Thank you all for your kind thoughts and words of comfort. So many of you have been where I am now. The incredible grief felt is the price we pay for sharing our lives with these extraordinary horses.

I would not be the person that I am today had I not fallen in instant love with a beautiful filly whose front half finally caught up to the height of her hind quarters so many decades ago.
Mill must have been on life #5 since I forgot the nearly foot long ethymoid hematoma she passed from her nostril in 2017. She was truly one of a kind.

--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent 2-13-1989 to 6-11-2022
Jack 22 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker

Hi Mary
You can’t upload videos to groups.io, but what most people do is create a YouTube or Vimeo video and post the link here. 
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

I'm very sorry for your loss.  Mill was fortunate to be so loved.
--
Sheri P in IL 2021
Peaches Case History & files:  https://ecir.groups.io/g/CaseHistory/files/Sheri%20and%20Peaches

I understand your concern. She should have end of life comfort.

Your should stop the leucine and AAKG and the TC/Standlee products.

How much PQ are you givings?

There is really no question here that it is the PPID  driving her laminitis.  All the other hormones produced by the intermediate lobe also influence insulin sensitivity. She's not the first one to have baseline ACTH normal and no other "classical" signs to have this problem.

Please believe we do not ever want to see a horse shaking in pain - just trying to get to the SOURCE of that pain and remove it.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Very, very sorry to read of your loss. What an amazing life the two of you had together. It gives me resolve to spend every moment I can with my boy and treasure them.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω

Thank you, Dr Kellon, for looking over Vandys history again.  I added a few more hoof pics & xrays to our case history to help.  She is due for another bi weekly trim but it wouldn’t be much to remove.  

 

It’s really a mute point about starting pergolide last December. 

 

 I have been treating/feeding her like an IR horse since at least 2010!  I have followed your protocols  regarding DDT+E.   And, actually, if I were only testing her ACTH, she would be normal!  She is not a typical Cushing’s horse.  Not cresty, not overweight.  She sheds out.  She sweats & she is exercised more than any other 31 yr old horse I know.  But…here we are.  With her sore feet.  

I was hoping she wouldn’t have a bad adjustment period since I was giving her the APF & J-herb.  

 

 I don’t think I will start any Metformin yet.  She has only been on a full 1mg  Prascend for 7 days now.  I will test at the end of June & reevaluate then.   

 

I’m sure the clogs are her favorite because they support her hoof wall with the casting cover & rigid bottom.  They also give her relief at the toe with the indention under the toe area.  The DIM also gives her digital cushion & frog a much needed cushion.  

 

This is a summary of things that I believe are pertinent to her current condition. 

 

I’ve added pics of hooves at different stages to our files.  Would like to add videos but haven’t figured that out.

 

 

8-30-21  Vandy barefoot at our camp. She was “off” a bit but was sound in boots to trail ride. We evacuated here for Hurricane Ida. Came home a few days later to major hurricane damage. Trees down. Pastures not accessible. So Vandy’s home & routine was majorly disrupted.  Trees down everywhere & she was only allowed in her stall & one small pasture. Lots of big trucks & chain saws for days. 

 

10-25-21 Took Vandy to LSU to get Coggins & decided to get lameness exam because she still had been a bit “off” - mostly turning on the right front. Dx lame on right front. I relented &  Vet put on clogs with screws. She was much more comfortable. First time in more than 10 years that she had a “fixed” shoe on her feet. Decided to wait to get TRH Stim test because of stress & seasonal rise. 

Xrays & report included. 

 

11-24-21  Pictures of hooves after I removed clogs. Terrible!!!

Beginnings of thrush. Under run heels. Lamellar wedge. Sole growing crazy. 

I trimmed & booted her for a week or so before replacing clogs. I do not use screws in the hoof. I slide the hoof between screws placed in the clog & wedge the hoof in place. I also use Artimud in the collateral grooves & under the DIM to prevent thrush. Then cast. 

 

12-3-21  Vandy was very comfortable in her EasyBoot Gloves to trail ride.

 

12-15-21 

First TRH Stim pre 21.7

                          Post >1250

         Insulin  77.5

Report included. CBC included

 

And - no- I didn’t start her on pergolide or Metformin at this time. First test. Maybe still in seasonal rise. Just not enough evidence for me. 

 

12-22-21 Started Previcox for arthritis. 

 

**Then Christmas. Still cleaning up hurricane damage. Vandys home & routine was still very disrupted.   I changed clogs out a couple of times. Vandy was very comfortable with them on but gimpy with them off. So I would clog for a month, boot for a couple weeks, then clog again. We would go for short trail rides where she would be fine. But pretty tired after. So I didn’t push her.  

 

3-24-22 Took Vandy to LSU for evaluation of rt front.  She came up lame a few days earlier with a bad cut on her foreleg.  Dx:Rt front laminitis with secondary laceration of rt foreleg. I also deduced that she got that cut from falling down while trying to sleep. 

I had been noticing her not wanting to roll & not taking her afternoon siestas. So started watching her at her usual nap times (early morning & after supper) where I knew she laid down.  Her knees would buckle & she would almost fall but never let herself lay down. That’s how she got the cut on her rt foreleg. 

X-rays & report included 

 

5-10-22 2nd TRH Stim pre 18.3

                                          post 1176

                 2nd Insulin 126

                      Glucose 92

Report included.  H&P & letter from vet included. Chem panel included. 

 

**5-27-22 Pictures of hooves taken after removing clogs & doing a very conservative trim.

 

Took Vandy off Previcox before starting PPID meds

 

5-22-22  Started APF Pro

5-25-22  Started Prascend 1/4

                   4days

5-29-22  Prascend 1/2 / 2 days

5-31-22  Prascend 1/4 (lost 

                   appetite)

6-2-22  Prascend 1/2 / 4 days

6-5-22  Started Phyto-Quench      

                 w/DC

6-6-22  Prascend 1 full pill 

6-11-22 Replaced Phyto-Quench with Bute for leg pain. 

 

Vandy has been on 1 full pink pill for 7 days now. Appetite is better even tho she is still being very picky. She is now eating 1 cup dry r/s/r beet pulp 3X day, 1 cup TC Senior Gold & 1/2 cup TC Senior 2X day, 1 cup Standlee Timothy pellets 2X day, as much (not much) free choice tested low NSC Bermuda hay (not weighed). She quit eating TC Timothy Balance cubes and Stabul 1 feed (I used the cubes & the treats to hide the pink pill). 

She still gets 2Tblsp iodized salt/day in her feed.  APF Pro 10ml, HA 1/4tsp, Jiaogulan 4tsp, AAKG 1 tsp/day -all syringed. 

California Trace Plus, Ground flax, MovEase 2 tsp, Leucine & AlCar 1 Tblsp each will slowly be added back into diet as she will accept. 

 

 

6-11-22  I replaced the Phyto-Quench with Bute to see if it helps the pain in her legs/feet. Her legs shake with pain when she walks. I did not get a video of her legs shaking. I have not seen her lay down since fall.  The Bute has made her able to walk without her legs shaking.  

 

I feel like I’m rehashing everything, but I just want Vandy to be comfortable.  She is 31 years old.  She has given me so many good years.  I want to do right by her.

 

Thanks

Mary & Vandy

Mary
May 2022,  Holden, Louisiana
Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Vandy  .
Vandy's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=275053  .

Yes, they are pretty smart and can easily be offended:) Good news they both ate their Stabul 1 this am with nothing else in it.  I was able to add salt to their soaked hay and will try to do that with salt/magnesium for evening meal.  I may look for a new flax source for those two as that may be the culprit.  Do you have a recommendation for when we should check insulin numbers again?  Thanks 
--


https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia

Most horses simply stop treatment after 30 days although reduced dose treatment for longer may be recommended. Ask your vet. Pre/probiotics are not involved.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

What a wonderful tribute to your lovely mare. Hold precious all these memories of 33 years together. You and Millionairess have been blessed. This group is an outstanding source of understanding and compassion.
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382

Ah, many thanks again for your wisdom. Will start to find ways to increase beet pulp.
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382

Hi Lavinia, 

After a 2 week delay due to my sprained ankle, I was finally able to address Shaku's fronts.  On Wednesday I removed a some toe between 10-2, but found his hooves very very hard and dry so left his boots off for a couple days as he was comfortable without them.  Our wet weather caused a lot of old sole and frog to shed off, so that by Saturday his toe walls were on the ground again.  I did a much bigger trim Saturday, put him back in boots, and posted updated photos.  Although I can see the toes still need to come back farther, and I need to do more in the heel area as per your markups, I can't get over the massive improvement in hoof angles, with much more upright heels on both fronts!  Such a relief!  I'll tackle his hinds and will tighten up his fronts a bit more today.

Thank you a million times over!

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

Hi Ferne:

I just replied to an old post re ulcers, Abler granules and Succeed written by Angie.  I then saw your entry re the importance of diagnosis.  I totally agree; however, I opted not to scope him because he has had a lot of change in his life over the last couple months and has clearly been overstimulated.  A couple weeks ago, he was brought in from turnout and they neglected to remove his muzzle.  Hence, he went at least 15 hours without food and this exacerbated his condition and he began going off his feed. I immediately scheduled endoscopy and was told he needed to fast 16-18 hours or they would not be able to evaluate his stomach lining.  Since I believe the fasting is what sent him over the edge, my vet and I decided to begin Gastrogard.  He has responded well within 4-5 doses and I am seeking advice as how to taper once we complete the 30-day treatment.  I assume pre- and pro-biotics will be helpful?

Thanks for your input.
--
Jeannette Mc, NorCA 2021

Here is another helpful post that has more links on free-feeding in horses with EMS:
https://ecir.groups.io/g/main/message/257390

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

Hi Angie

I am also treating my gelding for ulcers and began with Gastroguard and now putting him on Abler granules for a treatment of 30 days and tapering after that (I am considering also putting him on a maintenance dose for some time).  Can I ask what kind of tapering regimen did you follow?  Also, I've learned that abruptly stopping any kind of omeprozole causes a flooding or rebound of gastric acid production.  

What was the purpose of giving her Succeed?

Thanks for your help,
--
Jeannette Mc, NorCA 2021

Most states have laws actually requiring vets to write prescriptions in your situation. Unfortunately, Michigan isn't one of them https://www.avma.org/advocacy/state-local-issues/veterinary-prescription-orders but you could contact the Michigan State Veterinary Board https://www.michigan.gov/whitmer/appointments/oma/all/2/michigan-board-of-veterinary-medicine . Remember, where you fill the prescription is no one's business but your own and your veterinarian has nothing to do with where you fill it. There are plenty of online veterinary pharmacies you could choose from.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Kirsten is correct, and the most recent model for inducing ulcers experimentally has added phenylbutazone to the mix of alternate day 24 hour fasting. It's not that easy to induce ulcers. I would also point out that grass has a very high % of water so low calorie content, which is why grazing horses eat for so many hours. Horses that do not have EMS can be offered free choice hay and they will not overeat - which also means they spend a lot of time NOT eating because calories are much more concentrated in hay than pasture.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Can you add videos of your horse to your account?
--
Mary & Vandy
May 2022,  Holden, Louisiana
Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Vandy  .
Vandy's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=275053  .

"Foot pain" with heat and pulses is well documented in Excede treated horses even in the FDA information https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=9922e056-dcb0-46fd-bb56-9863bb0a189e .
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

That's exactly correct. I don't know who planted this idea in veterinarians' heads but have a good guess....
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

I'm so sorry and we're all grieving with you. I'm absolutely sure you're correct and it was quick. That was an eloquent tribute.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001