Date   

Re: IR / Seasonal Rise and Leptin/Insulin Retest

Eleanor Kellon, VMD
 

It's a good time to check if you want to see if you have a seasonal effect! - would also check ACTH. Fergus is only in his early teens so not likely to be having a huge seasonal rise but this comes up on the horses insidiously. As age advances, so does the magnitude of the  seasonal rise. With a horse that already has EMS, that eventually becomes an aggravating factor. Winter is not a good time to check your efforts. Cold can cause wide swings in insulin levels.If you want best case scenario, check in the Spring.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Albuterol dosage amount Studied done at University of Florida in 2012 compared oral, inhaled albuterol showed that oral administration is not therapeutic.

Eleanor Kellon, VMD
 

I don't know about that study and it doesn't appear to have been published but in my experience oral Albuterol does indeed work and it's also highly anabolic, causing obvious muscle bulking.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Need help with path forward for severe rotation

Kirsten Rasmussen
 

Hi Jessica,

Khan's insulin has come down even further so kudos to you for eliminating that factor.  It's clear to me that the pain she is in is related to trim issues and compounding errors made WRT trim throughout the spring/summer.  Her rads show this progression.  Usually we don't get to see the progression so clearly because most people don't have a series of regular radiographs to share like you do. 

In my opinion, what started out as a very manageable capsular rotation that could have been corrected early on with some basic trim adjustments seems to have snow-balled after shoes were nailed on without correcting the trim AND before she had time after her laminitis to grow in a new well-connected hoof capsule (which takes 6-9 months), then further worsened by standing her up in the NANRIC Ultimates on the tips of her coffin bone (which have her putting all her weight on a the very delicate tip of the coffin bone...this is where severe bone loss will start to happen), and now you are discussing tenotomies and euthanasia.  It's true that damaged circulation can be serious and affect outcomes--just google "fatal sinker syndrome" (which is NOT what you are dealing with).  Her circulation may be somewhat compromised right now but the best way to restore it is to get her into padded therapy boots so she can move around and have pressure and release on the sole and frog, which will stimulate circulation.  Then work on the trim corrections needed.  The pain won't go away immediately, but she might show signs of some relief and at least further damage will be stopped.  She is not anywhere near so far gone that she can't recover fully from this.  Tenotomies are an irreversible last resort and I don't think you should be considering it. 

Please ask Lavinia for markups once she is in boots and you have time to photograph her hooves as directed here:
https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help

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


Re: Equifeast

Eleanor Kellon, VMD
 

Yes, it is dangerous, and also illegal but unfortunately those laws are rarely enforced. 
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: ACTH - What is the target Number?

Eleanor Kellon, VMD
 

ACTH 51 isn't high for this time of year.  It sounds like his laminitis could have been of hind gut origin (did he have diarrhea?) but infections can also do this - Lyme, Potomac Horse Fever, probably others.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: ACTH - What is the target Number?

Cheryl Rowder
 

My horse had sudden onset of laminitis. He was totally fine on Thursday and diagnosis on Sunday. He is 11 with no signs of cushings. His ACTH was 51 - blood drawn the day he initially had pain from laminitis. The prior week he was unfortunately given a huge portion of alfalfa and then went to the field where they had placed a freshly cut round bale of coastal. I’m trying to figure out if it is possible that he may not have cushings. He is an OTTB, not heavy, no fat pads and it is the season when ACTH is normally higher. Could his ACTH have been high because of these factors. He is not insulin resistant or metabolic.

Sent from Dr Rowder’s iphone


--
Cheryl Rowder, PhD, RN
Georgetown, TX
8/19/2021


Re: ACTH - What is the target Number?

 

Hi Penny,
I know we told you earlier not to post a case history as your horse was neither IR nor PPID.  I would suggest that posting a case history at this point would be appropriate as your horse’s insulin levels are now above normal.  My guess is that you have the CH form all filled out and ready to post as we went through those details before.
--
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


 
 


Equifeast

 

What is with these claims.  This sounds dangerous to me especially if people really believe this
https://equifeast.net/a-new-approach-to-cushings-and.../
--
Jean and Amber (over the bridge)

Nikki (EC) and Buster (IR)

South Carolina

August 2004

NRCPlus 0412; CIR 0813, 1211; NAT 0612

https://ecir.groups.io/g/CaseHistory/files/Gloria%20and%20Amber


Re: Albuterol http://ufdc.ufl.edu/UFE0044187/00001

wacahootakj@...
 


--
Karen FL 2020


Re: Albuterol dosage amount Studied done at University of Florida in 2012 compared oral, inhaled albuterol showed that oral administration is not therapeutic.

wacahootakj@...
 


--
Karen FL 2020


Re: Albuterol dosage amount

wacahootakj@...
 


--
Karen FL 2020


IR / Seasonal Rise and Leptin/Insulin Retest

Jennifer Green
 

I was just reading through the various posts from others and noted the discussion of seasonal rise of insulin even for horses who are not PPID.  I had planned on retesting insulin and leptin levels in mid-September just to see if I’ve made any positive progress. Is this a bad time of year to retest? Would it be better to wait until winter or spring?  
--
J.Green 
MA, USA
2021
https://ecir.groups.io/g/CaseHistory/files/Fergus%20Case%20History
CaseHistory@ECIR.groups.io | Album


Re: Good news on insulin level but now what?? #file-notice

Alice
 

Thanks so much Sherry, Cass and Kirsten.....those  are all very helpful insights. Peanut and I will both benefit from your past experiences.  Thank you for being here and being willing to share!!

We will keep on the same path and watch for any changes. 

--
Alice A
March 2021, Custer, SD 
Case history: 
https://ecir.groups.io/g/CaseHistory/files/Alice%20and%20Peanut   .
Peanut's photo album: 
https://ecir.groups.io/g/CaseHistory/album?id=262374  .


Re: Albuterol dosage amount

~NeanPiggy~
 

Initially in 2018:  Dexium-SP 4mg 2x a day for 14 days. Albuterol was also given.  I would repeat dex occasionally after that.
Subsequent years I only give him Albuterol if he is having a bout, he starts to sound like he is a smoker. (Albuterol Sulfate Inhalation Solution, .083% 2.5mg/3mL)   Seems he needed it in the deeper snow, March and now again August for this year. 
I have a Flexineb.  Vials are Grey cap.  I found out they need to be replaced after about 100 uses.  They slow down. 



--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer/Mentor
Ridge NY 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 
https://ecir.groups.io/g/CaseHistory/album?id=78466


Source for Sam E

TERRI JENNINGS
 

Sam E from Pure Bulk has been sold out for awhile. Does anyone have a good source for Sam E in bulk?

Thanks
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Re: ACTH - What is the target Number?

Sherry Morse
 

Hi Penny,

A bit of housekeeping - could you please add the link to your case history to your signature?  https://ecir.groups.io/g/CaseHistory/files/Penny%20and%20burt

Without a more complete case history I'd say I'd be more concerned about his insulin number than his ACTH at this point.  If you have concerns based on outward signs I'd look at tightening up diet as a start but again, without an up to date case history it's hard to comment more than that.




Re: Invokana help

Carla Anderson Peters
 


Re: ACTH - What is the target Number?

 

Hi Penny,
Given the number of things we have to be concerned about these days, I think I would put this fairly low on the list.  There are symptoms you can watch for and address with diet such as being overweight, fat pockets, firm crest and footiness.  Otherwise, consider running these tests in late July every year to monitor the situation.  His insulin is more concerning than his ACTH in my mind.  If you keep following along here, as I believe you are, Penny, you’ll recognize the warning signs.  I keep all of my horses, IR or not, on the same diet because I believe it’s good for all of them.
--
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: ACTH - What is the target Number?

Penny Duthie
 

I was concerned about my boy possibly being ppid and had vet pull blood back in March. His atch baseline was 25.6 pg/ml insulin was 37.35 uIU/ml from Cornell. The vet said this was ok, now I’m questioning it again after reading here. Is there a reason I should be concerned?
--
Penny Duthie
Grant, Florida
Joined January 2020


Re: Need help with path forward for severe rotation

Jessica Gunderson
 

I thought it might be easier to just provide part of a consultation I received, as I do not want to misrepresent anyone's feedback.

"Reviewing the radiographs dated April 21 I conclude. LF reveals slight displacement of the L zone, shallow sole plus cup approx. 10 to 12 mm total and 10-to-12-degree PA. RF HL zone remarkably distended at the distal measurement, less sole depth than the left same amount of cup
May 4 21 Both L zones had remarkable increase in the distal displacement of the L zone. The RF had much less sole and a 15-degree PA the LF sole depth was questionable doe to oblique image the PA was approx. 10 to 12 degrees
June 28th RF HL zone extremely large ratio with large gas line within the laminar wedge, subsolar sepsis thin sole no cup. Remarkable osteoporosis which suggests limited weight bearing.
LF Extremely large HL zone with chronic gas line, about the same amount of sole and noticeable new but minimum new growth at the coronary band and 20-degree PA.
July 6th Rf progressive signs of uncompensated laminitis, resorption of the apex, signs of solar sepsis and further distended hoof capsule distortion. An attempt was made to perform a venogram unfortunately technique difficulties resulted in extensive perivascular contrast injection.
Aug 5 RF Both feet had the heels trimmed to 10-to-12-degree capsule and put in my ultimate. Both coffin bones reveal extensive resorption of the apex. The mechanical benefits of the ultimate can optimize reperfusion at the onset or shortly after and help avoid the cumulative ill effects that invariably haunt the majority of significant bouts of acute laminitis. Applying the ultimate with this degree of vascular damage, the subsequent large PA and destructive soft tissue parameters has limited mechanical benefits as the PA prevents the load from shifting from apex to heel as designed. However, there is some level of mechanics even at this very late stage of the syndrome. Soft Rides are nothing more than cushion boots and have very limited if any mechanical benefits that can adequately reduce the tension on the DDFT as it continues to tear the bone away from its failed antagonist and the domino effect picks up speed. To have any hope of saving Khan’s life and reducing the painful response we must quickly eliminate the force of the DDFT and reposition the load zone of P3 to a zero PA with a minimum of 20 mm of heel mass. The derotation shoeing, decompression trim and shoe placement are technique sensitive as specific goals are to be obtained followed immediately by a DDF tenotomy. The bone damage is permeant as well as a fair amount of the vascular supply but there may be a reasonable chance to enhance healing. The prognosis is directly related to the speed and quality of reperfusion to vital growth centers and the bone. Complications are to be expected and at best a protracted treatment period of 8 to 12 months lies ahead. The bone sepsis will trigger abscesses and potential sequestrum that require immediate attention and continuous monitoring. The RF will be the toughest to deal with as it is the steeper profile foot of the two feet. I will mark the images as I would want them to appear following the trim shoe and tenotomy. I am glad to help walk the farrier and surgeon through my protocol using What’s App consultation if you decide to go forward."

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