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Re: Sweet P meds second request
KATHIE DORVAL <bokayarabians@...>
I am wanting to know why Sweet P is on Invokana to lower insulin when his is not high, but his glucose was very high. I read here that Invokana is for lowering insulin, but does it also lower glucose? If it does lower both, why would you want to lower his insulin? Doesn't he need some to process the glucose?
-- Kathie with Libby and Sweet P Cobble Hill, BC, Canada Aug 2018 Case Histories Target Photos Sweet P Photos Addy Photos Cherokee Photos
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Re: Cold weather and insulin
One more....
Rercent blog by Dr Kellon on adaption to cold https://drkhorsesense.wordpress.com/2019/12/08/adaptation-to-cold-weather/ -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2019-2020 Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA
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Re: Turn Out Exercise vs. Low Iron Hay - How Important in the Big Picture . . .
Trisha DePietro
Hi Jennifer. I think we all struggle with the balance of what the gold standard is to treating our PPID and IR horses and our reality of their living situation. When its a boarding situation its a little difficult to get things to where they are "perfect", because we have little control over the overall process of care. So, I try to weigh things out in my mind of what has most benefit and worth the effort for the horse and seek the balance between the good and the not so good.
So, when I look at ANY horse/pony 24/7 turnout with windbreaks and/or access to shelter is "perfect". Does it decrease their insulin? Dr. Kellon would have to weigh in on that, but anytime you give an organism what they need, stress is decreased both at a cellular level and an emotional level. I know stress causes cortisol to go up and probably inturn insulin reacts to the increase in cortisol, but again, vets would need to chime in on that physiological response. Whatever you can do to increase his time outside of the stall and increase his activity would be ideal. He gets his good hay at night and I think thats great! the high iron hay is outside, but he also gets to be outside with friends and play and move and forage and emotionally be "a Pony". A muzzle is a great thing to try and there are many different kinds on the market. I don't know what he will do with a muzzle, every horse is different, you just have to try it and see. If you can find someone to partially lease him, they could provide the additional movement/exercise. If you can squeek out 15 minutes extra per week then that's fine. if not, then you are doing the best you can. If you can't do a dry lot, again, try to find other things that balance out the lack of a dry lot. Movement is always key to horses/ponies. he's got good feet- which is great! and you are able to have a dialogue with the barn manager which is also a plus! When I struggle with if "I am doing enough or doing it right"....I go back to the diet, trim, exercise protocol from here and see what I can do to improve the situation. If I have done everything I can- then I am good with it. Selling is a challenge...but so is keeping him. I commend you for hanging in there with him and doing everything you can to make his health better. I wish I was closer, I bet he would make a super carriage driving pony! -- Trisha DePietro Aug 2018 NH Dolly and Hope's Case Histories https://ecir.groups.io/g/CaseHistory/files/Trisha%20and%20Dolly%20-%20Hope Dolly's Photos Hope's Photos Ω
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Re: Favorite herbal for horses
Thank you Jessica for updating your history.
The use of small animal vet is one I would explore. Some will not help you but that is not my experience. I was not five hours from an equine vet, but far enough that I needed a back up plan. My small animal vet was very willing to spin and send in the labs for me. I'm just a horsewoner, but luckily had three equine vets in my life wiling to teach me how to draw bloods myself. When I explained to my small animal vet that I was working with an equine vet and this group, and was willing to pay her for her time and the submission to Cornell, she jumped right in. Also used Blueberry Muffins. -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2019-2020 Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA
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Welcome Message for Leslie Cobb
Hello Leslie' The ECIR 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 etiquette, what 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:
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. EXERCISE: The 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. -- Bonnie Snodgrass 07-2016 ECIR Group Primary Response White Cloud, Michigan, USA
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Re: Increasing CP - Leslie Cobb
Leslie, I am putting a brief note here to ask you to look for a new message in the Main group with your name in the subject line. It is our welcome post for new members.
-- Bonnie Snodgrass 07-2016 ECIR Group Primary Response White Cloud, Michigan, USA
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Re: Cold weather and insulin
There are two issues going on IME. Hormonal response to cold temps and vascular and neurological response in the feet causing "Winter Laminitis". They overlap but explaining how is above my pay grade.
IME with severe IR, below 50 degrees was enough to trigger a rise of insulin from 50 to 100 in November. PPID was controlled with ACTH in the mid-teens. Winter laminitis came in at below 40. Wrapping him helped his foot comfort but did not change insulin levels. Insulin and glucose levels taken in December and sometimes January supported this. Your mileage may vary. If you want to really begin to understand what is going on in either situation, a dive into the following may start the journey: Dr Kellon's NO Laminitis! proceeding Winter Laminitis gives a very in depth overview of how animals respond to cold, what happens in as the hormone loop as the animal tries to deal with cold weather and what happens in the feet for cold induced winter laminitis. https://www.ecirhorse.org/proceedings-2015.php Endothelin-1 play a huge role in laminitis, in any season. Dr Kellon has also written about this component in her 2013 NO Laminitis proceeding of the same name. https://www.ecirhorse.org/proceedings-2013.php Dr Kellon again explores the role of endothelin-1 along with other mostly discarded theories on what is going on in the metabolic equine in the 2017 proceedings Endocrinopathic Laminitis: How is it Different? and Acute care for Endocrinopathic Laminitis. https://www.ecirhorse.org/proceedings-2017.php -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2019-2020 Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA
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Re: Increasing CP
Karin & Inky <ksherbin@...>
Hi Leslie,
Thank you for asking about Inky and his progress on being ridden.
Inky had been doing very well for about 5 months at his new place where the barn manager slowly exercised him to build him up under saddle. She said he enjoyed the challenge and had a great work ethic and remembered all his dressage training. Inky lost his topline in September …. maybe due to his ACTH being at about 25 at 6.5 mg of pergolide…. but the barn manager was still able to ride Inky bareback (no saddles fit with his new conformation). We are talking WTC for about 40 minutes either in an arena or out in a field. Pretty good for a horse in his mid-20s who hadn’t been worked in a couple of years outside an occasional trail ride. His original owner competed him in area dressage shows in his youth. I think he was trained up to second level.
My vet agreed to up Inky’s pergolide to 7.5 mg daily in late October (there has been a perfect storm of circumstances in my life that has put updating his CH at the bottom of the list), and then on my own in late November I upped that to 8.5 mg based on him seeming lethargic. I had him re-tested in December and his ACTH was down to 12 (9-35 reference range). In January he is back down to 7.5 mg of pergolide. My plan is to reduce him to 6.5 again at some point and test him in the spring to see how he does at that dosage outside the seasonal rise.
I moved him to a new place mid-December because the previous facility had kept 9 horses 24/7 in a smallish dry lot starting in October, and the lot turned into mud fetlock deep with no shelter and no trees (tho he did get a blanket when temps dropped). Thrush and rain rot ensued. Now he is in a field, muzzled, for 7-8 hours a day and in a stall the rest of the time. Boarding requires compromises. He seems to be handling the part-time pasture okay, no foot soreness or fat pads developing. He is still a good weight. If need be I can move him back to the previous facility once the mud dries up and the barn manager allows the horses out on sparse pasture half a day and the dry lot the other half.
He looks beautiful when free-lunged for 10 minutes at a time (I am not sure about me riding bareback. I am about to lose my really good health insurance!). I recently put his Aussie saddle on over a thick western pad to lunge him; he moved wonderfully but he was sore the next day, full of the ouchies when I massaged him that led him to kick out his back legs. So no more saddling up until his topline returns, whenever that is.
I wish you and the other members of ECIR a wonderful 2020 for all your families, both horse and human.
Karin & Inky Forest, VA IR/Cushing's July 27, 2015 https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Inky https://ecir.groups.io/g/CaseHistory/album?id=834
From: main@ECIR.groups.io <main@ECIR.groups.io> On Behalf Of lesliecobb@...
Hi there, I was reading your posts on inky and was just wondering how things are going with his riding?
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Re: Urgent advice please. Think I overdosed Savannah with pergoloide.
Pat, go here for iphone help....https://ecir.groups.io/g/main/files/Case%20History%20Tools/Case%20History%20Form.pages( hoping this works for you)Scroll to the bottom of the page to learn how to update via iPhone. -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2019-2020 Join us at the 2020 NO Laminitis! Conference, October 22 - 25, Harrisburg, PA
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Re: Increasing CP
lesliecobb@...
Hi there, I was reading your posts on inky and was just wondering how things are going with his riding?
-- Leslie Cobb New York 2019
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Re: Urgent advice please. Think I overdosed Savannah with pergoloide.
Pat, go here for iphone help....
https://ecir.groups.io/g/main/files/Case%20History%20Tools/Case%20History%20Form.pages ( hoping this works for you) Some thoughts about eating supps..... - be very sure her bucket is clean; - start at square one, again, with just what she likes,then adding teeny amounts (not even 1/2 tsp ) of offending items. Keep at that teeny amount for maybe 4 days before attempting to add another teeny amount. And so on. Frustrating as hell, but she obviously needs her supps ; - find a method that will work to get the pergolide into her, and still remain friends....sticking capsule into a peanut shell works here. If you're dealing with powder ,either syringe, as you mentioned or find something that will make a paste with it,which she will go for ; - watch for more signs than just hollows above her eyes....review symptoms...www.ecirhorse.org - review how trim is going. It's a struggle. But you two have come so far. You have proved you can do it. -- Lorna in Eastern Ontario
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Re: Urgent advice please. Think I overdosed Savannah with pergoloide.
Pat Gauvreau <pgauvreau@...>
Martha and Cass.
I really appreciated your comments today. I was relieved to see Savannah was still ok today when I got to barn. She ate all her hay but not her mash with the supplements in it (as usual). She drinks water normally, not excessively. She has been on Jaiagolan for probably two years as well as tested hay for over a year. Regular trims which Lavinia thought are heading the right direction. She’s had mad barn amino trace plus but not much anymore as she hates them, 1Tbsp iodized salt in feed plus free choice which she consumes fairly often, organic flax oil for vit E, stabilized Flax, soyhulls and Alfalfa Timothy cubes, (minute amounts of mag ox, copper, zinc, maganese but she refuses the smell so have to omit them). Tried Anise and Fenugreek as I read horses like the smell and/or taste but they didn’t make a difference. She’s very picky and sensitive to smell/taste ?? and walks away never to return to her mash even when left all night. I’m at a loss on how to get her to eat these required minerals. Sometimes I try just leaving them free choice but she never eats them. If I only offer the soaked cubes and soyhulls she does eat those. Today I only put 2mg pergoloide into the soaked cubes but she ate only half then walked away. I’m hoping she finishes that overnight. I’ll syringe 2mgs pergoloide tomorrow and slowly increase again but will stop at 3mgs since fall rise is coming to an end. I’ll observe and increase if necessary from there. There’s no finances left for X-rays or blood testing so I watch the hollows above her eyes to judge status of IR. Lameness comes and goes. Hay is $32/bale with prediction of shortage for next year. Shavings for bedding is hard to find and very expensive to ship in since strike has been going on over 6 months on the island. It’s one thing after another it seems. Hard times for so many these days. We’re just taking it one day at a time hoping for the best. My computer hasn’t worked for a long time and I can’t buy a new one so can’t update my CH. I work from my IPhone only now. I was adding trim photos monthly but haven’t uploaded those recently. I’m trying to stay positive for 2020. -- Pat and Savannah Vancouver Island, British Columbia, Canada January 2018 Case History: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Savannah Photos: https://ecir.groups.io/g/CaseHistory/album?id=22028&p=pcreated,,,50,2,0,0
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Re: Cold weather and insulin
On Mon, Jan 6, 2020 at 06:03 AM, LJ Friedman wrote:
i think?? dr kellon mentioned 40 degrees. legs and feet wrapped.I believe that's for foot pain induced by cold temps to reverse a bit vasoconstriction but different from insulin triggered by cold. Maybe it is the same temperature for both I don't know but I think that it is a different mechanism the vasoconstriction experienced by central nervous system than the one experienced by high insulin and endothelin mediated vasoconstriction even when both are triggered by cold. Maybe someone more experienced can elaborate more diligently. -- María Durán Navarro Dec 2017 Madrid (Spain) Plutón´s Case History Plutón´s Photo Album _._,_._,_
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Re: Favorite herbal for horses
Ahahaha worth a try 🙈
-- Jessica Skene - Abitibi, Québec, Canada Sonara => Canadian X QH mare , 13 years old, historic of founder and Laminitis, IR / EMS october 2017 Link to case history: https://ecir.groups.io/g/CaseHistory/files/Jessica%20Skene%20and%20Sonara/SonaraCaseHistory2019.pdf Link to album: https://ecir.groups.io/g/CaseHistory/album?id=10295&p=Name,,,20,1,0,0 Link to hay analysis: https://ecir.groups.io/g/CaseHistory/files/Jessica%20Skene%20and%20Sonara/analysedefoin.pdf
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Re: Cold weather and insulin
Tanna
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Re: Cold weather and insulin
i think?? dr kellon mentioned 40 degrees. legs and feet wrapped.
-- LJ Friedman Nov 2014 Vista, Northern San Diego, CA Jesse and majestic ‘s Case History
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Re: Cold weather and insulin
Tanna
Do we know if there is a temperature at which horses at risk can experience problems? At freezing? Below freezing? Would keeping such a horse well blanketed, physically warm, help to offset some of the effect?
-- Tanna April 2019, (Yahoo Group member 2008)
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Re: cbd for pain, arthritis etc??
They ship to California. I'm in Northern California. -- Joy and Willie (aka FLS Boxcar Willie) Nevada County, CA - 2019
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Re: Update on Increase
i forgot to mention ground flax
Jesse eats only timothy pellets. adding salt , vit e and flax makes it very close to acceptable till you tighten more. -- LJ Friedman Nov 2014 Vista, Northern San Diego, CA Jesse and majestic ‘s Case History
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Re: Favorite herbal for horses
Jessica,
Chocolate chip cookies. -- Lorna in Eastern Ontario
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