Date   

Re: Tully-17 year old Australian Stock Horse

merlin5clougher <janieclougher@...>
 

Hi, Asha, and welcome to the list. Sorry you have to be here, but glad you found us, as there is a lot of cutting-edge information that can help your girl.

First of all, here is a link to our Pergolide Data Base (thanks to LeeAnne for taking care of this!)

http://tinyurl.com/yfahmda

You will see horses on doses of up to 10 mg. Dr. Kellon says:"The only correct dose of pergolide is the one that controls the ACTH" (or symptoms and dex suppression test, in your case)

If you increase the dose too quickly, then the horse can experience the "pergolide veil", a transient state of lethargy and loss of appetite. However, if your mare is still not suppressing, and still has clinical signs (infections etc), then you are not at the correct dose, and going higher can only help, not hurt her.

Second: liquid pergolide has a very short shelf-life: 14 days for some water suspensions, maybe a month for oil-based ones. Pergolide is sensitive to light, heat and freezing (I assume no freezing in your neck of the woods), so keeping it in the barn may have resulted in even further degradation of the pergolide. In other words, Tully may not be on 4 mg (assuming 1 mg pergolide per ml liquid) - she may effectively be on only 1 mg or less.

I will send another post, talking about the list mantra of Diagnosis, Diet, Trim and Exercise, but I don't want to completely overwhelm you - so to start with, lets concentrate on getting you and your vet up to speed on pergolide, pergolide dosage, and getting a more stable form of pergolide.

Here is a link to a bunch of info about pergolide; scroll to the bottom, and print out "Pergolide 101" for you and your vet:

http://tinyurl.com/2alwqb

Next, here is some info on how to get your vet on board with higher doses etc:

http://tinyurl.com/ya6sflv (about halfway down list);

http://tinyurl.com/yaj4g8w (second file down)

Finally, don't do the dex suppression test - it does carry the risk of laminitis with it. There are a couple of timely previous posts from Pauline and Kylie in Oz - we can work on getting your vet on board with the endogenous ACTH test a little further down the road.

More to follow!


Jaini (BVSc),Merlin,Maggie,Gypsy
BC09
EC moderator

http://pets.groups.yahoo.com/group/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

I was hoping to find out how much pergolide a 15.2hh horse could safely have, my girl is currently on 4mls, and my vets reckon 5mls is probably the max for a horse her size.


Re: Panacur power pack

merlin5clougher <janieclougher@...>
 

Hi, Laura -


Here is a post from Dr. Kellon about de-worming, talking about a thin rescue horse (# 123872 ):

"Double dose pyrantel is for tapes. Double dose fenbendazole (Panacur,
Safe-Guard) is for small strongyles but you have to do it for 5 days
straight and there are many strains resistant to this drug. Large
strongyles have essentially been eradicated since the newer dewormers
came on the scene.

It sounds like you still need to treat for small strongyles. Wait a
week or so then do the ivermectin. BTW, I've been using that protocol
for a few years now and talked with the parasitologist, Dr. Lyons at
Gluck, about it after his group published their findings on small
strongyle egg counts returning after only four weeks. He agreed it was
a reasonable approach. With high risk, debilitated horses like this, I
keep them on ivermectin every four weeks after doing the triple regimen.Also, the five day double dose fenbendazole treatment has been shown to cause colonic ulceration. Moxidectin (Quest) doesn't but it's dangerous in a thin horse.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001"

If there are encysted strongyles present, one has to use caution at this time of the year: they are starting to emerge, and sometimes removing adult worms in the gut causes a surge of the encysted ones to emerge, leading to gut damage.

If it were me, I would use moxidectin (Quest). It does have a smaller margin of safety, so you have to make sure you tape-weigh BooBoo, and give only the recommended dose.

What de-worming schedule has BooBoo been on so far?

Here is some more info on deworming:

http://pets.groups.yahoo.com/group/EquineCushings/files/Deworming/

Hope that helps a little!


Jaini,Merlin,Maggie,Gypsy
BC09
EC moderator

http://pets.groups.yahoo.com/group/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

--- In EquineCushings@..., "Laura" <lauratmatt@...> wrote:

Just wondered if the panacur power pack was safe to give an IR/Cushings horse that has had diarrhea for weeks? My vet believes it is large and small stronglyes. My horse is already on Forco and Bio Sponge with no relief in symptoms. I believe it is related to the change in hay. He is 30 years old.

Any advice would be welcomed!

Laura and Boo Boo Magoo
1/2010 NC


Re: Tully-17 year old Australian Stock Horse

 

Ooops, sorry Asha & all, that one got away from me before I could sign my name and delete the non-essential.

George & Wind
Mica Bay, ON
EC2010


Re: Tully-17 year old Australian Stock Horse

 

Hi Asha,

I agree with Pam, the liquid is very unstable and loses potency very quickly and as such the effective dose rapidly decreases. Pergolide powder in capsules is the recommended way to administer the drug. These capsules can usually be purchased in the dose size you require. My mare, Wind, is 14.3H & 875Lbs (397Kg) and is currently on 4mg of Pergolide. There are horse in this group that are about the same size and are on doses of 10mg. There are no known side effects of Pergolide in horses, other than temporary loss of appetite and 'spaciness' if the dose is increased too quickly. Even doses of 10mg are much less per Kg of body weight than human doses were.

If you look through the files section you will find a document/database which list horses and the doses they are on.

As Pam quoted Dr. Kellon as saying, the only correct dose of Pergolide is the dose that controls the disease, as determined by testing endogenous ACTH. ACTH should be below the following values for the corresponding time of year:

ACTH Normal range Nov - July 6.38 pmol/L (29 pg/ml)
ACTH Normal range Aug - Oct 10.34 pmoil/L (47 pg/ml)

The ACTH test is preferable to the Dex suppression test for a number of reasons, one being that it is as accurate a test and will not cause laminitis in sensitive horses as the dex suppression test has been found to do.

It would help greatly if you could fill out and submit a case history, including blood test results, especially for Insulin, Glucose and ACTH as well as the latest X-rays that were taken of her feet.

The group's philosophy is DDT/E which stands for Diagnosis, Diet, Trim & Exercise. The first step in your case is to determine whether your girl is PPID or IR. If she is then we can address those issues, if not then they can be ruled out.

While I know nothing of the herbalist who is prescribing her diet, this group's approach to diet is based on an analysis of the elements in the horse's diet, making sure it meets the NRC minimum daily requirements for nutrients and minerals and balancing the mineral and trace mineral ratios. If a scientific analysis of the hay and feed is not done, there is really no way to know whether you are meeting the horse's nutritional requirements. We also use some herbs, where and when appropriate.

What is your girl's body condition score? Does she have a cresty neck, fat pads, fat bulges above the eyes?

Please describe her diet, Kg of hay fed per day, type of hay, hours on pasture & type of grass, herbs or supplements being fed etc…



Member LSARC.ca
Member JMT.org
Member WCFN.org
Member savetheeaglesinternational.org
Member: greatlakeswindtruth.org

On 2012-04-16, at 10:51 PM, "ashabilling" <ashabilling@...> wrote:

Hi all,

I was hoping to find out how much pergolide a 15.2hh horse could safely have, my girl is currently on 4mls, and my vets reckon 5mls is probably the max for a horse her size.

Tully, who is a 15.2hh Australian Stock Horse mare and the love of my life, was diagnosed with Cushings in Autumn 2010 when she was 15 years old.(I suspect she may have had Cushings for much longer, she started to get a very heavy winter coat several years before she was first tested). She was put on 1ml of pergolide and at the 6 week test she was suppressing normally, although she still grew a very heavy, curly winter coat.

Everything went along smoothly until May 2011, when she developed a huge hoof abscess. It started like any normal abscess, but quickly turned into a massive infection,her whole leg was very swollen and it took weeks of antibiotics to reduce the swelling and stop the pus. The abscess burst out in 7 or 8 places around her hoof, and she ended up with only about 8cm at the front of her foot left intact. because she basically lost 80% of her hoof, her toe would flip up as she walked which resulted in some damage to her tendon, and she has permanent thickening in that pastern, months of massage have reduced it but it will never be normal.

In the next few months she had several small abscesses in her other 3 feet, She had another nasty abscess in her bad foot (right hind) and one nearly as bad in her left hind in September.

Aside from the foot problems, in August she developed an orange sized lump under her jaw, after weeks of antibiotics and several lots of x-rays vets decided to remove the tooth, the first attempt (with the horse dentist) was unsuccessful, but at last, in January 2012 after almost 5 months, they got the tooth out and she has not had an issue with it since.

The vets had been slowly upping her pergolide dose but getting no results, she was on 3mls in Jan 2012.
From when the tooth came out, (12th Jan 2012) until 4 weeks ago she was almost like a normal healthy horse, but she she has had another huge abscess (again in her right hind) so she has been on antibiotics AGAIN and she is now improving greatly.
Her last blood test was 3 weeks ago and she was still not suppressing at all, so they have put her up to 4mls a day. my vets reckon she cannot have more than 5ml a day, so I am starting to freak out.

I have a horse herbalist prescribing her diet, and the vets took x-rays of all her feet back in October and couldn't find any answers.

She has been by best friend for the last 14 years, I am desperate to find something to help her but nothing seems to be working.

Sorry for the very long and badly written post, I hope you can make sense of it.

Thanks,

Asha.


[Non-text portions of this message have been removed]


Re: pergolide tablets - close to date

Lorna <briars@...>
 

Hi Jaini,


Island Pharmacy in Canada sent samples off to check pergolide levels at 0days, 3 months and 6 months. I can't find that data right now, but I believe that even at 6 months there was minimal loss of potency.

Details are here:

http://pets.groups.yahoo.com/group/EquineCushings/files/Canada%20-%20%20Sources%20for%20Products%20%26%20Services/

Scroll down to Pergolide.


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


Re: pergolide tablets - close to date

merlin5clougher <janieclougher@...>
 

Hi, Claire - Since you are in the UK, I assume you are using Prascend? Or are you one of the lucky few that still gets pergolide?

If you are using Prascend, you could contact Boehringer Ingelheim, and ask for any data they have on potency and shelf life.

The only data available for compounded pergolide are from a very few studies, or one compounding pharmacy in Canada. The one study (Compounded Pergolide)

http://pets.groups.yahoo.com/group/EquineCushings/files/Drugs%2C%20Pergolide%2C%20Cushings%20Disease%20Treatments/Compounded%20Drugs/

suggests that capsules are at 75% to 91% potency after 60 days (study did not check for longer time periods; higher potencies are for capsules stored at 8 degrees centigrade)

Island Pharmacy in Canada sent samples off to check pergolide levels at 0days, 3 months and 6 months. I can't find that data right now, but I believe that even at 6 months there was minimal loss of potency.

So - the short answer is: it depends. It depends on how and where the pergolide was stored, whether it is capsules or blister packs, and the potency of the drug that was used for compounding. I know that some people have experienced a relapse in their horses' symptoms after a few weeks of using pergolide that had been either over-heated or frozen.

The best one can do is store your pergolide in the fridge, keep it away from moisture, and use it up by the expiry date - all the while monitoring your horse's symptoms and blood work (if possible)

Here is some more info in the files (check out "Pergolide 101):

http://pets.groups.yahoo.com/group/EquineCushings/files/Drugs%2C%20Pergolide%2C%20Cushings%20Disease%20Treatments/


Jaini,Merlin,Maggie,Gypsy
BC09
EC moderator

http://pets.groups.yahoo.com/group/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

--- In EquineCushings@..., "ermintrudeclaire" <claire@...> wrote:

hi, somehow I have managed to get my pergolide boxes out of order and the new box I opened today has an expiry of end 05/12. I will use it in time but just wondered how far over the date would be safe and still effective? What sort of margin do they allow on pergolide?
thanks
claire:-}
uk,july10


Re: Sabrina Very Painful Again

Heike Bean
 

It looks to me like you might have left the frog higher than the
heels/walls.

This is very painful, esp. for compromised feet.

08/VT

Heike Bean

heikeb@...

www.heikebean.com



From: EquineCushings@... [mailto:EquineCushings@...]
On Behalf Of sunshine12982000
Sent: Tuesday, April 17, 2012 10:20 AM
To: EquineCushings@...
Subject: [EquineCushings] Sabrina Very Painful Again





We have been working on Sabrina's feet, soaking, trimming, etc. She was
doing
well as evidenced by YouTube I posted on March 26. In the last few days or
the
week, she has gotten much more sore again. Saturday I could see that she was
having trouble. Sunday we got down to business on heel height. I have posted
16
new pictures of before and after Sunday's trim.

http://groups.yahoo.com/group/ECHoof/photos/album/861226757/pic/list?mode=tn
<http://groups.yahoo.com/group/ECHoof/photos/album/861226757/pic/list?mode=t
n&order=ordinal&start=41&count=20&dir=asc> &ord&#92;
er=ordinal&start=41&count=20&dir=asc


Re: Sabrina Very Painful Again

Nancy C
 

One way to tell if there is sole pain is with gentle, even pressure from hoof testers. Some people don't like them, but it's a diagnostic tool I have found helpful in ruling things out like abscess.

If you don't have hoof testers, you can gently tap the sole with the tip of your rasp to see what reaction you might get. Not as effective on the heels.

I have lost track of who is guiding you with the trim. She still needs more toe/wedge taken off for good form, in order to get her to use the back of her foot, but I'll leave that for Linda or whoever that might be.

If PA is like it is here in NH, the ground is very hard and dry from a fairly dry winter and very dry spring, sapping moisture out of the foot and causing pressure on sore areas, less over all hoof flexion especially with high heels. It would definitely exacerbate the current toe.

What are you soaking with? For abscess concerns from back a few months ago? No abscess erruptions, right?

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...


Re: Sabrina Very Painful Again

Linda <PapBallou@...>
 



Hi, Linda. I'm sorry, I'm have one of my ever increasing dumb days. I don't know what you mean.
No - you're not. I tend to phrase things awkwardly at times.

Thinking out loud here...we know she is IR, not certain if PPID, and this would be the time of year the ACTH should be the lowest.

Diet is a low s/s hay. Was clearly doing well and then started to get sore about a week ago...spring.

No chance she is sneaking tasty green grass shoots?

Have you noticed her starting to cycle? Dr Kellon has noticed a spring cycling/hoof pain issue with some IR mares.

For now, stop soaking. It softens all hoof horn (wall, sole) and that is the last thing you need right now. Toes are long but that can't be addressed at the moment.

Can you build up the padding in the boots?

Linda
EC Primary Response
West Coast
May 2004


Re: Sabrina Very Painful Again

sunshine12982000
 


Gayle -

There has been no trimming since before the video you posted?

Hi, Linda. I'm sorry, I'm have one of my ever increasing dumb days. I don't know what you mean.

The video I posted in March was outside, and Don was leading her. She was walking rather well. He continued to do touchups, worked on her heels and toes a little, tried to scrape overgrown bar off the bottoms, but always a little at a time (partially because her feet are so incredibly hard, it's difficult to make fast progress)for awhile, nearly everyday. Then we gave her several days rest (enforced by Don's own schedule). The end of last week, Friday or Saturday, I noticed she was having a little more problem. We decided to work on the heels on Sunday, and tried to get them down. She was wrung out before he finished with the left foot-the first one. Then he did as much on the right as he could. Yesterday, she was actually trying to tiptoe around the stall, so I took the new videos. The only thing he did last night was to scrub the right sole with Dawn and water just in case there's thrush. We don't have any regular treatments here, but I've read that can be mildly helpful. After doing her right foot, he just cleaned her boot on her left foot, because she could never have stood long enough on the right for him to do much with the left.

So, if I understand your question, between the video in March and the one last night, he's been primarily doing touchups trying to get where we THINK we need to be. But we decided to go further on Sunday because her lameness seems to stem more from sole or heel soreness than toe problems. What do I know?

Gayle and Sabrina
3/06
Fairview, TN
http://pets.groups.yahoo.com/group/ECHistory/files/Sabrina/


Re: Sabrina Very Painful Again

Linda <PapBallou@...>
 

We have been working on Sabrina's feet, soaking, trimming, etc. She was doing
well as evidenced by YouTube I posted on March 26. In the last few days or the
week, she has gotten much more sore again. Saturday I could see that she was
having trouble. Sunday we got down to business on heel height. I have posted 16
new pictures of before and after Sunday's trim.

Gayle -

There has been no trimming since before the video you posted?

Linda
EC Primary Response
West Coast
May 2004


Sabrina Very Painful Again

sunshine12982000
 

We have been working on Sabrina's feet, soaking, trimming, etc. She was doing
well as evidenced by YouTube I posted on March 26. In the last few days or the
week, she has gotten much more sore again. Saturday I could see that she was
having trouble. Sunday we got down to business on heel height. I have posted 16
new pictures of before and after Sunday's trim.

http://groups.yahoo.com/group/ECHoof/photos/album/861226757/pic/list?mode=tn&ord\;
er=ordinal&start=41&count=20&dir=asc

They are the last 16 in her file if the link doesn't go to the right page and they are dated 4-15. I think we made some dramatic differences in her heel height. I hope we're doing
this right, because she's really suffering for it.

Yesterday she could barely move, kind of "toe touching" especially with her
right. I'm hoping that this has to do with dropping the heels and realigning
everything, but I'm very worried about damage to her tendons. We do have her on
bute again. She had 1 gr x 2 on Sunday, and 1 gr yesterday. Without it, she
starts sweating and I'm so worried about her giving up. There's no strong or
fast pulse or heat, it doesn't really seem like laminitis. More like painful,
bruised feet and maybe painful legs.

Here's a short video of her walking forward last night.

http://www.youtube.com/watch?v=GCj-50PWDUU&feature=youtu.be

The second is when she was trying to go from her cubes in the corner, to her hay
feeder in the middle of her stall. She moved backwards rather than turn.

http://www.youtube.com/watch?v=0mXU9ODXtyw&feature=youtu.be

I am so afraid we've done more harm than good with her trimming. Please someone
take a look at her photos and give suggestions. The trim definitely needs
refining, but we can only get so far. She was literally falling down on Sunday
after we were done with the first foot, and we couldn't do anymore "fine tuning"
but I had hoped we were headed in the right direction. Now I'm not so sure.

We still haven't run new bloodwork, because we were hoping to be able to catch
her when the pain level was down so that we don't get a false positive. I feel
like we're starting all over again. This has been going on since January for the
poor baby, and she's got to be so tired of it.

Thanking you all in advance.

Gayle and Sabrina
3/06
Fairview, TN
http://pets.groups.yahoo.com/group/ECHistory/files/Sabrina/


Re: Tully-17 year old Australian Stock Horse

Pamela Bramell
 

Asha, Please hang in for one of the gurus to get back to you. I can tell you two things. The first is that it sounds like your gal is on the liquid pergolide which has a very short shelf life. If she is on the liquid, this could be a big part of the problem as the dosage won't stay consistent. The pergolide will start to degrade. On a fresh batch she may be getting the correct dose but as time goes by the pergolide is not as potent so she is getting less and less pergolide. As far as the amount of dosage goes, according to Dr. Kellon the only dose that is the right dose is the one that controls the ACTH.
While you are waiting to hear from one of the volunteers, you should go ahead and get the info together on what you are feeding her and try to get some hoof pictures. There is a file that tells you how to do that, but I am off to work and can't look it up right now.
Hang tight, I think your girl can be helped, you are just on a roller coaster right now! Your mare is in your good hands - I can tell you love her very much!
Pam/Buttercup IR/Frosty Cushings/IR
12/10
Va.

--- In EquineCushings@..., "ashabilling" <ashabilling@...> wrote:

Hi all,

I was hoping to find out how much pergolide a 15.2hh horse could safely have, my girl is currently on 4mls, and my vets reckon 5mls is probably the max for a horse her size.


Re: Enrich 32

Emily Olzawski <libra.smurf@...>
 

This is all I have from calling Purina before.

Enrich 32
NSC% is 10-14%
sugar is 6.4
starch is 3.6
Em    Dallas,TX
Sue and Raine


[Non-text portions of this message have been removed]


Re: Soft Ride Boots?

Lisa S
 

--- In EquineCushings@..., "Annette" <annettescherr@...> wrote:

Also I don't understand the comment about the shape of the soft rides impacting the growth of the hoof but their may be a valid point there.

Annette,

Where did you read the above comment? I did not see it in this discussion...Thanks!

Lisa in TX
Pookey Bear
June 2010


Re: Enrich 32

Allana KERELUK
 

Does anyone have an analyis of the Enrich 32 feed they can share? I have the feed tag, and see the pdf brochure on file, but am wondering how accurate it is to balance to min and max percentages?

Many thanks,
Kim & CG (IR/PPID)
Hi Kim
I don't have an analysis, but I use Enrich 32, 1-1/2 lb a day, and 1 lb of soaked beet pulp. My horse is doing well after feeding it for a year, following a bout of laminitis. I too was skeptical about the added stuff, but the boarding barn uses hay from various sources, so testing isn't possible. I supplement with Vitamin E, CTB, magnesium and MSM, but needed affordable, and a local source-that my picky eater would EAT. Even managed to get through the seasonal rise last fall, without incident, a first in the 5 yrs I've owned him. Several other IR horse owners at my barn are using the Enrich 32 also, with similar results. NOT for every horse by any means, but it's a year's worth of anecdotal info.

Allana and Mojave Moon
Illinois
Feb. 2011


Re: DEX SUPPRESSION TEST - FOR LINDA OR DR KELLON

Kylie T
 

Hey Pauline

Yes we do cross paths again :-)

I totally agree with you re. trying to get vets on board and convincing them...just can be frustrating when one is brushed aside with one's concerns and requests;-)

Sigh...I guess personally, if I'm ever faced again in which mine/a horse becomes laminitic as a result of the dex test (or anything else) I would just implement the emergency procedures of ice ice and more ice etc but in our climate it would last five minutes, the next best thing I guess would be cold tap water :-)not only does distance put in an obstacle, but the elements too :-)

Cheers Pauline :-)


Kylie, Annie and Angel Maurice
Sunny Coast, QLD
Aussie
Jan 11

I wonder if the issue is not so much being able to get the testing done- but to convince the vets of how it should be done.


Re: DEX SUPPRESSION TEST - FOR LINDA OR DR KELLON

Pauline <takarri@...>
 

--- In EquineCushings@..., "boofamaurice" <kylie_tuckerman@...> wrote:

One of my query is, testing for Cushings with the dex suppression test. I've read alot on the risks associated with it. The problem we face is not accessing the alternative - ACTH testing. I know I found resistance with ACTH testing on the coast.
Hi Kylie,

Crossing paths again :)- I wonder if the issue is not so much being able to get the testing done- but to convince the vets of how it should be done. I have an awesome contact at Gribbles that has helped me with out of state protocol before & I get the remoteness issue being a major factor in some cases. It will certainly involve groundwork,co-operation & time. I guess we won't know until we push those buttons. For me, because of what I now know about the potential side effects of the Dex test - in an already compromised animal- I would hate to risk it. I'd be more inclined to treat symptomatically, getting an outback vet on board is a harder issue.

Pauline
Jack,Spur
Australia
Aug 07
http://tinyurl.com/7qbdyas


DEX SUPPRESSION TEST - FOR LINDA OR DR KELLON

Kylie T
 

Hi Linda, Dr Kellon and everyone else :-)

Some of us here in Oz are remote and have limited access to vets, barefoot trimmers and accessing low S&S hay.

One of my query is, testing for Cushings with the dex supression test. I've read alot on the risks associated with it. The problem we face is not accessing the alternative - ACTH testing. I know I found resistance with ACTH testing on the coast.

The dex supression test is likely to be our only option particularly in remote areas. I now know that I can access testing for ACTH on the coast but when the only option for us is the dex test, is there anything we can use/do to at least prevent the risk of a horse possibly having a laminitic episode as a result. I guess if I ever come across such a situation ever again I'd like to be prepared.

Cheers
Kylie, Annie and Angel Maurice
Sunny Coast, QLD
Aussie
Jan 11


Re: Locket Girl

Kylie T
 

Hey Pauline!

Yep...I've been giving some guidance for resources etc...Now that I've learned from this group I can help Sarah with the contacts and resources I've gained here in QLD and Oz.

Cheers
Kylie, Annie and Angel Maurice
Sunny Coast, QLD
Australia
Jan 11

we also have another member- Kylie- in QLD- that I'm sure will be happy to offer support. I appreciate that you are in a very remote area-so it may make things a bit more difficult- but we are used to getting around things,so feel free to give us a hoy if you need it.

119181 - 119200 of 282194