Date   

Re: Insulineze

LJ Friedman
 

why don’t we develop our own product. We have to think of a good name? Insulin be gone, insulin away,?
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Proper protocol for handling bloodwork

 

I have a question about the handling of the bloodwork. I had a new vet come yesterday to draw Akira's labwork.I had spoke at length prior to the visit and emailed past labs and links to Cornell and whatever I could find that would be helpful. I am limited in my area to the vets that will come to my barn as most have you trailer in...and I am extremely challenged with vets and experience with metabolic horses. 

Yesterday he asked me if he needed to spin the blood or just send it as is. He drew for glucose, leptin and fasting insulin. I replied I wished I had the answer but asked if he could call the lab to verify. Today I got a phone call as he forgot to charge me for fecals and he gave me the result but said he spun the blood and was going to send it off and hoped it was correct. To say I am sick to my stomach is an understatement since the pricetag on the visit was through the roof. How will I know if the blood was handled properly and how can I trust the results? My prior vet has been taking emergency cases only through the Covid virus and til further notice and her price increase to just travel to my barn is no longer affordable. 
--
Nancy and Akira
3/20/2018  Burkesville KY

Case History: https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Akira


Vet Approved Invokana for Rio

hdavis
 

Hello,

I spoke to my vet today and she received the info you sent her Dr. Kellon in regards to Invokana.  


We also discussed testing for early PPID for Rio as well and we unfortunately are not able to do either of the early PPID tests and only ACTH.  Due to that would doing ACTH at all be helpful when she tested normal in the fall? 


We did discuss upping Rio’s pergolide to 1mg as perhaps as Dr Kellon mentioned earlier her insulin is being driven up from uncontrolled PPID.

My vet is on board to try Invokana but we have some questions:

1. Can we give Invokana with Prascend?

2.  My vet is coming out next Tuesday, so would it be beneficial to pull bloods and test glucose and insulin to see if the Prascend increase has helped at all?

3.  We will also do a CBC as suggested by Dr. Kellon. If it comes back with no issues when would you suggest we start the Invokana?

4.  When would you suggest to do another glucose/insulin test to see if the Invokana is working?

5.  What dose should we start at- the higher dose?

5.  Is the use of this drug a long term/lifetime drug like pergolide or can the dose be reduced?

thanks so much and looking forward to hearing some more info on these questions.

Best wishes,

Heather


--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa Case History
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

 Photos

https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .


Storm

Case History



photos

 
 

 




Re: Paste for Cushings

Deb Walker
 

Ironically, a friend of mine in central IL just had her 2 horses labs run for free through Cornell in conjunction with some kind of study her vet is involved in. After just paying Scotty's bill, I told her what a bargain she got.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: Updated CH - Scotty Labs

Deb Walker
 

Also, I failed to note in the updated CH that he has been getting 1 1/4 tsp Chondroitin Sulfate AM and PM. I know that wouldn't affect his labs, but I wanted my report to be accurate, so have corrected the CH.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: Updated CH - Scotty Labs

Deb Walker
 

Thank you Dr. Kellon and everyone for your quick and valuable thoughts. I am reluctant to add Metformin at this time, as from all I have read it is very expensive (?) and requires a lot of subsequent testing to see if it is actually working, and some horses have not reacted well to it. My mind just sees more $$ signs with no guarantees. Having said that, I have looked through old messages, files, etc. and cannot find a specific article as to where you buy Metformin, how it is fed (pill, capsule, ??), and costs. That information would be useful for me to have a back-up plan if there is a quick link that I am missing.

So, if I ask my vet to increase his compounded pergolide another milligram (from 4 to 5)...how do I actually go about it? I just received a 60 day supply of his 4 mg capsules from Pet Health Pharmacy. Order another capsule at 1 mg to feed in addition to until the next re-order? Is going up 1 mg all at once too much and if so should I order 1/2 mg capsules and increase more slowly, adding a full milligram after a certain period of time? I do want to stay on top of the seasonal rise for sure. It's just that darn insulin that spiked so high that has thrown me off. Is there something that can cause a false high insulin?

Thank you!!!! Dr. Kellon, I loved your comment about your 30+ horse that was still spunky. You are 100% right...we just want to keep them that way.


--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: Insulineze

Lorna Cane
 

Eww,sorry Kathy.

Is it expensive? Large dose?


--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: Insulineze

Lorna Cane
 

Typo....Insulineze.
--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: updated pretrim pictures ready for mark-ups

Lorna Cane
 

Do you mean the makings for Pete's Goop?

If so,I believe Costco still carries it/them.

--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: Insulineze

Kathy Thomas
 

Right, Lorna!
Donna is not a fan. I tried it tonight, and now she is off her feed again, so it may be a no go anyway.


--
Kathy 2017 and Donna

Harrowsmith, Ontario

https://ecir.groups.io/g/CaseHistory/files/Kathy%20and%20Donna


Re: New member 😕

Eleanor Kellon, VMD
 

While she's certainly a breed at risk of EMS, it sounds like you might be dealing with a club foot. We'll be able to help you more once all the information is available.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: updated pretrim pictures ready for mark-ups

Kirsten Rasmussen
 

On Tue, May 19, 2020 at 02:09 PM, Lavinia Fiscaletti wrote:
Also, squirt a 50/50 mixture of triple antibiotic cream+athlete's foot cream into the depths of the front sulci
I don't think you can find the triple antibiotic cream in Canada anymore (at least that's what a pharmacist told me when I asked), but I have found that Pete Ramey's 50:50 mix of zinc oxide (40% strength; found in the baby products aisle) + athletes foot cream (with 1% clotrimazole) works really well for thrush.
 
--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Re: New member 😕

Kirsten Rasmussen
 

Hello Liz,

Welcome to the group!  That's great that you are already soaking her grass hay!  Often one hoof appears to be the problem, but all are usually affected and sore to some degree.  Definitely post your hoof and rad photos when you get a chance, then add the link to them to your signature so the rest of the group can find them easily.  Please note that the first step with our approach is Diagnosis, so I would strongly encourage you to get your vet involved to have Hope tested for IR or PPID (more information in the Diagnosis section below).  If she has either or both of these metabolic conditions, then you are in the right place!

To address your question about what to do with a horse chewing fence boards in a dry lot, first make sure Hope is getting adequate calories and is not truly starving or being underfed.  If she has some weight to lose, we generally recommend feeding 1.5% of her IDEAL body weight, or 2% of her current body weight in grass hay, as well as appropriately balanced minerals and vitamins (see the section on Diet below).  We really advocate weighing hay so you know exactly what she is consuming, and then can fine-tune her diet if needed.  Soaking hay does tend to reduce calories slightly, but the added water weight can make it feel more filling.  If her weight is fine (BCS of 4.5-5 out of 9) and stable, and she is getting adequate calories and nutrients, it might be that she is eating the fences out of sheer boredom so anything you can do the relieve that should help, such as giving her a companion for all or part of the time if you haven't already,
feeding her hay in slow feed nets so it takes her longer to finish her meals, or putting out some safe hay cubes in a ball toy...I find they get most of the cubes out fast but its almost impossible to get the last couple cubes out so they will roll the ball around quite a while as long as they can hear them in there.

Please take some time to explore our site. On the left side of this page you will find our "Wiki" which is where you can find detailed explanations for how to use this group. We hope you will refer to the Wiki when you need step by step explanations. The "Files" area is the best area to do searches on specific topics or words. Diet, hay balancing, blood testing, etc. Most files are sorted into relevant groups. All pages have a "Search" box at the top of the page. Just enter a word or term and hit enter (more tips on searching topics can be found in the Wiki!).  We have additional sub-groups that you may want to join also.  If you have any questions specific to a horse's health please create a new message with a short subject line to alert members and moderators to the topic/question.  Unless its an emergency, it is ideal if your Case History has been started and uploaded before you ask for advice because we will want to know all those details anyways.

The following is our general welcome message for all new members.  There's a lot of information in this email so take your time and read through anything that applies to you.

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and 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 Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or 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 IR is diagnosed by testing non-fasting insulin, glucose and Leptin. Leptin is the hormone that says "stop eating". Knowing this helps to differentiate if a horse is IR "at baseline" or if an elevated ACTH is "driving" the insulin up. In Europe, substitute adiponectin for the leptin test.

*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: IR 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 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 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 IR/PPID individuals.

We do not recommend feeding alfalfa hay to IR/PPID 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.


--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


New member 😕

Liz Greene
 

Hello all, glad I found this group. I just purchased (last week) a 3yo Haflinger. I had a PPE done by a local vet in Ohio - I’m in WA - including rads of all 4 feet. I received the PPE report 2 days later with the all clear. The xrays showed up after she had shipped...I think her LF is rotated. 

Upon arrived, her LF is definitely dished, and she seems a bit sore on it. That hoof is definitely shorter than her RF. 

I've been searching for low sugar local hay and can’t find any, so soaking her grass hay for now. She’s on a dry lot, but is starving of course. I’m at a loss at what else to do? I feel like she needs more forage as she’s chewing the fence boards now. Please tell me anything I can do to help her...she’s all my hope, which, ironically, is her name. 


I’m not sure how to post pics, but I do have her xrays and pics.

--
Liz Greene in WA 2020


vit e talk on horse.com

LJ Friedman
 


-- https://thehorse.com/188244/equine-essentials-the-importance-of-vitamin-e/


couple of notes. This was sponsored by elevate from Kentucky performance
   This veterinarian does not like the synthetic. Synthetic is  shown as DL. She said you often need 2,times or more than the natural., which just has the D. No doses were discussed which I found quite strange. Suggested yearly lab checks to check on vitamin D level. She prefers the oil for disease like PSSM but prefers naturals for maintenance. She said no studies were done on PPID in vitamin E.  I use Walgreens Dl  version that cost me 3 cents For 400 IU. Now company sells all natural version of D version that cost nine cents for the same amount. Thoughts on my DL and 3200 IU per day?  testing? 



.
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Re: Dumb Question About Increasing Pergolide Dose

Lynn
 

Hi Martha,

Thanks! That helps! I was having a brain freeze. Relevante is at 2 mg compounded pergolide capsule form right now. In November 2019 I had his ACTH tested and for the first time since diagnosis his numbers went up a bit..I did choose not to increase his pergolide during the rise because of his extreme reaction to higher doses but then got concerned that maybe I made a mistake...but Lavinia said...

A reading of 32.3pg/ml in Nov in a known PPID horse who is well managed and not having any difficulties is a perfectly fine number. There is a reason for seasonal rise as it is a prep for the upcoming winter season and in "normal horses", readings in the mid-forties are the adjusted OK range. Allowing for some variation in the levels is not a bad thing if the horse isn't reacting negatively to that slight rise. I think you made a good call not raising his dose this time around based on his extreme behavioral reaction at a higher dose. Managing these horses is part science, part art and you need to pay attention to the whole picture, not just the snapshots in time that the blood work highlights. You are really good at knowing how Relevante is feeling and listening to that is part of the "Art" aspect. Just keep it in the back of your mind mind for next year in case there are any vague changes in his general demeanor that might signal a need to get things a bit tighter.

If this was one of mine, I'd be happy, leave the dose as it is, then retest in April/May. ACTH has peaked and is moving downward at this point so his is extremely unlikely to be doing anything untoward now.

Of course due to the pandemic and the barn just reopening i wasn't able to have ACTH and insulin tests done until yesterday. I have been monitoring his physical symptoms closely but if his numbers come back high again or higher I will have to increase his dose. My vet is very clued in and supportive of the ECIR protocol and thought he looked good. He did however note wear on his incisors. Apparently he is now grinding his teeth. Gah! So I'm concerned about ulcers, or he is unhappy or anxious, or........... 
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Insulineze

Lorna Cane
 

"Regarding SMS and Insulineze, they work much better if the diet has been shifted to roughage and away from cookies, pellets, concentrates and other rich foods"

Indeed. That caught my eye,too,Sherry.
It could even mean that a tight,appropriate  diet could work ,without using SMS and/or Insulineze at all.
It would be great,though,if somewhere there were studies showing that Inulineze is helpful for difficult cases.

--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: updated pretrim pictures ready for mark-ups

Lavinia Fiscaletti
 

Hi Judy,

I've added mark--ups to Bugsy's album:

https://ecir.groups.io/g/CaseHistory/album?id=243358

This time around, you want to build on the progress that was made at the last trim. This would include bringing the toes back to where the current breakover was placed; moving the breakover back a bit more; bringing the flaring in the lower 1/3 of the walls into alignment with the angle of the tighter growth at the top of the hoof capsule. On the hind feet, extend the breakover from 10-2 rather than just having it in the center of the toe. To see how much vertical height you have to work with, you'll need to measure the collateral groove depths in each foot; need at least 1" at the deepest point near the back of the foot to be able to move the heels back:

http://www.hoofrehab.com/HeelHeight.html

The frogs on the front feet are atrophied and elongated, with central sulci that extend up into the live tissue. Hind frogs are much more substantial and healthier. None are in ground contact, however, so are not functioning fully. As the heels get moved back and are more supportive, the other structures will be able to resume their proper functions as well. I' d suggest soaking his feet in a 50/50 mix of ACV (apple cider vinegar) + water 2-3 times per week. Also, squirt a 50/50 mixture of triple antibiotic cream+athlete's foot cream into the depths of the front sulci, then pack it with cotton to keep out dirt and help promote healing.

LF dorsal: Green lines follow the angle of the new growth down toward the ground. Blue areas are where to rasp the walls inward to align with the healthy new growth above. Note all the stringy, spaghetti-like material that is inside that bulbous toe - it's all exposed laminar wedge, which is just damaged, stretched lamina that are reaching ground level as the hoof capsule grows. At this point, it's a passenger that needs to disembark from the train.

LF lateral: Green line follows the healthier growth from above toward the ground. It aligns with the pastern angle as well. Orange line shows where the heels should be located. It also runs parallel to the pastern angle. Blue area is that excess, bulbous toe that can come off to bring the hoof capsule more in line with the healthier growth. Everything outside of the green line will eventually need to be removed as it grows down so that it doesn't hit the ground and impede breakover. The lateral wall looks like it might be a tad taller than the medial one so measure both collateral groove depths to see if they are the same as that will help make sure the medial-lateral balance is correct.

LF sole: Blue hashed area corresponds to the blue areas on the dorsal and lateral views. Put the hoof on a hoof stand, then look down on it from above, with your face close to the leg. You'll be able to clearly see where the wall starts to bulge out the closer you get to the ground. Rasp all of that inward in the bottom 1/3 of the hoof capsule so that it aligns with the upper growth. That will remove most of the flared wall that is visible from the bottom, leaving it out of weight bearing. This includes the heels, where you can create new buttresses using the bars (orange squares). The yellow hashes follow the leading edges of the bars that appear somewhat crumbly and ready to be tidied up. For reference, the red chevron is about where the true tip of the frog is located. No need to try to excavate the excess frog material as it will dry and shrivel up as the foot becomes more functional and can be trimmed off at that point. Allow the frogs to callous up as much as possible, limiting trimming to any ragged tags that may be present.

RF dorsal: Same general discussion as LF. Medial-lateral balance looks OK.

RF lateral: Again, sane comments as the LF. This foot is a bit more upright than the LF so heels may have more height available for adjustments.

RF sole: Similar to LF. Red circled area is the excess frog length, which is very obvious now on this foot as ti has virtually detached at the true tip location.

LH dorsal: View is a bit more oblique so can't really see the medial side well. Green line again follows the new growth, blue area is the detached, flared wall that needs to be removed. Note how the toe is flat on the ground, so the breakover is right at the front edge of the toe rather than backed up like on the fronts. Need to move that back, both by removing excess toe length and beveling the area between 10-2 to help bring the breakover back even further so it aligns with where the bony column needs it to be.

LH lateral: Green line runs parallel to the pastern angle and the newer growth at the top. Orange line shows where the heels should be. Just inside the line you can see some dried up periople/overgrown frog material detaching from the back of the heels, exposing more heel. As you bring the toes back and ramp the heels to encourage them to stand up taller, you'll keep finding more of this material drying up and curling away from where it has overgrown. Blue is the excess toe length. Unlike the fronts, note how there really is no ground clearance at the toe so the breakover is right at the leading edge of the toe.

LH sole: Same general discussion as in the fronts. Remember that the hinds tend to have more of an oval shape, while the fronts are rounder. See how the blue line is shaped, while the foot itself has spread forward and outward. Note how the heels have leaned outward and the lateral one has formed a "corner", rather than the entire wall running smoothly from back to front.

RH dorsal: Generally, same as the LH. The medial wall appears to be slightly taller so need to assess that.

RH lateral: Same as LH.

RH sole: Same as LH.

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


Re: Mad Barn Has Increased Product Favourites

Lorna Cane
 

Yes, I knew that,Jodi, 
But my point still stands. We,in Canada,have yearned to easily get our hands on J -Herb, and the polys, and etc. for, oh , in my case about 20 years.

When our dollar was at par with the US,it wasn't too bad,although still the shipping charges(not usually free shipping crossing the border),and several weeks needed, were part of the picture. And now with Covid......

You have a number of good companies available to you in the US. Now we have MadBarn up here.
You can always ask Scott what he thinks about adding those items,to his American site, if you feel strongly about it. He's very approachable.

--

Lorna  in Eastern  Ontario
2002
Check out ecirhorse.org FAQ - https://www.ecirhorse.org/FAQ.php


 


Re: Insulineze

Sherry Morse
 

I found this comment on the 'cured cases' site - http://www.curedcases.com/forum/view/3512/null/0 - rather interesting: 

Regarding SMS and Insulineze, they work much better if the diet has been shifted to roughage and away from cookies, pellets, concentrates and other rich foods

(Note: SMS is Si Miao San which is supposed to work in acute laminitis because it pulls blood away from the hoof, cooling it off and subduing the inflammation.)

I also find the disclaimer on the site to purchase it rather telling:

Nothing on this site should be construed as claiming efficacy for a product in treating any symptom or disease.


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