Date   

Re: Hooves look terrible ?? Need asssistance with hoof trimming with hoof mark-ups

a.k.a.petpalace2@...
 

Hi Nancy,
Thanks so much for your kind words of encouragement and additional information.  I may have just joined this group recently but I've been struggling with Apollo's hoof related health issues for more than a year.  I know I will get some flack for saying this but sometimes I'm tempted to just give up.  No matter what I do, nothing ever seems to be enough.  I do care about Apollo very much but it's emotionally, financially and physically exhausting at times trying to meet his many, seemly endless needs. I honestly didn't think it would be this hard for this long and if I had known, I'm not sure if I would have started because it seems no matter what you do, in terms of health, you've still dealing with an equine time bomb.  Unfortunately all this stress is affecting my health.  Had my post-op check-up today and although I'm doing well, my doctor says healing is a bit slow and that's probably because of my high stress level. Not sure how, but obviously I'm going to have to learn to deal with everything much better.  I'm actually not entirely comfortable posting these personal comments on this site as I'm normally a very private person and one of reasons I didn't joint ecir.groups.io earlier, but I'm doing so in case it helps someone else who's feeling discouraged, overwhelmed and exhausted.  
--
Karen B.
Wisconsin
2022
Apollo Case History: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Apollo
Photo album:  https://ecir.groups.io/g/CaseHistory/album?id=275817
 


Re: Update on Isaac

Trisha DePietro
 

Hi Rene. Are you trying to get him to eat the prascend mixed into the supplements and the carrier? If yes, you will always have trouble with this process until you separate out the Prascend.  Here is the process I used to see what was working and what was not working.  I used this groups suggestions and went through the picky eaters checklist.....I ended up taking out all the supplements and just offered the carrier for 2-3 days- just to see what would happen....she always ate the carrier...then I added back, one at a time, the vitamins and minerals over the next several days- very slowly and very small increments until up to the full dose of what she needed. Once I got her good with that, I added the Prascend, secretly hidden in a gel cap, mixed it in so food was covering it slightly and she stopped eating her food- no matter how I disguised it, it just didn't matter. So, I found a product from Horsetech that is used as a food flavoring, ordered the peppermint ( its safe for IR horses)...and I started to just syringe the peppermint. I syringed small amounts about 2-3 cc's 2-3 times a day....just to see what her reaction would be and if I could get her to appreciate the new flavor. When she really started to show an interest in the syringe, ie licking it etc. then I dissolved a 1/4 tab of prascend into it and gradually increased to her full dose which is 2 tabs. I am so afraid to type this for fear of her refusing her next dose, but its' working. I am so much happier and she is getting her full dose everyday without a hitch. I also syringe my other horse too and she also loves the peppermint flavor. Life is better now and I don't have spices and teas and samples and partially used food all over the place anymore.  The 6 cc's is tolerable to syringe, without it being too much to dribble out..( had to experiment with that too). Hope this helps...
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Re: Hooves look terrible ?? Need asssistance with hoof trimming with hoof mark-ups

a.k.a.petpalace2@...
 

Okay.  I didn't realize I needed pictures of back feet too.  Will do ASAP.  Is it same 4 views as fronts?  Will concavity and heel views also be needed?  I apologize for so many questions beforehand. I imagine it must be very tedious having to answer us "newbees" questions so many times.  
--
Karen B.
Wisconsin
2022
Apollo Case History: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Apollo
Photo album:  https://ecir.groups.io/g/CaseHistory/album?id=275817
 


Re: Nominating Dr Kellon and Re: How to say "thank-you". Please help.

Kelly Kathleen Daughtry
 

I voted as well. I couldn't tell from the website if we would be notified. Anyone know? Just curious. 
--
Kelly & Micah, Clayton NC

April 2016

Case History: https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20%20Micah 

Photos: https://ecir.groups.io/g/CaseHistory/album?id=264981

 

          


Re: Feeding elderly horse with Cushings

Eleanor Kellon, VMD
 

I would switch him to a diet of 100% soaked  Triple Crown Naturals Timothy Balance Cubes and if your dealer doesn't have them and won't order them contact Ontario Dehy for availability directly from them in your area.  Start with 1.5 pounds of cubes per 100 lbs of body weight and soak with enough water to make them soft. Do not discard any extra water. I would increase his pergolide by another 1 mg, at least.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: New blood results for Riosa, feedback please

Eleanor Kellon, VMD
 

Her numbers look acceptable, Heather. How is she doing? Still on estradiol?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Need help quickly

LJ Friedman
 

dont give up.. I had same issue years ago when Jesse had laminitis..  3 weeks later he was cantering in the arena???  are u using easycare boots etc??  you can make emergency boots with styrofoam and duct tape.  your horse wont remember these painful times once you get him better..    but u need to do what is suggested here..  local vets dont know much..  
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


Re: Nominating Dr Kellon and Re: How to say "thank-you". Please help.

Nancy C
 

Hi Dede

Nice to see you! 

Nominations for this award may continue to be submitted through July and August.  Three vets will be chosen each month as finalists with the "grind prize winner" chosen and honored at the AAEP conference in TX later in the year.

Details:
https://aaep.org/horse-owners/good-works-horses

Thanks for voting!  Share with others pretty please!

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Nominating Dr Kellon and Re: How to say "thank-you". Please help.

hueybre
 

Nancy, thank you so much for posting this wonderful way to pay tribute to Dr Kellon. She is truly an amazing veterinarian who so generously shares her time and expertise so that our horses can enjoy longer and healthier lives. Needless to say I did vote. Can you imagine how many votes Dr Kellon would receive if all the horses who reaped the benefits of  Dr Kellon's wisdom and generosity were able to cast their vote? Do you when the nomination process will be closed?  
--
Dede
in VA 2000 or 2001


Re: New labs in - advice on increasing Pergolide & arthritic pain relief

Eleanor Kellon, VMD
 

Yes, I would go to 3 mg and prescription as you said. Many people decide to go with long term NSAIDs in older horses, and if there are no options it's not a bad thing,
even if it does cause kidney and/or colonic disease. Before going there, I would suggest a rectal exam to check the pelvis for fractures and the SI joints for displacement.  Do you have access to an acupuncturist? Acupuncture and/or trigger point injections with Sarapin would be my first choice.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Feeding elderly horse with Cushings

Sherry Morse
 

Hi Jean,

We really need a case history to help you out.  If you did not change anything after getting that test result there's no reason to think that a test now will show a positive change in his insulin level unfortunately.  You may want to recheck his ACTH now in case you need to make another adjustment before we hit the full rise. 

Please note that Triple Crown Senior is not a suitable feed for an IR horse with an insulin over 200. Has your hay been tested?  If not, are you soaking it?  Is there a reason you're not using beet pulp (rinsed/soaked/rinsed) or Stabul 1 as a carrier for any supplements Snowman is on?  How much does he weigh?  How much should he weigh?  You can replace the grain with beet pulp, Stabul 1 and/or Triple Balance Timothy Balance Cubes (fed at a 3:4 ratio to hay) which should help bring his insulin down.  If it's still elevated even with a diet change you'll need to look at medication to get it down but you do not want to continue with it being over 200 which is well over the danger zone for laminitis.




Re: Update on Isaac

Sherry Morse
 

Hi Rene,

Re: oil - I would suggest you try something else as Olive oil is obviously not a winner for Isaac.

As far as the FFW - you can do a search of the archives or please do start a new topic.




Re: Dosage of Pergolide? Help understanding test results after being on pergolide

Sherry Morse
 

Hi Sharon,

You are getting capsules.  The original person who asked this question sounded as if they were using a powder not in a capsule.  If that's the case every time the container is open the powder is being exposed to air and it is probably going to degrade faster than if it were in a capsule.  




Re: Dosage of Pergolide? Help understanding test results after being on pergolide

Sharon Bice
 

Hi Sherry! 
Maybe I’m getting caught up on the terminology, but what do you mean by “ the most stable form of pergolide is capsules, not powder”? I get compounded peroglide from the place recommended here in Az (can’t recall the name at the moment) and it is powdered but in a clear water-soluble capsule. So should I be asking for it to be compounded in a hard pill form, versus a soft, see thru capsule with powder inside? 
Thanks and sorry!! 
--
Sharon Bice
December 2020    Sandia Park, New Mexico

Taillight's Case History:  
https://ecir.groups.io/g/CaseHistory/files/Taillight%20Case%20History

Taillight's Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=257590


Re: Update on Isaac

Mialisa@...
 

I added olive oil this morning and Isaac only nibble at his supplements.

This is another question: I just noticed Isaac has fecal water as his tail started getting dirty. I have noticed hind gut issues with Joshua, but not Isaac ever. Has anyone else ever noticed a problem with loose stools or stomach upset from Prascend? Should I search or start a new topic?
--
Rene` in WI 2021
CaseHistory@ECIR.groups.io | Album
https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac/Isaac%20Case%20History%206.pdf
https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua


Re: New to Group

Trisha DePietro
 

Hi Kate. You will be sent information on how to load a case history. It will allow you to put all of your horses information into one spot so that we can best advise you and its a beautiful tool to keep track of your horses progress and journey. 

When you say "scratchy" do you mean lame off and on ? She could have some unresolved pockets of abscesses in her hoof that need to come out. You could encourage their movement by applying an animalintex pad to the bottom of her hoof, wrap it or boot it to keep it in place...

The metformin is the right answer to quickly lower the insulin levels. I am assuming the 280 was an insulin test. She could be still "footy" because her insulin is not down enough yet. How much metformin is she on? She should be on 30 mg/kg two times per day. If she is not at this dose, it may not be helping to reduce her insulin levels enough. 

What follows here is our welcome letter to you. It contains the cornerstones of our protocol. Diagnosis, diet, trim and exercise ( when comfortable only). Your horse sounds like she has Insulin resistence. We have included lots of information on insulin resistence. This is a separate disease, genetic in most cases, and manageable with the right diet which is low sugar/starch combined to be less than 10% and the right amount of exercise if the horse is not sore.  There is ALOT of information here for you to review. Please don't get overwhelmed. We can help you assimilate the information, organize a plan and answer your questions along the way. Keep this letter handy because you will want to review it as time goes on.  I am not familiar with lucerne hay...but soaking it is key to any hay that has not been analyzed. You will learn that soaking removes up to 30% of the sugar content in hay. It does not remove starch.  We are sorry your horse is experiencing foot pain, but you are in a great place to help you sort it all out. 

Hello 

Welcome to the group! 

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. 

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


Feeding elderly horse with Cushings

jean banville
 

Hello all,
I have happily watched Snowman’s steady recovery from laminitis using the principals I have learned from Dr Kellon et al. Syringing the Prescend has helped insure that he gets it! He gets a trim every 4 weeks and has no soreness. His insulin was 200 in April, should I retest to see where we are at this point?
I am hoping for guidance about feeding a nearly 33 year old Arab gelding with onset of Cushings in the last 2 years. He does not have much grinding surface left although he does eat hay with some quidding. His body condition score is 5-6 and he is active and lightly ridden. My initial attempt to manage increased (70’s) ACTH with Prescend ended in failure with SEVERE veil sx including lack of appetite and constant liquid stool. I switched to Chasteberry (Mad Barn) with good effect on energy and appetite and GI function. Vet checked ACTH in April and it was in the 40’s. Although my vet was happy with the ACTH, I realize that this group considers that value still high, so I started APF Pro 6 mls once daily for 3 days and restarted Prescend 1/4 tab with titration every 4 days until we reached a full 1 mg. This time he is doing great with NO side effects. When should I recheck ACTH? This guy has never been foot sore or showed any subclinical signs of laminitis.
Also, his current feed is 6-7 lbs of Triple Crown Senior Gold soaked and divided into 2 feedings with 10 lbs of first cut Timothy.
My other 4 are on Stabul 1 2 cups a day as a carrier for Equi VM and Timothy hay in 2 feedings.
Is there any alternative to the TC Senior Gold that would be recommended?
Thanks a million!
Jean B from NH


--
*Jean B from NH
joined 10/27/21*


Re: Dosage of Pergolide? Help understanding test results after being on pergolide

Nancy C
 

Hi Laura

Though they have backed off in recent years, the manufacturer of Prascend has pushed the compound viability issue for a long time. Several years ago, the ECIR Group Inc. funded a small group of members who submitted their 30-day old pergolide capsules for testing by this lab https://www.arlok.com/laboratory-services/analytical-testing

Stability is each case was found to be 90% or higher. Here's an older message from me https://ecir.groups.io/g/main/message/223447

You are not throwing your money away.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Re: Hooves look terrible ?? Need asssistance with hoof trimming with hoof mark-ups

Nancy C
 

Hi Karen

Hang in there. It's hard work but oh so very, very rewarding when you get it right. I had to take over trimming my guys' feet when COVID came along. I will be 70 this year. Take it slow. Do it often. When they get rock hard, I soak the feet to give my hands and back a break with the rasp. I plan extra time to get the time that it takes to get the job done allowing for rest of both of us. I take lots of pictures for my own review.

Learning to the read the foot is a great investment of time as well. If one never picks up a rasp, learning the signs as outlined in this video can help owners assess what may or may not be being done by their hoof pros and help open up discussion. https://www.youtube.com/watch?v=cfEzM_SPemQ

In my opinion, unless lots has changed since your fall rads, Apollo should respond well to a physiologically correct trim
More here about that: https://www.ecirhorse.org/realigning-trim.php

Deep breaths. Apollo appreciates you.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Re: New blood results for Riosa, feedback please

Sherry Morse
 

Hi Heather,

I'm not sure how the Triglycerides compare to our usual measurements (did you get a reference range with those?  I can tell you that the Google says it's equivalent to 70.859mg/dL but that's it) but I'd be very happy with the glucose and insulin numbers (to convert pmol/L to our usual uIU/ml you divide by 6 so that would be a 27.66 reading for insulin and glucose we want to see about 5.6mmol/L).  If you need a refresher on the conversions that's here: DDT +E – Diagnosis | ECIR Group, Inc. (ecirhorse.org)

Just as important as the numbers - how is Riosa feeling these days???



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