There is very strong evidence that it is genetic.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Can't do anything about the protein but I'd soak it to lower the nitrate. However, if he's been eating more than a week or two there's a good chance the trim is the issue.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

I seem to recall that not too long ago (but I cannot find the posts) someone mentioned that IR (or was it ACTH?) testing could be thrown off if the horse was being fed biotin and /or methionine. Is that so or did I imagine it?
--
Deborah
November 2012
Middle Tennessee
Case History: https://ecir.groups.io/g/CaseHistory/files/Deborah%20and%20Tara

Hi Alice,
Try this.  I searched the files on “pain relief”.

On Tue, Mar 29, 2022 at 01:08 PM, Bobbie Day wrote:

Pain Relief Alternatives to Bute and Banamine (groups.io)

This link doesn't take you to the correct article.  Can you re-post? Thanks
 
--
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  .

Here’s another way of looking at it that might help.  Some people are more likely to burn in the sun.  It’s a genetic trait which more likely appears in those with less sun exposure in their ancestry, northern tribes.  People with this trait need to protect themselves more carefully from intense sun exposure.  If these guidelines are ignored, a painful sunburn will be the most likely result.  The details are different but the point is that neither of these susceptibilities is something you can alter but their negative after effects can be prevented with care.
--

Hi Jamie,
I can’t tell from your case history so it would be good if you clarified this.  Did you begin splitting his pergolide dose when you increased it in December?  If that’s the case, his dose has been effectively 1.25 mg and you have now increased it to 2.25 mg.  The 0.25 mg is a bit of an odd and inconvenient ‘add on’ so you might want to focus on getting to an ‘even’ dose with your next increase.  I would continue with 2.5mg for three weeks and then test him again.

Looking at his diet, I can see a few places to tighten it up.  You could switch out more of the TC Safe Starch for Timothy Balance Cubes.  They don’t need balancing (not sure about the TC SS) but do need added ground flax, salt and vitamin E.  Vitamin E needs to be fed with oil to be absorbed properly.  You seem to have stopped the salt, which I add to the dampened cubes successfully.  And it appears you were giving KER EO3 oil, which I believe is for the flax Omega 3’s, but that has apparently been stopped and not been replaced with another source. 

As far as metformin goes, have you tried it before?  If not, I would definitely try it, unless his other issues would dictate otherwise.  Here’s a short blurb on metformin usage and you can find much more by searching the files here on ‘metformin’.
--

If obesity does not cause IR then what does? I have 8 Arabians including three mother/child pairs and three individuals with the same sire (who is now deceased). Is there a genetic component? Should I anticipate IR developing in the offspring of IR mares? I am currently adjusting the diets of all of them but wonder if IR may develop anyway.
--
Susan H TX 2021

Oh goodness, I'm sorry. That makes sense.

I have returned to giving him the 2 1/4 pills once a day.  Based on the recent ACTH levels, should I increase it? We just went from 1 1/2 to 2 1/4 in December when ACTH and Insulin were so high. 

The vet is also recommending Metformin for insulin levels since there is nothing else I can do with diet. He is not in pasture, gets no hay or treats, just 15-20 pounds of soaked Triple Crown Timothy Balance Cubes 2x day. He 33-34 with one good nostril, so I don't really exercise him. He just walks where he wants to walk and does whatever he wants to do. 

Should I increase Prascend?
How do I address his insulin levels?
What more can I do for his diet?
--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker

HI Jamie,

Half life of the medication refers to how long it takes the body to metabolize it once it's ingested. When you split the dose, the result isn't cumulative as the earlier dose has already been metabolized, so you are only maintaining what the half dose achieved rather than increasing the effect.

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

Dr Kellon, I hope you will comment on this.  I balance for Flame and suggested Beth ask about protein.

(Thanks Beth for pointing to the hay analysis in his history)

FYI -
ESC (Simple Sugars) 7.1
Starch 1.1

Glucose also appears to be high in latest labs. Beth may have mentioned this earlier.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022

Thank you, Dr. Kellon.
--
Kim 10-2014

Clover, SC

Dually: IR; Grits and Bella: PPID, IR; and Eeyore (deceased, but not PPID related)

Case History https://ecir.groups.io/g/CaseHistory/files/Kim%20and%20Grits%20-%20Eeyore%20-%20Dually

Photo album Grits https://ecir.groups.io/g/CaseHistory/album?id=1314

Photo album Eeyore https://ecir.groups.io/g/CaseHistory/album?id=6586&p=Name,,,20,1,0,0
Photo album Dually https://ecir.groups.io/g/CaseHistory/album?id=9046&p=Name,,,20,1,0,0
Photo album Bella https://ecir.groups.io/g/CaseHistory/album?id=64978

Flame’s most recent batch of hay tested high in protein 18.1 & nitrates were 0.36%. The results are uploaded in his history. He has been eating it with no problems until yesterday. Yesterday I noticed that he was a little foot sore in front (on a scale of 0=no pain & 10=worst pain ever) I’d say 2/10 & reluctant to go forward. He’s the same today. Other factors are the coming on heat (we live in Las Vegas), insulin > 200 (Invokana has been ordered) & long feet (farrier managed to skip us & he’s 3 weeks overdue). Today I increase his J herb to 4 tbs (was 3) & added AAKG. I’ve ordered Phyto-Quench today. Any suggestions? 
--
Beth & Flame dx 2013 & Diana dx 2020

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  

Thank you for the guidance on the dosing, Bute/Gastro Guard combo, and breathing issues.  The split Prascend dose was one full pill in the morning and one and a quarter in the evening, so for the whole pills, they are kept in the foil until they are dispensed. Is that what you mean when you say half life and decreased effectiveness?  If so, they are taken out of the foil immediately upon their administration. I received his ACTH results today, and it looks like his levels are better than what they were in December of 2021.  He gets no hay due to expired teeth and weakened jaw muscles (age related). Again, his diet is only soaked Timothy Balance Cubes with the Uckele supplements (vitamin E, Herbal Mune, and Equi VM, salt). 

3/17/22
ACTH level was 49.3 pg/mL with a range from 2-30
Insulin was 68.59 uIU/mL with a range from 10-40

12/13/2021
ACTH level was 72 pg/mL with a range from 2-35
Insulin was >200 uIU/mL with a range from 10-40

3/17/22 link to  xrays

I will be updating his case history soon.  I just received the xray results and the ACTH levels.  

--
Jamie Miller
Louisville, Kentucky, USA
July 2019
Horse: Hiram Walker
Walker Case History: https://ecir.groups.io/g/CaseHistory/files/Jamie%20and%20Walker
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=93084
Link to Profile for Hiram Walker

Thanks Dr Kellon, that's actually what I'm using now. Once I can get Dangles to eat more than a pinch.... sigh.
Terrie, always good to cover all bases! 
--
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

 

--
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  

Hi Lavinia, 

Looking to see if you can evaluate my mare's hooves. I have included X-rays from Feb and March of her angles as well as photos of her feet. We are working on trying to correct negative and flat palmar angles and contracted heels/frogs. She was in shoes on the fronts for many years and we just pulled them last November and doing barefoot trims every 4 weeks. Please let me know if I can provide anything else. 

https://ecir.groups.io/g/CaseHistory/album?id=273694

Thank you!
--
- Stephanie 

March 2022, Ridgefield, WA

Case History: https://ecir.groups.io/g/CaseHistory/files/Stephanie%20and%20Tianna
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=273694

--
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