He has ad lib hay and I have no way of weighing it so that was only a guess. He gets 250g of maxisoy once per day with his mineral supplements. He seems to maintaining his weight and always has hay left in his nets. I will stop using the MSM. My trimmer suggested it as an anti-inflammatory. I have stopped feeding the lecithin now as I was only feeding to ensure he didn't get any ulcers either from the bute he was on and from the couple of days he stopped eating.

Re the bulge. I'm not so sure it is an abscess as it extends down the hoof for the full depth of the new growth which is about 15mm and it probably bulges out I'm guessing 5 - 10mm. Hoof doesn't seem hot. All the new growth seems a bit soft so I'm not sure that this area is any different. Should I soak just that hoof in epsom salts to try and draw it out or just leave it? 

I really need to get his trim sorted as I really would like to start doing some hand walking. Hoping Lavinia can give me some guidelines soon.. Thank you all for your feedback
--
Debbie Rainbow
Western Australia
2021
https://ecir.groups.io/g/CaseHistory/files/Debbie%20and%20Kody
https://ecir.groups.io/g/CaseHistory/album?id=259494

Thank you!! I use this :)
--
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

Good evening. I received Ero's metabolic test results back and would love help interpreting these numbers and any action steps. I included the report from Cornell in my CH folder and I updated the numbers on his CH form (along with recording his recent injuries). 

- I'm not certain if I filled in the CH "Lab Normals" section accurately as that language wasn't on the report.
- The leptin score says "pending" but I received a voicemail from my vet who said it came back "high". I'm not surprised as Ero is ALWAYS hungry and can get angry when he's not eating, and pushy when there's food in sight.
- Overall, vet was "okay" with the numbers, but said to watch his weight as he's "EMS and could develop PPID based on ACTH numbers". 
- In the past two months, I've transitioned his diet and hoof care. Both are on track, although is hooves are surprisingly not nice and tight looking. Any additional diet changes I should be making? I took photos from his trim last night and will post to his album. 
- He's recovering from an injury so movement has been minimal for the past three weeks. Vet gave the okay to start tack/hand walking this week. 
- He's extremely tight over his SI, hips and hamstrings and is short-strided behind. He externally rotates/twists his right-hind leg out and wears down his lateral hoof wall. Vet gave him a 1 out of 5 on lameness eval (RH), and said to exercise over poles and back-up, to strengthen. My barefoot trimmer suggested an osteopath first. 

Everything I'm learning here has been immensely helpful, but I feel we're not out of the woods just yet. Any advice on what to do from here would be greatly appreciated. 

Thank you!
--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album

Dr. K and all, I have not seen any improvement so far with the additional DC, and rubbing her knee with just about all the suggestions. Today, I took her boots off just in case that was causing her reluctance to move, I have not been able to catch her trying to get off her pad and I wasn’t going to force her.
Anyway, after I took her boots off she immediately laid down, we’ve been taking her water and putting her hay in a net (she’s reluctant to even put her head down), so we had to force her up to put everything back on (big storm next four days) and she could hardly move, she had to be pulled and she had a laminitic stance, walked with her front legs stretched out in front of her not like it was a hobble or a bad knee. I do not know what to think now, last time I thought it was her feet we had her blocked and it turned out to be her knee. I was hoping to test her in spring but I think rather than spend the money that’s tight on blocking it would be a better investment to test now.
Her diet is tight however I’ve read more and more members are struggling with the same thing. My long winded question is would it hurt to up her to a full dose to see if that helps Dr. K ? I just don’t know what else I can do for her? And is it safe for me to continue the DC? I know I can’t give the j herb with it, can I start on alcar instead? Sorry for bombarding you with all these questions again, I’m in a desperate situation.  

And I know this is a stupid question but considering all the changes in the environment do you think the rise could be changing too? Would that even be a factor? Just seems like a lot of members are going through the same thing, I’m just wondering if it’s coincidence? I know that sounds silly but it’s been on my mind .
Thank you everyone, all suggestions welcome of course 😞.

--
Bobbie and Desi
NRC Plus March 2020
Utah, Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi 

https://ecir.groups.io/g/CaseHistory/album?id=78821

Oh yes and he runs and plays.
--
Francine & Magic in Quebec Nov 2020
Was a member 10 yrs ago with Shamy

Frances, thanks for your suggestion. The current wheat bran is a newer bag, and it looks and smells fine. Additionally, Audi had a few days when I was between wheat bran bags (I substituted an extra lb of beet pulp those days), so he was not getting what bran, but the digestive issues persisted.

--
Lindsay in TX 2020

Audi Case History:  https://ecir.groups.io/g/CaseHistory/files/Lindsay%20and%20Audi

Audi Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=248156 

Hi Glenys Nice to see you back - Happy New Year
--
- 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

Maybe your wheat bran is starting to turn bad if you have purchased a large bag. It can go "off" in hot humid weather and give a horse the scours. Take a handful of it up to your nose and sniff for for any sour, bad odors.
--
- 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

Hi All,

I have updated Cody's case history, I think I got everything.  I need to schedule bloodwork.  Last January he came back "normal" on the regular acth so I asked for the TRH stim and got a positive diagnosis for PPID.  Do I need to schedule another TRH stim for him as that is how he was confirmed and is there anything else I should check?
--
Sherry, Feb 2018, Gates, NC
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Cody  

https://ecir.groups.io/g/DustyHoof/album?id=38179 

https://ecir.groups.io/g/BlueHoof/album?id=38486

https://ecir.groups.io/g/CaseHistory/album?id=38227
 

For anyone in the far west considering buying Emcelle Tocopherol to supply Vitamin E, here's a tidbit. I ordered from QC Supply. The package was delivered within 36 hours.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Hello Nancy,

Crackers has been on a dosage of 5mg compounded pergolide since October 2019 when his insulin started creeping up.  I'm not sure what the concern is about the glucose though.  He routinely varies in the 70's and 80's going back to 2011.  While on metformin it peaked at 138 which I thought would be of more concern.  His insulin readings were in excess of 200 when the temps were 50 to 75 degrees.  His most recent at 50 degrees F was an insulin of 27.72 which is lower than the previous reading taken at 64 degrees F with an insulin of 44.88.  What I see with his latest test results is an overall lowering of all numbers.  I realize that he still comes up as IR uncompensated using the calculator but I have read on this group that some horses (especially mini's) are sometimes always this way.  His numbers are not that far off from obtaining the holy grail of IR compensated.  His next tests will be in February - typically the coldest temps here.  Also, I don't know if the iron overload comment applies to me but I did have Crackers tested in accordance with the group protocol and Dr. Kellon confirmed he is not overloaded. 

I will of course post his next results and update my case history. My fingers are crossed for results similar to October 2020.

Thank you for taking the time to review my case history and providing comments.
--
Ellen and Crackers
July 2011, Goldendale, WA
Case History: https://ecir.groups.io/g/CaseHistory/files/Ellen%20and%20Crackers
Crackers' Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=1645

Very cute! Do they stay on?
--
- 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

Thank you Cass!  Got it.  I'm going to give it a shot and see if my vet will send it to Cornell.  Thanks so much for straightening me out, I read your words, but it didn't stick haha.

And thank you, Willie's breeder named him.  He said Willie was born shaped like a box - wide as he was tall!  ;)


--
Joy and Willie (PPID/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526

Overall, I’m pleased with the direction Audi is heading, but I still feel like “normal” or “healthy” is just beyond our grasp.  During the rise, his ACTH was still a tad high, at 31.1 pg/ml on 3 mg CP, and he was still symptomatic.  When I posted for advice, Dr. Kellon recommended holding the CP dose where it was and retesting around the new year.  Further, I got some good (although not easy to hear) advice about new ways to address his trim, possible pain levels, and diet.  I’ve done my best to implement all those suggestions:

*Trim:  My wonderful trimmer, Lisa, popped in here and was able to have some constructive discussions with you all.  Audi has had 2 trims since that time.  I should have photos to post shortly.

*Pain control: Along with modifying his trim a bit, I also started him on PQ, initally at a 2x dose but more recently at a single scoop per day.  We’re also trying him in hoof boots on all 4, whereas he was previously only booted on the fronts.  He seems to love his new boots and looks considerably more comfortable in them.

*Diet:  The criticism was that our hay might not be digestible enough for him.  He is now on a minimal amount of hay, just 5 lb/day, with another 20 lb made up of highly digestible bagged products.  Complete details are below and also in CH.

Although Audi is technically due for a retest, I kind of hate to bother with that right now since he’s still not looking as well as I’d like.  I’d very much like to move toward closer monitoring of symptoms for making treatment decisions and bloodwork done less frequently, about twice per year.  To that end, I made myself a spreadsheet to score and monitor his PPID signs.  I hope to keep it updated every couple weeks or so.  It’s posted in his CH, as are some new photos.

As you’ll see from the spreadsheet, there is a lot to be hopeful about.  Audi is moving better and gaining some weight, among other positive changes.  However, I do feel as though I’m shoveling quite a lot of high quality food into him with only modest gains (+/- 20lb in nearly 2 months, if the weigh tape is to be trusted), and although I am lightly exercising him, I don’t feel like his muscle mass or tone is improving much.  His eyes are also bothering him quite a lot right now, and his skin never fully cleared up.  He still has good days and bad days with regards to his activity and attitude, and he sweats when the temp goes over about 70F.  

So where do we go from here?  Should I bite the bullet and get more bloodwork done?  Or does it seem like he could benefit from a higher dose of CP?  How does his diet look now?

 

CH is up to date.  He is in Scoot Boots 24/7, and his current diet is:

5 lb hay

15 lb ODTBC

3 lb RSR beet pulp

1 lb ground flax

1 lb wheat bran

Finally, I don’t necessarily consider it a PPID issue, but he’s been having smelly cow patty manure for a little while now, along with loud gut sounds and a bit more gas than ususal.  What to make of that?  Does anything in his diet seem likely to be the cause?  (Although he developed the loose manure after being on the current diet for over a month.) Should I try him on a probiotic?  He was last wormed Nov 19.  None of this seems to bother him.

As always, thanks!

--
Lindsay in TX 2020

Audi Case History:  https://ecir.groups.io/g/CaseHistory/files/Lindsay%20and%20Audi

Audi Photo Album:
https://ecir.groups.io/g/CaseHistory/album?id=248156 

Duh ... just realised the log-in was at the bottom of the page.  Ignore my message :)

--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Thank you Sherry!

 I have tried the case study, but kept getting lost on my phone.  So I will try it from a computer.  
I keep getting a bit lost on this site, but there is so much helpful info.  I will do some searching and a lot more reading.    

thanks for all the help.  It is a bit overwhelming.

--
Charmyn 
Yukon, Canada
joined Jan 2021

--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Hi Deb
Sherry has pointed out a couple of things in his diet that might need tweaking. I had a couple more thoughts.
In your case history you have him on 5kg of soaked hay plus 250g each of maxisoy and speedibeet, right? Is he a normal weight on this (no fat pads, ribs palpable) and holding his weight? If his ideal weight is 450kg then, as Sherry says, he can have 9kg per day. So he should be getting more hay. If he puts on too much weight with more hay, you could reduce the maxisoy and beet. I’ve found with my easy keeper that sticking to the hay rather than the super fibres keeps her in slimmer condition—plus hay is more chew time. 

Do you have any idea what kind of grass your hay is? My concern if you use mostly soaked hay with no analysis would be that the protein levels may be low, especially for a heavily muscled breed. Pretty sure Carol does an amino acid mix that is safe, which could help that. 

The bulge sounds like a possible abscess to me, too. Is it soft/hot? Does he react if you press it?  

 

--
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