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Re: Prascend, possible false-positive tests, and re-testing

spiritwinddesertarabians@...
 

Thank you for the clarification, Martha. I believe I did see the veil. Good to hear no harm from it if not needed. 

Thanks!
--
Bev & Sariah (PPID) from Idaho, 2021
CaseHistory@ECIR.groups.io | Files


Re: Prascend, possible false-positive tests, and re-testing

 

Hi Bev,
You only want the endogenous (baseline) test.  There are no lab standards to compare to for TRH Stim testing during the fall rise as well as for a horse already on pergolide.

When starting pergolide, the horse frequently exhibits a veil.  You might notice this if you gave a horse pergolide that wasn’t PPID or you might not but no harm will be done.
--
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: Need to help a friend in crisis. How can I add a case history for her? Can a moderator please assist with this quesiton?

 

Hi Jessica,
Equi VM is a very concentrated supplement so it needs a little something which tastes enticing.  A serving is 40 grams, most of which is probably active ingredients.  Even if it were entirely things we like to avoid, that is only 40 grams when you are feeding Khan over 9,000 grams of hay.  Just to add some perspective.
--
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: Prascend, possible false-positive tests, and re-testing

spiritwinddesertarabians@...
 

Thank you Sherry. 

Should the PPID test include the baseline plus the TRH (I think I got that right) or just the baseline at this point?
Still curious, if a horse does not have PPID and is given Prascend erroneously, what ill effects can it have on the horse?

Thank you,
Bev & Sariah (PPID) from Idaho, 2021
CaseHistory@ECIR.groups.io | Files


Re: Urinalysis shows no diabetes, no EMS

Sherry Morse
 

Hi Mary Ann,

Not Dr. Kellon but we usually diagnosis horses as diabetic based on elevated glucose and low insulin levels which indicate pancreatic exhaustion.  Also, as far as a 'maximum dosage of Pracend' there are a few things to remember:

1 - the correct dose of Prascend is the one that controls ACTH
2 - dosing of Prascend is independent of weight
3 - while BI's literature in the US lists one cutoff for the maximum dosage of Prascend (3mg), their literature in Europe gives a different cutoff (5mg)
4 - in spite of BI's literature we have many, many horses that are on much higher dose of Pergolide. (Pergolide because Prascend is prohibitively expensive at higher doses.)

As far as testing - you can do that after 3 weeks on the new dose.




Re: Urinalysis shows no diabetes, no EMS

Mary Ann
 

Dr. Kellon, both specialists feel that her levels were elevated somewhat from the sedation and stress (she lost her longtime pasture mate last summer and then had the major uveitis flare and was heavily sedated for frequent exams and treatments and the installation and re-installation of the SPL - all during the seasonal rise). She tells me that the Prascend dose can go as high as 4mg for a horse of her weight, but they both strongly recommended I not give the max dose until further blood work is done. She's been on the 2.5 now since early August. We plan to retest ACTH in late September. What test(s) would you perform to diagnose diabetes? 
--
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


Re: Prascend, possible false-positive tests, and re-testing

Sherry Morse
 

Hi Bev,

Looking at your CH your first 2 PPID tests were done too early for the seasonal rise to have an effect.  There could have been an effect from trailering but how much of an effect is hard to say.  If your local vet can draw blood for insulin/glucose/Lyme and CBC they can do an ACTH test as well.  Yes we are going into the fall rise, but testing at home now will let you know if the current dose of pergolide is doing the job or if you need to increase it prior to the rise.  You can see the weekly chart for normal ACTH levels here: https://liphookequinehospital.co.uk/wp-content/uploads/Seasonal-Changes-in-ACTH-Secretion2.pdf

If you want to test iron levels be sure you read and understand all of the KSU guidelines: https://ecir.groups.io/g/main/files/Iron,%20Iron%20Testing,%20Iron%20Overload/KSU%20Iron%20Submission%20Information.pdf

Make sure you are clear on what you need to do to have non-fasting bloodwork for insulin and glucose: https://www.ecirhorse.org/DDT+E-diagnosis.php







Re: Diva laminitis, help and hoof evaluation

Sherry Morse
 

Hi Anna,

I'm glad that Diva is doing a bit better now. I would think the uneven ground is bothering her because of the way her weight is pushing on her hooves but hopefully as she gets better you will see less of that.




Re: Private: Re: Hay testing

Sherry Morse
 

Hi Tina,

First off some housekeeping - please add you CH folder link to your signature.  Directions on how to do that are here: https://ecir.groups.io/g/main/message/267601

I found a bunch of files that have been moved into that folder from the main files section, but I no longer see a case history for Griffin.  The jpg files of your x-rays should be uploaded into the photos section but they're pretty typical in showing a long toe and not a lot of sole which means the trim needs to be addressed.  I suspect 2 of them are post trim pictures, but could you please confirm that? If you are able to take photos and put them in the photos section and then post to the group asking for markups Lavinia will be able to help you with that after the NO Laminitis! Conference is over.

Do you have the results of Griffin's TRH stim test?  If he is PPID and is not being treated that can cause weight loss as well as loss of topline.  However, given that the vet notes indicate that Griffin weighed 780lbs in May he had a fair amount of weight to lose.  We prefer to see IR horses at a 4.5 to 5 on the Henneke scale which means that ribs may be visible. If you haven't already found this you might want to take a look at the chart here: https://ecir.groups.io/g/main/files/Case%20History%20Tools/Tools%20and%20How-To%20Help/Body%20Condition%20Scoring%20Guide.pdf and use that as a guide for how thin Griffin is.

1 - you need to change his diet and eliminate the things that are not below 10% ESC+starch (TC 30, TC low starch, and the Standee hay).  You can continue to use the Stabul 1 as a carrier. A safe substitute for the Standee and Low Starch is the Triple Crown Naturals Timothy Balance Cubes.  You may find that once his diet is under better control (no sugar highs and lows) that he is no longer totally insatiable.
2 - He will NOT starve or develop ulcers if he goes for a few hours without having something in his mouth as there will still be food moving through his intestines between meals.  Horses really can go for multiple hours without food and will be fine.  We were just discussing this at the ECIR NO Laminitis! Conference and 4 - 6 hours is not an unreasonable time frame. Even non-IR horses that live out 24/7 do not eat constantly.
3 - you may want to consider soaking hay ahead of time so you can feed it to him right away. Given the level of ESC+starch in both of these hays I would try to find an alternative if possible. The orchard grass is definitely not safe and even the grass hay is barely safe.

Remember that our philosophy is:

DIET - this is where the change needs to start to eliminate the cause of the laminitis issues
DIAGNOSIS - you know that Griffin is IR and his diet needs to change to address this.  If he is confirmed PPID as well he needs medication to control his ACTH
TRIM - as noted above the x-rays I'm guessing are post-trim are better but if we could see what his hooves and body condition are now we can help you with improvements
EXERCISE - not to be done until it's safe to do so - usually about 6 months after a laminitic event.




Prascend, possible false-positive tests, and re-testing

spiritwinddesertarabians@...
 

ECIR Newbie here, learning and forming a plan for moving forward.

Due to triple-digit heat, I have not traveled to retest my mare since 2020. Maybe a blessing!? Both tests in 2019 and 2020 were done in late June, and early July (in Idaho) at a very nice professional equine hospital 100+ miles away, in a metro area, and over interstate travel. Likely a stressful event for the mare. She is fairly calm about new experiences, but otherwise a complete homebody. She has not ever displayed PPID or IR symptoms that I can recall or confirm. PPID Testing, so far, was done as a problem-solving step in our attempt to resolve reproductive issues.

Now, in mid-August (and still in triple digits - ugh), I am concerned for possible Seasonal Rise impact on the test. Honestly, I'm not sure if the first two tests weren't influenced by Seasonal Rise or stress. I'm not saying she does not have PPID, but I don't know that I should feel confident in those first two tests given the big picture? I'm considering waiting until December/January to do the next ACTH test. And, given the previous dubious circumstances, I assume I should do the baseline and TRH draws.

In the meanwhile, I am hoping to do the following tests soon, using my local veterinarian and following the ECIR guidelines: Insulin/Glucose, Iron Overload, Lyme Disease, and possibly an overall Blood Chemistry Panel - not sure of details to request for this. I am also going to explore testing my hay. 
I would truly appreciate feedback on my thoughts and plan so far!!

Last but not least, Sariah, my lovely black mare, has mostly resigned herself (finally) to the daily syringing of the 1mg Prascend dissolved in a few drops of water, however...I would like to know, IF...we have indeed had a false-positive situation, am I doing her harm by continuing the Prascend? It seems I should leave her on it for the next 3-4 months until the next ACTH testing for obvious reasons, but, her well-being is foremost. 
Thoughts, guidance please!

Thanks Again,
Bev & Sariah (PPID?) from Idaho, 2021
CaseHistory@ECIR.groups.io | Files


Re: Conflicting information on peripheral loading

Anna Kulginova
 

On Mon, Aug 2, 2021 at 01:42 PM, Maxine McArthur wrote:
Hi Anna
Following up on Kirsten’s comment, I would add that I think it’s important to ask your horse about whatever ‘method’ you use. Not just her soundness level, but her stance, her demeanour, whatever her particular ‘happiness meter’ shows. Is she improving even if slowly, or is she seeming less comfortable as time passes? You know her best. If the horse says one thing and the human expert says the opposite, the human is wrong. 
--
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

 

Thank you.
That is really sound advice!
We have had a bumpy barefoot road.
My farrier got burnt out and was doing an increasingly bad job on my pony for the past year. 
After that we went barefoot with our barefoot trimmer in march and Diva has been really great, she was moving so well, seemed to be happy when the shoes first came off.
But she has been footy in her turn out on and off and then had her first laminitis episode. 
I just don't have enough data to decide if she was doing better as a whole since she was steadily OK when in shoes, improved a lot for a while when barefoot but then got laminitis.
Time heals all wound I guess, right now she is improving a tiny, tiny bit each day but I am kind of dreading the next and coming trims!
 
--
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: Conflicting information on peripheral loading

Anna Kulginova
 

On Mon, Aug 2, 2021 at 11:53 AM, Kirsten Rasmussen wrote:
Hi Anna,

You are going to have opposing viewpoints, unfortunately, and I suggest following the one that makes the most sense to you.  If something feels wrong to you, trust yourself.  Your laminitis trimmer/farrier might be an expert but his methods are not what we have seen here at ECIR to work long-term.  Frequent trims, removing walls from load-bearing and supporting from below with pads and boots is what we think will give your horse their best chance at recovery.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album
Thank you for this input. 
The more I am learning and reading the more I feel that removing walls from load bearing and taking care of the temporary discomfort that brings is what is going to help long term.
I would love to be able to do her trims myself since then I could get instant feedback from my horse on what is working and not and also be able to take a little at a time, but I am just not knowledgeable enough.
Right now the plan is to let the laminitis farrier trim her next Friday since they are already booked and then go back to my usual trimmer as soon as absolutely possible after that. 
It is not going to be easy to actually relay this to the laminitis farrier though, but I will have to persevere. Hopefully they say that Diva is looking OK enough for the usual trimmer to take over.

--
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: Conflicting information on peripheral loading

Anna Kulginova
 

On Sat, Jul 31, 2021 at 03:36 PM, Eleanor Kellon, VMD wrote:
NSC could never be higher than WSC.  The real issue though is the fractions that influence insulin.  That is ESC and starch.  WSC could be an issue in hind gut laminitis (not metabolic) and that's possible in your northern areas with something like ryegrass but even so it's never been proven to occur.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Thank you for this info! I will really make sure to get a hold of an ESC and starch analysis for the next haylage lot.
 --
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: Need to help a friend in crisis. How can I add a case history for her? Can a moderator please assist with this quesiton?

Sherry Morse
 

If the Equi-VM balances the hay I would suggest stopping the Equinety and P45 and replace both of those with the balancer that you know is correct for that hay rather than using things that may not be correct.  Again, it's been developed by Dr. Kellon she has never said it's not safe for an IR horse that I can recall. 




Re: Diva laminitis, help and hoof evaluation

Anna Kulginova
 

Thank you, these casts are supposed to be able to handle that the hoof expands so I really hope that this is not the case for her.
She has improved a bit since I wrote the post.
--
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: Diva laminitis, help and hoof evaluation

Anna Kulginova
 

I did a rim cast with cast material that you moisten and then it hardens, this is not the type of cast you can rasp though and it isn't rock hard but flexes a bit and lets the foot expand.
I did not use DIM or padding under the heel, that would probably have been a good idea in hind thought but it was complex enough to put the cast on for me as it was :).
She has improved since I wrote the last post and is OK walking straight and up- and downhill now. I found out that she gets lame and hobbles when the ground is on a sideways slant and that is still true but it was very much more pronounced before.

--
/Anna
Sweden, 2021

Diva Case History
Diva Photo Album


Re: surgery

Carolyn Marshall
 


Re: Inadequate sweating

Rita Chavez
 

Hi KC, we must have posted about sweating at the same time. Have you tried the JHerb? I’m just really curious to know if other horses with anhydrosis could benefit from it. It seems to be working on mine! 




--
Rita C. and Stetson (2001 Tennessee Walking Horse/Gelding, diagnosed IR)
Aiken, South Carolina USA
June 2021

https://ecir.groups.io/g/CaseHistory/album?id=265166 

https://ecir.groups.io/g/CaseHistory/files/Rita%20C.%20and%20Stetson


Re: Sweating!

Rita Chavez
 

Thanks, Sherry! I’m just SO thankful to this group. 




--
Rita C. and Stetson (2001 Tennessee Walking Horse/Gelding, diagnosed IR)
Aiken, South Carolina USA
June 2021

https://ecir.groups.io/g/CaseHistory/album?id=265166 

https://ecir.groups.io/g/CaseHistory/files/Rita%20C.%20and%20Stetson


Re: Need to help a friend in crisis. How can I add a case history for her? Can a moderator please assist with this quesiton?

Jessica Gunderson
 

We are weaning the thyro-L. We were at 3 scoops and now we are at 1 scoop. 
Mary and I use the same hay and she did have it balanced. Equi-VM is the match for this hay. I have it, but I am not feeding it because my vet was worried it may be triggering for Khan because of the kelp, alfalfa and corn.
--
Jessica and Khan
N.D., 2021
https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Khan

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