I will ask about that. We did have a pretty sudden short stretch of unusually cold weather but I think we were out of it by then and he was definitely not sedated.
Thx!
--
Chemelle
Hillsboro, OR
2019
https://ecir.groups.io/g/CaseHistory/files/Chemelle%20and%20Andy 

https://ecir.groups.io/g/CaseHistory/album?id=94380

Thank you Dr. Stephen, for taking the time to come here, and for providing a fuller picture of the situation with Shaku's blood work. 

Kirsten and Shaku are lucky to have you on their team.

I hope you'll be able to find time to come here again.......not because you feel it necessary to defend yourself,though. Just to join us , so that we all can learn.

--

Lorna Cane
Ontario, Canada
2002

 

are there any other supplements that would be beneficial for tiko. you have his hay report for analysis.  thank you, daisy and tiko
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-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0

will put in my case hx as soon as i can; labs done after being on pasture  for 10 days with no grazing muzzle done 10/01/19 for about 6 hours per day.  labs done 5/2019 was not compensating then after 2 months back in muzzle he was  compensating ir in  6/17/19, ; new labs insulin 23.6, glucose 104, , ratio 4.4,risqi  at 0 .21, mirg at 8.0 , leptin at 10.4, all put him back in not compensating;  how much non compensating is he. i plan to do labs again mid to late november.  i guess i should put muzzle on again for  about 6 weeks then repeat labs; pasture choices are short overgrazed or  much larger pasture   10 plus acres , taller grass  some clover minimal alfalfa  but much more moving about. thoughts, thank you, daisy and tiko
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-- 
Daisy, Tiko and Whisper
CO, April 2019
Case History:  https://ecir.groups.io/g/CaseHistory/files/Daisy%20and%20Tiko 
Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=90099&p=Name,,,20,2,0,0

Hi Lynn,

As a horse owner whose horses have lived to be in their thirties and early forties, I don't see 24 as being old. 
If it were me,I would test ACTH again. I think it hasn't been tested since last January, when the results were good,but when,also, they weren't being affected by seasonal rise.
His lack of energy may not be from this, bit I would start there.

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Lorna Cane
Ontario, Canada
2002

 

Thank you Dr Stephen for jumping in, you and your team do provide the highest standard of care for Shaku (who has other problems in addition to IR) and you already know how much we rely on you and appreciate everything you do.  You genuinely care and I see that in how you ask after the dogs and how you were upset by Anna's death in the spring.   Without you and your team I don't know what Shaku's life would be since he needs regular procedures...he likely would have been PTS.

I should have re-emphasized that the reasons for pulling blood post-sedation were outside our control, as Dr Stephen explained, rather than not making it clear that Dr Stephen was not at fault in any way, so I must apologize for not making it clearer.  Despite arranging with the small animal clinic a drop off at 1215pm, no one was there and I waited 30 min with the sample (not on ice because it's just 2 min away) hoping someone would come back from lunch and process it.  We both agreed a new blood sample would be better than one not processed immediately, but I wanted to make sure so that evening I asked the group for feedback and learned the post-sedation blood was not going to give accurate numbers.  Money being very tight for me (truly, after this year's hay bill for low sugar hay etc I am completely broke), I decided to ask the small animal clinic to dispose of it.  I am still waiting to hear if they have someone who is comfortable doing a blood draw on horses to come out and resample.

I feel sick thinking that Dr Stephen feels attacked and that my words have been a part of that.  I am truly sorry.


--
Kirsten and Shaku (IR)
Kitimat, BC, Canada
January 2019

Shaku's Case History: https://ecir.groups.io/g/CaseHistory/files/Kirsten%20and%20Shaku  
 
Shaku's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=82559&p=Name,,,20,1,0,0   

I'm sorry you feel the need to defend yourself. All I said was the results would be difficult to interpret. Please see messages 182526 and 222970 for references.  This is a drug effect, not a stress effect.

True that shipping, fasting, different feeds etc. can influence the metabolic results and that is exactly why we recommend a strict protocol in sampling including no shipping https://www.ncbi.nlm.nih.gov/pubmed/27651674, https://www.ncbi.nlm.nih.gov/pubmed/18315878. 

I hope you will be able to stop in often and peruse www.ecirhorse.org as well as the free proceedings from our last three conferences. Our goal is to stay on top of publications in this field and pass that information on to our owners and their hard-working caretakers.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

--
Cheryl and Jewel
Oct 2018
Port Alberni BC Canada
https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel

https://ecir.groups.io/g/CaseHistory/album?id=81063

You can copy and paste the URL from your CH and load it into your auto signature, even on your phone. 

This is your link
https://ecir.groups.io/g/CaseHistory/files/Brenda%20and%20Amigo

This is your member profile
https://ecir.groups.io/g/main/member/4033828?p=,,,100,0,0,0::joined,members,brenda,100,2,0,4033828

Don't forget to hit SAVE. Lol.

The phone is definitely less friendly than a desk or laptop but it can be done!
--
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

Hmmm. Unless he was sedated or you had a sudden cold snap I'd ask that the test be repeated. They may still have the sample. Even a high sugar hay shouldn't do that.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

I’m not sure if there is information in the pergolide database that indicates how many horses on pergolide are still being ridden and at what age.  Bodie is 24 and still being ridden.  However, I wonder if some of his lack if energy is due to age or symptoms of his PPID being not controlled well enough. 
--
Lynn McKechnie

N. California, May, 2011

Mica:  https://ecir.groups.io/g/CaseHistory/files/Lynn%20and%20Mica  
Bodie:  https://ecir.groups.io/g/CaseHistory/files/Lynn%20and%20Bodie

I can't seem to see how to add the CH onto signature. I will try again after work from a computer instead of my phone. 
Learning to use this Group format is more frustrating that the cushings LOL
--
Brenda Woodall
Linden Alberta
June 2019

I am the vet being referenced in this conversation and I feel there is a need to defend myself and other rural vets and let this group know the following:

1. Shaku and Kristen have been a part of my practice for many years and I do the best I can to support her and him. As rural mixed animal vets it is extremely difficult to know everything about everything so please be kind to those of out there doing the best we can for all owners and patients; including dogs they may have  

2.  I am not the reason this horses blood is “a waste”.  I do listen to my clients; all of them and I also listen to my patients. I don’t cop an ego or think I am more knowledgeable than them on a topic of their passion but I do have knowledge. The above comment in reference to that was a bit out of line on a professional list service.

Shaku’s blood was drawn on arrival however due to processing delays; remember I am working in the field 6 hours from home which means no centrifuge and no freezer we were relying on another small animal clinic to do this. They were the reason for the blood draw while sedated as they were closed when Kristin arrived to drop her horses initial “on arrival” samples off.  I was concerned about the length of time that sample was going to sit at ambient temp without being processed and froze and therefore made the decision to redraw blood at the end of his appointment.  Dr Kellor; is there a clinical paper(s) that shows the effect on these values being ran at Cornell on a sedated horse; if so please post the link; if not please share the reasoning  I am aware of the glucose mobilization but not of other changes.  

3. Due to location and time between visits (Kristin does not have a trailer and is not able to haul  Shaku without some logistical challenges to an equine clinic); I recommended she still submit the EMS panel. There are many horses affected by stress prior to blood draw and also just the time of day and temp of the day and time of feeding are all factors resulting in variables in results. 

4. At this time, unless the sample is frozen as per the instructions left with Kristin to give to the clinic processing the sample the, the sample going to Cornell is useless

5. The sample going to idexx should still go

6.  As an FYI; there are many of my hours and my amazing technicians hours put in keeping up to date on this every changing dynamic syndrome and disease. Please, as you post and read and worry about yours and all the affected horses, that we also are trying our best to do the same. 

Thank you Kristin for being such an advocate for Shaku. 

Andy's test results just came back today. His ACTH was normal so he must be responding favorably to the 1 mg of Prascend/day but his insulin topped out at the test max of 200! He's never been anywhere near that and all he is getting is supposedly a low sugar (esc+starch <10%) hay. They must have made a mistake and given me a higher sugar content hay?!
I will start soaking immediately and we'll put him on metformin.
I have a new batch of Teff coming in this weekend.
New case history to be uploaded. No wonder he still isn't feeling good. :(
Should I be doing anything else?
--
Chemelle
Hillsboro, OR
2019
https://ecir.groups.io/g/CaseHistory/files/Chemelle%20and%20Andy 

https://ecir.groups.io/g/CaseHistory/album?id=94380

Kirsten,  I accidentally had blood drawn for an ACTH test *after* floating Logo’s teeth one spring.  There was a marked unexpected increase in the ACTH.  My vet consulted with Cornell and they determined it was most likely a result of just having floated.  We repeated the test several weeks later and all was back to ‘normal’.
If the blood has been shipped, I think you could call the labs and have the tests held.
--

My vet made that comment about the pergolide losing potency (I dont agree). Each time we test his ACTH it has gone up, with exception of the first "re-test". Honestly, I just think he needs a higher dosage and she is trying to find another reason as to why its not under control (his ACTH has never been near normal range)
To answer your questions:
I buy compounded pergolide in capsules and keep it in the door of my refrigerator , (it has a vegetable saver bin with low humidity.)
I am buying 30 capsules at a time, but I used to buy 100 (he was doing ok at that time)
I asked Pet Health Pharmacy about the issue and they swear that their compounds are tested for potency. And they retain full potency for 6 months. They also stated that they do not have to be refrigerated. But they should be kept out of direct sunlight.



--
Susan Morgan
June 30, 2018
Ione, California
Case History: https://ecir.groups.io/g/CaseHistory/files/Susan%20and%20Knight

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=71655

Hi Maria,  I’ve posted several times about the dosing syringes we use.  This seems like it might be a perfect application, unless deworming is a hassle.  I cut the top off a large plastic dosing syringe and fill it from the cut end.  It’s important to cut just after the end begins to taper which then acts as a stopper for the plunger.  You could load up a week’s worth of syringes with whatever paste-like stuff that tastes good.  Then the feeder could insert the tablet into the syringe and squirt it into the horse’s mouth.  If he doesn’t accept a syringe well, maybe you could train him first with something yummy in there.
Additional syringe tip - don’t remove the plunger to wash and it will last longer.
--

By the way,Pat, I in no way intended to suggest that you not take Dr. Kellon's course!
It's fabulous.

But you said you're not good at math,so having someone balance for you is another way to go.
Dr. Kellon also does balancing for people.

--

Lorna Cane
Ontario, Canada
2002

 

Hi Pat,

Not Dr. Kellon, but check out our Files.
Scroll down to number 6, Diet Balancing, for help with this.
Alternatively Mad Barn will do a custom mix for you ,as well.

--

Lorna Cane
Ontario, Canada
2002