Date   

Re: WAS UPDATES - Now increase pergolide without test?

Sherry Morse
 

Hi Deb,

If Scotty were mine and I thought he needed a dose increase I would start slowly but i wouldn't necessarily double his dose without having actual test results. If your vet comes out to draw blood in a week and you've already started bumping him up that bump will not show on the test results, at least not to an appreciable extent.  However, you will have gotten a headstart on taking him up if needed.  You can judge how far up he needs to be for the rise period based on the test results, but to get a better picture of where he is overall you'll need to test again in the Jan/Feb time frame so you know if he needs an adjustment outside of the rise.




Re: Just Diagnosed

Sherry Morse
 

Hi Marcy,

As we typically see her toes are too long and she doesn't have a whole lot of sole although it's better than many.  Based on your weight calculations vs. ideal weight she did have quite a bit of weight to lose so if she's losing on the measured amount of hay keep that up.  Depending on your hay results you may be ok with not soaking, but some of that depends on the horse as well.




Re: New member My Mare Chicy diagnosed with Founder 9/15/2021 at just less than 3 months in foal

Sherry Morse
 

Janet,

Getting a full set of hoof pictures and any x-rays of her feet posted (directions here: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help) will help us better help you.  Once you have the photos posted if you send a note with the topic "hoof trim help needed" it will alert us that you have those up and need some help with determining steps forward.

If there's any chance the fetus is still alive do keep Chicy off any fescue going forward.




Re: WAS UPDATES - Now increase pergolide without test?

 

Hi Deb,

This indicates to me that you can give him APF and increase his pergolide fairly rapidly.  I don’t know what the end dosage goal should be.  It’s always a guess.  If I recall correctly, he’s been above normal for quite awhile now.  Maybe divide the capsule into 1 mg portions for the first round.  Give him 1 extra mg for a few days, then 2 mg for a few days and then 2.5, which would be half a capsule.  Then wait 3 weeks and test.  It would not hurt to work up to two 5 mg capsules - he may well need all of that and extra would not hurt him.

The leftover pergolide/water solution will be fine over the few days it will take to use it up.  Keep it covered and dark.  I keep mine on the fridge door in my barn.  As Cass suggested, a handy box of Prascend is perfect for this but I figured you should get the increase started ASAP.  I too keep some handy for increases and emergencies.
Today, I am celebrating my husband’s umptiump birthday but we can all celebrate the peak of the rise and look forward to its diminishing effect.
--

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: WAS UPDATES - Now increase pergolide without test?

Deb Walker
 

So sorry...I wish I just knew how to edit and add some comments.

Martha...the only sign has been him being sore without boots after going so long (3-4 weeks) without them. And the *bump* that I asked Lavinia about on his sole, which my trimmer did rasp a little bit off.

He can walk fine in his Clouds...no apparent pain...but that is also where we were at in 9/2017 and by 10/2017 he was at UWMadison and almost at the point of being put down. They had a plan...I agreed to their plan...and here we are, thank God, 4 years later.

I don't see any change in his crest. I do see his sheath is swollen more than usual. With his boots, he is not exhibiting any signs of pain, he wants to walk and I am reluctant to take him, and he is mostly a happy camper and eating well.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: WAS UPDATES - Now increase pergolide without test?

Deb Walker
 

Also...my farrier is coming out Wednesday...hence my questions on laminar wedge etc. Trying my best. I am grateful for everyone here, and for an excellent vet and excellent new/old farrier. But, if Scotty sinks again...I will not let him suffer anymore. He has been so good for so long.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: WAS UPDATES - Now increase pergolide without test?

Deb Walker
 

Thank you. Basically my vet says whatever is recommended here she will prescribe. She is very in touch.

So, Martha. Scotty showed a bit of the cloud at the beginning of pergolide and increases. Not horrible. He seems to tolerate things pretty well. I do have APF on hand.

So if I am understanding correctly...Give him his 5 mg pergolide/capsule.

Dissolve contents of 1 extra 5 mg capsule into a cup with 10 ml of water. Start with 2 ml to Syringe it in his mouth? And go up from there? How much to go up?
Can I save the extra dose in the frig or just throw it out?

Thank you. I really wasn't at all worried...until I realized this is where we were 4 years ago, and we won't do it again.




--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619


Re: AVRIO Pharmacy - Change in capsules

Laura Risley
 

Hi all,

No worries, your capsules contain the same amount of medication.  At Pet Health in Youngtown we only had 2 sizes of capsules 3 and 0.  At Avrio we have several additional sizes available, including a size 4 capsule (the higher the number, the smaller size) there is less filler in the smaller capsules.  I’m happy to help if there are additional questions. 

--
Laura Risley, PharmD
Pharmacist at Avrio Pharmacy (Pet Health division)
Owner of Bo and Sid
Phoenix, AZ 
Joined 2021


Re: How to Store Pergolide Once Blister Foil is opened?

ferne fedeli
 

My horse used to get his Pergolide (Pet Health capsules) in a slice of carrot about 1/2" thick.  I used a Phillips screwdriver to make a hole in the middle and inserted it.  He ate them this way for probably 2 or 3 years and then suddenly this year, he started refusing to eat them.  Now I have currently been using Beet-e-Bites Pill Pockets in Licorice Flavor, which he just loves.  I did also use apple slices and watermelon pieces in the interim, which he also likes...
--

Ferne Fedeli  Magic & Jack   2007

No. California
Case History

 

 


Re: Hay question low de - Invokana horse

 

Lecia,
I just read an old message that corrects my notion that soy hull pellets can replace BP. My error. Please see:  
https://ecir.groups.io/g/main/message/146234  

Did you read the Files on incorporating BP into the diet? My Cayuse wouldn't eat BP, either, when she was truly free-fed hay.  I had to reduce her hay ration by the amount of BP fed. I used a two-step process. #1 was to figure out how many pounds of hay she ate free fed. #2 was to substitute 2 pounds of hay for each 1 pound of dry BP. 
https://ecir.groups.io/g/main/files/5%20Core%20Diet/Beet%20Pulp/Beet%20Pulp%20Basics%20–%20How%20to%20use%20BP%20in%20Your%20Equine’s%20Ration.pdf 

Have you found a safe feed that your horses love? Cavalor FiberForce? I use ½ cup Stabul1 and 1 teaspoon of salt for each ½ lb. of dry BP fed RSR.  It only takes a little taste tempter to get them to consider BP. My pair figured out they like BP after a week or two. Feeding it overnight helps because they have a long time to pick at it.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: AVRIO Pharmacy - Change in capsules

 

I have had the same experience and called them about it.  They told me it has the equivalent amount of Pergolide.  Will start on it soon.
--
Jackie Decker and Tori
June 2016
White City, Oregon


Re: Just Diagnosed

jjlittle@...
 

I uploaded x-rays from diagnosis of laminitis  9-9 and a side view of Mocha taken in August when we were working with a saddle fitter. (if I didn't do it right let me know)  She has now been on the diet for 11 days and has lost some weight.  I didn't think she was obese but vet felt she needed to lose 100lbs.

Thanks for the advice.
--
Marcy and Mocha 2021

https://ecir.groups.io/g/CaseHistory/files/Marcy%20and%20Mocha

https://ecir.groups.io/g/CaseHistory/album?id=268259


Re: New member My Mare Chicy diagnosed with Founder 9/15/2021 at just less than 3 months in foal

Qhgirl
 

A lot has happened since my last post on Friday night.  My farrier came out and moved Chicy's toes back a little more.  I was able to find a somewhat local vet that came to my farm and ultra sounded Chicy.  He could not see the foal but said it is resting on her bladder.  He could see the unbiblical cord, the embryonic fluid and placenta.  He could not see the fetus so was unable to determine if the fetus is viable.  He will come back in 10 days hoping the fetus will reposition and he can see it. He said if the fetus is not alive she will expel it and not to worry about the placenta since she is 80 days and the placenta is very small.

He accessed Chicy's feet and said her heels are way too far forward which is causing stress on her flexor tendon that supports the coffin bone.  Indicated long toes and forward heels would be a contributing factor to set her up to founder. He said she needs a wedge and frog support.  He made a small frog support that will act as a wedge and indicated this should give her some relief in her deep flexor tendon and also take the pressure off her sole in front of the frog where her coffin bone is pushing down on her thin sole. 

He recommended due to her pain she be on bute 1 gram 2 x day for a few days until she gets into her therapy boots with a wedge and frog support.  I ordered the Cloud boots today and a thin frog support pad that can go inside the boot on top of the small wedge that comes with it.  We are hopping this will provide some relief and can get her moving around instead of standing and laying in a stall all day.   

He recommended holding off on the metabolic panel for a couple of weeks until she has less pain.  He is on board with her new ECIR diet.  My farrier will be calling him for detailed instructions until I can get up to speed in this group on trims and such and get him some information (he does not want to join the group but is interested in reading the hoof treatment methodology).  So much going an and I work a full time job as well as take care of my farm so I myself have not had much time to dive into the group documentation at this point.  

This has been a total merry-go-around for me.  I have a lot of confidence in this vet and it is wonderful to have someone so knowledgeable come to Chicy to save her so much stress and pain from a trailer ride. I still do not have the answers I was seeking but feel I am now on track to get them.  The vet said we have time to make decisions about the foal if it is still alive which he thinks is a strong possibility.  He also said once we get her in the boots and pain under control he feels she could carry and take care of the foal.  So here we go again.  By the way, Dr Kellon, this vet is a bovine, pig, sheep and horse vet.  He hold clinics at his farm on AI and raises all the same animals on his farm and teaches husbandry and holds an open house annually. His farm is a working farm. I feel like Chicy is fortunate to have him and he makes emergency calls as well.  What more could a horsey girl ask for?  lol. Thank you, Dr Kellon, for suggesting a bovine vet which jogged my memory about this particular vet.  When I called him today with my situation he was very responsive and arrived here in a couple of hours.  
--
Janet and Chicy
Chester SC
09/17/2021


Re: DIXIE rescue pony

terrieheining
 

Sorry, I chose Reply to Sender instead of Reply to Group. Thought I would not be properly part of the group until I had organised my case history.  Huge J curve of learning in many aspects of my life. Apologies.
TerrieH in Australia 2021

--
TerrieH in Australia 2021





















Re: Private: Re: DIXIE rescue pony

Sherry Morse
 

Hi Terrie,

Please address all questions through the group going forward so everybody has the information.  You don't need the other tests unless you have an issue with elevated iron levels.




On Monday, September 20, 2021, 09:44:33 PM EDT, Terrie Heining <shirayda@...> wrote:


Thank you.  I am in the process of gathering all the information/photos etc required for the case history form. Blood for ACTH was drawn yesterday and I have now booked the vet to return to take more blood for the tests on Page 6 and from these it appears that I calculate the info to go on Page 7.  Do I also need the tests on Page 8 (Serum Iron, TIBC and Ferritin)?

The Prascend was dropped back to 1mg daily on Aug 4, 2021 so the blood taken yesterday should reflect the lesser dose.  I am a week into the process of transitioning feed to just Speedibeet to carry her supplements with no chaff, am including the weight of the Speedibeet in the daily calcs of total feed, and am soaking the measured amount of teff hay for one hour before feeding until the test results come back on it.  I have removed MSM and Bute All paste from the mix. 

I have engaged Carol Layton to sort out dietary issues and organise hay analysis, so hopefully I am finally on the right track for Dixie.
Cheers
Terrie Heining




Re: AVRIO Pharmacy - Change in capsules

V F
 

Hi Natalie,
I experienced the same - smaller capsule & not tinted light blue. I emailed my inquiry since the phone lines take forever (I was number 2 & it took close to half an hour to actually talk to someone). I got a response from the pharmacist who said it is the same RX, they are just using different capsules now & do not add any coloring. So far my horse seems to be doing fine, so I believe she is correct. But if you have any questions, I would ask, just to be sure this time of year.
--
Virginia F, Lily, Jasuur, Cache, Haat & Spiritt in the sky, in South Central Oregon
ECIR 2010
Jasuur case history and bloodwork folder:  https://ecir.groups.io/g/CaseHistory/files/VirginiaF%20and%20Jasuur
https://ecir.groups.io/g/CaseHistory/album?id=147028


Re: How to Store Pergolide Once Blister Foil is opened?

Sherry Morse
 

Hi Victoria,

I can't believe that your stable staff won't do something that takes me about 2 minutes to do (including feeding it to the horse) when I horse sit for people who have horses on Prascend.  Be that as it may, to stick Prascend in an apple you cut the apple into 8ths and then stick the Prascend tab into an apple piece.  It's very easy to stick them in.  I usually feed at least 2 or 3 pieces at a time to help mask the taste.

For a carrot you need one with a good thick end and I usually make sure the piece is about an inch long as you need to cut a hole into it with a knife, put the Prascend in the hole and then put whatever got carved out back in on top of the Prascend.




Re: Uckele Absorb All

Jennifer Green
 

Hi Cass,

After my epiphany regarding feeding my boy Purina Enrich, I think suspect is the the new normal for me.

I just ordered Fergus Psyllium this weekend per Dr. Kellon’s recommendation and we’re going to give it a try. But I’m always reading to see what works for others, in case we have to try something else; so whet I saw this pop up I was curious.   

I will read the link.

Thanks! 


Re: Uckele Absorb All

 

Jennifer, glad you’re thinking critically. EquiShure is a great example of the benefits of using ECIR’s Search function. Here’s one post to start with:
No, a product that is 35% fat is NOT safe for our EMS horses. And that doesn’t address all the issues raised by this product claiming to treat the hindgut  problems. I’d start by reading Dr Kellon’s Horsesense Blog about hind gut ulcers. 
 
I’m not saying digestive upsets don’t occur. They do, and my own horses have had them and recovered, usually despite my treatments. 

It’s hard to reject a supplement offered by my vet. My experience has been that expensive quick fix supplements don’t do anything but cost me money. I’ve fallen for a couple. Live and learn. 
 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Re: Allergies, Laminitis & Cushings

 

Hi Stacy,
Welcome to the ECIR group!  This is the formal welcome promised by Sherry.

How did Buster do with starting pergolide?  Some horses experience some apparent depression when starting it and it sounds like your vet was trying to avoid that with the long intervals between dose increases. We recommend giving an adaptogen (APF) to avoid this veil.  I mention this because it’s quite possible that 1 mg will not be enough to control his PPID.  You’ll want to keep testing and making appropriate dose changes until you get the ACTH into the teens or low twenties.  This may or may not help his hair coat but it should have a positive effect on his allergies - a good reason not to get too involved in treating him for those until his PPID is better controlled.
I want to caution you on giving NSAIDs with omeprazole to act as a stomach protectant.  There’s recent evidence that things don’t work that way and the combination is worse the the NSAIDs alone.  We don’t recommend them either as they have little effect on the pain of metabolic laminitis.

I agree with all of Sherry’s points and see that you’ve followed up on the testing results. Thank you for posting the radiographs and the bloodwork results.  Was the testing done fasting or not?  I am totally not the hoof person here but to me it looks like a trim issue.  I would hesitate to give him J-herb without passing his latest xrays past someone like Lavinia.

And on to the formal welcome with all its reading material.  Let us know as questions arise.

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 (look under the Hay Balancing file if you want professional help balancing). 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. 

--
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


 
 

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