Date   

Re: Getting off Prascend with the same vet that put him on it

Kimberly
 


--He is being re-tested on 6/7/22 and is on Metformin.  My vet has the same bloodwork that is in Mouse's case history.  I am trying to understand how to read the blood work and advocate for my horse.  The same vet has done all of the blood work on Mouse and will be re-testing on the 7th.  The vet says he is PPID, has been since the beginning and needs to be on Prascend.  What are you seeing that says differently?  I have a very good vet and want to ensure that I am being clear in how I am trying to explain what I learn in this group.   I am certainly not going to take him off of it until things calm down but I need to understand why there are two very different opinions on what the issue is with Mouse and if the way to treat it is with Prascend.  In another post it was indicated that his ACTH was good so no need to raise the dosage.  He is still on 1 tab daily.  All of us are frustrated, the vet is mad, and I am advocating for my horse.  What in the blood work does or does not indicate PPID?  I understand the insulin being way too high and our goal is to bring it down with either Metformin or diet or both.  Does high insulin not indicate PPID?  Guidance and knowledge is much appreciated.  


https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia


Re: Spirulina for Head Shaking in an EMS Horse

TERRI JENNINGS
 

Cindy,
I’m curious about what prescription medication helped your head shaker. 

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


Re: Recurring Laminitis & Ertugliflizin

kalloway@...
 

Thanks Martha for your response.

Yes I have had her ACTH levels tested every year since I was advised to put her on Prascend (even though her ACTH test came back as a negative for Cushings. The vet felt it might help her because she has classic signs of being an EMS horse. Fat above eyes, cresty neck, fat deposits in various locations).

In February 2020 I was advised to get her ACTH tested which came back at 80. The Lab ranges I have seen for the time she was tested here said that 80 was the top of the normal range for that time of year. 80 is the highest she has ever tested at and this was the point that I was advised to increase her dosage from 1/2 to 1 tablet. A couple of weeks before I had been weaning her off prascend to test to see if she actually had cushings at all as I had been feeding her tablets for years without a positive ACTH Test. Now I can't really say if she does not and it is now it is too risky to take her off the drug to test. 



--
Karen
Victoria Australia
March 2021


Re: LAVINIA REQUEST FOR MARKUPS PLEASE

terrieheining
 

Hi Lavinia
I had the trimmer booked for first thing in the morning on 24th May but she was held up and the vets could not hang around waiting so took the xrays and then the trimmer arrived after they had gone.   I do understand that xrays after the trim on the same day is the best, and is what I have done in the past, it just did not go to plan this time.   I will take fresh photos after the trim next week and upload them for comparison with the xrays from 2 weeks ago which may be helpful, or not.  I can get another set of xrays done if needed and could try to organise for xrays next Thursday, the day after the trim, just to be sure that things do not go pear shaped again with one or the other being late. 

Dixie has been trimmed every two weeks since August 2020 and next trim is this Wednesday 8th June.  Dr Kellon suggested in February that we follow a presentation by Pete Ramey regarding a horse with very similar issues to Dixie which I downloaded and sent on to my trimmer,  however to my inexperienced eye, she does not appear to be doing anything different which is why an evaluation for Dixie will enable me to provide specific information and if my trimmer will not follow your guidance then I will have to find another one that will. 

Many thanks for your response.


--
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  




Feeding tips for overweight/laminitis prone horses

Adibrito
 

*I am still working on creating a case file … so much detail (important I know) but I’m hoping these will be simple questions to answer 🤞 
 
We have one laminitis prone and one overweight mare on the same protocol:
 
Soaked TC Timothy Forage balancer cubes 
(16lbs for one and 12lbs for the other)
Flax meal
Vit e
Salt
 
We currently feed 4 times per day and have been doing so for the last 3 weeks. We already see so many benefits! As you all can understand, it’s becoming cumbersome so I was wondering if it would be possible to feed them less times per day? Any suggestions for making this less time consuming would be appreciated. It’s difficult and sometimes impossible to always be home to feed 4x each day.
 
Rn we feed morning, lunch, dinner and overnight.
 
Since they are on dry lot continually, we’ve been concerned about them going without food for too long. Is this something we are right to be concerned about?
 
But our hay has just been cut and bailed so we are 30 days out from using it (another question - can I test the hay now or do I have to wait the 30 days). So hay isn’t an option unless we purchase some - and even then it won’t be tested. But perhaps untested soaked hay is an option for making this more doable and affordable long term?
 
Also want to mention they are together on the dry lot so it’s a challenge to make sure they are getting their specific overnight portions. All other meals are eaten in their stalls so we know they get what they’re supposed to.
 
Thanks for reading and sharing your experience 🥰  I Welcome all your suggestions and appreciate your knowledge!
--
Angela D in TN 2022


Re: LAVINIA REQUEST FOR MARKUPS PLEASE

terrieheining
 

Thanks Sherry,
The xrays were booked in and vets could not stand around waiting as the trimmer was held up and arrived late so best laid plans fell apart.  All the trimmer is doing is rasping the toe up into a wedge as you can see on the xrays and the photos and this has not changed on any of the xrays or photos since the start of my album.  Trimmer does not appear to be doing anything at all to the heels so the shape/alignment is not changing to my inexperienced eye, and now my vet is telling me the same thing following these last xrays when she compared them back to all previous xrays. Plus we now have the issue of the RF pedal bone appearing to be lytic,  I will take more photos next Wednesday when the trimmer is back next, but that will be of Dixies hooves following the 2nd trim after the xrays, so not sure what use they will be now.  
I have been following the diet prepared by Carol Layton to the letter until recently when Dixie went off her feed altogether so have now started dissolving her supplements in water and syringing them in, but I would not think that the short period of inadequate supplements and feed could be responsible for the deterioration of the pedal bone, however I have Michelle Wein coming to see Dixie next Wednesday for some fresh eyes and thoughts as I am way out of my depth here.  Michelle has completed studies with Dr Kellon so I am assuming that her outlook will be on the same path as ECIR. 

--
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: Updated Trim Pictures and Case History

Jamie Miller
 

Thank you. I will share the trim information with the equine podiatrist and trim at 4 weeks.  I am not sure how he feels about taking off so much and if he feels he'll be interfering with bone and vessels or not.  Walker had glue on Sigafoos for the past 3 years and did very well, seemed comfortable despite abnormal ACTH and Insulin levels (which he has apparently always had since we've been tracking levels).  How do the Easy boot Glove with Soft Gaiter and the Easy Boot Glue on Shells compare to the Sigafoos? These were the ones seen in the link for Hoof Rehab. 

Is Metformin the only option, as I've read about others mention Steglatro and Ertugliflozin??  

As for addressing insulin with diet, I'm guessing there's nothing better to feed him other than the 18 lbs/day of soaked TC Timothy Balance Cubes (no hay or grass being given)??

Thanks again!
--
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


Re: Hay Analysis done and need help

joykagawa@...
 

Thank you, Martha for your comments. The feed store employees did not know where the hay came from. I know there is a fee involved with having someone balance my hay. I would like to take Dr. Kellon's course but after these 2 months of dealing with laminitis and all the things involved, I don't know if I have the time or energy. So I hope Dr. Kellon can advise re: fee, taking the course, or buying supplements from Uckele. Unfortunately, my horse does not like the vet and it is usually a minor rodeo in order to get a needle into his neck. I hope that does not cause false or skewed blood test results. I have given 2 x 1 Tbsp. salt since last year at least, so salt is not new in regards to a cause for increased clear urination. I appreciate all the info I have read from moderators, contributors, Dr. Kellon and all. Thank you for your efforts to help us. 
--
Joy K in CA 2022
https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Alabama
https://ecir.groups.io/g/CaseHistory/album?id=275576


New pain management since CBDs are a no go with new PPID diagnosis

TERRI JENNINGS
 

Hi All,
I’ll be uploading a case history for Mr. Beefy (31 year old QH) in a few days. He tested positive for PPID with a TRH stim test 2 weeks ago. He is already looking better after just two weeks on 1/2 tab of Prascend. He has arthritis which we were managing well with Neurogan CBDs. Those pellets were magical for him. He was even playful again for the first time in years after starting them. Since his PPID diagnosis I now need to find a new pain management strategy. What should I try first?  DC, Phytoquench, Equioxx?  My goal is quality of life for this old guy.
Thanks,
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Re: Zahr Update: Insulin and glucose results

Mikaela Tapuska
 

Thanks everyone, good to know regarding the APF. Perhaps I'll see how he does with this change, since we've already gotten started with the increase, and then go from there in deciding whether to try and bring it up here or not. Luckily so far he hasn't had issues with his appetite during dosage increases (knock on wood), he just gets quite lethargic and seems sleepy most of the time. Granted, that side effect of the pergolide has never entirely gone away since it showed up, so maybe I am misunderstanding the pergolide veil effect if it's usually more of a temporary effect during the actual medication increase.

Is it possible to split the prascend pills up accurately into quarters? I know they break in half well but I thought there were issues splitting most pills beyond that, as the manufacturers can't guarantee where in each half the active medicinal compound is concentrated. But knowing that, since he is sensitive, I think I'll keep him at 2.5mg for a few days longer before increasing it again to 3mg.

Thank you!

--
Mikaela Tapuska in Calgary AB, 2021

Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr

Photo Album : https://ecir.groups.io/g/CaseHistory/album?id=274255


Re: Zinc sulfate monohydrate and Copper sulfate pentahydrate

Barbara Rosensteel
 

Thanks Dr. Kellon.   The product is 35.5% zinc with a guaranteed analysis that includes 50 ppm (max) cadmium, 5 ppm (max) lead, and 4,000 ppm (max) iron.   That does not seem very "clean" to me, but perhaps in the small amounts it is given the amount of iron and heavy metals are so small as to be of no concern. 
--
Barbara Rosensteel

Sept 2007, Cookeville TN



 


 

 

 

 

 

 

 

 

 

 

 

 


Re: Recurring Laminitis & Ertugliflizin

Maxine McArthur
 
Edited

Karen, I'd soak the hay and see if it helps her.
The Feed Central tests are done using NIR method, which can give a lower ESC+starch result than tests done using the wet chemistry method. The other thing you could do is take a sample using at least 30 of your bales and send it to Equi-Analytical in the US for a wet chemistry analysis. I have done this before (it's not that expensive and they email you the result) and the wet chem result was a bit higher than the NIR result given by the hay supplier. With a really sensitive horse you need to know. Equi-Analytical has instructions for taking samples on their website and the forms. They are quick to respond to emails also, if you have questions. 

--
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: Recurring Laminitis & Ertugliflizin

 
Edited

Hi Karen,
I see that Faith has been diagnosed PPID and she’s on 1mg of pergolide.  There is nothing in your case history to suggest you’ve tested her ACTH since her last dose increase several years ago.  I would definitely keep up with that testing as PPID is a progressive disease and often requires a dose increase with time.  Elevated ACTH can result in increased insulin levels.

edited to add
I just saw in an earlier post that you have tested her ACTH recently and it was low.  Something you said made me wonder if it was ever high.  I might consider increasing the pergolide (in a separate experiment from soaking the hay) to see how it affect the insulin.  TBs are rarely insulin resistant without PPID involvement.  It’s generally the smaller, thriftier breeds and ponies which become IR at baseline.  There’s always the exception and the rest of the breeding mix matters as well.
--
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: Recurring Laminitis & Ertugliflizin

kalloway@...
 

Thank you Dr Kellon and Sheri for your replies. I will look at the fact sheet and give it to my vet. 

I have a trimmer caring for Faith's feet who is experienced with Laminitis and follows the ECIR recommendations. 

Given the insulin test results I am really putting the latest laminitis down to high insulin levels. Why it is high I can't explain on the face of it with the hay tests that I have been given. HOWEVER I I am becoming suspicious that all is not as it would seem in those test results. If they samples taken were only from a bale or 2 then they might not be representative of the 200 bales I have from one of these suppliers. There is variation in the bales that makes me think this is possibly the case, especially in light of Faith's insulin test results. It is either that or my mare is really sensitive to sugar levels and needs hay extremely low to not have insulin high. If it is the latter then that may become impossible to manage unless this drug works. 

 
--
Karen
Victoria Australia
March 2021


Re: Hay Analysis done and need help

 

Hi, Joy. 
I glanced at your hay analysis. Your hay balancer will address this more specifically. In my experience, it's unusual for magnesium in hay to be more than twice calcium. Your sample is still at Equi-Analytical. I suggest you call tomorrow and ask the lab to confirm the calcium and magnesium results.  Odd things can happen to irrigated hay during drought, but it's worth double checking. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Hay Analysis done and need help

 

Hi Joy,

Welcome to the ECIR group!  I’m sending you this welcome from the group as a response to your first post here.  There is a lot to read about our group and how it can help people care for their IR and/or PPID horses.  And there are many more worthwhile links to follow.

Thank you for uploading your case history and hay analysis.  Your hay protein is a little high, which might indicate high nitrates.  Is it irrigated?  Your hay is under 10% ESC+starch, which is good, but not all horses can tolerate even 10% so that’s something to be aware of should you have issues once you quit soaking and transition to the new hay.  Your iron looks fine.

After your hay is balanced, it may be determined that California Trace Plus isn’t the most suitable match for your hay, or it may be just perfect with the addition of a little of this and that, as guided by your balancer.  Vitamin E needs to be fed with oil to be absorbed properly so I would continue with the capsules, provided they contain oil.  Balancing will tell you whether to continue the Mg and/or how the dose needs to change.

When your vet arrives for blood draws, make sure your horse has had access to hay for at least the previous four hours and that any commotion is limited.  He should not be sedated before the blood draws, which should be done first thing, definitely before any dental work.

The increase in urine could be because he is getting more salt and drinking more.  PPID can cause an increase in water consumption and peeing but I’m not sure if either of those causes an increase in frequency.

If you haven’t already, I’m sure you will receive more advice from others.  What follows is our welcoming letter.

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. 

 
--
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: Ava's update - insulin, glucose, and TG on Invokana with L-car and increased feed

Nancy & Vinnie & Summer
 

This is fantastic news!! How much BP and Stabul 1 are you feeding?  I want sure if the CH is updated?I am always curious s8mce I have been battling TG elevation for a while.

Thanks in advance,  Nancy :)
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Hay Analysis done and need help

joykagawa@...
 

I have just figured out how to upload my CH and Hay Analysis. Dr. Kellon, will you help me balance my hay please? Alabama is doing well, still dry lot, closed grazing muzzle when turned out, soaked orchard grass and transitioning to this year's tested orchard grass (total hay 19 lbs,/day), 9.4% ESC+Starch, so I won't have to soak, 2x4oz cold milled flax, 1 tsp Mag. Oxide powder, 4 Vit E human capsules (400IU each), Calif. Trace Plus 2x2 oz, 2x1 Tbsp noniodized salt. He seems to be urinating much more often, clear in color, I noticed in the last week but he could have been doing so before. I am wondering if Vit. E in Calif Trace plus is sufficient so I don't need the 4-5 capsules per emer. diet instructions. Also do I continue 1 tsp. Mag. Oxide? Is the iron and protein content in my hay a concern? I called my Vet and left message to make appt. for IR and PPID blood test, possible radiographs and when to do his dental work that is overdue.
--
Joy K in CA 2022
https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Alabama
https://ecir.groups.io/g/CaseHistory/album?id=275576


Jack's not eating well - Metformin?

Hilary McGregor
 

Jack has been on Metformin since April 28. His hoof pain has decreased and we have weened him off Previcox. Still waiting for blood test results to know insulin/glucose post Metformin. I'll update his case history soon.

For at least three weeks Jack has not been finishing his hay. This is very unusual behaviour. He has lost some weight. He is bright and doesn't appear to be sick. He seems to be hungry and eats his soy hull mash with great enthusiasm. He is roaming around his "dry" paddock nibbling bits of green that are coming up now (not good, I know). He has been on this hay since February and was eating this hay without issue until he wasn't.

Are there any systemic effects of Metformin that could be contributing to him not finishing his hay? Could his dose be too high if he's lost weight?

Jack had his teeth floated on May 27 - mouth and teeth in great shape and no concerns identified. The vet caught a urine sample and it was more dilute than it should be even considering sedation. We have not been able to catch a urine sample since to re-check. Jack is pooping normally and a recent fecal float was negative. I have not noticed any changes to his drinking and urinating frequency.

How much soy hulls can he safely eat per day? He's getting about 240g (dry) at the moment. I offered him some plain r-s-r beet pulp and he wasn't interested. Might try again and mix with soy hulls that he likes.

  
--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
NRC+ proficient grad January 2022

Amika's Case History Folder
Amika's Photos Folder

Jack's Case History
Jack's Photos Folder


Re: Zahr Update: Insulin and glucose results

Sue Ring
 

Hey Sherry,

Working on updating CH.  I misspoke and tried to edit my response, maybe did not/has not appeared??  I am speaking to my vet this week about proper dosage for upcoming seasonal rise and while I am VERY happy that he had such a dramatic drop in his ACTH numbers, I realize I need to keep him on this  downward ACTH trend and not pull back his dosage at this critical time.  Thanks!!  Very happy to be getting my boy back and to have found a pathway that is working thanks to your help and all those who contribute here, especially Dr Kellon!  
--
Sue R in NC 2021

CASE HISTORY:  https://ecir.groups.io/g/CaseHistory/files/Sue%20and%20Shifty

PHOTO FILES: 


 

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