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Re: 13 yo Arab Appears to have Cushings
You may post whatever you like for discussion on questions. No rules about that! We do not use the testing cut offs because they are based on statistics and standard deviations to give predictions of what level will give you the highest probability of a correct result. Biological organisms don't obey statistics. If you look at the literature on insulin in normal animals it is clear that the laboratory "reference ranges" are way too wide. To give you an idea of what I'm talking about, see https://wp.me/p2WBdh-O3 and https://wp.me/p2WBdh-1hR .
-- Eleanor in PA www.drkellon.com |
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Re: Crisis with a cushings mare
She is on her pergolide still. I never removed it. I can’t find hay here unless it’s a compressed bale from TSC
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Re: Crisis with a cushings mare
Yes, no shipments have even been sent to my state. She’s checking the next state over and will call me back but we’re looking at hours and hours away. -- |
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Re: Advice on balancing diet please.
I didn't see anything missing in your diet recommendations from Forage Plus.
If you are going to be getting new hay soon, I'd wait until you've done so then see what her metabolic bloodwork shows after a week or 2 on it. If insulin is still too high, proceed with a second Ertugliflozin trial. You should check kidney function and triglycerides prior to starting Ertugliflozin, and continue to monitor both of them as well as urinary glucose. There are also feeding instructions that Dr Kellon can share with you upon request. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Re: Mya - waiting on trim - has abscesses - diet /pain please advise
Oliver's breed and late in life onset of laminitis are highly suspicious of PPID. The same may be true for Mya but her genetics predispose her to EMS. How long have you had her?
-- Eleanor in PA www.drkellon.com |
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Re: 13 yo Arab Appears to have Cushings
Thank you Dr Kellon. I wanted to know if this group uses the information in the document, esp the testing cut offs, etc. If you do not use them I will not post them. Trying to be cognizant of the group rules. Many thanks, Nancy |
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Re: Crisis with a cushings mare
Hi Kay,
Could you buy some grass hay and soak it before feeding it? 1 hr in cold water or 30 min in hot water. I think that's better than taking a chance on pellets which cannot be soaked to remove sugar. Please don't lose sight of one of the most important things, which is to get her back on pergolide ASAP. Without pergolide all the dietary measures in the world are not going to help the PPID, and if PPID isn't controlled insulin rises and that's when laminitis occurs. It's possible that her diet doesn't need to be as strict once she is at a therapeutic level/dose of pergolide. We have many PPID horses here that do fine with a bit of pasture and some leeway in diet because their PPID is being medicated appropriately and as a result their insulin stays low. (And we have many PPID horses that need both pergolide and a very strict diet because they also have EMS.) -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Re: Muzzle Grazing PPID Mare
You probably could get away with that, but no guarantees.
-- Eleanor in PA www.drkellon.com |
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Re: Advice on balancing diet please.
<Is soaking hay for 2 hours minimum satisfactory?
Canberra, Australia 2010 https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles
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Re: Crisis with a cushings mare
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Re: Advice on balancing diet please.
Rebecca,
If you restart the ertugliflozin you probably won't have to worry about her hay or soaking it. The loss of glucose in the urine from these drugs means the slight variations in hay based diets are not an issue. In fact, soaking may be detrimental. -- Eleanor in PA www.drkellon.com |
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Re: Mya - waiting on trim - has abscesses - diet /pain please advise
Lori Ricigliano
Dr Kellon
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I will get hay tested - finding an extension that I can borrow a hay borer so I can get the proper samples of our hay You mentioned on my other horse Oliver (see link below ) that he should be put on Prascend in addition now even though not showing PPID in bloodwork - would that benefit mya or not in this case ? And why him and not her - the insulin or glucose level ? He is doing better on metformin since Thurs the pounding digital pulse has stopped . Thank you so very much Lori On Jul 19, 2022, at 2:18 PM, Eleanor Kellon, VMD <drkellon@...> wrote:
-- Lori R in MN - 2022 Owner of 3 Metabolic Horses MYA Photos: https://ecir.groups.io/g/CaseHistory/album?id=276519 |
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Muzzle Grazing PPID Mare
My 20 year old Arab mare was diagnosed with PPID in May of this year. She was not herself most of last summer and seemed tender footed. I then observed a crest on her neck and she had fatty deposits above her eyes. She had not been ridden all last year. Coming out of the winter she was showing no tenderness in the front and she had lost most of the crest and fat pads above her eyes. Noticed More consumption of water and peeing and more frequently seeking out salt block. She seemed to be back to her old feisty self though. Had vet out and he did a stimulant test 5/02/22. ACTH pre was 15.0 pg/mL and post was 699.0 pg/mL. Insulin was 8.28 uIU/mL. She was started on compounded pergolide with 1 mg scoop daily. I didn’t tritate the dose and she had some of the veil going on but vet advised to stick it out and the veil symptoms are very much diminished. Had another test ACTH test done in July and she came in at 24.4 pg/mL and insulin at 14.41 uIU/mL. She has been on dry lot since last November. She receives TC ration balancer daily as well as a dribble of TC Senior to help her take the pergolide powder. No decrease in appetite or loss of top line or muscle mass. Question: could I let her graze with a muzzle for a couple hours per day, such as 7:00 am to 9:00 am? We are in Wisconsin. Vet thinks this change is ok as she isn’t IR. My plan currently is to test her again in late fall unless symptoms arise to warrant sooner.
-- -- Rose F. Wisconsin 2022 |
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Re: 13 yo Arab Appears to have Cushings
I'd say the EEG is finally starting to catch up to us! lol! We don't agree with everything in that document but I think it's an improvement on previous iterations.
-- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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AAEP/Zoetis Good works!! — June honorees announced!
AAEP has announced the June winners of the AAEP/Zoetis "Good Works" award.
https://www.facebook.com/AAEPHorseDocs/photos/a.347949547690/10158302397522691 If you are not on Facebook, here is the AAEP press release announcement. https://aaep.org/news/dr-beau-whitaker-honored-aaep-good-works-recipient-june?fbclid=IwAR1RBSfYekBSyomXCoptdRNG2dSmbYrUmrxYo4gerPv83aRLXQCZdauLVkk ECIR will be composing a press release especially for Dr. Kellon, her nomination and submission for the "Grand Prize", with more about her work with the ECIR Group Inc. If you would like to add your vote to the conversation, a note of congratulations on AAEP's FB page and/or a nomination for Dr Kellon would be awesome. We'd like to make sure AAEP hears from as many of you as possible, letting them know how your equine was helped. https://aaep.org/good-works-nomination Dr Kellon's email is drkellon@.... Phone is 717-484-2946 Congratulations dear Doctor, Friend and Mentor! -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
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Re: Crisis with a cushings mare
I did, we have very limited dealers of Triple Crown, no one can order it in, I can’t locate Timothy cubes either. So what do I do now? I can dry lot her later and get her off grass
-- Kay @ K & J Ranch LLC VA, USA 2022 https://ecir.groups.io/g/CaseHistory/files/Kaylee%20and%20Cassidy |
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Re: Advice on balancing diet please.
Rebecca.speed@...
Thank you Kirsten,
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Re: HELP! Farrier hit blood vessel in sole
Hi Karen,
My gelding started having intermittent lameness issues beginning in 2014 and by 2015 was lame most of the time. He was seen by no less than 4 vets and 3 hoof care professionals. He was not diagnosed until I requested bloodwork to check ACTH, insulin and glucose. He had all the classic symptoms of undiagnosed Cushing's disease except difficulty shedding/thick coat, and he was insulin resistant. This group and my former hoof care professional (that encouraged the blood work and got his trim dialed in, god bless you Pamela) literally saved my horse's life. He would have been put down well before now if I had not found out his actual diagnosis. Getting everything to work all together takes time and dedication. And there are steps forward and steps backward for my horse, but he is 1000x better now. I rode him last August and that was nothing short of a miracle to me. I'm so very sorry about your brother. The grief resulting from sibling loss is well documented to be as deep and painful as the loss of a child. I also understand loss and what it does to you (my son). My horse has been my rock and my therapy, so when he goes, it will not be pretty for me. But he's here now. And I do everything in my power to follow the welcome letter and all the advice and protocols here. Hang in there. This group will help you. Sending hugs and some peaceful vibes your way. Joy -- Joy and Willie (EC/IR) Nevada County, CA - 2019 Case history: Willie's Case History Willie's photo album: Willie's Photos |
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Re: 13 yo Arab Appears to have Cushings
We're very familiar with it, Nancy. Do you have any questions?
-- Eleanor in PA www.drkellon.com |
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Re: Advice Needed on Body Condition
He looks good to me! I would continue what you are doing and remember exercise is the very best way to control this.
-- Eleanor in PA www.drkellon.com |
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