Date   

Re: The ECIR Group —THE RESEARCH 2020

Sandra Draibye
 

Very cool stuff.  I am particularly excited about the possibility of ECIR collaborating with universities - so many unanswered questions that it would be so great to have consistent answers to....
--
Sandra on Vancouver Island, B.C.
December 2018


Re: Monosodium phosphate sources and measements - Dr Kellon

Laura and Ero
 

Sorry for the immediate follow-up, but I just spoke with the folks at Uckele. Ironically VM (20 lbs) is now backordered and monosodium phosphate is available. However, they worked to get me what I need for the time being and WERE SO HELPFUL!  And they are sending me free "IR-Safe" free treats to boot. TBD if I'll feed them, but TOP NOTCH customer service. 

Thank you for the quick responses. I don't know how you respond to everyone so timely, but you do great work and I'm very grateful. Thanks again. 

--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Vitamin E and oil

Kandace Krause
 

Hello all,
If your horses vit.E is in the form of pellets or powder and they need it in oil to make it digestable, what do you use?
I have received Mad Barn AT+ and am about to start this well recommended supplement to my horses (PPID & PPID/IR).
Thanks
--
Kandace K Rocky Mountains, Alberta, Oct 2
https://ecir.groups.io/g/CaseHistory/files/Kandace%20J%20and%20K


Re: Monosodium phosphate sources and measements - Dr Kellon

Laura and Ero
 

Yes - timing is getting tight. So either of these products will work then, whichever I can get sooner (and/or the best value)?

Thank you!
--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Re: Monosodium phosphate sources and measements - Dr Kellon

Eleanor Kellon, VMD
 

Hi Laura,

I was so glad to find a source of it I didn't pay attention to the amount. One bag will only last about 10 days.

The 26% on the Uckele product isn't purity. It's the % of the weight that is phosphorus and is the same for both products. The Uckele makes more sense but it was on backorder when I did your  balancing.

BTW, COVID is starting to have a negative effect on availability of many items. You have probably already noticed it at the grocery store. The problem is inability of manufactures to get either ingredients or packaging.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Severe laminitis case

Candice Piraino
 

Welcome to the group! 

Let’s start here and you will hear from others and Dr. Kellon shortly! If you have any questions or concerns please don’t hesitate to ask here! 

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. 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. 

--

Candice 

Primary Response Team

September 2018, Summerfield, FL

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

Shark's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71507 

PHCP Barefoot Trimmer @ www.arkhavenfarm.com

 


Re: Pergolide dosage on newly diagnosed PPID mare

Sherry Morse
 

Hi Anne,

The correct dose of Prascend is the one that controls the ACTH. Given Tricana's last test result I would want her on at least 1mg a day and then retest after 3 weeks on that dose.  Hopefully that's enough to control her ACTH but she may well need more.

I was just reading a report last night on a pony that was a .5mg dose of pergolide and somebody gave it 55mgs.  When this was discovered the pony was found to have an increased heart rate and a decreased appetite and was unusually anxious but all effects disappeared within 8 days.  https://www.sciencedirect.com/science/article/abs/pii/S0737080620302720




Re: Lavinia is there ever a right time for corrective shoes?

Lavinia Fiscaletti
 
Edited

He can drive the nails but my concern is that her hoof walls are heavily compromised and trying to attach a shoe at only a couple of points (nails) will result in more wall damage.

There are metal shoes that are designed to be glued on as well.

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


Pergolide dosage on newly diagnosed PPID mare

anneefrancis@...
 

Question:  Tricana has acclimated to a 1/2 pill of Prascend, read:  she's back to her old self energy wise.   My vet is saying to get her up to 1 pill/day.  Is there any value to testing at a 1/2 to see if that dosage is sufficient?  Or should I just get her up to 1 pill a day and then test?   I don't know if there are any ill effects that come with ingesting more than is necessary.   Thoughts?

Best,

Anne
--
Anne & Tricana

May 2016

https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana



Re: Severe laminitis case

Sherry Morse
 

Hi Calla,

You'll get a full welcome message shortly but some of the information that will help us help you and your girl:
  • Is she PPID and/or IR?
    • Do you have current test results if the answer to above is yes?
  • Can you share hoof pictures?  (To do this you'll need to join the CH subgroup at https://ecir.groups.io/g/CaseHistory and then create a file in the photos section named Calla and ??? and then open that folder to upload pictures)  Directions on the pictures we need are here: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help
  • Can you let us know what she's currently eating (quantities as well what she's eating)
  • If you need to trim her feet and she doesn't want to hold one up you have a couple of different options ranging from having the vet block the other foot so she can hold up the one you need to work on to trimming her while she's down or getting her to put the foot you want to trim on a block of some sort so you can work around the edges.  The odds are you're not going to want to do anything with her soles (we can see this better once we have pictures to evaluate) so you really only need to concentrate on getting her toes back and any flares off at this point.
  • Given the time of year my guess would be she's having a bout of winter laminitis so getting her legs wrapped and her feet in boots with socks will probably help her as well.
  • If she is PPID or IR bute is contraindicated and previcox may not help either - you need to remove the triggers and get her trim in order to help her feel better.
Again, you'll get a full welcome message soon with many more details but do peruse the http://www.ecirhorse.org website for information on testing, diet and trim.




Severe laminitis case

Callamartin555@...
 

Hey everyone, this is kind of my last hope for a horse I have with severe laminitis. She will be put down if I can’t figure something out to help her. I was told this was my best option to get help for her! She is 21 years old and has a pretty severe rotation of her coffin bone. We have managed her really well for the last couple years but she has gotten bad this last couple weeks. Well we have been able to maintain her pain and movement really well over the last couple years with strict diet and equi-bow. But this last week she has been really sore, like she hasn’t been this sore since we got her. To be honest Were going to call the vet to come out her down this week... The problem with her is that her coffin bone was already severely rotated. So when we got her we were able to pick up her front feet to trim them, but eventually we weren’t even able to pick up her front feet because she had to put weight on one front foot and that was challenging for her so we could only file the flares. But we got creative and kept her feet managed best we could. If anybody ever needs ideas to help a horse who can’t pick up their feet we can probably help haha. 
 
She actually made an unreal comeback when we got her and we switched her diet and did bodywork with her. But I think everything is catching up with her unfortunately, and I don’t know what else to do but make the responsible decision. She is on cubes from Ontario that are safe, but she has been getting a little hay. She is also on previcox daily, sometimes bute if she is really bad. Any help would be so much appreciated, thanks! 


Monosodium phosphate sources and measements - Dr Kellon

Laura and Ero
 

Hi - I received the following feed recommendation from Dr Kellon, but am looking for clarity on the monosodium phosphate sources and units of measure. 

Feed recommendation (background):
-Hay source #3 from options in case history
-Keep current flax, Vit E and salt 
Add:
- 2 scoops  Equi VM https://uckele.com/equi-vm-20lbs.html
  and 
- 1.5 teaspoons of monosodium phosphate https://www.ebay.com/itm/Monosodium-Phosphate-99-9-PURE-MIN-3-5-2-30/283493313587?_trkparms=aid%3D1110006%26algo%3DHOMESPLICE.SIM%26ao%3D1%26asc%3D20131231084308%26meid%3Df9f177df2098491eab36836cf96d3132%26pid%3D100010%26rk%3D2%26rkt%3D12%26sd%3D283143391524%26itm%3D283493313587%26pmt%3D0%26noa%3D1%26pg%3D2047675%26algv%3DDefaultOrganicWithAblationExplorer%26brand%3DMindy+Materials&_trksid=p2047675.c100010.m2109 
- Stabul 1 as a carrier

My questions: 
1) How long will the above monosodium phosphate product from ebay last at 1.5 teaspoons a day? I'm trying to figure out how many bags I need to buy. Also, reviews are bit concerning (source and packaging). 
2) Alternatively, would Uckele's product be a suitable option?  https://uckele.com/monosodium-phosphate.html  The purity/concentrations are different (ebay product at 99.9%) and (Uckele product at 26%). Given this, I wonder if I'd need to buy/feed even more (making the ebay product the better choice?) 


Thanks for any additional clarity and help as I continue to learn. 


--
Laura and Ero

October 2020 | Colgate, WI USA 

Ero Case History

Ero Photo Album


Re: Phyto Quench

Patti SoCal 2020
 

Thank you, Dr. Kellon. I wasn’t sure if the Devils Claw was good for PPID/IR horses.
--
Patti SoCal 2020


Re: Shrinking eye - what can help to preserve eye health

Joanne in CO 2020
 

In summary, see the vet to rule out more serious causes. If it is due to senile fat atrophy or past trauma and vet simply wants to watch it, then also monitor her eye for dry eye since an enophthalmic eye tends to have dryness. You had asked about supportive supplements: artificial tears, increased water intake, omega-3 supplementation have all been shown by studies to help with dry eye.
--
Joanne, Colorado,  2020


Re: Shrinking eye - what can help to preserve eye health

Joanne in CO 2020
 

Glad you were able to get an appointment as it is difficult to get a definitive diagnosis without the aid of proper equipment & testing. These are my "observations", not "diagnoses", solely based on the pictures.  A "shrinking eyeball", called phthisis bulbi, is indeed known to develop in eyes experiencing a non-remitting inflammatory course. Your horses's eyeball does not have the appearance of a phthisis bulbi eye. Basically, a shrinking eyeball is a dying eye. All parts lose function, involving the cornea, which becomes opaque & smaller in diameter than the non-affected eye. Your horse's corneas look quite clear and of equal diameter. I see the right eyeball is in a more sunken position as compared to the left eyeball. This is called enophthalmos.  It can occur in elderly due to age-related fat atrophy behind the eye. It can also occur due to trauma causing changes to the eye's bony socket or surrounding sinus, or enophthalmos can be due to damage to the nerves affecting the extraocular muscles. Her right eyelid does not appear droopy and her pupils appear of equal size. These are good signs that help to rule out damage to the nerves that affect the extraocular muscles. Another good sign is full range of eye movement. It is still a good idea to see the vet to rule out some very rare but serious causes.  Also, I see signs of posterior synechia (iris stuck to her lens superiorly), in both eyes. This can occur from a past uveitic episode, in both eyes.  
Joanne, Colorado,  2020


Re: Invokana urine trsting

TERRI JENNINGS
 

Thank you Dr. Kellon.

Invokana was given at 8:00 AM and psyllium at 5:30 PM. 

I’m guessing my feed room temperature is too cold. 
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Re: Use of Palmitoylethanolamide(PEA) for pain management

Jeanne Q
 

Great!  Thanks Dr. Kellon!  

Yes, Glory has been through it all this last year.  She has not once given me any sign that she is giving up.  That is why we are still trying to find her some comfort.  The next try will be some corrective shoes this Thursday.  Cross your fingers!

As a side note:  I also started taking PEA myself to see what Glory was feeling from it and for chronic back and neck issues.  400mg before bed.  The first week all I noticed was that I was sleeping like a champ.  I usually wake because of aches and pains and have to change positions.  The second week Ive got to say my aches and pains for the most part were diminished.  Cant say anything about this 3rd week as Ive been sick with a sinus infection.  But I felt no side effects what so ever,  
--
Jeanne Q MN 2020
https://ecir.groups.io/g/CaseHistory/files/Jeanne%20&%20Glory
https://ecir.groups.io/g/CaseHistory/album?id=241360


Re: Shrinking eye - what can help to preserve eye health

Eleanor Kellon, VMD
 

Stephanie,

They won't be elevated with ocular disease https://pubmed.ncbi.nlm.nih.gov/21496078/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Use of Palmitoylethanolamide(PEA) for pain management

Eleanor Kellon, VMD
 

I should mention that in human trials it has been found that even when dose is reduced to once a day the improvements continue to the 30 to 60 day mark. Initial improvement is usually seen by the end of the first week.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Use of Palmitoylethanolamide(PEA) for pain management

Eleanor Kellon, VMD
 

Thank you, Jean. That's very encouraging. Glory is about the  most difficult test case we could find, with significant bone loss, rotation and sinking https://ecir.groups.io/g/CaseHistory/photo/241360/4?p=pcreated,,,20,2,0,0 .

Many things about PEA are very appealing. It's tasteless, naturally occurring in the body and has been virtually free of any side effects in human studies.

Keep the reports coming everyone.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001