Hi, Daniela -  you would need to test once per month, as you wean down the dose. With early PPID, weaning down the dose is a good option. Once you it July, as you said, it will be time to put her back on.  If the ACTH springs up before July, then you will know for next year that reducing the dose during summer won't work for her.
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 

Dana, what are PRP injections?
--
Mary and Halo and Wellon

West Fargo, ND, USA

Joined spring 2016

https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Halo

 

I read posts on underrun heels..such as this:

The way to correct the underrun heels is exactly as already outlined
for Millie - repeated trims to keep the toes backed up, lower the
heel to the live sole plane, keep it low and in alignment with the
coffin bone. This would be much easier to accomplish if she was
barefoot. Neither one of these horses has collapsed heels so should
be easier to correct than some horses.

In Jesse's case, what should be done for his underrun heels in the hinds?  Is this a farrier fault or a confirmation issue , or a combination?
Should I have markups for the farrier?
For now, the rule I tell the farrier is ,,, not to touch the frog or sole and leave the feet ugly but functional. Not sure how to properly advise on the lowering of the heels so the farrier does what we know is best. and does no harm,  thanks 
--
LJ Friedman  Nov 2014  San Diego, CA

 

 

https://ecir.groups.io/g/CaseHistory/album?id=2117 

.https://ecir.groups.io/g/CaseHistory/files/LJ%20and%20Jesse

Thank you!
--

By ECIR Group - Equine Cushings and Insulin Resistance

Learn more at https://www.ecirhorse.org/laminitis.php

Having personally been to Dr. Bowker's clinics, I can say he strongly emphasizes not trimming anything on the frog. Period.  He is currently researching the extreme microscopic structures of the foot, particularly the frog in conjunction with , I believe, either MIT or one of the top med schools, using their knowledge and state of the art MRI equip to further our understanding of the frog. He believes that all the vessels in the frog(i'ts not a fat pad) are a hydraulic fluid filled system to provide cushioning and messaging to the foot and lower leg, and he has found stem cells, other microstructures in the frog that are used in healing, etc.  The following comment is from Hoof Armor's facebook page, when the owner of that product attended a Bowker clinic this fall. 

"-- Here’s one for ya...the central sulcus of the frog contains a scent gland used by horses, particularly stallions in the wild, to mark territory and the lay down trails. The frog and digital cushion consist of “myxoid tissue.” Myxoid tissue exists in several places in the hoof and is much like stem cells and can become ligaments, cartilage, fibrous tissue or fatty tissue depending on hoof conformation and movement.
One thing Dr. Bowker stressed is that most research on the equine hoof, indeed, most anatomical research, has been done on horses from slaughterhouses. Many of the “findings” have been on hooves that are already damaged and deteriorated. For instance, some researchers say there are no blood vessels in the frog, but Dr. Bowker’s microscopic studies have shown “a bazillion” of tiny blood vessels as small as 4.5 microns which the others didn’t see. The digital cushion in a healthy hoof is filled with a network of ligaments and the lateral cartilages are nearly 1” thick. In comparison, a deteriorated hoof has fatty tissue where ligaments normally are and the lateral cartilages are less than ¼ inch thick. What many consider “normal” are actually deteriorated. Many of these changes happen before the obvious symptoms of navicular syndrome appear and before observable radiograph changes."




Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Thank you Dr. Kellon!  I will start with the boots and Temporary diet that Jaini recommended.  Jaini recommended I ask you to complete my mineral balancing, please let me know how to arrange this. I have my hay analysis and water test posted in photo album mistakenly, Now added a hay and water folder with hay analysis to my main folder, will add water later. 
--

Andrea
January 2018, Winnipeg, MB
Uma’s Case History: https://ecir.groups.io/g/CaseHistory/files/Andrea%20and%20Uma   .
Uma’s Photos: https://ecir.groups.io/g/CaseHistory/album?id=14923  .

It's safe but would be very expensive.
--
Eleanor in PA

www.drkellon.com 
2 for 1 course sale 2018 is on
EC Owner 2001

Herbal tinctures come in alcohol or a Glyercite base. Glycerin is non-nutritive and tastes sweet. Is this safe for IR?

I use it daily with diabetic clients. And thought of it while trying to find Devil's Claw without the Yucca. Perhaps a Glycerite Tincture?

Thanks,

Beverly Texas 2014

Thanks Jaini! I will grab the recommended supplements today and slowly increase the flax. Should I wean her onto the calcium & magnesium?

I will contact Dr. Kellon regarding mineral balancing. 
--

Andrea
January 2018, Winnipeg, MB
Uma’s Case History: https://ecir.groups.io/g/CaseHistory/files/Andrea%20and%20Uma   .
Uma’s Photos: https://ecir.groups.io/g/CaseHistory/album?id=14923  .

There is no equine specific research available on this. I would avoid Jiaogulan at least for the first trimester so you *should* be safe. L-arginine and acetyl-L-carnitine should be safe so try that first, together with the padded/lined boots.  Also very, very important to get a hay analysis and get her diet properly supplemented for minerals and protein. In the meantime, add 10 g/day of magnesium.

You can't test for iron overload during pregnancy. Pregnancy naturally causes ferritin to drop to ensure adequate supply of iron to the fetus.
--
Eleanor in PA

www.drkellon.com 
2 for 1 course sale 2018 is on
EC Owner 2001

Hi Andrea,

No hay soaking required!  YAY!!  Hope you saw Dr Clougher's message to here:  https://ecir.groups.io/g/main/message/216380  I think it answers all of your question in your follow up post to Pauline.  
--
Maggie, Chancey and Spiral in VA 
March 2011 
EC moderator/Primary Response

Thank you Paula! I will be getting her blood work on Jan 23. My appointment is 12:30pm. Is that too late in the day for the IR related tests? Also doing digital X-rays then.

i have always treated my horses as if IR since I have a pony who is both PPID and IR (confirmed by blood work) on prascend, and my others 2 are Rocky Mountain horses, which are prone to IR. Vet has never done blood-work on her but now that I see the iron content in my water, I do want to do blood and will do the tests you recommended as well.

I had my hay tested locally, analysis in photo album (I see now I should make a folder for it in my case history, will do :)) the hay is 4.81% esc + starch and 1.4% fat so thankfully given the temperature outside I don’t need to soak. With the exception of supplements I am following the emergency diet, both dos and don’ts. I think I calculated the requirements for supplements, but would like to have someone more experienced make recommendations. Is there a volunteer who does this? How do I arrange it?

Thanks

Sent from my iPhone


--
Andrea
January 2018, Winnipeg, MB
Uma’s Case History: https://ecir.groups.io/g/CaseHistory/files/Andrea%20and%20Uma   .
( https://ecir.groups.io/g/CaseHistory/files/Andrea%20and%20Uma ) Uma’s Photos: https://ecir.groups.io/g/CaseHistory/album?id=14923  .
( https://ecir.groups.io/g/CaseHistory/album?id=14923 )

I would like to ask If I can wean Salta  off pergolid. I just decrease her dose from 1,5 to 1mg. If the blood results (ACTH) will be good, can I keep lowering the dose (may be even wean her off completly) until July when the seasonal rise begins again? And how often do I need check the blood if I decide to wean her off completly for couple of months?. If you think it is too much risk I wont want to risk it. Thank you for your answer

--
Daniela
October 2017, Slovakia (Europe)
Salta Case History: https://ecir.groups.io/g/CaseHistory/files/Daniela%20and%20Salta
Photoalbum: https://ecir.groups.io/g/CaseHistory/album?id=10032&p=Name,,,50,2,0,0

Good ,Sue.
Please add your full signature to every message:

Sue 
Colorado Springs
11/17/17

Cookie case history   https://ecir.groups.io/g/CaseHistory/files/Sue%20and%20Cookie  .


--

Lorna in Eastern Ontario, Canada
ECIR Moderator 2002
https://ecir.groups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf

 

Hi, LJ - the other causes of laminitis include feed-room break-in (carb overload and subsequent hind-gut bacterial die-off with the horse suffering septicemia), exposure to black walnut shavings, eating sweet alyssum,  retained placenta in mares, some infectious diseases, and any cause of septicemia. In some of those cases, when you realize that things are going sideways, icing is truly beneficial in the first 24 to 48 hours surrounding the event,and most beneficial before the laminitis actually begins. (only helpful in cases where you haul the horse out of the feed room, or start icing while you wait for the vet to come clean out a retained placenta. Other cases are usually not realized until the horse is actively laminitic).   I believe the studies done on icing in laminitis have been with laminitis induced by means other than hyperinsulinemia.  Does icing help if you ice immediately after your IR horse gets out on to grass, and is presumably having an insulin spike? Unknown - there are no studies. Does icing help when you catch your horse in the grain bin, and start icing before the explosive diarrhea, colic, etc? Yes, it does (but of course the vet is on his/her way while one is icing).

Laminitis secondary to vaccines usually occur, to my understanding (I could be wrong), in IR or PPID horses who are already close to the edge of tipping over into frank laminitis. 

So, despite lack of evidence that icing helps after an IR horse gets out on to grass, do I still ice? Well, I confess, I do, for the first 24 hours. (along with forced marching, and giving metformin)
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 

Hi Cassie,

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

https://ecir.groups.io/g/CaseHistory/album?id=13687&p=pcreated,,,20,2,0,0

In general, underrun heels (severely on the hinds),long toes and flaring walls are a problem on all the feet. Need to make a concentrated effort to back up the toes so that the breakover gets set correctly. Then bring in the flares in the lower 1/4-1/3 of the hoof capsule so that at ground level the "footprint" is aligned with the new growth at the top, directly under the coronary band. There is an issue with "High-Low syndrome" in the fronts, which means one foot is taller and narrower (LF) while the other if flatter and wider. Although the heels need to be moved back, you can only do that IF there is enough collateral groove depth to allow it. See here for more:

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

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

If there isn't enough depth to work with, then leave the heel buttresses where they are but add a bevel to the very back of them that slopes back toward the heel bulbs.

Rads RF/LF: In the 11/2017 rads, the bony column on the LF is fairly well aligned (pink). The RF shows the HPA (hoof-pastern axis) to be broken back, which means the bony column dips down (purple) and away from being correctly aligned (pink). Green lines follow the angle of the new growth toward the ground. Blue lines are where the toes need to come back to, blue "x's" are the excess toe that is extending the breakover point beyond where the pink line hits the ground - get rid of that excess length.

LF lateral: Blue is where the toe needs to be removed to shift the breakover back to where it should be. Green line follows the angle of the new growth downward. DOn't thin the dorsal wall to match the green line, just be aware of it - that excess will grow down and be removed in future trims.

RF dorsal: Green lines follow the angles of the new growth down to the ground. Bring the lower 1/3 of the walls inward til it matches the upper angle of growth. Leave the remainder to be addressed later when it has grown down further so that you don't over-thin the already compromised strength of the walls.

RF Lateral: Remove the excess toe length (blue).

LH dorsal: Green lines again follow the angles of the new growth. Use those to determine how much to bring the flaring material inward on the bottom 1/3 of the hoof, then bevel it under.

LH lateral: Blue again is where the toe needs to be backed up to.

LH heel-toe: Appears that the medial side is higher than the lateral one (lime) so need to adjust that to make hem level.

LH sole: Yellow circles are where the heel buttresses are now, purple where they should be - aligned evenly with each other and with the widest part of the frogs. As the heels have migrated forward and outward, the heel bulbs and frog have been dragged downward and under, covering the actual heel wall growth. Blue is where the toe should be - hashed areas are what needs to be removed to get the template in place for the hoof capsule to be able to grow back in healthy. Before making any move to reposition those heels, make sure there is over 1" of collateral groove depth in both sides of the back of the foot. If there isn't, leave them where they are and just move the toes back and the flaring walls inward.

RH dorsal: Green lines follow the healthier angle of the new growth just under the coronary band toward the ground. Outside of the lines is flared, less connected wall that needs to be brought inward and beveled under.

RH medial: Blue is where to move the toe back.

RH sole: Same as the LH.

If Cleo is not landing heel first when moving, boots and pads should be part of her life until such time as she can comfortably land correctly.
--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team

Hi, Andrea, and welcome to the list!

Well!  The pregnancy thing is well beyond my expertise, so I will flag Dr. Kellon on this. 

Meanwhile, getting off the Buckeye is good. Great job on your case history!  Your hay is fine for ESC, starch and protein. You will need to add 13 grams of calcium which is 38.4 grams of calcium carbonate, and 10 grams of magnesium = 17 grams of 58% magnesium oxide = 20 cc or 1 tablespoon plus 1 teaspoon.  You will also need copper, zinc, a little manganese, plus iodine and selenium. Sadly, there is no over-the-counter mineral mix that can cut the mustard, although Genevieve's mix comes close:  http://lechevalaunaturel.blogspot.ca/p/blog-page_10.html   It will be important to have adequate trace minerals for the baby, and for when the foal is growing, as copper deficiency is implicated in equine osteochondrosis dissecans.  Your best bet will be to get a custom mix made up by Mad Barn, which is what I do:  https://www.madbarn.com/   The cost for my mix is about $1.44 per day.

If you go here, you can find someone to balance your minerals for you:  https://ecir.groups.io/g/main/files/6%20Diet%20Balancing/3.%20Getting%20Help%20with%20Mineral%20Balancing.pdf   Your very best bet is to get Dr. Kellon to do the balancing, as she has extensive experience with pregnancy/lactation in mares. 

She is only getting about 17 mg of iron daily from the water, so that is not a huge concern (although the hay does have significant iron in it).

You can increase to 3/4 of a cup of ground flax to get the required omega 3 fatty acids.

So, for her, the Temporary Emergency Diet will look like this:  the current hay (no need to soak);
2,000 IU Vitamin E (best is in 400 IU capsules containing a little soy oil; I get mine from National Nutrition: http://www.nationalnutrition.ca/detail.aspx?ID=2022  )
20 cc of magnesium oxide
38.4 grams of calcium carbonate (feed store should have these last two items)
1 to 2 tablespoons of iodized salt
3/4 cup ground stabilized, or fresh, flax. 
Continue using the ODTB cubes to get her supplements into her.

All of the horses can benefit from these additions; once you get your hay balanced and a custom mix, all the horses can also have the custom mix.
--

Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy

 

 

I like to review my nutrition for Jesse every few years, lol.  A member in horsekeeping said the standlee shreds are much cleaner than the LaBudde shreds that I use, ( both are premium).  This is from standlee:

Is there added molasses in the beet pulp pellets or shreds? --
My takeaway is that the LaBudde shreds also have this by product , even though they list as molasses free? 

Also, I stayed away from pellets bec they have high iron.  Are shreds still the go to bp?
( I did read many posts on this topic)
LJ Friedman  Nov 2014  San Diego, CA

 

 

https://ecir.groups.io/g/CaseHistory/album?id=2117 

.https://ecir.groups.io/g/CaseHistory/files/LJ%20and%20Jesse

Hi Angela,

Thanks for providing the latest labs and rads. It would be really helpful if you would please put all of the info in a case history for your girl.

From the labs, your girl is not only severely IR, she has gone beyond IR into actually being diabetic. Her diet needs to be made excruciatingly tight to get this under control. Adding in Metformin might be something to discuss with your vet.

The low T4 does not necessarily mean depressed thyroid function - it is likely secondary to the severe IR and imbalanced diet. To diagnose primary hypothyroidism (extremely rare in horses), you need to test T4, free T4, T3, free T3. This can only be done at Michigan State University. Because she is already underweight, supplementing thyro-L could be problematic if it pushes her into hyperthyroidism as that will encourage her to lose more weight.

She is on 1mg of Prascend - were there previous labs that showed an elevated ACTH? Prascend (pergolide) is not a treatment for IR.

According to the radiographs, the trim needs to be corrected. Her toes are too long out in front of her, there is sinking, heavy flaring of the hoof walls. Bony column alignment appears to be pretty good but the dorsal wall is flaring away from its alignment with the bony column. That's all fixable but only if the hoof capsule is trimmed to realign it properly with the bony column. Frequent trim adjustments - may need to be every two weeks initially - are much more easily accomplished if you use boots and pads rather than attached appliances.

Quiessence is a pricey way to add magnesium to the diet - magnesium oxide is a much less expensive alternative -  but it won't help anything unless there is a deficiency. Getting you hay analyzed is the only way to know for sure.

Jiaogulan is available here:

http://www.mybesthorse.com/productsorderhere.html

https://www.herbalcom.com/index.cfm?CFID=108738102&CFTOKEN=fe62f952f8060b2a-E89E6F37-F84B-ED5C-E0787FB78CBBE314&jsessionid=f030a1f94344160ae5e82e5d485867151d36

See here for info on Jioagulan:

https://ecir.groups.io/g/main/filessearch?q=jiaogulan

Overdosing any NSAID is dangerous as it greatly increases the chances of side effects. After a week or so, NSAIDs will also interfere with the body's ability to heal. As long as she is eating and drinking, she is better off without them so that she doesn't do too much on her compromised feet. If she want/needs to lie down, let her - it is a good thing.

--
Lavinia and George Too

Dante, Peanut, Nappi and George over the Bridge

Jan 05, RI

ECIR Support Team