Date   

Re: Update on Flirt

Lavinia Fiscaletti
 

Hi Roger,

Dealing with the wedge itself is fairly easy - you just cut it off. Inflammation is not causing the toes to keep getting longer -  it's the trim not tsetting the breakover in the correct location while removing everything that is interfering with that goal..

The high insulin level is what is driving the laminitis and allowing Flirt to graze is part of that. His diet needs to remain tight at all times, regardless of what level his insulin comes back at. When the levels come back good, celebrate that with a High Five! but don't let your guard down. The Invokana doesn't "cure" his EMS/IR, it only helps manage the insulin levels on top of the correct diet - it can't overcome excessive sugars in his daily rations.

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


Re: Update on Flirt

Roger Benson
 

I just received a text from my vet.  Test results were: Glucose normal, TGL normal, but insulin 133 when last test was 13.2.   ACTH not yet available.  He will get me the the exact umbers in a day or two.  Not sure where the higher insulin came from.  We had been on a downward trend for 8 months.
Flirt is on 75 mg per day of Invokana  Should I bump it up?  He is also on .5 mg of prescend.  Waiting for ACTH NUMBER.

I had a conversation with my current vet whom I sent the latest rads to.  He was extremely discouraged.  He called the laminar wedge in the left foot a “laminitis explosion.”  He was unsure how to deal with that wedge.   He thought inflammation within the hoof capsule was the problem and that he did not think external trimming changes would help.   He was talking end of life.  He will be here for the last time on Saturday.

I am still searching for a farrier experienced in dealing with founder.  I have contacted a big equine clinic in Minneapolis but they want eyes on before recommending a farrier..   Can anyone recommend a farrier in central MN?

Very discouraged, but committed to helping Flirt.

I will post a video of Flirt walking tomorrow.  He does better on a grass surface compared to a hard surface.
--
Roger and Flirt
January 2018  Atwater, Minnesota
Flirts Case History
Flirt's Photos


Re: Terrie and Dixie Prascend dose advice needed

terrieheining
 

Thank you Sherry. I thought it needed to be within the "normal?" range and we were too low. Fresh X-rays delayed till next week as vet unavailable & hay posted off yesterday to be tested.

--
Terrie H in Australia 2021
Case history: https://ecir.groups.io/g/CaseHistory/files/Terrie%20and%20Dixie 

https://ecir.groups.io/g/CaseHistory/album?id=268416










Re: Magnesium

Thurstonjs@...
 

Thx, Lorna!

The hay I'm feeding has .21% magnesium, TC timothy Balance cubes has .30%. I also feed California Trace and TC Golden flax, neither of these has magnesium.

So for example, if I'm feeding 10 pounds of the hay, would that be 10x.21%? Same for the TC timothy Balance cubes?

I updated my case history the other evening and lost the entire document. I need to recreate it, fortunately I kept a pdf copy.
--

Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose

https://ecir.groups.io/g/CaseHistory/album?id=268230


Re: Lavinia mark up requested on sole pictures please

Qhgirl
 

Hi Maxine,
I have seen those pictures. I know the parts of the outer wall, inner wall waterline, white line sole. Those are great pictures but most of them have a lot of wall. What I read in the trim link is to go into or through the white line. That is a broad statement and looking at those pics most do not go near the white line. This is where my questions lie. 
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


Re: Magnesium

Lorna Cane
 

Hi Jackie,

I can't tell from your Case History how much magnesium you need to feed, but 56% means that 56% of the amount of the magnesium oxide product , is actual magnesium.This is fairly standard.
If you are feeding 30g by weight of the mag.ox. product,for example, only 56% of that 30g is magnesium, not the full 30g.
It will depend on how much magnesium is in the hay and other items being fed to determine how much magnesium you need to add.
I usually need to feed at least 10g of magnesium, for my situation.It may be different for you.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Magnesium

Thurstonjs@...
 

Hi all,

I'm trying to figure out how much magnesium oxide to feed my IR/PPID horse. I purchased some from California Trace, it says 56,% on the front? Based on what she is currently being fed and her hay, she is getting .51%.

Thank you in advance.
--
Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose

https://ecir.groups.io/g/CaseHistory/album?id=268230


Re: Need advice on blood testing rechecks/protocol

Sherry Morse
 

Hi Lisa,

Not sure what you mean by a 'bit early' as the peak for the seasonal rise is pretty much this week (autumnal equinox). For horses that are PPID yes we like to see them within the 'normal' range or not much over it.  If you take a look at the Liphook chart you'll see a good representation of where a normal horse should be for each week of the year (https://liphookequinehospital.co.uk/wp-content/uploads/Seasonal-Changes-in-ACTH-Secretion2.pdf). 

If you raise both of them up to 2mg now you'd want to test in early spring to see if that's enough to keep their ACTH in the "normal" range.  Given that they were both in the 100s at the end of July when most normal horses might be in the 30s I would not expect to be dropping them back down in the spring.





Re: Lavinia mark up requested on sole pictures please

Maxine McArthur
 

Janet, have you checked the photos section on this group? There are some photos of trims including backing toe. https://ecir.groups.io/g/main/photos

The other thing that may help you while you are waiting for Lavinia’s markups is to check out her comments to other members—most of them will show how to back up a long toe. 
--
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

 


Saraphina new hoof photos,help Lavinia

CYNDI CARLSON
 

Hi,
 Philip is coming Wednesday to trim Saraphina.He would like your help if possible Lavinia or should I say your guidance. She is moving around better all the time.  still sore but she is on her feet more than I see her lying down.She has no problem picking her feet up for me but does not hold it up for long so pics can still be difficult. The white on her soles is Artimud,really hard to get it off for pics and I do not want to use a hoof pick so there’s some white Artimud on there. I would appreciate any input.Thank you!
--
Cyndi Carlson in Colorado 2021


Re: Setback: need advice on X-rays

Sherry Morse
 

Hi Joan,

The only way to know if the swimming is helping his insulin levels would be if you knew what it was at some point before you added swimming in and then checking it after swimming has been a regular part of his routine and absolutely nothing else in his management was changed.  Swimming daily (as with any exercise on a regular basis) can probably help lower insulin but a session every other week probably isn't going to necessarily do a whole lot.  What will help is getting an idea of what his current insulin, glucose and ACTH levels are, making sure his diet tightly controlled and getting his trim as optimal as possible.




Re: AVRIO Pharmacy - Change in capsules

Joy V
 

It's ok, I sent an email to see if I can get the correct size adaptor.  Thank you though Laura.

Just want to confirm, the molasses flavoring is not actually molasses, correct?  

Thank you again,
Joy


--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: AVRIO Pharmacy - Change in capsules

Laura Risley
 

I’m sorry Joy.  Unfortunately there are some issues with the phones, it’s not just us, but all around.  I’ll call you soon here and if I can’t get through I’ll call with my cell.


On Sep 27, 2021, at 12:23 PM, Joy V <jvenham@...> wrote:

Aaaand  now I can't get a call to go through to Avrio.  One ring and then nothing or a straight busy signal.  This is definitely not a great first impression all around.



--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Re: Setback: need advice on X-rays

jandchornby@...
 

Thanks everybody. My vet is as sure as he can be that there is no active laminitis and puts the soreness down to his running around without boots. He went out sound and came in dog lame that day. Is it feasible that the long toes and  leverage, combined with lack of support, could have caused rotation on the right and l sinking on the left??  There have been no pulses.  He swam on 5 consecutive days last week up to 500m so wouldn't that strenuous exercise lower insulin levels? It doesn't seem to have affected his comfort levels. He has been on metformin previously when he's had flare ups but again my vet thinks that swimming is the best way to keep insulin levels low. I'll speak to him about blood tests.

Thanks Lavinia, yes please markups would be very useful. I can add pics of his hind feet which have never been shod and never had problems of any sort with.

Joan Hornby
UK North West
December 2020
https://ecir.groups.io/g/CaseHistory/album?id=268474 


Re: AVRIO Pharmacy - Change in capsules

Joy V
 

Aaaand  now I can't get a call to go through to Avrio.  One ring and then nothing or a straight busy signal.  This is definitely not a great first impression all around.



--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: AVRIO Pharmacy - Change in capsules

Joy V
 

Thanks for your reply Laura.  I'm just nervous to change *anything* because it's taken almost 2 years to get my horse at his current condition.  

Also, the adaptor sent for the bottle to syringe the dose out is too big for the bottle.  There's no way it will fit.  This is frustrating.


--
Joy and Willie (EC/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526


Re: Setback: need advice on X-rays

Lavinia Fiscaletti
 

Hi Joan,

Thanks for creating a photo album and adding Ranger's radiographs.

There was no bony column rotation back in Dec 2020 but there was some sinking. The HPAs were broken back, significantly on the RF. The feet did show capsular rotation, which is when the hoof capsule pulls away from its tight attachment to the coffin bone. This can be due just from toes that are being let too far out ahead of where they should be and/or from laminitis. As there is a ski tip on the LF, it's likely the toes have been too long horizontally for some time. Need to fix the trim to address this, which means taking the toes back so the breakover is set where the bony column needs it to be. Sole s were thin and heels were underrun..

The latest rads from 9-2021 showed that the HPA on the RF had improved and that the sole depth on both feet was slightly better. Heels were still underrun.The toes, however, had gotten longer and further ahead of where they needed to be vs. the  6-2021 rads, so were putting leverage on the hoof capsules. Sinking appears to have increased as well. It's possible the post-trim soreness was due to his soles and/or heels being trimmed more than they should have been. Running in the mud could have strained tendons/ligaments so added to his discomfort. As Kirsten mentioned, this is the time of year when an EMS/Ir horse can get into trouble with rising ACTH/insulin numbers due to the seasonal rise effect - in essence, he may be the victim of the "perfect storm" of assaults.

Because the there wan no trim done, his toes are definitely still too far out ahead of where they need to be so agree with you that getting the farrier out to get the trim optimized is a good idea. would suggest pulling the shoes and going back to the padded boots as shoes aren't going to solve this, nor will they solve any possible elevated insulin/ACTH which could be the driving factor(s) underlying his bouts of laminitis. Only way to know if these are a problem is to have blood work run now. Agree with you that getting the farrier out to get the trim optimized is a good idea.

If you want, I can mark-up the rads to help guide the trimming. Would be helpful to see a full set of hoof photos of the hind feet as well:

https://ecir.groups.io/g/main/wiki/1472

GreenGuard muzzles make us feel better about putting a muzzle on our horses but they do little to prevent the horse from consuming as much grass as it wants to - too may large holes that they can easily get grass thru, esp. if the grass is shorter. Need a sealed muzzle to be effective.

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


Re: AVRIO Pharmacy - Change in capsules

Laura Risley
 

Hi Joy!

I'm sorry that I did not update earlier on the change in oil-base and that you weren't told when you placed your order.  I want to reassure you, and the others, that we are indeed using an oil base - MCT (medium-chain trigylceride) oil.  it is the preferred oil here.  The suspension will be white rather than cloudy.  If the particles you are seeing are darkish in color, that is actually the powdered molasses flavoring.  We have ordered an oil-based liquid flavor for the future that will mix better. I took a look at a couple orders in lab and they are mixing well - except for the flavoring settling out - the liquid does appear milky and thinner.   

I hope this helps!  Please let me know if you have other questions!

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Dr Kellon Micro Current

Qhgirl
 

Hello Dr Kellon, 
would it be beneficial to use micro current on Chicy's legs?  I know they must be tired and her rear legs are stocking up at times. I have a small portable machine with leg wraps for horses. Thank you. 
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


Re: Uploaded new x-rays and hoof pics

Lavinia Fiscaletti
 

Hi Marcy,

Good that she does have access to some turnout.

Although it appears as if the heels need to move back more, lowering them was not correct as that resulted in the palmer angle being lowered - which it didn't need as the bony column was well-aligned in the rads. Now, the HPA will be somewhat broken back.

The toes are what needed to be brought back, which they still need. I tend to agree with the farrier who thought that groove is likely an injury due to its shape; it would have taken a large abscess to create a crack that long and you wouldn't have missed it when it drained.

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

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