Date   

Re: Update on Flirt

Eleanor Kellon, VMD
 

Most recent trim is definitely an improvement. When you post hoof photos, please be sure to tape the hair up away from the coronary band - or just clip it off.  We need sole shots.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Supplement Changes/Sore?

Eleanor Kellon, VMD
 

I would ask for the Lyme multiplex from Cornell.  The odds of having Anaplasma but not Lyme are pretty long.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Supplement Changes/Sore?

Eleanor Kellon, VMD
 

Yes, trace minerals on the hays and you need to ask if it was NIR analysis. If so, repeat the sugar and starch with wet chemistry. Also add nitrates on the small squares.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Euthanasia within 24 hours

Candice Piraino
 

HI Amy,

I am so sorry to hear that you have had to make this tough call, but as their trusted owners, sometimes making a tough call is best. My heart goes out to you!

Honestly, if she were my horse, and I have tried everything under the sun to save her, I would let her have whatever she wanted for her last final day on this Earth. I am not a vet and unsure what Dr. Kellon would say, but as a fellow horse owner, if you have already made the appointment and it is in the horse's best interest, then yes by all means give her some turnout time. 
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Re: Supplement Changes/Sore?

Kathleen Rauchle
 

I thought of another question.  When Echo was diagnosed with Lymes.  The Vet did a quick at farm test.  When I asked her to run numbers again (the ones from March) She said her notes said Ana plasma not Lyme disease.  Which was also confusing because she had Lyme disease symptoms not  Ana plasma symptoms.  I didn't do the Ana Plasma test because I thought it was Lymes and that test was another $100...alone.  Should I still do Lyme titer again anyway?

Thank you,
--
Kathleen R
Central WI 
2020

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo

https://ecir.groups.io/g/CaseHistory/album?id=252630

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo/KATHLEEN_RAUCHLE_top_field_1st_crop_rounds_Mixed_grass_hay_2021-08-27_395849_1264%20%282%29.pdf

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo/KATHLEEN_RAUCHLE_2021_2nd_crop_sm.sq.grass_Mixed_grass_hay_2021-08-27_395848_1263%20%282%29.pdf


Re: Supplement Changes/Sore?

Kathleen Rauchle
 

Thank you Dr. Kellon for the response. 

Are my hay analysis incomplete because they do not have the mineral breakdown?  I know I can send in another analysis to Dairyland labs to get the trace minerals.  (I should have just did that right away). 

We have been weighing for the most part.  She gets the small square hay in 3/4 inches hole bags mixed with the large bale hay and then get the difference in either a 1 3/4 net or the porta grazer of just the round bale hay.  We have been giving a bit extra because I am afraid of her sitting too long without hay.  Even with the small hole net she still eats through it too fast. (of course she likes the small square hay more that is why I started to mix it)  She has been having left over round bale hay at night the last few days. Back in the early spring when she was restricted she started to eat the other horse's manure, worried she will start to do that again.

She has been in dry lot 100% since August(It was a short time we tried grass in August about 2 weeks).  Otherwise before then she was also only in the dry lot all spring.  Some grass started to take off in the early spring in the dry lot and we had to make it smaller, because one night may her slightly sore again. I will not lie she is still reaching under fence to eat what she can, its not much but could it make a difference enough?  I have been using a natural weed killer spray (vinegar) to keep it back but has not been possible with the constant rain this lately.

I was thinking the toe could come back a bit more also.  Was a bit disappointed in my last Cody James rasp, feels like it takes more effort to use than last one.  I trim every 2 weeks.
--
Kathleen R
Central WI 
2020

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo

https://ecir.groups.io/g/CaseHistory/album?id=252630

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo/KATHLEEN_RAUCHLE_top_field_1st_crop_rounds_Mixed_grass_hay_2021-08-27_395849_1264%20%282%29.pdf

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo/KATHLEEN_RAUCHLE_2021_2nd_crop_sm.sq.grass_Mixed_grass_hay_2021-08-27_395848_1263%20%282%29.pdf


Re: metformin dosage

Maxine McArthur
 

Hi Vicky
If we calculate 1000lbs to be 500kg, your vet is suggesting exactly the dose that ECIR recommends. 

30mg per kg of 500kg bodyweight = 15,000mg.
30 x 500ng tablets = 15,000mg. 

Twice daily.

 
--
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

 


Re: Update on Flirt

Roger Benson
 

Any reaction to most recent trim by new farrier compared to previous trim 10 days before?  Some new photos are posted in our album.
--
Roger and Flirt
January 2018  Atwater, Minnesota
Flirts Case History
Flirt's Photos


metformin dosage

vicky monen
 

Hi,

Can I ask what is the dosage for metformin for a 1000lb horse?

My vet gave me the following prescription and it sounds like alot to me.

my vet  "He’ll get 30 (500mg) tablets twice daily for 30 days. I put in 6 refills"

Under the metformin info under the files here, it suggests 
"The Metformin dose in horses is 30 mg/kg, twice daily, for a total of 60 mg/kg/day. After one week, retest insulin and glucose."

I just got his newest labs back and his Insulin is steadily increasing.  It is now at

ACTH Baseline Equine 8.53 pg/mL 2 - 35
Insulin Baseline Equine 91.26 uIU/ml 10 - 40

I obviously  have to add the metformin as his diet is very tight.  No grass, weighed low starch and sugar hay in ultra slow feed nets, rationed out 4 feedings through the day.  He has lost weight and definitely looks thinner than ever.  Hay is at 4.7% for the past few months now new hay is 5.2%. 

Prascend is at 2 mg per day at 1 xday.

I will add the metformin in hopes that it will help with the insulin.  Is this something he will need indefinitely, or until the insulin comes back down? He is super sensitive with any changes in diet, hay, medications, supplements, is there anything else to add with the metformin other than milk of magnesia? How much of milk of magnesia does he need?  He is also currently on omeprozole due to GI upset and diarrhea lately. 

Currently he shows no outward signs or symptoms that his pracend is not sufficient. 

Thank you for any suggestions. 
--
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: Supplement Changes/Sore?

Eleanor Kellon, VMD
 

Hi Kathleen,

She is getting more than enough magnesium from her hays alone.  The Thyro-L and cinnamon don't have anything to do with this either. Let's take a deeper look.

D:  Diagnosis. Insulins have been clearly abnormal and not too
far from the acute laminitis zone.  She's young to have PPID but it is possible the normal seasonal ACTH rise is pushing her over the edge into laminitis. This is also a common time of year for Lyme to rear its head and you know she has it. Check titers.

D:  Diet.  There's no way to tell which supplement is best for her because your hay analyses are incomplete and do not contain trace minerals.  Are you weighing all hay or just estimating what she eats? Both hays have very low sulfur which impacts sulfur amino acid levels and hoof quality. The squares have a high end sugar/starch which means individual bales in the load could be too high. There is also a high protein level which together with the low sulfur is a nitrate risk and you should get the nitrate level tested. Have you stuck to dry lot since August?

T:Trim: Post trim photos looked pretty good but I think I would be more aggressive about backing up the toes. The March films were much improved but toes still too long.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Rehab plan and med/bloodwork questions

Kirsten Rasmussen
 

Hi again Ellen,

I'm glad her pain has come down.  We all know how distressing that is.

Timeline with diet changes is 72 hrs, tops, if this is insulin-related.  A 4 year old Thoroughbred is very unlikely to have high insulin though.  Usually we start seeing metabolic problems after the age of 5 (when they are no longer growing) and that early it normally shows up in the genetically prone breeds, such as ponies and Morgans.

Your vet might think it's crazy to test ACTH in a 4 year old, and we would agree.  It's extremely unlikely she has PPID.  But you can still request the test if you think you are dealing with a metabolic problem. 

Mostly likely this is due to trim issues that probably go back as far as her racing career.  Did she have the P3 bone remodeling when you got her?  Yes, Bute would have slowed down abscess mobilization, if she has any.  Jiaogulan will speed it up and that can cause worse hoof pain until the abscess surfaces.  Bruising/pedal osteitis flare up is also a reasonable explanation for the pain in 1 hoof, but does not mean laminitis is/was present, nor does capsular rotation due to long toes.  I know you're just trying to cover all the possibilities, so it's fine to do diagnostic bloodwork to rule out a metabolic problem.

Once you have your bloodwork results, let us know.  If she is not IR or PPID, you can still get feedback in our sub-group ECHoof, which is where trim problems in non-metabolic horses are discussed. 
  
--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album


Re: Sending Pilgrim’s PPID bloodwork after 1 month

Kirsten Rasmussen
 

Hi Suzanne,

It sounds like a lot has happened since 2019 so it would be great if you could update your Case History for us.

After 3 weeks on the prescribed dose we recommend rechecking ACTH.  If Pilgrim has a history of high insulin, I would have insulin and glucose checked too.  The best lab is the to use is the one you usually use, so you can compare new results with previous results.  So pick a lab and stick with it.  One ECIR member had her last blood pull stopped at the border on its way to Cornell recently for an unknown reason and the sample was spoiled.  U Guelph is fine and is what we recommend for Canadians.  I'm not sure what you mean by U Guelph "not being in depth" last time but they will provide whatever your vet requests.

If his current dose is adequate you would maintain it until next July-Aug, when you'd retest to see if it's still adequate.

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


Re: New member joined 2021

Jane Hester
 

Oops! I’m not so bright! Working on setting up case history but stuck😬. I’ll look at it more tonight as definitely want to do it.
--
Jane Hester in NC 2021


Re: New member joined 2021

Jane Hester
 


--
Jane Hester in NC 2021


Re: Euthanasia within 24 hours

Jennifer Murphy
 

So sorry to hear you're saying goodbye, Amy.  Even when we know it's the right thing to do, it's still hard. 
--
Jennifer in NH
2020

CH - https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Flea

Photo album - https://ecir.groups.io/g/CaseHistory/album?id=251041&p=Name,,,20,1,0,0


Supplement Changes/Sore?

Kathleen Rauchle
 

Hello Everyone,

I have not asked any questions for sometime, but I just updated Echo's case history and added her latest hoof pics and also current hay analysis's. We have been feeding Equi-Shine Supplement for her all this time but I have been feeling it is not enough.  Her cresty neck has not changed all year and she still has fat pads on her rump and behind shoulders.  She has been getting hay only since August (tried short turnout did not work).  In Sept I gradually was switching her from Equi-shine to Mad Barn Amino Trace, while gradually ending the Heiro supplement.  She is currently on about 20 lbs of hay mixed between the small squares and large rounds.  

After 5 days of being at full dose of Amino Trace and no Heiro.  She suddenly did not want it.  She would eat around the Amino Trace.  I added some Equi-shine back and she liked it.  So one day she did not get her full 1/2 dose of Thyro-L.  I got her to eat more but not all. So next day I dropped the Amino Trace to 1/4  2 oz amount and Equi-shine back to 1/2 about 2 oz. amount.  She ate all her food but she was suddenly sore in her front hooves yesterday 10/11/21 along with digital pulse in all 4 hooves which we had a slight digital pulse when sitting idle too long but never in all four.  

Up until about 2 weeks ago we started riding 4-5 times a week at 30 intervals walk and trot.  (reason for not last 2 weeks is hurt back falling off.)

What could have caused this?

Could it be the lack of supplement going in? Now that the Heiro is done is she not getting enough Mag Oxide?

Could it be the one day not having the correct Thyro-L dose?

Our could it be the sudden lack of exercise the last 2 weeks?

I am at a loss and feeling really defeated.  We have been doing good for a while now and felt we were on track.  She walks and trots just fine on soft ground.

My real question is.  Would I be better off just keeping her on the Equi-shine supplement, adding Mag Oxide, and start  adding in the Chasteberry and Jaiolugan right away?

I am afraid of trying the Amino Trace again in case she does not like it.  I use Teff pellets also just to mask taste of all the powders she is getting.

Any help is greatly appreciated.
--
Kathleen R
Central WI 
2020

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo

https://ecir.groups.io/g/CaseHistory/album?id=252630

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo/KATHLEEN_RAUCHLE_top_field_1st_crop_rounds_Mixed_grass_hay_2021-08-27_395849_1264%20%282%29.pdf

https://ecir.groups.io/g/CaseHistory/files/Kathleen%20and%20Echo/KATHLEEN_RAUCHLE_2021_2nd_crop_sm.sq.grass_Mixed_grass_hay_2021-08-27_395848_1263%20%282%29.pdf


Re: New member joined 2021

Jane Hester
 

Thank you! I feel a little better this morning after reading your reply—I was reading so much about PPID yesterday that I was overthinking!
--
Jane Hester in NC 2021


Euthanasia within 24 hours

amyscrivanich
 

I am giving Mater her “final gift” tomorrow (24 hours from right now).   This is an odd request, but I want her to have some pasture and treats before she goes.   Would be bad to give her turnout today or at least tonight?   Euthanasia is planned for 11 am

 

--
Amy Scrivanich
Charlotte, NC
Nov 2004 (my original PPID horse passed in 2015)
https://ecir.groups.io/g/CaseHistory/files/Amy%20and%20Mater%20the%20mini

https://ecir.groups.io/g/CaseHistory/album?id=264439

 


Re: Chronic Laminitis 8yo rp x welsh

Candice Piraino
 

Hi Molly,

Welcome to the group! 

First please post a case history so we can get a better picture to provide more customized advice for you and Deacon. Also, if you can post the lab results that would be best as well. Many times PPID/EMS + horses are misdiagnosed, so we can help you with that as well. We also would love to see the rads, so please post those in the album. Let us know if you have any difficulties. 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine (look under the Hay Balancing file if you want professional help balancing). If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you.

--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Re: Domino and Clover ‘s journey so far!

Kirsten Rasmussen
 

Don't forget to add the hyperlink to your albums to your group signature!  You can copy and paste the hyperlinks in to your signature here:
https://ecir.groups.io/g/main/editsub
Now that you have your photo albums created, please add the hyperlinks for them to your signature. 
Clover: https://ecir.groups.io/g/CaseHistory/album?id=268990
Domino: https://ecir.groups.io/g/CaseHistory/album?id=268987

If you have completed a Case History form for each horse, they can be uploaded now.  In the "Files" tab of the Case History subgroup ( https://ecir.groups.io/g/CaseHistory/files?p=updated,,,20,2,0,0 ), click on Files in the menu on the left, then create a new folder called "Mikey and Clover", then upload your .pdf Case History for Clover there.  Repeat for Domino.   This is where you will upload any other documents that are in pdf form, like hay analyses and bloodwork.  Keep the original document on your computer as a word or pages file so you can update it as needed.  Then add the hyperlinks to these 2 new folders to your signature. 

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

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