Nicolle,

The NSAIDs do not actually treat anything. They are an attempt to control the pain but aren't very effective. Ask about using Tramadol instead. At least that wouldn't be damaging her kidneys. Do her legs and feet feel warm or cold? Is there any unidentified plant material in her hay?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Nicolle ,
IV Oxy Tetracycline is normally not a hospitalization requirement. An IV catheter is sewn into the neck and vet wrapped and then the vet comes daily to slowly administer a bolus of Oxy Tet. Some owners in my endemic area are taught how to slowly administer the bolus after the vet has done the first two days and no side effects have been noted, ( Oxy Tet administered quickly can cause collapse and possible death). Horses eat , drink , can be turned out in a paddock if they are not prone to rubbing their neck or have another horse across the fence that can pull out the catheter. You just need to supervise them. 

There is a test for Potomac fever available. As I mentioned before though, most vets' start treatment and don't wait for the test results, they simply confirm with the results. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .

What is the reason for putting your horse on thyroL?   As you did not mention anything about a weight issue.  I’m just curious about the reason.  
--
Janet M. OH 2021

Shevawn,
The mods or Dr. Kellon can provide more detailed advice, but I read that your vet advised you to give Cassie 1mg Prascend 2 times a day.  The ECIR group does not advise twice a day dosing vs. once a day. She definitely needs more pergolide with those numbers, but you should titrate up to 2 mgs or more once a day. There is no research that demonstrates twice a day dosing is better. 
The Thyro-L will not affect her insulin. It can help a horse lose weight, but if her weight is fine, but the hard crests are the only symptom, the thyro L may not do anything at all for those. And after 60 days of administration, her thyroid will depend on it and you will need to slowly wean her off of it. 
Lavinia will have to comment on the shoes. Comfort in her feet will come from removing triggers as you know and I am thinking once you get her ACTH back into an appropriate range, her comfort will increase. My advice is to see if you can manage boots on her if the shoes are not padded and her sole, etc. is exposed. If the shoes are just on the walls, then she is now weighting her walls which are laminitic and not what you want, but will Lavinia will have better advice.
Remission is simply very expensive magnesium. You can achieve the same thing with mag ox. If her hay is balanced with supplementation, you won't need most of the supplements you listed and can discontinue. Pergolide costs are going to increase, so you want to discontinue supplements that aren't doing anything positive.
Regarding capsules, if you are certain she is eating her treat, then the Prascaend will dissolve when it hits the acid in the stomach. I don't think that is your problem, the issue is that she needs more pergolide per dose.  PPID is a progressive disease, meaning it needs increased prascend or pergolide mesylate compound over time to continue to stay in check.

--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .

--
Nicolle D in BC Canada 2022
https://ecir.groups.io/g/CaseHistory/files/Nicolle%20and%20Elsa
https://ecir.groups.io/g/CaseHistory/album?id=276759 

Hi Shevawn, 

You really need to get that ACTH down.  If you are going from 1 Prascend to 2 Prascend, they need to be given at the same time of day to have an increased effect on ACTH.  Otherwise you are effectively giving a max dose of only 1 Prascend, which has the same effect on ACTH as 1 Prascend 1x a day (but doubles the expense!).  Make sure you titrate up the dose by adding 1/4 pill every 3-4 days.  After 3 weeks on the new dose you need to redo bloodwork to make sure it's enough to control the ACTH.  I suspect it will not be enough.  Since the seasonal rise is underway this is critical.

Adding Metformin now, dosed at 30mg/kg 2x a day, should also help get her insulin down, which will stop or at least slow the laminitis progression, and relieve some pain.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Feeding soaked hay will also give her quite a bit of water, which you are already doing.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Thank you Sherry.

Martha, this is what I heard back from EA:  Unfortunately we do not have this sample anymore as we are only able to retain samples for 2 weeks.  If you would like a wet chemistry test performed we will require a new sample.

So I guess that means I either need to keep looking or buy the hay and send another sample and keep soaking until I get results?
--
Lori J in NC 2022
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Lesley

Do you hit the quote text icon when responding, by any chance?

Quote the entire message you are replying to

1. Under the message you want to reply to, click the Reply link.
2. On the text formatting toolbar above the text editing box, click the Quote post icon at the far left. The message text is inserted automatically at the top of your reply’s text editing box, along with the message’s posting date and time and the author’s name.

Here is what the Quote post icon looks like in the HTML editor (the icon is similar in the Markdown and Plain Text editors):

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022

Hi, Shevawn.
Welcome back. So sorry Cassie is having a flare.

Have you looked for Cassie's old case history in your computer files? It was originally a MS Word 2010 document. It would be a huge help to ECIR volunteers and moderators if you would update Cassie's case history with information from your last version in October 2019 and today.

If you can't find it and need to start a new form, you can get the process going by checking the Wiki, here:
https://ecir.groups.io/g/main/wiki#Case-History-Help 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Have had a good  several years with no laminitis - know protocols from previous bouts.     But 16 year old PPID/EMS/IR mare Cassie is now having another bad flare.   Not sure what triggered,   heat is extreme,  never in pasture without mask (although totally dead).  Only change was in hay - supplier no longer carrying CA bermuda that she had done better on than timothy.   Had it tested right away,   very low ESC+Starch , protein about the same as the timothy so was elated. But Crest became hard and large.   Soaking hay didn't make a difference, so have stopped feeding it and gone back to CA bermuda.   Blood work has just come back,   ACTH = 215 where top of range =30 and Insulin 146 where top of range=40.   Vet advised to double Prascend - 1 pill 2X day , syringing vs. hiding in anything.   Also starting on Thryo-L for 60 days,  1 scoop 2X day.  Retest in 6 weeks.     Questions for the group - any chance the capsules I put the prascend in were not dissolving in right spot in gut for med to work?  (I put one in water, and it kept it's form but was gummy ,   whereas one of my supplements in a capsule I dropped in water totally dissolved in a couple minutes)     Anyone else have trouble with Teff hay, I thought it was to be the greatest for EMS although hard to find?   I am not sure why vet did not recommend Metformin.    Any new advances in something to put on feet to keep more comfortable?   She has been quite rotated from the past,  but comfortable barefoot until this flare.  Trimmer glued on plastic shoes due to ground being like cement in her track,  but no comfort.    Am giving every supplement out there (Phyto-Quench,   Remission,   Reversatol (expensive+)  ,  hoof supplement.     Thanks for any insight.
--
Shevawn and Cassie
03/2015   Gordon, TX
CH folder:  https://ecir.groups.io/g/CaseHistory/files/Shevawn%20and%20Cassie 
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=76832

Thanks so much!  Just wanted to double check!! Much appreciated.
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Lesley, 
You may not be missing a thing. But I believe the page you're looking at is the EC Horsekeeping Home page. 
https://ecir.groups.io/g/Horsekeeping 
If you're already subscribed, you may need to hit the "Hamburger" icon in the center of the bottom of the page: it's a stack of 3 horizontal lines, like a stack of coin. That link will reveal the Photos, Files, WIKI and other sections.

If you are not subscribed to the subgroup, you can do it easily from the Home Page. Just above the dates and columns on the EC Horsekeeping Home page, you'll see a link to subscribe by email. After you're subscribed, you will be able to see the messages, topics, Files, etc.

BTW, if you would kindly delete the quoted text from your messages and just post a reply with the name of the person you're replying to, it would be appreciated. The quoted text hides your signature. 

Thanks,
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Cass,  I'm not sure what I'm missing. Maybe its because I'm viewing from my Samsung phone.  The whole page is about execute, group address, hashtags...  there are just tons of  dates at the bottoms of the page but nothing that give a title of content