Date   

Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

Lorna Cane
 

 
 >Current bale is untested but is being soaked in hot water for 30 minutes. 

I don't know how we can know if his diet is good,without knowing how the hay tests.There may well be important imbalances that will show up,and can be corrected,when you are able to get testing done.

>If diet is good all i got left is the trim part,that alone is soooo frustrating,might have to end up trimming my own horse here,not sure i'am up to that.

Many of us have to do just that.
It's daunting, in my own experience. But what's the choice when the trimmers won't do what the horse needs?
Rhetorical.

Lorna in Ontario,Canada
ECIR Moderator 2002


*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf


https://www.facebook.com/ECIRGroup




Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

Nancy C
 

Hi Corrinne

You have probably heard this before or in reading posts from others.

Standlee pellets are not tested to know what teh ESC and Starch levels are.  They could be too high.

You've probably heard you can use mag ox instead of remission but the amount you are using is probably okay for now.

You are basically on the emergecy diet for now until your hay is tested.  The emergency diet is designed to cover ust teh real glaring holes in supplementing these hoses until you can move to what you need for your hay.

I bet you know that.  Am I missing something else?

Nancy C in NH
ECIR Moderator 2003

FACT: With knowledge of the nutrient profile of the forage and the animal's weight and level of work, one can supplement only what is needed to target nutritional needs.  See  Smithey and Gustafson, Nutrition Complexities and Mineral Profiles of Hay 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 






---In EquineCushings@..., <sassafrass45@...> wrote :

Hi 

Can someone PLEASE look at jasper's diet that's in CH and tell me what needs to be changed or added.
Corrine and Jasper
MN 4/2014
ECHistory8


Re: Commercial minerals

 

Donna - Tractor Supply usually carries it also, if you need it immediately.

Jean and Amber
In Summerville, SC
August 2004


Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

corrine haffner
 

Hi 

Can someone PLEASE look at jasper's diet that's in CH and tell me what needs to be changed or added. Only change since update is hay,he's now on plain grass hay. Need to get at least diet part in order here,new hay this year will be tested. Current bale is untested but is being soaked in hot water for 30 minutes. 

If diet is good all i got left is the trim part,that alone is soooo frustrating,might have to end up trimming my own horse here,not sure i'am up to that. Jasper is counting on me to get him sound again,so we need the groups help on this diet thing. Nancy yes i have one anti fatigue mat i stand him on for trimming,farrier starts with the worst foot first,then does back feet.

Corrine and Jasper
MN 4/2014
ECHistory8


Re: Pain relief for very painful horse

Nancy C
 

Sorry...forgot my signature and the link to the Proceedings.

Nancy C in NH
ECIR Moderator 2003
FACT: Blood flow to the foot passes to the rear of the foot, providing support and dissipating vibrational energy. See RM Bowker, VMD, PhD, The Vascular Cushion Of The Frog What Does It Do?  2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 





---In EquineCushings@..., <threecatfarm@...> wrote :

Thanks for your thoughts Kerry.  I have to say again that the group does address the worst of pain incidences represented by issues of recumbency, not eating and not drinking, sweating and trembling.

There are many incidences where what Lavinia describes - use of pain meds in stead of dealing with underlying causes - has been experienced here.  Husbandry and verterinary practices also play a role. The use of cement flooring, the inability to see what needs to happen to the trim, or that ACTH or Lyme needs to be controlled, that diet can play a pivotal role are not looked at.

On a personal level, the use of pain relief without an ability to address the cor probelm is why my horse spent two winters locked in a stall. So he would not do further damage. We eased the pain - maybe - but fear of tearing up the feet kept him miserably indoors.  He did not suffer from ulcers thankfully but he very likley has impaired kidney function as a result.

This is quote really speaks volumes:  Then no amount of pain meds will effect a "cure" and the poor animal ends up being euthanized.

Recommend reading of Bowker's 2013 NO Laminitis Proceedings as well as Dr Kellon's proceeding on Endothelin1 at the link below my signature. to get a great background in why NSAIDs particularly don't work and in fact, work against repair of the foot.

Your last prapgraph Lavinia represents  truly holistic way of how ECIR approaches the welfare of these horses.

---In EquineCushings@..., <shilohmom@...> wrote :



It seems that rather than striving to better mask pain, we as owners/vets/ hoof care professionals need to first do a better job of identifying and addressing the cause of the pain. Remove or manage the cause and the pain is also stopped or lessened. That way, we can best help these noble animals we are all so passionate about.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team


 


Re: Pain relief for very painful horse

Nancy C
 

Thanks for your thoughts Kerry.  I have to say again that the group does address the worst of pain incidences represented by issues of recumbency, not eating and not drinking, sweating and trembling.

There are many incidences where what Lavinia describes - use of pain meds in stead of dealing with underlying causes - has been experienced here.  Husbandry and verterinary practices also play a role. The use of cement flooring, the inability to see what needs to happen to the trim, or that ACTH or Lyme needs to be controlled, that diet can play a pivotal role are not looked at.

On a personal level, the use of pain relief without an ability to address the cor probelm is why my horse spent two winters locked in a stall. So he would not do further damage. We eased the pain - maybe - but fear of tearing up the feet kept him miserably indoors.  He did not suffer from ulcers thankfully but he very likley has impaired kidney function as a result.

This is quote really speaks volumes:  Then no amount of pain meds will effect a "cure" and the poor animal ends up being euthanized.

Recommend reading of Bowker's 2013 NO Laminitis Proceedings as well as Dr Kellon's proceeding on Endothelin1 at the link below my signature. to get a great background in why NSAIDs particularly don't work and in fact, work against repair of the foot.

Your last prapgraph Lavinia represents  truly holistic way of how ECIR approaches the welfare of these horses.

---In EquineCushings@..., <shilohmom@...> wrote :



It seems that rather than striving to better mask pain, we as owners/vets/ hoof care professionals need to first do a better job of identifying and addressing the cause of the pain. Remove or manage the cause and the pain is also stopped or lessened. That way, we can best help these noble animals we are all so passionate about.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team


 


Re: Pain relief for very painful horse

Kerry Isherwood
 

Kerry- May I have permission to email you privately? Since we are in NY also,
it would be very helpful if I could consult with you about some local issues.
----------

Yes, of course, unless its about local politics. I dont know a damn thing about that. ;)

TwinOats@...


Re: Pain relief for very painful horse

martha williams
 

Hello Kerry and all -
        There ARE a number of modalities for pain relief for horses.  An
equine Internal Medicine Vet with interest in pain management would know
how to deal with this very important subject.
       Butazolidine is the drug usually used first (and often too much and for too long).  It is a very effective analgesic/anti-inflammatory,  but it can have disastrous consequences to the entire gastrointestinal tract and should, in most cases, be used sparingly and only when needed.
All NSAIDS (including Previcox) have some negative effect on the gastrointestinal tract as well.
      If the horse cannot tolerate NSAIDS,  Fentanyl patches are very useful
but they should be managed by a vet.  Sometimes  Fentanyl patches
can be combined with Lidocaine or even butorphenol drip for acute situations. I see you are an LVT so you may be able to manage some of these modalities in conjunction with veterinary prescription and advice. I am sure there are other drugs and combinations as well, but that info is way beyond my knowledge capability.
     To address the issue shared by Nancy:  that if highly effective pain
relief is offered, the horse will move around and injure itself further.  I am
sure Nancy is right in many many instances, but I think it would be uncommon for most horses to do that when they have been in excruciating pain to begin
with.  I've seen many suffering laminitic horses in the past year who were (albeit temporarily) heavily medicated. They were still miserable and not
exerting themselves at all, but some of their pain was alleviated.
I'm wondering if decisions on meds in  these cases could be managed on a case by case basis?
       There is no question that ALL the testing, trimming, and strict dietary management advised by this amazing group must be addressed urgently and completely ASAP.   One MUST address the triggers of this awful
disease and not just cover it up.  If I understood  correctly, that is what Nancy was referring to as well. 
         Kerry-   May I have permission to email you privately?  Since we are in NY also,
it would be very  helpful if I could  consult with you about some local issues.

      I apologize for the length of this post.  I hope I have not over-stepped my bounds.
      Williams/Dubrow.   NY. '08

 

"....use of Fentanyl patches which were carefully monitored by Dr., and subsequently tapered.
     Yes, this is a narcotic, but does Dr. Kellon or the group object to the use of this drug?   When nothing else is appropriate, relief of intransigent pain is sometimes of supreme importance......"

------------------------------------------------

I cannot agree more with this last statement.  Pain management is a huge topic in small animal medicine to the point wherein the advances in large animal seems paltry in comparison.  I worked with Dr. Muir (a veterinary anesthesiologist and "pain specialist", shall we say) at the Animal Medical Center in NYC and, as vet techs, we were taught to identify, measure and treat pain for various pre- and post-operative surgeries; aggressively manage known painful conditions or post-op surgeries in the ICU; and generally do our damnedest to prevent the dreaded state of wind-up pain whereby an animal reaches an exaggerated or extrapolated level of excruciating and almost untreatable pain due to poor prevention (ongoing underdosing of pain control measures), inappropriate drug choice, or in emergent cases, the impossibility of prevention (ie, trauma cases) that present in your ER.  Some animals would have to achieve near-coma status via analgesics/etc bordering on ventilator-dependence in order to break the vicious wind up pain cycle. 

Having lived that professional lifestyle for many years, I feel Im at a huge disadvantage as a horse owner that I cannot expect the same depth of pain management & treatment if/when my horse(s) will need it, that my dogs & cats & even my child, would have available to them if ever in need.  This is not meant to be a critique, but merely a lament of the frustrations of equine medicine.  Perhaps I've even said too much.

Kerry, LVT in NY
Sept 2014


Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

corrine haffner
 

Hi Lorna

I have rescue remedy always forget about it when farrier comes,will try to remember to use it next time farrier is coming. He has places that he likes scratched,so i scratch him, rub on his head which he does like. I stand him on rubber mats to be trimmed. 

messaging his muzzle or gums not sure that would work, he's really weird about having his muzzle or mouth messed with. Farrier suggested i tranq him for next visit really don't want to put yet more drugs into him already have enough problems. As it is don't know what set off this laminitis attack joint injection are a high possibility was also tranqed that day too once for xrays. Then was given more tranq to do joint injections. 

Then not sure if diet is quite right,know trim is less the ideal so got alot of things not right going on,so i keep asking for help. He was only a little sore the day vet came and now he's really sore,thought i was doing the right thing by having the joint injections. Seems like i'v made alot of mistakes and jasper's the one who pays for them:( 

Corrine and Jasper
MN 4/2014
ECHistory8


Re: Pain relief for very painful horse

Lavinia Fiscaletti
 

Hi Kerry,

You bring up some excellent points. Pain management is very important in horses, just as it is in every other species. One of the biggest problems we see here, however, is over use/abuse of various pain meds - most notably the NSAIDs - in the futile attempt to eliminate pain while correctly diagnosing and treating the actual cause falls by the wayside. We seem to do a much better job of the diagnostic and treatment side of the equation with our smaller, companion animals. We've all been conditioned to view a horse that is down as being in a totally unacceptable state so we strive to get it up on its feet as quickly as possible. Never mind that it is down because its feet are not physically up to the task of supporting it at this time - it must be standing so that all the humans involved feel better about the situation. And the horse temporarily feels better too - until the feet catastrophically fail. Then no amount of pain meds will effect a "cure" and the poor animal ends up being euthanized.

NSAIDs have very little effect on endocrinopathic laminitis (the most prevalent type) yet long courses and high doses of these drugs are routinely prescribed and administered. The underlying, driving forces of high insulin, elevated ACTH and/or poor mechanics are unrecognized, under-treated or dismissed entirely while the horse continues to suffer. Gastric ulcers, colic, comprised liver and kidney function, impaired ability to heal, deteriorating hoof condition (from overuse of compromised structures) are common secondary complications of extended use of pain medications because they are only aimed at managing a symptom while the condition remains unresolved.

It seems that rather than striving to better mask pain, we as owners/vets/ hoof care professionals need to first do a better job of identifying and addressing the cause of the pain. Remove or manage the cause and the pain is also stopped or lessened. That way, we can best help these noble animals we are all so passionate about.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team



Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

Nancy C
 

I know you are working hard Corrine.  Been following.  I may have missed if you are using them, but anti-fatigue mats a life-saver for trimming sometimes. Many but not all trimmers know to work on the worst foot first.  You may know this too.  Sometimes working on the hind first is in order if they have not been trimmed in a long time.  Give him a place to go while you work on the fores.

The trim is the hardest part.  While many are reluctant, owners have to own that part of the process too.

I know you know that.

Hang in there.  Hugs for Jasper.

Nancy C in NH
ECIR Moderator 2003
FACT: Sensory nerves in the foot can be activated via tactile light pressure receptors and can affect vascular perfusion through the foot bringing more comfort to the horse. See RM Bowker, VMD, PhD, Nerves, Nerves, Nerves: Why Are They So Important To The Horse?  2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 







---In EquineCushings@..., <sassafrass45@...> wrote :


Jasper is down part of the day and is still eating and drinking,i'am having the tough time watching him hurt.I spend hours in the barn grooming and just being there with him.  I'll check out the PQ here, sounds good cost doesn't matter at this point.

Thank you for your response,
Corrine and Jasper
MN 4/2014
ECHistory8


Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

Lorna Cane
 



>Then the issues of him not standing still for trimming don't help,he's crabby, ornery and plain hates getting trimmed now,was never that way before.

Because it's painful for him. I know you know that.

Do you stand him on mats?
Massage his gums? Massage his muzzle?
Just thoughts,although they may not cut it for him.

Have you ever tried Rescue Remedy?

It can help take the edge off,under stressful situations.For people,too.

 


Lorna in Ontario,Canada
ECIR Moderator 2002


*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf


https://www.facebook.com/ECIRGroup




Re: Commercial minerals

Chanda
 

Donna,

Remission is a commercial magnesium supplement for horses, labeled as being for horses prone to laminitis.  It's available from many places, but I usually get it from Horse.com   AniMed Remission  

While plain MagOx is cheaper, if you can get it locally, I can't, so I order Remission.   [If I'm paying for shipping, then free shipping from Horse.com for my whole order, is better than what shipping costs to freight most things.]

Chanda

MT 9/04 


Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

corrine haffner
 

Hi Nancy

I'v been spending hours reading on here,i pretty much anwsered my own question on the NSAID for pain relief for jasper. As much as i want to take his pain away i know that's not the anwser. 

I can get diet in place faster then the trim part,i updated the diet part of his CH only thing that's change since i updated is hay,got a big round of plain grass hay. The hardest part of the DDT & E is the trim and trying to get farrier to do whats needed. Have issues with his trim and Lavinia has been helping me with that part,i show farrier the mark ups. Farrier does some of it then says his toes can't come back any more,so toes get left to long,same with heels. Have pictures in my album of last trim that was done on 4/28/2015 also have current xrays in album,xrays were done 5/5/2015.

Then the issues of him not standing still for trimming don't help,he's crabby, ornery and plain hates getting trimmed now,was never that way before.  Here are the numbers to the post from earlier they pretty much tell it better then i can, 193823 & 193756. The one from Dr Kellon really made me think i'v got to get the DDT all in place not just parts of it. 

Jasper is down part of the day and is still eating and drinking,i'am having the tough time watching him hurt.I spend hours in the barn grooming and just being there with him.  I'll check out the PQ here, sounds good cost doesn't matter at this point.

Thank you for your response,
Corrine and Jasper
MN 4/2014
ECHistory8


Re: Pain relief for very painful horse

Kerry Isherwood
 

"....use of Fentanyl patches which were carefully monitored by Dr., and subsequently tapered.
     Yes, this is a narcotic, but does Dr. Kellon or the group object to the use of this drug?   When nothing else is appropriate, relief of intransigent pain is sometimes of supreme importance......"

------------------------------------------------

I cannot agree more with this last statement.  Pain management is a huge topic in small animal medicine to the point wherein the advances in large animal seems paltry in comparison.  I worked with Dr. Muir (a veterinary anesthesiologist and "pain specialist", shall we say) at the Animal Medical Center in NYC and, as vet techs, we were taught to identify, measure and treat pain for various pre- and post-operative surgeries; aggressively manage known painful conditions or post-op surgeries in the ICU; and generally do our damnedest to prevent the dreaded state of wind-up pain whereby an animal reaches an exaggerated or extrapolated level of excruciating and almost untreatable pain due to poor prevention (ongoing underdosing of pain control measures), inappropriate drug choice, or in emergent cases, the impossibility of prevention (ie, trauma cases) that present in your ER.  Some animals would have to achieve near-coma status via analgesics/etc bordering on ventilator-dependence in order to break the vicious wind up pain cycle. 

Having lived that professional lifestyle for many years, I feel Im at a huge disadvantage as a horse owner that I cannot expect the same depth of pain management & treatment if/when my horse(s) will need it, that my dogs & cats & even my child, would have available to them if ever in need.  This is not meant to be a critique, but merely a lament of the frustrations of equine medicine.  Perhaps I've even said too much.

Kerry, LVT in NY
Sept 2014


Re: Commercial minerals

Donna Powell
 

Nancy,

What is Remission?  I searched and only found info on Remission for cancer.




From: "threecatfarm@... [EquineCushings]"
To: EquineCushings@...
Sent: Wednesday, May 6, 2015 5:12 PM
Subject: [EquineCushings] Re: Commercial minerals


Could you use Mag Ox instead of Remission and save money?  You bet.

Nancy C in NH
ECIR Moderator 2003

FACT: With knowledge of the nutrient profile of the forage and the animal's weight and level of work, one can supplement only what is needed to target nutritional needs.  See  Smithey and Gustafson, Nutrition Complexities and Mineral Profiles of Hay 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.
 






Re: Pain relief for very painful horse) WAS Need Help ( Jasper's really sore 8 hours after joint injections)

Nancy C
 

Hi Corinne

You have been through  lot in the past months and, since this appears to be a new laminitis case as a result of injections you probably have a constellation of things going on that contribute to pain.  ALCar may help if, when you have diagnosis, diet and trim in place.  Adding it now, may be less likely to do so but I could be wrong.

IOW -- if the triggger(s) for his lamintis have not bee addressed and removed if possible, if his pain is mainly from mechanical foot issues s a result of unaddressed laminitis, rotation or sinking or even abscess (with or without appliances), the AlCar will be less effective.  It can help with insulin sensitivity so I would be thinking bout adding it to your diet when you have things balanced.

Would like to hear from Dr Kellon re: using PQ while on doxy, however, I think in this case I would be looking at using the Phyto Quench (hopefully available today at Uckele) to get you through to your hopefully excellent upcoming farrier/trimmer visit.  PQ is expensive.  You may need to use as much as three times the recommended amount but if pain is affecting his willingness to eat and drink, if he is recumbent most of the day, then that is where I would go.

Beau had a very bad time with abscess all winter.  I used the PQ at double strength.  He had begun to not finish eating, and was lying down most of the time.  The PQ helped me help him get through the abscess pain and blow quite a large solar abscess. Now waiting on PQ to help us help him with the compensating foot and hind end.  At this time he needs movement to help shed excess sole and develop the back of the foot and to help his hind end.

The problem with sledge hammer pain relief is it makes them feel better when most often they should not be feeling better.  The human feels better too.  But the other aspects critical to long term rehab are not in place -- especially hoof mechanics, IMO.  Letting pain relief do the work of getting them to feel better while not addressing the core of DDT+E is setting yourself up for potentially more heartache down the road.

All NSAIDs - including Previcox - have issues in the GI system.  Been discussed here a lot lately so take a peak at message archives.

Corinne, I know you are looking only for a little break for Jasper while you work to get all other things in place.  I truly understand that feeling.  IME that is where the rest of DDT+E can truly help.  Working towards getting the the diet is spot on, as I know you are doing, will help him address what he needs to do to repair.  He's working as hard as any dressage or endurance horse trying to get well.   Massage, grooming, and just being with the horse is a big boost to their well-being too.   It also helps the human learn to recognize the sometimes very tiny signs that you are making progress.

It needs to be said again  the trim is critical for pain relief. For those of you thinking of coming to the NO Laimintis! Conference in Texas, November, trim will be a big part of the program.

This is a long answer to your quick questions.  :-)  Pain relief comes up all the time and we've got many folks worried like you, so thanks for allowing me to go on.

Hang in there.

Nancy C in NH
ECIR Moderator 2003
FACT: Standing on cement significantly reduces blood flow to the equine foot.
See R. M. Bowker, VMD, PhD, Nerves, Nerves, Nerves: Why Are They So Important To The Horse?  2013 NO Laminitis! Proceedings, www.ecirhorse.org
and
See RM Bowker, VMD, PhD, The Vascular Cushion Of The Frog What Does It Do?  2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 




---In EquineCushings@..., <sassafrass45@...> wrote :

Hi 

Proper diagnosis will hopefully happen in july miss handled blood work,made results iffy. Getting trim right is being worked on. Can't re test till july he's being treated for lyme dease yet.


Thanks,
Corrine and Jasper
ECHistory8

 


Re: Fargo Diet Review

Kerry Isherwood
 

Hi Beverly & LJ (a two-fer),

re:  IR's fat intolerance--

No blood tests used, only the powers of deduction and observation.  Until I started pergolide and finally got her insulin controlled, I couldn't feed **any** fat -- tried some of the "30% supps" made for fatties whereby you feed  ~1 lb/day to meet vit/min requirements:  all caused an instant insulin spike (the ones with added fat).  I tried adding a teaspoon of Cocosoya oil to her Mag supp to get her to eat:  even a *tsp* of oil set her insulin skyward.  Same thing with a mere oz of ground flax:  insulin jumped. 

How did I know?  There are clinical signs that I've identified that correlate with her high insulin swings (and yes, those I confirmed with bloodwork & journal keeping early on).  My mare's particular signs that I learned over time are (in descending order of prevalence):

--drastically increased drinking & urinating (aka PU/PD)
--hardening of what is normally a soft but very prominent crest
--tearing (clear discharge) from eyes, particularly her left
--thickened front legs (cannon area)
--behavior change (depressed/hangs in shed corner all day)
--increased appetite (eats every scrap of hay instead of leaving the stemmy stuff; then starts eating leaves, manure, the fence, bark, etc)  She seems insatiable when normally I know how much she eats per day down to the pound (I weigh everything).

Furthermore, and what is the most helpful clue I have at my disposal to identify her insulin status is hopping on her daily to assess body & foot soreness.  Ive ridden my mare every day for almost 11 years so I know when she feels good vs the "high insulin" lethargy, whole body stiffness, "laziness" that occurred over the prev 11 years when I didn't have the knowledge to know what was wrong.  Over the last few years my well-meaning trainers and friends kept telling me she was "arthritic", "old", & "time to retire" b/c of her age (21) & her stiff, stumbling, lethargic demeanor.  I even stopped showing & obtained a young horse as her replacement.  But once her IR was diagnosed (summer 2013) and diet corrected she quickly bounced back to feeling great under saddle and we actually got out the show gear and evented most of 2014 with great success. It was still during this time that she couldn't tolerate fats in her diet.  It was only after we diagnosed her as early PPID and started pergolide could I finally get her insulin to behave and eventually be able to feed her the needed flax.  She's at 1oz Triple Crown OmegaMax flax per day; I don't risk giving her any more than that.  She's tolerating that just fine, whereas she could not tolerate the exact same product & amt before pergolide. 

re:  increasing pergolide in spite of "normal" ACTH--

for some reason, my updated CH is missing.  So here's a very brief summary of my mare's PPID diagnosis:

Pinky was diagnosed IR summer 2013 (age 19).  managed very well on diet changes thru summer 2014 until she began to fall apart in August 2014 when her insulin began to increase despite "emergency diet", etc.  In Sept/Oct 2014 her insulin climbed and she also became hyperglycemic.  I was despondent b/c there was nothing my two beloved local vets could recommend to prevent the inevitable laminitis that was coming.  From all of my years working in veterinary ICUs and ERs I had already decided that I would not let my mare suffer the pain of severe rotational laminitis and instead would elect for euthanasia.  In desperation I asked my two local vets about the possibility of Cushings as the reason for her refractory hyperinulinemia (super high insulin that wouldn't budge).  Both said no way, the mare looked too good (ie, no harsh coat).  Dr. Kellon was the only one that looked at all the subtle pre-PPID signs and said, could be very early PPID, let's try pergolide.  Pinky's pre-pergolide ACTH was only 36.6 (Cornell's normal is up to 35).  She veiled as expected on 1mg but after a few days my pony was back to feeling great!  Her retest ACTH after abt a month on 1mg perg was 26.  So on paper she should've been "controlled", right?  Well, shortly after the retest Pinky had a major backslide into all of the symptoms described above but without a trigger I could identify.  It lasted a few days and I couldn't get her out of it, so I made the decision without consultation to increase her pergolide by 0.5mg.  Definitely not the wisest thing to do (increase a sensitive med without my vet's nod) but as I explained, I already knew that if Pinky foundered badly that it would be the end, so I felt I had nothing to lose.  (Please note this was my experience only and I do not condone making rash or unguided decisions such as I did--in retrospect it was irrational & highly inappropriate for me to do that, but i want to tell the tale as honestly as it happened).  The increase worked and she has not had a relapse yet, some seven months later.  More importantly, she feels the best she's ever felt under tack, and I mean in the entire 11 years I've owned her (she's 21 now).  My trainer and my two local vets are slowly warming up to the "idea" of "Pre-Cushings" based on how good my mare looks and behaves. 

I did not follow-up with another ACTH to see how low the add'l pergolide dropped her ACTH, bc TBH, I was so emotionally exhausted by the whole ordeal that I literally had to "shut the book" of labs and journals and just enjoy the healthy pony for awhile.  I believe that would've been a vital piece of info to have as a target ACTH in the future but alas, none of us really know what we're doing with this disease (PPID) and its terrible sidekick laminitis when it roars into town so let my story be but a learning tool for others.  I feel like Pinky's in blissful remission and I should make hay while the sun shines before gearing up for battle again with the approaching equinox.  Soon Ill have to get my purple tops in order, but I still have a few good weeks left.

I may not have answered your questions with direct answers, but hopefully offered anecdotes that will initiate further thinking and deductions of consequence on your own paths to success,

Best of luck,
Kerry in NY
Sept 2014


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ThePitchforkPrincess@...
 

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Re: ECH 8 files moved?

ThePitchforkPrincess@...
 

HI Kerry
I checked the activity on Pinky's case history in ECHistory8.

All that came up was:
Oct 4, 2014:
7:49 PM Kerry.isherwood Added folder "/Kerry Isherwood"
7:49 PM Kerry.isherwood  Added file "Kerry Isherwood/PINKY CASE HISTORY.pdf
7:53 PM Kerry.isherwood Edited file "Kerry Isherwood"
8.41 PM Kerry.isherwood  Deleted file "Kerry Isherwood/PINKY CASE HISTORY.pdf
8:42 PM Kerry.isherwood  Added  file "Kerry Isherwood/PINKY CASE HISTORY.pdf
 
This is what is in your Kerry Isherwood Horse 1 folder now.  

You added the folder for Kerry Isherwood Horse 2 on Sunday 
March 8, 2015 :
Mar 8, 8:53 PM Kerry.isherwood  Edited file"Kerry Isherwood  horse 1"
Mar 8, 8:54 PM Kerry.isherwood  Added folder "Kerry Isherwood horse 2"
Mar 8, 8:54 PM Kerry.isherwood  Edited file"Kerry Isherwood  horse 1"

This is consistant to what is in your files.  
The only other activity is that you added pictures to your photo album.  
Do you perhaps have a folder in one of the other ECHistory sites?  

- ​LeeAnne, Newmarket, Ontario

ECIR Archivist 03/2004

 

Are you in the Pergolide Dosage Database?

   ECIR Files Table of Contents

      Dawn's Case History

         Taken For Granite Art - Lightweight Cement Sculpture and Memorials

 

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