Date   

Re: Is it safe for Khan try prascend/pergolide (Dr. Kellon please weigh-in thank you)

Jessica Gunderson
 

Thank you Dr. Kellon. When I was working with Rood and Riddle they mentioned they were having three year olds come in with PPID so I was unsure of how age driven it is still thought to be.

The appliances were taken off August 25th. I will post new pictures and new X-rays which don’t look great for a normal horse but considering where Khan was in August I was on cloud nine, now this. Including the link as well here if that is of any help.  https://keystone.asteris.com/#/share/KINGSLYEQ/share-request/74541822-1121-0100-2218-ffffff211110/share-recipient/21ffdac5-0100-7754-2218-ffffff211110 No signs of new abscesses that I can discern, my farrier did discover one on Tuesday. He thought it was old but was never able to drain. She has heat and pulses in 3 legs, it was all 4 for awhile, which is terrifying because she has never had anything in the backs before. Temperature is 98.7 so not elevated. 
--
Jessica and Khan
N.D., 2021
https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Khan
CaseHistory@ECIR.groups.io | AlbumCaseHistory@ECIR.groups.io | Album


Re: Hay fertilized with cow manure vs commercial fertilizers....

Eleanor Kellon, VMD
 

What do you mean by unbalancable?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Hay fertilized with cow manure vs commercial fertilizers....

Nancy C
 

I balance for Trisha. Just in quick to add: the Ca;Phos;Mg is .29;.50;.20.

I have found in the literature where "manure" can be high in phos. https://ag.umass.edu/crops-dairy-livestock-equine/fact-sheets/manure-application-on-hay-fields
When manure is used as the sole source of nitrogen for a grass hay crop, other nutrient levels in the soil, specifically phosphorous and potassium may increase over time.

But, if I understand correctly, her grower is also applying a commercial fertilizer with no phos, however rate of application is unknown.

Trisha's two girls are IR and PPID. Let me know if we need to move this to Horsekeeping.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021

Recordings of the 2021 NO Laminitis! Conference released to attendees 09.03.21.
Veterinary Professional CE certification hours submitted to AAVSB Race 09.08.21
2021 NO Laminitis! Conference Video Recordings available to new subscribers 11.09.21
  www.nolaminitis.org



Re: Feeding cubes or pellets

Angie
 

Thank you Dawn for your suggestions and insight. I am trying to find the Timothy Balance Cubes now.  The local store can't get them so I'm looking at a 2 hour drive to another feed store. Cost will be about $11/day.  In the meantime, he is on timothy pellets along with his salt, E, and flax. I just need to dial in a good balanced diet for the next few months. I appreciate your thoughts on this.  It helps to hear from someone from "outside" my emotional drama.
--
Angie
October 2020, Mendocino County, CA

Case History: https://ecir.groups.io/g/CaseHistory/files/Angie%20and%20Jacob
Jacob's Photo Album:

 


Hay fertilized with cow manure vs commercial fertilizers....

Trisha DePietro
 

Hi everyone. I just wanted to share a little dilemma I just ran into with the hay that i bought this year. It is a second cut hay with perfect sugar and starch levels....BUT it is unbalanceable because of the Ca:P ratio...I had no idea hay could be unbalanceable....So just wondering if others have found this in their hay that was fertilized with cow manure?  


--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Is it safe for Khan try prascend/pergolide (Dr. Kellon please weigh-in thank you)

Eleanor Kellon, VMD
 

My reply just disappeared so trying again.

 

Your vet may be thinking of dexamethasone suppression rather than the TRH stimulation. TRH stim is safe and you can do it now.

 

We're very aware ACTH doesn't always test abnormal. The founder of this group had a mare like that. However, it's highly unlikely at her age and even if ACTH isn't up the mechanism is still high insulins and hers haven't been high enough for acute laminitis, although you should recheck.

 

Her trim was in such bad shape it's hard to picture that being corrected in only 3 months. Is she out of the appliances? Can you post photos? If she hasn't drained abscesses that would be my first suspicion. Pumping her full of bute every time you see a pain flare will prevent those collections from draining.


--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Is it safe for Khan try prascend/pergolide (Dr. Kellon please weigh-in thank you)

Jessica Gunderson
 

Thank you Martha for your quick response. You are correct the case history is out of date she has been off of bute and on phyto quench since the end of August. She is on bute again since Friday night so I stopped the phyto quench. Vet wants 3 days on 4 grams/day and then to taper off if pulses and heat are gone. I used bute for two other instances just one 2 gram dose/day during the last few months to help with a trim and x-rays, but otherwise she has been NSAID free since end of August. 
--
Jessica and Khan
N.D., 2021
https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Khan
CaseHistory@ECIR.groups.io | AlbumCaseHistory@ECIR.groups.io | Album


Re: TC Timothy Balance Cubes

 

Hi Laura,
Timothy balance cubes are hay and treated as such as long as they are a part of the normal diet, which is what we try to have the measurements reflect as accurately as possible.
--
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: Is it safe for Khan try prascend/pergolide (Dr. Kellon please weigh-in thank you)

 

Hi Jessica,
I’m sure Dr. Kellon will weigh in as needed.  We often suggest a pergolide trial to see if that helps to solve problems such as you describe.  Yes, there are PPID horses which don’t show an elevated ACTH - ACTH is not the only hormone involved but it’s one that can be measured.  I’ve never read of the TRH stim test being dangerous - we certainly recommend it here.  The best time to do that is outside of the fall rise because we don’t have normals to which to compare the rise values.  If you put her on pergolide and then decide to do the stim test, you will need to remove the pergolide three weeks in advance of testing for the same reason - no testing normals.  Given her age, I would think her being PPID would be unlikely, although not impossible.  Not sure why the first test you did was so elevated, if it was because there are no units to compare to.

Her case history is a few months out of date so you may have made changes that aren’t reflected there.  I would not have her on NSAIDs and omeprazole.  That seems to be a dangerous combination in terms of gut health.  We don’t even recommend the long term use of bute.  Devil’s Claw is often a satisfactory substitute and doesn’t cause the same issues.
--
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


 
 


TC Timothy Balance Cubes

Laura Sager
 

When testing blood for a non-fasting insulin/glucose,...are TC timothy Balance Cubes considered hay and ok to be eating, or grain and should not be fed before blood work?
--
Laura L, NY 2021


TC Timothy Balance Cubes

Laura Sager
 

When testing blood for a non-fasting insulin/glucose,...are TC timothy Balance Cubes considered hay and ok to be eating, or grain and should not be fed before blood work?
--
Laura L, NY 2021


Re: Possible Supplement to Stabilize Insulin???

 

Hi Suzanne,
There is no supplement capable of lowering insulin.  Management is what takes care of that and it seems you are doing well there.  Metformin is prescribed by your vet to decrease insulin but it should be saved for dangerously high insulin levels as it can lose its effectiveness over time.  You may have also read about invokana, which is the next drug to try after metformin.  Insulin wise offers a refund if it doesn’t perform as expected.
--
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


 
 


Is it safe for Khan try prascend/pergolide (Dr. Kellon please weigh-in thank you)

Jessica Gunderson
 

Hello, Is it safe to give a non-PPID horse prascend? While Khan x-rays are better she never stopped being sore and on Friday she went into another acute laminitis attack.  Given we are 7 months in and the EMS protocols don't seem to be helping her I was wondering if we could try prascend to see if it helps? I was listening to Dr. Debra Taylor on the humble hoof podcast talk about undiagnosable PPID and doing a necropsy of a horse who tested negative for PPID but the necropsy showed the horse had PPID, as well as reading multiple personal accounts on the FB laminitis pages I follow where horses tested negative for PPID, some of them several times but they did have PPID and treating it was the only thing that helped.  My vet will not do a stim test on Khan because she feels it is too dangerous for her (will trigger laminitis) so I was wondering if I could safely give prascend to Khan to see if it helps given we have the diet and trim under control and she has never stopped being foot sore. Thank you.
--
Jessica and Khan
N.D., 2021
https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Khan
CaseHistory@ECIR.groups.io | AlbumCaseHistory@ECIR.groups.io | Album


Possible Supplement to Stabilize Insulin???

Suzanne and Pilgrim
 

Pilgrim has gone from compensated IR to having normal insulin levels. I was giving him Insulin Wise in his daily beet pulp but it seems my money could be better spent elsewhere. I think I read on this site that the product is purported to be able to affect insulin levels but there is a lack of research to back this up.  Is there a supplement out there capable of doing that?  Joagulan perhaps?
--


Re: Feeding cubes or pellets

Eleanor Kellon, VMD
 

 Any horse with good teeth turns "long stem" hay into "short stem" hay. Observation of the contents of the intestinal tract at necropsy proves it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Lethargic since July

 
Edited

Hi, Cathie.
You describe lethargy really well. I step up to say I appreciate the behavior changes in a horse that's a firebrand. But lethargy is a symptom of uncontrolled PPID or of hoof pain from uncontrolled insulin. It's not good, no matter how tractable it makes our horses.

Two good reads about the seasonal rise are in Files here:  https://ecir.groups.io/g/main/files/3%20Cushings%20Disease%20-%20PPID/Cushings%20Disease%20Treatments/Pergolide/2.%20Pergolide%20Dosage/Seasonal%20Influences%20on%20ACTH.pdf 
and  
at the ECIRhorse.org website. https://www.ecirhorse.org/seasonal-rise.php  
This chart is a visual of the build-up of ACTH during the seasonal rise. https://www.thelaminitissite.org/ppid-faq/acth-interpretation It makes sense that he's feeling better now that the seasonal rise is on the decline. I've seen the same in my own PPID horses, who are now frisking, bucking and galloping around normally. The absence of that behavior is part of lethargy.

Keep in mind that PPID is a progressive neurodegenerative disorder. Pergolide dosage that worked a year ago may not be effective now. Control is a moving target for most of us.

A final factor is that increasing pergolide dose during the period the seasonal rise is rapidly advancing in August and September seems to be almost ineffective in controlling ACTH. That's the observation here made by Dr Kellon. It's my own experience also, shown by lab results.

Based on my personal experience with 3 PPID equines, my approach is: 
1. Make sure ACTH is well-controlled by the first week in July. That means ACTH in the high teens to low 20's gauged by pg/ml. If it isn't, begin to adjust dose immediately. Aim for normal ACTH outside the seasonal rise. 
2. Even with well-controlled ACTH, be prepared to increase pergolide dose by the second or third week in July in anticipation of the big peak in August, September and October. There's lag time in pergolide effectiveness, maybe around 3 weeks. Everyone's experience is different, but increases of 2 - 2 ½ mg help my horses IF I start early enough. I don't mean increasing to 2 mg. I mean adding an additional 2-2 ½ mg pergolide. Adding "too much" pergolide does no harm. Not increasing pergolide makes ACTH almost impossible to control during the rise, leading to lethargy, possible laminitis, weight loss and other symptom of uncontrolled PPID.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Analyses of Standlee SmartBeet Pellets In Files

 

Hi, Nancy. Going into the factors that affect hay/BP soaking is OT for this group because of the detail involved. But it's perfectly on topic in the ECIR Horsekeeping subgroup. I started a thread there to help explain. Others can review, correct and amplify. https://ecir.groups.io/g/Horsekeeping/message/30218 

To answer your question about softened water, though, it's fine to use. Squeezing out the water isn't strictly necessary unless your horses require it. One of the key benefits of BP is the amount of water is absorbs. Anything that keeps our horses hydrated is good, so extra water, even softened, is good.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Lethargic since July

Cathie
 

I am looking for feedback and suggestions to further resolve symptoms of lethargy in my Dorado.

Since July 2021 he has become more laid back and easy.  Not to complain and to some degree its because I handle or ride him every day and include practices to desensitize him and show him everything I can, but its just not him and I think it coincides with the fall rise.  During the summer he was lethargic while still in shoes.  We had planned to get him to barefoot and riding in boots which occurred in August and he made that transition well.

Originally Dorado started Prascend 1/2 mg in Sept 2020 and never had any veil or lethargic symptoms in the beginning.

Beginning of the fall rise on August 3rd 2021 we tested ACTH and found he was not controlled and raised his dose from only 1/2 mg of Prascend to 1 1/2 mg during August/Sept.  There were no sore foot symptoms until Sept 23.  I was able to get it resolved in a week.  We X-rayed 2 weeks later and he had no rotation. Dorado rested 30 days and hand walked easy lines another until recently.   On November 12th we tested ACTH again at that time ACTH was controlled at 27 but the TRH test went to 809.  Since then he is on 2 mg of Prascend per my vet and partially because of my comments about the way he goes.

He does seem to be starting to be more energetic. Typically he wants to trot off and you have to insist on walking to keep it.  During the period of time July forward he was happy walking and you had to ask for a trot 2 or 3 times.   Keeping in mind not all is equal living in Michigan July was hot and November is cool with wind and things blowing everywhere.  We are just starting to W/T/C again and had one recent wild episode on the lunge which is the normal response from him, not the laid back horse from this summer & fall.

I appreciate your support and comments to better his health and avoid mistakes.  You're a great resource I treasure.
Thanks,
--
Cathie Y in MI 2020
https://ecir.groups.io/g/CaseHistory/files/Cathie%20and%20Dorado 
https://ecir.groups.io/g/CaseHistory/album?id=252680


Re: Feeding cubes or pellets

Frances C
 

Ah, thank you once more Dr. K. Now I will never worry about "long stem" again.
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


Re: Feeding cubes or pellets

celestinefarm
 

Angie,
A couple of thoughts here. If you can feed the Timothy Balance cubes, that would be your number one choice. I understand you are saying it is not affordable in the long run, but you also said it's only for a couple of months Right Dorsal Colitis is serious and needs to be treated as per your vet's instructions. A couple of months worth of TC cubes at 15-17 lbs a day is probably going to run you around $250-300 a month. If that is not possible or you are looking at very long term elimination of hay, hay pellets and balancing those pellets is going to cost probably more. I can't imagine buying a complete pelleted feed such as stabul 1 is going to cost less, and simply feeding timothy pellets without balancing vitamins and minerals to them not viable either in the long run.
 if you simply feed a quality timothy or grass pellet, make sure he has salt, Vit E and flax, he will be fine. It's certainly not ideal, and you will want to try to improve his diet if he responds well to your vet's instructions. For a couple of months, IMO, as you are trying to treat a serious illness, I think he'll be ok and if he were mine, I would try it, monitoring him carefully.
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .

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