Hi Tara,

Knowledge is power,so in light of that I'm going to tell you how to find your CH, instead of copying the link for you.This is for others in your shoes,too.

Go to Subgroups, in column to left of the Messages.

Click on it and then scroll down to Case Histories on right side of page.

Then click on Files on Left side of page (did they do that on purpose - left,right,left ???), and scroll down to 3rd page for Tara and Elf.

Doesn't the power feel good ? :-)
--

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

_._,_._,_

Hello All.  I just ran some labs on my Pony Elf.  He is a 20 yrs young TB/Welsh with a history of IR.  Somewhere in the other format is his CH.  (if someone could help me retrieve that-thank you!).  Elf has never been laminitic.  His biggest problem is his weight.  I exercise him 2-3 times a week, but cannot restrict him enough to be at the weight that he should.  It would mean a life of isolation because he is my only pony...I have thought about getting another pony so I could starve them together (joking!).  Anyway...I ran his labs to see how he is coping and get his acth.  He is now cushings positive...and I have been reading that the seasonal rise may be coming sooner for us here the NE.   But, my question is about leptin.  It seems Cornell has changed the reference range and I am wondering...did Eleanor and/or the info from this group have anything to do with that??

Here are his stats  acth 73.1 pg/ml   (range 9-35)               Insulin Baseline Equine 99.00 uIU/mL     Leptin Baseline 10.76 ng/mL (range 1-10)   Glucose 90 mg/dL (range 71-113)

And below is something I don't recall seeing on the labs:

NOTE: The leptin test had a change of antibody July 1, 2016 that necessitated a change of reference ranges. The equine reference ranges prior to July 1,
2016 were: normal 1 – 4 ng/mL, intermediate 4 – 7 ng/mL, high > 7 ng/mL. If you have been treating a horse and tracking progress using leptin results,
please call the lab to discuss it.

So, I plan on starting Elf on pergolide asap and getting some weight off.  How do you interpret his results??  Do you think he is truly metabolic??

Thank you all, so very much!!

Tara and Elf

February 2014

I found the folder on treats, so please disregard this question : https://ecir.groups.io/g/main/files/Treats%20for%20Horses 
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Genevieve  March 2012

Hemmingford, Quebec

Rose Case History, Photo Album

Hi Amy,

Would have been better to have given the dose so you would have known how well it was controlling the ACTH at this point. Water under the bridge at this point. You know the ACTH is higher than it was before starting the pergolide so need to plan accordingly.

Yes, seasonal rise is starting in some horses at this point - all the more reason to consider raising the dose to stay ahead of the curve. The idea is to maintain the ACTH within the normal ranges all year long. How tightly within really depends on the individual horse and how sensitive it is to changes in it's ACTH. Some horses will have major laminitis issues when ACTH rises more than a few points above mid-range while others can have raging high ACTH yet still appear fine (they're not, but...).

Splitting the dose is not advised as that will lower the effectiveness of the drug but extend the time frame of the coverage. Better to first find the dose that controls the ACTH then add a second dose if your horse needs to have more consistent control over the course of the day. Again, very individual.
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Thank you so much Lavinia for your input! Here are a few answers to your questions, as well as new questions from my end (sorry – there are a few questions):

TRIM – What makes you think that the rotation is not due to her lamimitic bout in June of this year, in other words, how can you distinguish between a new vs old rotation? Also, do you see the sink at left or right side?

I’ve just uploaded fresh pictures of the front hooves. If you could give me some guidelines for the trim “tweeks”, it would be awesome!

EXERCICE – how comfortable must the horse be before trot or riding can be introduced. Does she need to be comfortable walking on hard ground without boots? Or if she is comfortable trotting in hand in the sand without boots, that is considered sufficient?

Medication – yes, the Isoxsuprine treatment is now over, and she is not taking any other pain medications.

DIET – I generally follow he NRC recommendations except for:

Vitamin E – 2000 IU

Selenium and Iodine – I use KER’s recommendations

Cu, Zn and Mn = I use 150% of NRC

Ratio Fe:Cu       4.0

Ratio Zn:Cu       3

Ratio Mn:Cu      ≤ 3

Ratio Mn:Zn      0.5-1

Ratio Ca:P         1.2-2

Ratio Ca:Mg      2

I’ve just ordered Chrome from Platinum. It’s a missing piece from my ration.

Are there any treats recommended for IR horses, apart from beet pulp chunks?

My vet recommends that I give Equitop Gonex (78% glucose, 20% mussel) from Boehringer. She said that the company had great results with laminitic horses. I raised a concern about sugar and got the reply that it is only 4 calories over the 18 700 000 calorie requirement. I find the argument a little deficient, as the horse caloric intake does not rely on sugar. Unless I have the “go” from you, I won’t give it. I don’t want to risk the improvements done so far, plus I don’t see how an articulation supplement could improve the situation.

DIAGNOSIS – I’ll test for PPID as per your recommendations. Do you think it can wait a couple of months or should it be done soon? Should I retest glucose and insulin at the same time, hoping that numbers have improved now that she is no longer in crisis? Alternatively, at which frequency do you suggest performing these tests?

Again, thanks a ton, your input is much appreciated!

Genevieve  March 2012

Hemmingford, Quebec

Rose Case History, Photo Album

I just received the interim report from Cornell on Inky's latest blood test. While the leptin is missing, the ACTH came back as 66.5 pg/mL. It had been 26 after the introduction of pergolide a year ago.

This wasn't an apples to apples comparison however. Last year, Inky had his pergolide in the morning, and the blood was drawn at 1 p.m.

This year, Inky had his pergolide the afternoon before, and then had his blood drawn the next day at 1 p.m. In other words, he was about 3 or 4 hours away from getting a new dose. The vet had told me not to change the pergolide administration back to the morning, that it wouldn't make that much of a difference in the result.

I'm not so sure. Inky never shed out completely, but his coat isn't horribly thick or long. He's actually doing much better this year in terms of how he looks and acts.

Anyone wish to comment on whether the change in pergolide administration could have led to the higher reading, or could he truly need a higher dose?

Karin & Inky

Forest, VA

IR/Cushing's

July 27, 2015

https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Inky

Thank you Lavinia for reassuring me. I thought I had finally begun to understand the quagmire of hay analysis acronyms but occasionally my eyes cross and I panic. I chose Litchfield because we are planning a move to Michigan and the Lichfield lab will probably be pretty local to me. 

--
- Bonnie 07-2016

Charles County, Maryland

Mouse Case History, Photo Album

Hi Bonnie,

Looks like it may be at least partly wet chem as the NIR tests are usually quite inexpensive as compared to the wet chem. I don't see anywhere on their list of tests that they do ESC at all. However, ESC is a fraction of the WSC so a WSC of 8.0 means the ESC will obviously be only part of that.Based on that, yes the hay would be safe.

I'd call to confirm the NIR vs wet chem question. If they say both, ask specifically which parts were done with which process.

Litchfield is an NFTA certified lab (B rating):

http://www.foragetesting.org/files/2016_Certified_Labs.pdf

--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Not what I expected! I used Equi-Analytical for a hay test done last Feb and got WSC, ESC, Starch results (plus all the rest) which confirmed for me that my hay was safe. But it took nearly 2 weeks for the test results to get to me AFTER I made a call to inquire.

I decided to use Litchfield Analytical  for the next tests. I thought they used wet chem method but it looks like it may have been NIR only? The results were fast but what I got is:  Starch=1.04, Total Sugars (WSC)=8.00, and NSC=9.04.

I was expecting to find an ESC value. Doesn't the WSC (total sugars) also include fructans? Does that mean that the NSC value of 9.04 is really partly fructans  so the NSC value would actually be lower if they had actually done an ESC test? I believe this should be a safe sugar/starch level hay from these figures but would like someone more knowledgeable to give me a warm fuzzy about these test results.

Should I not be using this lab? Guess I can call and ask about Wet Chem testing. I know most forage testing labs use NIR only.

-- 

- Bonnie 07-2016

Charles County, Maryland

Mouse Case History, Photo Album

Hi Jennifer,

Good on you fro noticing the small changes in her attitude and poop consistency. Excellent control of her PPID at the last testing as well.

With the good control you had, and the seasonal rise just starting to be a factor, and ACTH below 20 would be fine. More than that would have me making a plan to start raising her pergolide dose and scheduling another blood draw for mid-Sept to reassess how well my plan had worked.

Possible that the missed dose had some effect if Darcy is quite sensitive and ACTH is starting to be less controlled with the seasonal rise effect coming into play but I would be looking more at things like weather and her drinking. Dry poop is a sign that her water intake may have been off for some reason or that she was a bit dehydrated. These could make her feel lethargic or somewhat "off". Is her salt/water intake adequate with the July temps? Has she been sweating more (or maybe less, which could indicate anhydrosis)?
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Poulticing not drawing anything.

Took another shot at backing the front toes and took photos showing the red (I assume old white line).  Comments?
--
Sharon P, Elsa  April 2016

Courtenay, BC Canada

Elsa, Case History, Photo Album

Hi Vicky,

Thanks for the update! Totally agree with Lorna :)

Here's the link to Samson's photos"

https://ecir.groups.io/g/CaseHistory/album?id=1226

Lots of good progress has been made - still needs some tweaks. Don't agree with waiting on getting the toes backed over time as you'll be chasing your tail on that unless you do the adjustments every 2 weeks - hard to do with shoes on. The thin soles won't respond until those toes get backed and stay that way. Really wouldn't want to see more than a smidge of added heel height as the bony columns are almost perfectly aligned in the latest xrays.

Xrays show the bars are pretty jammed up under the rear of the coffin bone and in the sole shots (although hard to see thru the shoes) they are visibly over-running the soles. Work to tame them back, in and down.

On the fronts, the branches of the shoes extend well back to the widest point of the frog - this is good. Just need to keep them set wider so they aren't covering the frog and encouraging the heels to contract. Keep working to get those heels themselves backed to this same point. Also need to get both heels even with each other and with widest part of the frog, rather than one further forward than the other.

On the rears, would work to get the heels backed, just like on the fronts. The shoe branches are shorter so not providing as much support as they could be.

Toes can come back on all four feet. Would like to see the shoes set further back so as to be better aligned with the break over of the CB. A shoe with a more pronounced bevel at the toe would be additionally helpful.

Just as an FYI, it is the excessive urination that drives the excess drinking (not the other way around) so be careful to never limit his water intake.
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Hi Kelly,

Just to add to what Lavinia has said, you should be expecting to have a lab report  for all the tests sent to you, email or snail mail,so that you have something for your records.

That's part of the deal.

--

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

I am a new member. I been working on gathering all the info needed for my horse's case history and have now gotten that up to date. I have also created a photo album with radiographs and hoof pics. I just received the lab test results today on hay that I am buying in quantity (based on the test results).

My horse suffered badly from "Stupid-owner-itis" and had his first episode of laminitis on 2016 01 22. My vet got to me as a blizzard hit our area. At the time the urgent matter was laminitis and she did pull blood for a Lyme test  at the time. He was overweight, eating too much grain and being treated again for heaves/lung congestion. The inhaled steroidal medication probably was what tipped the scales to laminitis. She suggested I get him tested for IR once his laminitis was under control.  I hauled him to her clinic recently for follow up radiographs and learned that she couldn't pull blood for testing after trailering. So, IR testing still to come. He is doing pretty well hoof wise, no rotations at all. 

So, I don't know for sure if I should have joined this group without having IR or PPID postive test results. I really need to get my horse's diet on track and have been changing it gradually since last January, more changes since 2016-07!

I could really use an existing spreadsheet that I could  put my hay test results, supplements, etc into so I can see it all listed  in columns and be able to "see"  the existing diet. I haven't found this type of spreadsheet on ECIR. I really don't want to reinvent the wheel if I can borrow an existing spreadsheet and then I'll get help with real diet balancing.

** Would someone please point me towards the location of a spreadsheet that I may use or let me borrow one that they have created, please. 

--
- Bonnie 07-2016

Charles County, Maryland

Mouse Case History, Photo Album

Hi Kelly,

The numbers you received pertain only to thyroid tests, with both T3 and T4 being in the normal range. Pretty common findings as primary hypo/hyperthyroid are rare in horses.

There is only one Cornell - in NY. Antech is a general lab that many vets use for blood work. They do many of the common tests themselves but must send out ACTH, leptin to other labs as there are only a limited number of labs that actually can do these tests (Idexx does the same thing). They will then get the result and report back so your blood work may be "in transit" at the moment. Whether the Antech branch your vet used outsources to Cornell or not is unknown - would have to, in order to get the leptin. You will need to follow up with your vet to find out whether there were more tests ordered or not. Many vets are not aware that Antech outsources many of the more complicated tests. It would save money and time if the tests were sent directly to Cornell, as well as lessening the chances of blood sample mishandling, rather than thru an "intermediary" such as Antech but for the vet, shipping everything to Antech is simpler -" one stop shopping".
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Because of Micah's weight issues, I wanted to have a check up  for her.  I kept her on gastroguard for a month so there should be no ulcer issues. Her teeth are fine, no worms, etc. Vet said she is in perfect health. 

But in an email  I asked, "'Id like to check on Micah's blood levels now to see how she is doing. I would like the blood work to be sent to Cornell. I'd like to have her serum insulin, glucose and Leptin tested. Cornell is the only place that will test  Leptin in the US.   My understanding is that the blood  handling has to be exact...meaning plasma separated and put in a plastic tube and freezing it to be sent.  Makes a huge difference as does the lab that tests. 

https://ecir.groups.io/g/CaseHistory/files/Kelly%20and%20%20Micah