Date   

Re: TSF Metabolic Support, Bunch Grass, and Palmer Angle questions

Shera Felde
 

Thank you for the link (not sure why finding these things is so hard for me!)

How about now? https://ecir.groups.io/g/CaseHistory/album?id=253720
--
Shera Felde, Central Oregon, 2020
https://ecir.groups.io/g/CaseHistory/files/Story%20and%20Shera
https://ecir.groups.io/g/CaseHistory/album?id=253720


Re: Laminitis(?) emergency

Eleanor Kellon, VMD
 

Tory,

We can't tell what's wrong with your donkey or what might have come first but it's extremely dangerous for a donkey not to be eating. They will mobilize fat to the extent it can shut down their organs. If you can get an emergency vet  visit, do it. In the meantime, see if you can get her to eat picked grass. She also needs the option of plain water instead of just with electrolytes.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: At my wits end with Riosa - Dr. Kellon please help, advice needed

Judy and Bugsy
 

No problem Heather. 

These critters of ours can certainly be a puzzle at times. Thanks for the tip on the “human booties”. That will come in handy. 


The other thing that I noticed with Bugsy that may be similiar with Riosa is the important role that exercise plays. I’ve noticed that If I’m not able to keep right up with his regular exercise I notice very subtle changes. If he is shifting weight on the front and doesn’t get his exercise he shifts more frequent the next day - it’s very subtle but we notice these kinds of things. If he gets his exercise the shifting subsides. Common thought would be if a horse is a bit sore, leave him alone - but with boots or in sand,  whatever makes him comfortable, exercise is absolute key with him. 
--

 

Judy and Bugsy

Regina, Saskatchewan, Canada

Feb. 25, 2020

https://ecir.groups.io/g/CaseHistory/files/Judy%20and%20Bugsy
https://ecir.groups.io/g/CaseHistory/album?id=243358

 




Re: Next steps for Baby

Christopher Lynds <Jan4slt@...>
 

Thank you Martha, I will keep the same thread going with the replies.  
The ECIR site recommendations on emergency diet have been followed like this:  We have been soaking hay and I'm asking for more guidance in giving ration balancer like California Trace (how much?) and I have been adding 2 Tablespoons iodized salt, Vit E elevate 2 ml oil per day.  What about Magnesium? Do I grind up human supplements and give 1.5g/500lb so for her 1000lbs, 3 g per day?  I can give flax meal starting today. She will accept a small amount of shredded soaked/rinsed beet pulp as I have trial tested her over the past few days. We are weighing dry hay, soaking 60 min and she is eating it, so do I need to replace any of her hay with BP? 
I will ask the vet about tapering off the Bute.  Baby has taken Equioxx for two years with hour long or more trail rides and daily riding until pasture this winter. You have read the history of this spring. I have the CH labs posted. I agree that masking the cause of the pain isn't going to help. I agree that xrays will be the gold standard for getting information.  They will most likely take a set of diagnostic for the farrier to see prior to trimming, but then do I need to ask the vet to wait until after the trim and shoot another set to show the trim/comparison?  Does that mean all four hooves done twice?
Thanks for your replies.
--
Jan L in CA 2021
https://ecir.groups.io/g/CaseHistory/album?id=264927
https://ecir.groups.io/g/CaseHistory/files/Jan%20Baby


Re: Pergolide dosage for mini cross

 

Hi Valletta,
The amount of pergolide you need for your little guy is whatever it takes to control his ACTH.  There is no weight relationship to the necessary dose.  I have a mini on 11mg now.  Titrating up to whatever you’re comfortable with is fine but be sure to retest in three weeks to see how that dose is controlling his ACTH.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Desi earned her wings

 

Bobbie, I’ve been thinking about you a lot since I first learned of Desi and I will continue to do so.  Her loss will leave a big hole for you, one that will take time to mend.  Try to fill it with memories as well as taking the time to help others who haven’t had your experiences.  Time will heal your heart.  I still think about Logo after two years and some of my thoughts are not exactly joyful but it’s still wonderful to have those memories to reflect upon.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Pergolide dosage for mini cross

Candice Piraino
 
Edited

Hi Valletta!

Well you are doing a great job so far and this horse is lucky to have found you since you are already familiar with what to do and the resources to reach out to!

I personally use Pet Health Pharmacy and they are still doing a great job for my two PPID & IR horses. I have been using them for at least 2+ years now. I just had to increase my Lipizzan's pergolide and waiting on it now. My mini (about 350lbs) is doing well on her 2.75mg and her ACTH numbers are at 16.9 pg/mL as of 6/7/2021. This is just one example of where an equine is in regards to their medication. I recommend still titrating the dose up to at least 1 mg- so start at .25 for a few days and then go up to .50 for a few more days and then to .75 and then to the full 1.00. Of course pending how he is doing/feeling. Then once he is at 1.00 for 3-4 weeks, test him again to see where his numbers lie and go from there. If his numbers aren't in the "teens" with at least 1 mg, then I would increase it gradually until you can find what works best for him. Pet Health Pharmacy can and will help you with the dosages/calculations.

You can also add APF (adaptogens) to help Scout adjust to his medication. 
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Re: Next steps for Baby

 

Hi Jan,
I think it would help those of us who are following this if you kept your posts in one thread, for now at least.  It’s much easier to scroll down to see how the conversation is evolving than to have to look for separate messages.  You’ll get better responses that way.

I am having some trouble sorting how how you’ve responded to our suggestions.  NSAIDs won’t help the hoof pain of laminitis.  The only thing that will is to remove what is causing it.  If you focus on resolving the pain with drugs, you will be distracted from finding its cause.

Plan to test her ACTH again about three weeks after you increased the dose.  Her issues with ligaments, etc will be helped by having her PPID controlled.

We will be most interested in seeing the new radiographs and how they compare with the trim.  Having a lot of experience with laminitis does not always mean there isn’t room for improvement.  

--

Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Desi earned her wings

Candice Piraino
 

Bobbie- big BIG hugs to you and Desi! Bless you both and may Desi be running wild where she is and for her to carry you whenever you meet her!

Thank YOU for being her person and treating her so well!
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Re: Climbing ACTH numbers

 

Hi Sue,
As we would not recommend a pergolide/ cypro combination, I would guess Sherry is referring to the compounding pharmacy for pergolide itself.  There are at least several who have lots of experience and know that it’s relatively unstable under conditions where any water might be introduced.  When I first began using pergolide, eons ago, I was referred to a local compounding pharmacy which prepared a flavored oil suspension which seemed to work fine.  The same preparation in water would have lost activity rapidly.  Now I purchase capsules from Pet Health Pharmacy but there are other sources our members use as well.  Using a reliable source lets you know whether or not 1mg was adequate because you can trust that the drug itself is fresh and well tended.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Laminitis(?) emergency

Candice Piraino
 

HI Tory!

First I have to say you have come to the right place and I am sorry you are having to deal with this with your donkey ( I LOVE DONKEYS!). You must be frustrated for sure!

Ok So this will be a long reply, but we do need a case history for your donkey and completed to the best of your ability. 

In the meantime, let me just say donkeys tend to go down as a very last resort with pain. Different then horses in general- most horses lay down fairly early in the laminitis stage. BUT Donkeys can make huge and fast improvements. Their coffin bones are much smaller and this is a great benefit for us. We just need to remove the triggers.Were there any xrays taken so we know the degree of rotation or sinkage of bones inside the hoof?

Yes, if this were my donkey, I would remove all donkeys off of grass and try to keep everyone "together" or at least so they can see one another. 

What kind of hay/straw is this donkey receiving? What are the electrolytes? 

The following will help you with what can follow next. Please ask if you have any questions or concerns, even if you are having issues uploading your case history.

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine. If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 

 
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Next steps for Baby

Christopher Lynds <Jan4slt@...>
 

I have changed the Prascend to 2 mg daily on 2021/06/14. and the Metformin to 13 tabs BID on same date per vet visit. We are not giving Gabapentin.  Vet still wants me to give Bute 2g daily, did not agree with taper and eliminate.  Plan labs for ACTH and insulin in July, at least 3 weeks after the changes.  Meanwhile, Baby is so sore, she is weight shifting, walks very little, can get up from lying down on sand bed in her pen.  She has a good appetite for soaked low carb hay and small amounts beet pulp (just tried it to see if it might be a way to introduce additives, but decided to stick with oral syringe for med admin accuracy.)  Getting more xrays this week and farrier eval with vet input. Last xrays 2021/05/20 prior to trim. Sherry thought toes were too long, but the X-ray does not adequately reflect the current trim as the farrier used these xrays to reset her later that day.  She has thin soles, a club foot with capsular rotation on the right front congenitally.  She still has pulses, which have been ongoing since April. 
My latest worry is weight loss with more ribs showing and now wrinkles to her neck on both sides which looks like looser skin. I don't have elemental analysis of hay, posted what info I had at time of purchase and started giving dry hay on 2021/05/18.  We have been soaking it consistently now for a week. I have not given any ration balancer, only 1-2oz iodized salt.  Stopped Performance Platinum on advice form ECIR re: not safe for IR horse, although the vet called the company rep who said it is safe, recommended one scoop daily (about 6 oz dry volume.)  I am giving 2ml Elevate Vit E oil on her beet pulp or on the soaked hay. 
What else can I do?  The link to getting a hay analyzer drill bit was not on line. I have 10 bales left of the lot I purchased. I trust the hay analysis I posted but don't know how I can get mineral balancing unless I get samples to a lab?
I'm hopeful that she wants to eat, but discouraged about any progress.
Thanks for some supportive advice.  
Lorna asked if I meant Hay Analysis in the photo album, yes that's what info I have. 
Sherry asked is Baby standing up more than lying down, yes. She is in rocker shoes same as reported 2021-05-20. She has easy reach of both hay and water. She was tape measured at 1000 lbs and 15.1H by vet at 2021-06-14 eval. She had been on Equioxx since bowed tendon 2019-06-near end of the month and did trials off the med, decided she was much better on it at 1 tab per day.  When the hamstring flare up 2021-03-31 happened and we put her in a pen for comfort/safety/easier access to water and off pasture, we changed to Bute by vet recommendation.  Then we got the IR diagnosis from labs returned after the 2021-03-27 draw, done at a routine vaccination clinic and kept her off pasture, still walking well until big change 2021-05-10 with increased lameness.  We soaked hay, sourced low carb hay and started feeding that. She was not improved and had another vet consult 2021-05-20 and got the Rx for Metformin and Gabapentin.  We started those the next day, but only gave one dose of Gabapentin and then decided not to give it on recommendation of ECIR as it wouldn't help her pain.  She has never had an access and hoof trims are very important of course.  Her farrier is working with the vet office and very experienced in laminitis care, has been caring for her since onset of PPID with that laminitis bout.  
Plan a team consult tomorrow with xrays, trim and decisions about getting more labs, previously planned for mid July, and evaluation of her situation. 
I can try to get  a hay probe, send off to a lab and compare to the previous analysis on the same bales if that is going to make any difference. Is there anything else to do?
--
Jan L in CA 2021
https://ecir.groups.io/g/CaseHistory/album?id=264927
https://ecir.groups.io/g/CaseHistory/files/Jan%20Baby


Re: Climbing ACTH numbers

Sue Ring
 

Hey Sherry,

Are you referring to the Pergolide he is currently receiving (at the 1.0 mg caplet dosage that does NOT seem to be controlling his Cushing's) or are you referring to the Pergolide/Cypro compound that she wants to give him in an attempt to reduce his high ACTH numbers from his most recent blood draw??  I have contacted her and expressed my desire to have his Pergolide dosage upped instead of going right to the Pergolide/Cypro compound?  I am not sure about the Pergolide/Cypro compound dosages other than that it comes in a powder.  I do not believe she has ordered it as I contacted her office and said I wanted to 1.)  Discuss her reasons for wanting to give the Pergolide/Cypro compound to him and 2.)  Discuss with her my preference to use an increased dosage of Pergolide alone and see how that works.

Thanks.....
--
Sue R in NC 2021

CASE HISTORY:  https://ecir.groups.io/g/CaseHistory/files/Sue%20and%20Shifty

PHOTO FILES: 


 


Laminitis(?) emergency

Sierratac@...
 

My name is Tory and I'm in Tennesseee looking for guidance on how to help my donkey.  I don't trust the vet who saw her to provide any more assistance and the other mobile vet hasn't gotten back to me yet and won't for at least another day. Anyway he basically just said "probably laminitis," gave a pain shot and left me with Bute. After I looked up laminitisI saw UAA recommended for acute and got a tube from him to administer. This all happened Saturday (when I first saw her down). I knew they were all overdue for a trim but hadn't noticed anything unusual til that morning.  

She is lethargic, weak, and now not really eating/drinking (she was doing both up to yesterday). I could barely get her up and the farrier helped me get her across the pasture to the barn yesterday so she is off grass with only hay/straw and water with electrolytes.  I have the gate open so the other 2 donkeys could hang out near her but so far they haven't (her mom is practically feral and doesn't like humans being close or her voice trimmed so when she saw the farrier roping  her daughter across the pasture she probably decided she didn't want anything to do with it) so I'm concerned she's going to be too depressed to recover soon. I have someone coming to look at an area to clear and fence off from the rest of my pasture so they can't graze all the time anymore, I realize the error of my ways so please don't get onto me about it I already feel bad enough.  I just want to know what more I can do or give to her besides electrolytes and Bute. Should I attempt to corral her mom into the barn with her? It's a pretty large space gated off, not a single stall.


Pergolide dosage for mini cross

Valletta Lochridge
 

Well, looks like I'm back in the PPID saddle again.  It's been about 5 years since my PPID/IR mare passed and I recently added a Shetland/mini cross in his mid-20's to the family.  I've watched Scout at my neighbor's place for the past 5 years and I suspected PPID because of his increasingly inefficient shedding and loss of topline.  So when he came to live with me, we tested with Cornell.  His ACTH is 61.2 pg/mL.  Scout came to me a bit on the thin side, no fat pads anywhere, so I was shocked to find that he is horrendously IR.  Non-fasting Glucose 108 mg/dL and Insulin 136.58 ulU/ml.  GI Ratio 0.79.  For the 3 weeks that I've had him, he has been on a diet of tested, low s/s grass hays (balanced by my hero, Kathleen G.), custom mineral blend by Horse Tech, loose salt and Vitamin E mixed in about 2 cups of soaked Mountain Sunrise timothy pellets.  Weight calculator puts him at 400lbs which seems heavy to me based on the way he looks - I would have guessed him at no more than 300lbs.

I will be starting him on compounded pergolide through Pet Health Pharmacy (I'm hoping that they're still doing a good job?) and I'm wondering about the dosage.  My wonderful vet is very open to Dr Kellon's recommendations through this group.  If this was a full-sized horse, my thought would be to titrate up to 0.5mg and retest after 1 month at the full dose.  But I have no idea how the pergolide dosage translates to a little guy.  

Can someone please guide me as to the recommended dosage for a 350-400 lb mini cross with an ACTH of 61.2?  I should also add that he was also just diagnosed with squamous cell CA found in the sheath - not sure if that enters into this picture but thought I should mention it.

Valletta in CA with Rego (IR), Scout (PPID/IR) and Bailey (thankfully no issues at this point!)
2012


Re: Desi earned her wings

Rita Chavez
 

I'm so very sorry, Bobbie. Like many others I know the deep, soul-wrenching pain too well. I watched Desi's video and she looked like such a character, so full of self-awareness and a playful attitude. Your memorial to losing her was quite touching and I doubt you left a dry eye on this board. Thank you for all you did for her. I can only offer you cyber-hugs and hope you know what a special gift you gave her when her time came.

Run free across the Rainbow Bridge, sweet Desi! 
--
Rita C. and Stetson (2001 Tennessee Walking Horse/Gelding, diagnosed IR)
Aiken, South Carolina USA
June 2021

https://ecir.groups.io/g/CaseHistory/album?id=265166 

https://ecir.groups.io/g/CaseHistory/files/Rita%20C.%20and%20Stetson


Medicine update

Erica Reimers <Ereimers90@...>
 

I convinced my vet to allow for compounded pergolide to help with cost. . He's currently been on 3mg of prascend(to finish out the pills I have left) for the last two weeks and will be on that dose for another 2 weeks. We are upping him to 3.5 mg for another 4 weeks and then will retest labs(acth and insulin). I have placed my order with Pet Health pharmacy for the 3.5mg (or 4.6mg pergolide mesylate) capsules. The pharmacist there said in order for my horse to get 3.5mg of Prascend/pergolide,  they have to multiply that by 1.31 due to the mesylate portion of the compound to get 4.6. So we placed an order for 4.6mg pergolide mesylate capsules. My vet has been confused and tried to state that my horse would need 3 capsules a day so I'm letting the pharmacy fix that with her. Each capsule is 4.6 mg of pergolide mesylate so he would only need 1 capsule a day. Let's hope the pharmacy can get that straightened out with my vet.  Also, is Triple Crown safe starch truly safe for PPID and IR horses? Per their website. Nsc is 8.7, so it should be safe, but I wasn't sure if anyone here had personal experiences with it. 
--
Erica H.  CA 2021


Re: TSF Metabolic Support, Bunch Grass, and Palmer Angle questions

Sherry Morse
 

Hi Shera,

That link goes to x-rays from September of 2020 when her toes were even longer than in the November x-rays you had shared.  You should be able to load the current x-rays into your photo album here: https://ecir.groups.io/g/CaseHistory/album?id=253720




Re: Climbing ACTH numbers

Sherry Morse
 

Hi Sue,

Not all compounded pergolide is created the same way and there are storage concerns with some types so knowing where you're getting the compounded from and in what form can also help us with providing advice on that.





Re: TSF Metabolic Support, Bunch Grass, and Palmer Angle questions

Kirsten Rasmussen
 
Edited

Hi Shera,

I'm glad she's doing better WRT insulin, but I just want to caution you that 61 uIU/ml is still too high to take chances with her diet.

Is she still getting 2 cups of the low carb pellets?  I would stop these, anything with rice bran in it is not good for a horse with EMS.  Plus she doesn't need the calories.

Have you managed to bring her BSC down?  If you're finding she's not losing weight on her current ration, then you can start cutting it back.  We generally recommend feeding 2% of ideal weight, or 1.5% of current weight, whichever is higher.  But for some real easy keeper horses, lowering that seems to help.  I have been feeding my horse 1.7% of his ideal body weight to maintain a BCS of 4.5 because I found that 2% of his ideal weight just kept him fat with a BCS of 6.  You could start by removing 0.5 lbs hay and see how she does for several weeks.

Not sure if she is turned out with other horses and sharing their hay, but EMS horses with elevated insulin don't get the signal to their brain that they are full and can stop eating.  If she's out with other horses she could be eating a lot more hay than you think, hence the weight problems. 

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Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
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