Thank you Lavinia!  I am really looking forward to tomorrow's appt.  Hoping the shoes are pulled and she will just have to tough it out because boots are not a real good option for this rather interesting mare; she won't tolerate even being wrapped unless absolutely necessary, or wearing bell boots.  She runs around in her stall when I do have to wrap her, then eventually stands still in the corner pouting til she has to move again, which she seems to think involves running. Even certain things like fetlock boots and polos piss her off so much when I was riding her, I'd have to take them off because she will repeatedly stomp her feet.  This was never the case until her ligament went back in 2012/2013 (except for bell boots; always off the list).  So, perhaps if we have to protect her feet more than being barefoot, he will do a composite shoe w/the packing.  What exactly is a composite shoe?   A plastic glue-on?  Of course, if I have to go the boot route, tranquilizing her should help her typical reaction.

Perhaps even more troubling is the fact that prascend can't be given with Ace.  Ruby is getting to the point where she needs some ace every day.  Can anyone suggest anything I should do?  This sounds like a huge issue I have to solve fast.  A friend that works for Farnum suggested trying Quietex or Vision??

Will be sure to taper the Prascend like you advised when I start it.  The re-test late August makes sense too.  Many thanks for that...

By adding the aloe juice or papaya puree, does that change anything in her mineral balance?  I'm thinking it doesn't, but want to be sure.  Anyone know what kind to try and how much?

One last thing; I just was at the barn and the "rehab" vet was out for another horse (not the vet that did the PRP but one I was thinking about sending Ruby to for a couple of months of the aqua tread and laser).  She noted how incredibly fat Ruby is and again pointed out that this is not good for her ligament and could cause laminitis.  She very much urged me to cut down on her 15 lbs of hay given her obesity.  I pulled out the weight tape, and good ole Ruby is up to 1100 lbs (from 1050 or so in Feb).  I explained that I was worried about her IR and not having enough to eat.  Her suggestion is to feed dengi chopped hay instead of the orchard grass I just tested.  I am not familiar with dengi; anyone have any thoughts?

Seems like every time I try to get an issue under control, another problem is created!  Ah, the joy of an aging horse who has exponentially aged me in the last few months!

--
Mauri   02-2016

Elverson, PA

Ruby Case History: https://ecir.groups.io/g/CaseHistory/filessearch?q=ruby

Hay Test: https://ecir.groups.io/g/CaseHistory/files/Mauri%20and%20Ruby/Hay%20Analysis

Ruby Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=1191

Hi everyone! Haven't posted about my own girl for quite awhile. Still waiting for blood results but will back hopefully today. In the meantime, considering the fact that I board her 45 minutes from where I live, and I can't get hay in quantity for testing, I switched her over to the ODT cubes. She is currently on receiving about 11 pounds of cubes per day (she is 900 pounds) and about 1 pound of TC Lite to incorporate her supplements into.  Her supplements come from SmartPak and include Vit. E, salt, the Senior Ultra Combo of biotin, etc. and she also gets HA.  I stopped the Senior multi-vitamin because I didn't want it to affect what is already in the ODT cubes.  Her ACTH level had risen this year so she is now on 1 mg of Prascend, up from .75 mg. She receives a dose of Previcox daily.  Biggest issue we have dealt with recently stems from my farrier taking too much sole and toe off of her about 8 weeks ago making her very sore and lame. Vet x-rayed. Both fronts looked good except little sole on front L.  Good balance, etc.  No rotation, etc.  X-rayed again last week and sole is growing. She is way....overdue for a trim and shoes. Vet gave farrier explicit instructions and farrier comes this Thursday to shoe.

Can I use the ODT cubes in place of hay long-term.  My own tested hay will be impossible considering where I board.  What else do I need to know/do, etc.

Thank you very much,

Theresa Leri/Khaiti

Roseville, CA

Hi Sue,

Ain't marketing grand (NOT!). As long as he didn't actually say the product cures PPID he's safe. Testimonials are used very convincingly by oh-so-many companies to tout the superiority of their products. Unfortunately, they have little-to-no relevance to the facts.

You are correct that (not) shedding is not a good indicator of PPID control. The long hair coat on his horse could have been due to mineral imbalances and because the product does supply added Cu and Zn that could have helped. It doesn't appear to add any iron (certainly a plus), vit E amount is negligible.
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Hi Mauri,

Looks like Ruby is PPID - there should be no increase of ACTH from Feb to June in this hemisphere. The 33.1pg/ml ACTH was on the high side of normal so this isn't a total surprise. When was the blood drawn in relation to all the other things going on that day? Prascend caplets are the patented form of pergolide.

You shouldn't give Ace along with pergolide (Prascend) as it will interfere with the perg. Ace long term not a good idea anyway.

We recommend dosing the pergolide (Prascend) once daily. Should taper onto the drug by starting at .25mg for 4 days, then .5mg for four days, then.75mg for 4 days, then 1mg. Easiest way to give 1/4 tablet (.25mg) is to dissolve 1/2 tablet in 10cc water in a small syringe, shake well and administer 5cc. Refrigerate the rest for next day. Repeat process. For the .75mg, give 1/2 q tablet plus 1/2 syringe. Plan to retest after 3 weeks at the full dose. As that time frame puts you into July, might make (financial) sense to wait to retest until late August to see what the seasonal rise is doing to her ACTH so you can make pergolide dose adjustments then, if needed.

Pegolide veil is a possibility - using APF to counteract works well for most horses. The veil is temporary so one bottle should be all you need.

Some horses have a tendency for gas/loose manure (my Dante is one). Can try adding aloe juice and papaya puree.to see if that helps. The ADF/ADF of the hay can also be a culprit.

Will need one of the vets to address the Ace/Sedivet questions.

You do not need to pull shoes in order to do xrays - but it is certainly helpful. That said, the shoes should be coming off because she desperately needs to have a realigning trim put into place. Toes are much too long horizontally, there is a slight dishing of the dorsal wall visible, heels are under run. The corrections will need to be done on a frequent basis so leaving the shoes off and using boots/pads for comfort would be the ideal situation. Shoes make it difficult to do the necessary trims as often as they should be done. Alternately, if the farrier were to make major corrections this time around then use a properly placed composite show with packing that might also work well. If this new farrier wants to apply other, more complicate appliances or shoes, I would advise against it.

Please try to keep in mind that you are the owner and therefore are this new farrier's employer. You are entitled to ask questions and to receive answers about anything and everything he is planning to do. That doesn't mean you need a confrontational attitude but quiet firmness mixed with a little ego stroking can go a long way to getting the answers you want and the results Ruby needs.
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

Hi Vicky,

Technically, as this horse is not IR/PPID, this is in the OT category. However,  lots of discussion about this in the message archives as it comes up frequently. Lyme is a nasty, insidious disease that can, among other things, cause a brutal laminitis that is difficult to resolve. Because so many of our immune-compromised horses do end up dealing with Lyme disease, I'll do a quick overview.

Hopefully, the blood work was sent to Cornell for their Lyme MultiPlex test as that will give you the most comprehensive information.

By the time a horse is diagnosed it is usually a chronic situation. Best avenue of treatment would be to start with IV Oxy-tetracycline for a month, followed by 3 months of oral doxycycline or minocycline. The IV doesn't need to be done in a hospital setting as long as the owner/caretaker are capable and have a good working relationship with their vet. The oxy-tet gets at the encysyted stage of the spirochetes, which the oral doxy/mino is ineffective against.

Compounded doxy powder can be ordered, which makes both the cost and administration of the abx much better/easier as you don't need to count out (and try to administer) 50+ pills twice daily for several months. Link to one possible source:

http://www.pethealthpharmacy.com/

Keep an eye out for any gastric upset. If you need to, can administer probiotics to help in that department. If using them, need to give ones that have at least 25 BILLION cfu's, not the usual counts in the millions, that most less expensive products supply. The probiotics need to be given two hours AFTER each dose of the abx are administered to be of any help, otherwise the dose of abx kills the "bugs" you are feeding in the probiotic.

Although there is lots of marketing for "non-chemical" treatments, there are no "holistic" treatments that have actually been proven to do any good.
--

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team

I recently went to the Western States Horse Expo with friends, & they spoke to a rep for SweetPro (sweetpro.com/horse) who said he took one of his horses off Pergolide after feeding this product.  In essence, he was saying the product would control PPID.  Apparently the horse shed out & looked lots better after being on that feed for a while.  Their literature does not claim this; it says it's safe for IR & Cushings horses & safe to use along with any medication the horse is on.  IMO (a little knowledge of equine nutrition),the ingredients are OK, I think, tho maybe a bit low in Cu & Zn.  I'm thinking his claim is BS, as getting a long hair coat to shed out doesn't mean the ACTH is controlled, but I told my friends that I'd check with people who know lots more than I do.  :-)

Sue L.

N. Calif.

2011

Hi All,

I pulled blood last week and did PRP (platelet rich plasma) on Ruby's left front sesamoidean ligament.  I have an appt tomorrow with a new blacksmith and if shoes are pulled, will get x rays.

She needs to be sedated as she has not been turned out in about a month or so and that is the only way I can hand walk her.  She will be hand walked another month, then re-ultrasounded and if all looks ok, I do a month of tack walking.  If she continues to show healing of the ligament on ultrasound, then I progress to trotting, etc.  This means the soonest she could be turned out is around November/December as she has to be sound w/t/c first.  I will have to tape her muzzle closed at that point as there are no dry lots at the farm.  Ace will be needed for a long time!

Some of my blood work has come back.  Fortunately, no Lyme disease.  However, ACTH went from a high normal back in February 2016 (33.1) to 42.5.  Her glucose is now 90 and her insulin is now 18.61.  In 2/16, glucose was 80 and insulin was 19.03.  Leptin was 18.02 and is now 16.35.  Her RISQI is now .23 (unchanged since 2/16); her MIRG is now 8.4 (was 10) and her G:I is now 4.83 (was 4.2).

I am not sure what made her ACTH change, but as for her diet, she's been on the "safe" hay I just tested since early May and on the pellets/ODBC since early to mid March.  Any chance the ACTH going up is due to a delayed seasonal rise? (probably not!). Has her G:I numbers slightly improved?  I can tell you her water drinking has been excessive as well as her urination; her PPID now explains why! 

Vet has prescribed 1 mg/day of prascend.  I should be doing .5 mg am and pm, right?  I am only familiar with pergolide from old days, so is prascend the exact same thing?  In other words, I should expect the veil, etc?  Is there any danger in giving Prascend with Ace tabs?  Boy, sure hope not!

I would like to get Ruby on AFP Pro, but is it safe to give with Ace??  I left a message with Auburn Labs and hoping to hear something soon.  Was thinking maybe it would also help her persistent gas and looseness, which intermittently continues despite misoprostal and sucralfate.  She eats only ODBC as a carrier for her sport horses pellets, flax, E, meds, and probiotics and 15 lbs of hay.  Hay is now tested and 4.6 NSC, but 17.4% protein, which is kinda high.  (see link below).  I am to just add some Zn and Ca and I will be all balanced, per Dr. K.  

Has anyone ever noticed ODBC giving gas or loose poop?  Just wondering if that is what is causing the issues.  I am willing to try another safe carrier if I need to experiment which hopefully will not throw off my mineral balancing…I am leary of the nsc fluctuations in TCL; can anyone suggest something else that is more consistent in low ncs?  (this is why I have always just used the ODBC!).

I really hate keeping Ruby on ACE and especially if it means I cannot use all the good stuff, like J herb and APF.  I have heard good things about Sedivet but no one is willing to give her a daily injection at the farm; does anyone know if sedivet can be given orally?  I once called the manufacturer and they were of no help.  Any other suggestions to keep her calm?

NEWS FLASH: the vet from Auburn Labs called back and said he did not think there is a problem giving APF while on Ace…if anyone has input about this, please let me know.  At this point, I will go ahead and order it - the big bottle as he recommended 10 cc/day!  Ouch $$$...

Finally, how many weeks/days should I give the 1 mg of Prascend before I re-test for ACTH?

Thanks for the help everyone!

Mauri   02-2016

Elverson, PA

Ruby Case History: https://ecir.groups.io/g/CaseHistory/filessearch?q=ruby

Hay Test: https://ecir.groups.io/g/CaseHistory/files/Mauri%20and%20Ruby/Hay%20Analysis

Ruby Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=1191

I'm not a moderator - just a member who recently went through diet balancing.

If you look under Files, then 6 - Diet Balancing - there is a file called Getting Help - there is a list of experts who will help you.  You can also do it yourself, but I highly recommend getting the help.

https://ecir.groups.io/g/main/files/6%20Diet%20Balancing

--
Sharon, Elsa  April 2016

Courtenay, BC Canada

https://ecir.groups.io/g/CaseHistory/files/Sharon%20and%20Elsa

 https://ecir.groups.io/g/CaseHistory/album?id=987

Wow! Thank you so much for the great reply, Maggie!  Lots of good info--some I have figured out and a lot that I didn't realize yet.  I have started adding iodized salt (although the Giant brand I had in the cupboard has, of all things, dextrose in it...I assume it is a negligible amount because the calorie count is still 0, but I will be looking for a different brand when this is gone).  I will order the Vitamin E; I've seen on here the recommendation is the E-50 from Uckele.

Good info on the Quiessence.  Yes, it is pricey.  I will be glad to not buy any more!  I have a few pounds left--hopefully it is not too detrimental to finish that up?  I have contacted Kathy Brinkerhoff and she will be doing the balancing for me.

Regarding the hay, I usually do not buy from Tanner Farms, but I was caught short last year.  I usually buy hay from PA, all brome.  I will talk to that farmer about getting a hay analysis done before I actually buy it.  If it doesn't test well for me, I may go with Tristan.  It is good hay, but more expensive for me than the PA hay...  However, I DO NOT want to have to soak hay in the winter, that is for sure!  I guess with the hay I have now, I do not have to soak, right?  I noticed the sugar and starch numbers looked very good, but does soaking help at all?  I really want to keep a steady weight loss but still feed him the maximum amount of roughage I can for his digestion and to keep him chewing longer.  Definitely want to ditch the TC30--another expensive item

Since you are in the area, what vet do you use?  I use John Nolan at Piedmont Equine in The Plains.  He has not advised me to get any further testing, but then I haven't complained about anything, except for the laminitis, which another vet from the practice came out for.  I guess either I can educate them on what needs to be done after doing the research you suggested or I can find another EC/IR savvy vet.  I will study up on that Cornell page you mentioned.

Regarding trimming, I learned to do barefoot trimming a few years back from Paige Poss and a few others, so I trim his feet.  I am waiting for a little wet weather to soften them up right now because they are HARD!  However, they all still look in fairly good shape--did them a few weeks ago when it was so wet.  I detect no issues with soundness, but I am disappointed to hear I probably should not be longeing him.  I keep the circles very large (I usually walk a circle with him so it is probably a 30 meter circle with some straight lines), limit it to 20 minutes max on good footing, and his laminitis episode was very mild...is it still contraindicated?

Thanks again!  Nice to know I have a neighbor who can help!

--

Erin 06-2016 Aldie, VA

Niles Case History, Photo Album

Hi all,

I am reaching out to you to see if you can help redirect me, as a Fresian in the barn with my IR Pony has Lyme Disease.  I was wondering if anyone here has any resources to direct me to in order to help assist the owner/friend of this horse such as this group has helped me with IR and my Samson.

The friesian is under the direction of a vet, but my friend is exploring all options to get her boy help. 

I thought it couldnt hurt to ask you all.  Please forgive me if this was against protocol for posting.  Please feel free to delete if so.

Thank you so much! Blessings to you and all your horses in this group!

`Vicky Monen and Samson

Ga, Aug 2015

https://ecir.groups.io/g/CaseHistory/files/Vicky%20and%20Samson

Courtenay, BC Canada

Elsa,

https://ecir.groups.io/g/CaseHistory/files/Sharon%20and%20Elsa

 https://ecir.groups.io/g/CaseHistory/album?id=987

Courtenay, BC Canada

Elsa,

https://ecir.groups.io/g/CaseHistory/files/Sharon%20and%20Elsa

 https://ecir.groups.io/g/CaseHistory/album?id=987

Hi Mauri,

I just saw this message now but haven't received any emails from you.  Are you using the correct email?  No matter I will email you so we can get your case history sorted.  Your update is in Ruby's folder.  :-)

Here is the link to Ruby's folder:

https://ecir.groups.io/g/CaseHistory/files/Mauri%20and%20Ruby

You should add it to your ECIR signature so that everyone can find your information quickly.  
--

Laurie - 05 2016
Collegeville, PA
Atticus Case History - https://ecir.groups.io/g/CaseHistory/files/Laurie%20and%20Atticus

Atticus Photos - https://ecir.groups.io/g/CaseHistory/album?id=1210. 

Atticus Hay Analysis - https://ecir.groups.io/g/CaseHistory/files/Laurie%20and%20Atticus.

Hi Ladies

Thank you so much for replying so promptly. I've been trying to get all of the data together for you. Just waiting on the report from the vet from his blood tests for IR.

In regards to the track it's dry, we have however in the last week had a very small amount of grass coming up under the trees, which watching Jake he doesn't seem to eat. When I changed his diet over to low sugar, low starch, high fibre we gave him the option to choose the sugary feeds and he won't touch them at all, he knows what's good for him. We have 7 horses currently running on the track and where possible we try to give Jake some extra time to eat additional hay. Would you suggest we increase his hay?

With the Pergolide I was telling my vet when we last tested him that he doesn't really like the taste of the Ranvet stuff and she said Bovavet do a concentrated liquide pergolide which she specially had to order in, I was to give him 1ml and it would last a few months. She did say that it was more unstable than the Ranvet product but we could give him a try. I feel this has taken us a few steps backwards, but we all make mistakes. Last year when he was originally tested I asked about the tablets and was told that you couldn't get them here in Aus. Can we order the compounded capsules directly from Bovavet or do we have to go through our vet? Looking at their website i think the vet has to order? Anyway I tell him everyday he must have it and he has seemed to pick back up since going to the Ranvet stuff. ALSO, I must note that with the Ranvet Pergolide it's the most stable his temperament has been...since he was in work 6 days a week years ago. Do I speak to my vet about increasing his dosage? How much should we increase it by?

He's off the tumeric now, I'll ask Carol about it as she does recommend Tumeric with the crushed linseed. We want to have a diet done by her, however I'm studying NRC Plus myself so I'm determined to balance it myself. We have even been tossing up with giving him in addition to the low sugar meadow hay some Rhodes grass, I might email Carol about that. What are your thoughts?

Jake doesn't have boots for himself, he's currently wearing my stock horses boots until we can sort out what to do with his feet. We try to give him a break as these Easy Boot Back country which aren't designed to be worn all the time. Oddly enough when Jake abscessed a couple of weeks ago he has now formed this weird lump on his coronet band? Do you know what this could be? My partner is a barefoot trimmer who's studying with Daisy Bicking and has just learnt the glue on shoeing technique. We have sent some information with the xrays and pics (which I'll upload now) of his feet to see what she recommends. However we are tossing up whether to cast, do a couple of rounds of glue on's or just put him in boots. We know what the cheaper option is and the benefits of each but we can't seem to come to a conclusion. Do you have any suggestions, pros and cons? Have you had any experience with casting and glue on's with horses such as Jake?

Coat issues - This winter I haven't clipped Jake, last year I did and he seemed quite comfy, we are trying to rug less this year and as he has such a thick coat to keep him warm let him be, however underneath you can feel it's not exactly breathing. Any suggestions on what we can do, the last thing I want him to do is develop another skin condition. I noticed last year that if I didn't clip regularly his skin and coat were awful. This winter as he's on the right diet with minerals his coat is softer, it's nothing like last year but still a little gross underneath.

Muscles - Jake has lost a huge amount of muscle mass in the last 6 months, it seems to have fallen off him. *sad face*. Our gut feeling is that he's in pain so moving less. I stopped giving him regular body work as I became too busy, however we have just started this back up. Do you think that with regular exercise, how often and what sort of intensity should that be?, he will gain muscle again. How does the muscle wastage normally work with PPID horses?

Hooves- I'll upload photo's of his hooves, you'll notice that his off front leg grows a lot of flare. It also bends when he has the flare. We had an acupuncturist/ holistic vet look at him 18 months ago and said that he's got arthritis in his off front knee and also his near hind hock, he becomes shaky when going downhill, takes it slowly, but really only since he's been losing muscle mass. He hasn't been trimmed at the moment, it's a VERY fine line with trimming with him. My partner was trained that priority goes to comfort. With this flare he's more stable, walks like a trooper around the track, however as soon as we take that off, or lessen the flare he steps short again. Any ideas about what we can do there?

I have so much information to read my mind is buzzing, thank you so much!!

Kind Regards

Kathryn

Perth, WA

Photos https://ecir.groups.io/g/CaseHistory/album?id=1220

Case https://ecir.groups.io/g/CaseHistory/filessearch?q=kathryn