slight lateral flare in the lower 1/3 that can be tightened up (blue area).

LF lateral: Green line follows the dorsal wall from top to bottom. Orange line shows where the heels should be standing - which is about parallel to the angle of the green line. You can see how far forward they are instead.

LF sole: Blue solid lies on the heel buttresses are where to bevel the wall out of ground contact, so that the bar and heel-wall juncture remain as the load-bearing structures there. Do NOT try to back the heels up as at the moment, they are already too low relative to the height in the front half of the foot. Blue hashed lines are the area to bevel out of ground contact. Also, roll the toe along the blue hashes at the front of the foot. Orange lines across the backs of both heels are where to rocker the heels back toward the heel bubs. More info at this link, esp. see figures 2 and 3:

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

A bit more reading here:

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

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

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

RF dorsal: Again, the green lines follow the angles of the new growth coming in under the coronary band toward the ground. The blue areas are the slight flaring that is in the lower 1/3 of the hoof capsule.

RF lateral: Blue area is the toe length that can be removed and then roll the toe under. Orange line shows where the heels should be.

RF sole: Same idea as the LF, except that there is a bit more toe to remove. Yellow hashes are along the leading edge of the lateral bar that appear to be crumbling away, so they can be removed - just don't want to get too aggressive, only what is already crumbling away.

LH lateral: Green line shows where the dorsal wall wants to be - you can see the slight bull nosing of the actual wall outside of the green line. Orange line shows where the heels should be lining up.

LH sole: Same idea as the fronts. Need to preserve every millimeter of vertical height in the back half of the foot. Bring the toe back a bit and roll it under. Blue solid lines are where to bring the walls in the heels in to. Blue solid line at the toe is where to back the toe to. Orange hashes are where to rocker the back of the heel buttresses toward the heel bulbs.

RH lateral: Green line shows where the dorsal wall would be if the hoof capsule were standing more upright, while the yellow line follows the actual bull-nosed shape. orange is where the heels shoudl be standing.

RH sole: Same discussion as the LH.

You want to see him landing heel first at all times, except at a slower walk where landing flat is OK. Never want to see toe-first landings at any gait. If he is the least bit uncomfortable, he should be in padded boots for support and protection.

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


Dr. Kellon - request for clarification of diabetes and pancreatic dysfunction in lab results

Mary Ann
 

Dr. Kellon,
I had a one hour consult with my vet today and she would like to get some clarification on some of the topics we discussed about Rosie's high ACTH, insulin and glucose numbers. Are there other blood tests in addition to the endogenous ACTH test you would recommend I have done, and why? Can you elaborate on Rosie's latest lab results and the comment that her bloodwork "is consistent with advanced, untreated PPID with pancreatic exhaustion and diabetes"? Can you recommend recent literature that I can provide to my vet that indicates diabetes is found in horses and also recommendations for treating diabetes and pancreatic exhaustion? Can you explain why certain ingredients in senior pelleted feeds (such as Purina Superfibra Integri-T) are not suitable for a horse with advanced/uncontrolled PPID and why? Can you give some details as to why a specific amount and/or type of fat in the diet of an aged PPID horse may not be beneficial?

Due to my mare's aversion to needles, she has been consistently sedated 45 minutes prior to the vet's arrival with Dorm gel (1 mg dose). This allows the vet to perform oral and eye exams and administer vaccines and/or draw blood samples with great ease. She can become extremely agitated as soon as the vet arrives and they begin working on her. This heightened state of anxiety alone can cause a significant rise in cortisol release which, in addition to the sedation, can lead to much higher ACTH levels (according to my vet). She wants to do the next bloodwork in September as that is the month is was performed in the previous year. She is still not comfortable increasing Rosie's dose of Prascend higher than 2 mg based on her weight. She would like to know more information on this. Can you provide me with links to studies or scientific data that talk about giving higher doses of Prascend than what is on the manufacturer's label? Ultimately, she is agreeable to leave it to me as the owner and caregiver to either maintain her at 2mg or raise it to 3mg without first sampling the ACTH level again and with no new symptoms other than a small change in topline condition and the continued frequent urination and thirst. We plan to take another full set of x-rays in September to compare them with last year (for my own peace of mind). We discussed tapering her dose of Flunixin in September once the bloodwork results are in and then weaning her off the Flunixin during the winter months when her uveitis seems less likely to reoccur. She also brought up a valid point regarding hay analysis and mineral balancing. If this year's crop tests above the 10% NSC range and soaking is recommended, will the lab that performed the analysis (based on dry matter) retest a soaked hay sample to see how much of a change has occurred in the level of nutrients that were sampled? She recommended I contact the lab who will be doing the analysis to find the answer to this question.
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Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie

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