Date
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Is Matty IR? Questions about sample treatment.
muff747
http://www.liphookequinehosp.co.uk/documents/EquineMetabolicSyndrome.pdf
para 2 (a)(i)
I e-mailed the article written by Dr K in the files "DDT Diagnosis" - to my vet prior to speaking to them about how I needed the blood sample taking for IR.
I just spoke to my vet and he explained why they were saying he should be fasted - he is governed by the recommendations of how the lab wants the horse to be treated before the blood is drawn. We came to a compromise after reading their literature, that sample could be taken first thing in the morning when he had been fed soaked hay overnight (I make sure he has plenty of soaked hay to last till morning) but not given a feed that morning. He quoted from the above article on the labs web site - I have noted the relevant para above.
Then we discussed how the sample will be treated once drawn. I thought it had to be processed as quickly as possible in preparation for shipment to the lab - but my vet said it is not that important for the IR test, only for the ACTH test. Is he right? Am I going to risk wasting my time and money again if he treats the sample incorrectly?
Chris/Matty UK 07/09
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
http://groups.yahoo.com/group/ECHoof/photos/album/2107815589/pic/list
para 2 (a)(i)
I e-mailed the article written by Dr K in the files "DDT Diagnosis" - to my vet prior to speaking to them about how I needed the blood sample taking for IR.
I just spoke to my vet and he explained why they were saying he should be fasted - he is governed by the recommendations of how the lab wants the horse to be treated before the blood is drawn. We came to a compromise after reading their literature, that sample could be taken first thing in the morning when he had been fed soaked hay overnight (I make sure he has plenty of soaked hay to last till morning) but not given a feed that morning. He quoted from the above article on the labs web site - I have noted the relevant para above.
Then we discussed how the sample will be treated once drawn. I thought it had to be processed as quickly as possible in preparation for shipment to the lab - but my vet said it is not that important for the IR test, only for the ACTH test. Is he right? Am I going to risk wasting my time and money again if he treats the sample incorrectly?
Chris/Matty UK 07/09
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
***Because you told me he was not fasted. If they were taken fasting, they are completely useless for the purpose of diagnosing IR.***
I wasn't telling fibs, he was *not* fasted for the previous tests. I don't know why the vet is instisting on fasting now...
http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker%202/http://groups.yahoo.com/group/ECHoof/photos/album/2013611080/pic/list
http://groups.yahoo.com/group/ECHoof/photos/album/2107815589/pic/list
--- In EquineCushings@..., "merlin5clougher" <clougher@> wrote:
Chris
Feeding soaked hay is okay. That's what we want to see. How is he responding on low sugar and starch hay.
You need to be careful with all blood but in this instance, especially the glucose. If it is not spun and frozen with in the correct time frame, the glucose will continue to deteriorate, giving you an incorrect reading. Many vets in teh US re now taking glucose right int eh barn for that reason.
I notice you've not sent your vet the group web site link. That might prove helpful
<http://www.ecirhorse.com/index.php/diagnosis>
It is all lined out there under the DIAGNOSIS page, including the research to support the group protocol.
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
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Feeding soaked hay is okay. That's what we want to see. How is he responding on low sugar and starch hay.
You need to be careful with all blood but in this instance, especially the glucose. If it is not spun and frozen with in the correct time frame, the glucose will continue to deteriorate, giving you an incorrect reading. Many vets in teh US re now taking glucose right int eh barn for that reason.
I notice you've not sent your vet the group web site link. That might prove helpful
<http://www.ecirhorse.com/index.php/diagnosis>
It is all lined out there under the DIAGNOSIS page, including the research to support the group protocol.
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
We came to a compromise after reading their literature, that sample could be taken first thing in the morning when he had been fed soaked hay overnight
We came to a compromise after reading their literature, that sample could be taken first thing in the morning when he had been fed soaked hay overnight
Then we discussed how the sample will be treated once drawn. I thought it had to be processed as quickly as possible in preparation for shipment to the lab - but my vet said it is not that important for the IR test, only for the ACTH test. Is he right? Am I going to risk wasting my time and money again if he treats the sample incorrectly?
merlin5clougher <clougher@...>
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
Here is the information I have been given by one of my labs (Idexx):
ACTH (endogenous) 1 mL frozen EDTA plasma (Lavender top)
ACTH Separate plasma into plain tube, freeze, ship frozen on ice (mandatory)
Collect blood into a chilled lavender top tube, centrifuge and separate plasma into a plain plastic tube & freeze immediately, ship on ice
Glucose 0.5 mL serum(centrifuged SST), or 0.5 mL sodium fluoride/potassium oxalate plasma (Grey top)
GLU Refrigerate, ship on ice Run on receipt, result same day Post prandial values may be elevated, fasting sample strongly recommended
SST must be centrifuged after being allowed 20 minutes to clot, gel must completely separate clot and serum
Grey tops should have at least 1 mL of blood drawn or resulting hemolysis may cause falsely elevated results
Sodium fluoride suppresses but does not stop glucose metabolism
Insulin 1 mL serum (Red top) INS Refrigerate, ship on ice Referred out, please allow 1 week for results
Recommend freezing serum and shipping on ice
If you have questions regarding fasting requirements for insulin testing, please contact one of our pathologists
And here is the link to information on a variety of blood handling recommendations from the same lab:
http://www.idexx.ca/downloads.cfm
The long and short is: glucose in particular will continue to be metabolized unless kept chilled/frozen and the serum separated from the clot. If this is not done, the results will be falsely low. I have had the lab tell me that insulin is good, refrigerated, for 48 hours, but they recommend separating, freezing, and sending on ice just to be sure of good quality sample. ACTH must of course be frozen.
The horse is a trickle feeder, not at all like dogs, cats and people, who eat meals separated by longish periods without food. Feeding soaked hay overnight before the blood draw is perfect.
Here is a link to the recommendation for blood handling from Cornell:
http://pets.groups.yahoo.com/group/EquineCushings/files/Blood%20Testing%20for%20IR%20%26%20Cushings%20Disease/Sending%20Blood%20Work%20To%20Cornell/
This is in the Blood file/Sending Blood to Cornell folder. Good info.
Hope that helps.
Jaini(BVSc)Maggie,Merlin,Gypsy
BC09
EC Support
> http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker%202/
Hi, Chris -
I just spoke to my vet and he explained why they were saying he should be fasted - he is governed by the recommendations of how the lab wants the horse to be treated before the blood is drawn. We came to a compromise after reading their literature, that sample could be taken first thing in the morning when he had been fed soaked hay overnight (I make sure he has plenty of soaked hay to last till morning) but not given a feed that morning.
Then we discussed how the sample will be treated once drawn. I thought it had to be processed as quickly as possible in preparation for shipment to the lab - but my vet said it is not that important for the IR test, only for the ACTH test. Is he right? Am I going to risk wasting my time and money again if he treats the sample incorrectly?
Chris/Matty UK 07/09
Here is the information I have been given by one of my labs (Idexx):
ACTH (endogenous) 1 mL frozen EDTA plasma (Lavender top)
ACTH Separate plasma into plain tube, freeze, ship frozen on ice (mandatory)
Collect blood into a chilled lavender top tube, centrifuge and separate plasma into a plain plastic tube & freeze immediately, ship on ice
Glucose 0.5 mL serum(centrifuged SST), or 0.5 mL sodium fluoride/potassium oxalate plasma (Grey top)
GLU Refrigerate, ship on ice Run on receipt, result same day Post prandial values may be elevated, fasting sample strongly recommended
SST must be centrifuged after being allowed 20 minutes to clot, gel must completely separate clot and serum
Grey tops should have at least 1 mL of blood drawn or resulting hemolysis may cause falsely elevated results
Sodium fluoride suppresses but does not stop glucose metabolism
Insulin 1 mL serum (Red top) INS Refrigerate, ship on ice Referred out, please allow 1 week for results
Recommend freezing serum and shipping on ice
If you have questions regarding fasting requirements for insulin testing, please contact one of our pathologists
And here is the link to information on a variety of blood handling recommendations from the same lab:
http://www.idexx.ca/downloads.cfm
The long and short is: glucose in particular will continue to be metabolized unless kept chilled/frozen and the serum separated from the clot. If this is not done, the results will be falsely low. I have had the lab tell me that insulin is good, refrigerated, for 48 hours, but they recommend separating, freezing, and sending on ice just to be sure of good quality sample. ACTH must of course be frozen.
The horse is a trickle feeder, not at all like dogs, cats and people, who eat meals separated by longish periods without food. Feeding soaked hay overnight before the blood draw is perfect.
Here is a link to the recommendation for blood handling from Cornell:
http://pets.groups.yahoo.com/group/EquineCushings/files/Blood%20Testing%20for%20IR%20%26%20Cushings%20Disease/Sending%20Blood%20Work%20To%20Cornell/
This is in the Blood file/Sending Blood to Cornell folder. Good info.
Hope that helps.
Jaini(BVSc)Maggie,Merlin,Gypsy
BC09
EC Support
> http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker%202/
http://groups.yahoo.com/group/ECHoof/photos/album/2013611080/pic/list
http://groups.yahoo.com/group/ECHoof/photos/album/2107815589/pic/list
muff747
Hi Nancy, I have been soaking the haylage since he first went footy - no improvement. When he was in the bare paddock when the ground was frozen (he went out with boots and pads), he got a small pile of unsoaked along with the others, but he would have only been out for a few hours (not eating all that time) then back in with soaked haylage. I tried not soaking for a couple of weeks, no deterioration, just the same! Tried him in the field grazing with the herd, no deterioration. At present, trying him on box rest with soaked hay-I will walk him out today after one week to see if there is any improvement, but I'm not optimistic because this was tried back in 2009 with no improvement.
I haven't sent the vet that link but I have already sent the information on there about IR diagnosis to him with a link to a web site about Dr K'S work (can't remember which) which mentions the group and the website. It doesn't actually say how to handle the G/I sample between drawing the blood and getting to the surgery, that's the bit I'm concerned about, I don't think he is taking it straight to the surgery - what is the correct time frame?
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I haven't sent the vet that link but I have already sent the information on there about IR diagnosis to him with a link to a web site about Dr K'S work (can't remember which) which mentions the group and the website. It doesn't actually say how to handle the G/I sample between drawing the blood and getting to the surgery, that's the bit I'm concerned about, I don't think he is taking it straight to the surgery - what is the correct time frame?
--- In EquineCushings@..., "Nancy" <threecatfarm@...> wrote:
Feeding soaked hay is okay. That's what we want to see. How is he responding on low sugar and starch hay.
You need to be careful with all blood but in this instance, especially the glucose. If it is not spun and frozen with in the correct time frame, the glucose will continue to deteriorate,
I notice you've not sent your vet the group web site link. That might prove helpful
<http://www.ecirhorse.com/index.php/diagnosis>
It is all lined out there under the DIAGNOSIS page, including the research to support the group protocol.
Yes, I've read you've been soaking hay. For this email was agreeing with procedure to feed him soaked hay only before the blood draw.
Hopefully you saw Jaini's email regarding sample handling and links to more info. Glucose needs to be spun and put on ice or frozen asap. My vet spins it in the barn here then puts it in the fridge. If your vet can't get it spun well inside an hour I'd be suspicious of the glucose results. Many vets here are now using a portable veterinary glucometer right in their trucks.
Your vet may be thinking of drawing insulin only. Ideally you'd like to see the relationship between the glucose and the insulin as the blood is drawn while eating low S&S (or soaked) hay, especially if the insulin comes back within so-called "lab normals".
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
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Hopefully you saw Jaini's email regarding sample handling and links to more info. Glucose needs to be spun and put on ice or frozen asap. My vet spins it in the barn here then puts it in the fridge. If your vet can't get it spun well inside an hour I'd be suspicious of the glucose results. Many vets here are now using a portable veterinary glucometer right in their trucks.
Your vet may be thinking of drawing insulin only. Ideally you'd like to see the relationship between the glucose and the insulin as the blood is drawn while eating low S&S (or soaked) hay, especially if the insulin comes back within so-called "lab normals".
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
Hi Nancy, I have been soaking the haylage since he first went footy - no improvement.
Hi Chris
Just want to make sure we're talking soaked and drained hay. You probably know this but for others following along, we need to make sure the sugar water is not accessible.
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
toggle quoted message
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Just want to make sure we're talking soaked and drained hay. You probably know this but for others following along, we need to make sure the sugar water is not accessible.
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
--- In EquineCushings@..., "Christine" <muff747@> wrote:
Hi Nancy, I have been soaking the haylage since he first went footy - no improvement.
muff747
Yes definitely - Chris/Matty UK 07/09
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--- In EquineCushings@..., "Nancy" <threecatfarm@...> wrote:
Hi Chris
Just want to make sure we're talking soaked and drained hay. You probably know this but for others following along, we need to make sure the sugar water is not accessible.
muff747
Yes I saw Jaini's answer. I am happy about the treatment of samples at the surgery and getting it to the lab. Also I think he said he was just taking one sample. I have a bad feeling about this. It is so hard to keep tactfully trying to get him to do it your/my way, he insists it will be fine, he knows what he is doing and they do get accurate results! I feel like I'm labelled a troublemaker.
Chris/Matty UK 07/09
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Chris/Matty UK 07/09
--- In EquineCushings@..., "Nancy" <threecatfarm@...> wrote:
Yes, I've read you've been soaking hay. For this email was agreeing with procedure to feed him soaked hay only before the blood draw.
Hopefully you saw Jaini's email regarding sample handling and links to more info. Glucose needs to be spun and put on ice or frozen asap. My vet spins it in the barn here then puts it in the fridge. If your vet can't get it spun well inside an hour I'd be suspicious of the glucose results. Many vets here are now using a portable veterinary glucometer right in their trucks.
Your vet may be thinking of drawing insulin only. Ideally you'd like to see the relationship between the glucose and the insulin as the blood is drawn while eating low S&S (or soaked) hay, especially if the insulin comes back within so-called "lab normals".
Nancy C in NH
February 2003
Moderator
Got a NO LAMINITIS tee shirt?
<https://sites.google.com/site/nolaminitis/no-laminitis-t-shirts>
http://www.ecirhorse.com/
--- In EquineCushings@..., "Christine" <muff747@> wrote:
Hi Nancy, I have been soaking the haylage since he first went footy - no improvement.
muff747
Vet must have changed his mind before coming, he put the blood into three seperate tubes. He got the hoof testers out and found Matty reacted worse in the heel area, he said indicative of navicular pain, he couldn't find a pulse or heat in his feet so ruled out laminitis. I told him about the bruising I saw but he is very anti barefoot and just shook his head and said his feet are good but the best I can expect of a TB. He recommended wide web shoes - sigh... He did say Matty is a credit to me, he's 23 and looking good.
I won't have any results until next week as they won't send it off so near to the weekend, well they didn't last time so it will be kept frozen until Monday.
I'm keeping him on soaked hay but he has gone out into the bare paddock for a few hours this afternoon. I'm still struggling to get him to eat BP (he's on Speedibeet now)with minerals added. I am only up to two pinches, that's after about three weeks now!
It is very tiring - all this conflict, I mean the conflict between your advice and the vets and with Matty - trying to get him to eat what's going to help him.
I wonder if someone could take a look at the lab's recommendations on testing for EMS, here's the link http://www.liphookequinehosp.co.uk/documents/EquineMetabolicSyndrome.pdf
I'll post again when I get the results.
Chris/Matty UK 07/09
http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker/
http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker%202/
http://groups.yahoo.com/group/ECHoof/photos/album/2013611080/pic/list
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I won't have any results until next week as they won't send it off so near to the weekend, well they didn't last time so it will be kept frozen until Monday.
I'm keeping him on soaked hay but he has gone out into the bare paddock for a few hours this afternoon. I'm still struggling to get him to eat BP (he's on Speedibeet now)with minerals added. I am only up to two pinches, that's after about three weeks now!
It is very tiring - all this conflict, I mean the conflict between your advice and the vets and with Matty - trying to get him to eat what's going to help him.
I wonder if someone could take a look at the lab's recommendations on testing for EMS, here's the link http://www.liphookequinehosp.co.uk/documents/EquineMetabolicSyndrome.pdf
I'll post again when I get the results.
Chris/Matty UK 07/09
http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker/
http://pets.groups.yahoo.com/group/ECHistory2/files/Chris%20Hardaker%202/
http://groups.yahoo.com/group/ECHoof/photos/album/2013611080/pic/list
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
Yes I saw Jaini's answer. I am happy about the treatment of samples at the surgery and getting it to the lab. Also I think he said he was just taking one sample.
Lorna <briars@...>
What are you asking about the lab's recommendations, Chris?
Lorna in Ontario
2002
Moderator
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Lorna in Ontario
2002
Moderator
I wonder if someone could take a look at the lab's recommendations on testing for EMS, here's the link http://www.liphookequinehosp.co.uk/documents/EquineMetabolicSyndrome.pdf
tomtriv <ThePitchforkPrincess@...>
It is very tiring - all this conflict, I mean the conflict between your advice and the vets and with Matty - trying to get him to eat what's going to help him.Hang in there Chris. Once you get all this in place it gets so much easier and when Matty starts to respond there is no feeling like it. Matty is sure lucky he got you as an owner. There are people that for various reasons (which may include fear being labeled "troublesome") don't put in the time and effort and their horses suffer. Keep at it Chris.
-LeeAnne 03/04
Newmarket, Ont
muff747
The vet said that their protocol for diagnosing IR is the same as yours but it's too complicated for me to take in. He said there is more info on Liphooks web site than I had sent to him via e-mail.
Thanks
Chris/Matty UK 07/09
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Thanks
Chris/Matty UK 07/09
--- In EquineCushings@..., "Lorna" <briars@...> wrote:
What are you asking about the lab's recommendations, Chris?
Lorna in Ontario
2002
Moderator
I wonder if someone could take a look at the lab's recommendations on testing for EMS, here's the link http://www.liphookequinehosp.co.uk/documents/EquineMetabolicSyndrome.pdf
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
Hang in there!
Yes, it is VERY tiring--especially when one of the vets you are 'fighting' is your husband, who happens to be funding the whole endeavor!
Over the past nine months or so of Pookey Bear's illness I have experienced considerable 'caregiver fatigue,' which I imagine is nothing compared to some of the EC members who have been caring for multiple IR/Cushings horses, for multiple years. I do not know how they do it!
I also absolutely hate conflict and have been raised to be very respectful of authority, so it is hard for me to directly question the vet, or even suggest that he might not be 100% right. So I do try to approach it from a 'humor me' position, rather than trying to do my best imitation of 'The Owner From Hell,' which I know they probably think I am anyway!
In the case of the lab work, rather than telling my hubby that 'the internet people' say it should be done a certain way, I asked if it would be possible to do the draw in the suggested manner so that I could more easily compare Pookey's results to those of the large group of IR horses whose results are in the 'database.' He understands words like 'database!' And it then makes sense to do it 'their' way, through 'their' lab, so that the results will be more comparable.
Do not grow weary! You are helping your horse!
But don't feel that you necessarily have to be confrontational, either--there are other approaches that might work to get your vet (and farrier) on your team, to ultimately help Matty in the best way possible.
I have also used homemade cookies. Lots and lots of cookies! They call me 'the cookie lady' at the vet clinic!
Lisa in TX
Pookey Bear
June 2010
It is very tiring - all this conflict, I mean the conflict between your advice and the vets and with Matty - trying to get him to eat what's going to help him. <Chris,
Hang in there!
Yes, it is VERY tiring--especially when one of the vets you are 'fighting' is your husband, who happens to be funding the whole endeavor!
Over the past nine months or so of Pookey Bear's illness I have experienced considerable 'caregiver fatigue,' which I imagine is nothing compared to some of the EC members who have been caring for multiple IR/Cushings horses, for multiple years. I do not know how they do it!
I also absolutely hate conflict and have been raised to be very respectful of authority, so it is hard for me to directly question the vet, or even suggest that he might not be 100% right. So I do try to approach it from a 'humor me' position, rather than trying to do my best imitation of 'The Owner From Hell,' which I know they probably think I am anyway!
In the case of the lab work, rather than telling my hubby that 'the internet people' say it should be done a certain way, I asked if it would be possible to do the draw in the suggested manner so that I could more easily compare Pookey's results to those of the large group of IR horses whose results are in the 'database.' He understands words like 'database!' And it then makes sense to do it 'their' way, through 'their' lab, so that the results will be more comparable.
Do not grow weary! You are helping your horse!
But don't feel that you necessarily have to be confrontational, either--there are other approaches that might work to get your vet (and farrier) on your team, to ultimately help Matty in the best way possible.
I have also used homemade cookies. Lots and lots of cookies! They call me 'the cookie lady' at the vet clinic!
Lisa in TX
Pookey Bear
June 2010
muff747
OMG Lisa, that must be difficult to manage! I haven't had conflict with the vet-yet, we have a good rapport but I feel I cannot insist he does it my way because then there would be conflict. Thanks for your messages of support, it means a lot and keeps me going(:
Chris/Matty UK 07/09
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Chris/Matty UK 07/09
--- In EquineCushings@..., "lonestarquarterh" <mostlyaggies@...> wrote:
Yes, it is VERY tiring--especially when one of the vets you are 'fighting' is your husband, who happens to be funding the whole endeavor!
Hi Chris
I just took a quick look at the Liphook info. It appears they are reviewing all possible tests and proxies that can be used to determine what they call EMS. They aren't strongly advocating any one or two avenues but give the pros and cons of each of the above. The group is really familiar with all the studies sited.
This journey can be very tiring and very frustrating. You may not hear it in the posts but each of us knows exactly how you feel. We have been right where you are and we are sending you thoughts to help you be strong.
So take a break, have some tea and breath deeply. Go groom Matty, take him for a walk and give him many, many big hugs.
Nancy C in NH
February 2003
Moderator
http://www.ecirhorse.com/
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I just took a quick look at the Liphook info. It appears they are reviewing all possible tests and proxies that can be used to determine what they call EMS. They aren't strongly advocating any one or two avenues but give the pros and cons of each of the above. The group is really familiar with all the studies sited.
This journey can be very tiring and very frustrating. You may not hear it in the posts but each of us knows exactly how you feel. We have been right where you are and we are sending you thoughts to help you be strong.
So take a break, have some tea and breath deeply. Go groom Matty, take him for a walk and give him many, many big hugs.
Nancy C in NH
February 2003
Moderator
http://www.ecirhorse.com/
--- In EquineCushings@..., "Christine" <muff747@...> wrote:
I wonder if someone could take a look at the lab's recommendations on testing for EMS, here's the link http://www.liphookequinehosp.co.uk/documents/EquineMetabolicSyndrome.pdf
Great points Lisa!
There is a doc in Files > 8 Pulling it Together called Getting Your Vet On Board. Here's the link to the folder. Once there scroll down a bit.
<http://pets.groups.yahoo.com/group/EquineCushings/files/8%20Pulling%20it%20Together/>
Cookies figure prominently!
Nancy C in NH
February 2003
Moderator
http://www.ecirhorse.com/
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There is a doc in Files > 8 Pulling it Together called Getting Your Vet On Board. Here's the link to the folder. Once there scroll down a bit.
<http://pets.groups.yahoo.com/group/EquineCushings/files/8%20Pulling%20it%20Together/>
Cookies figure prominently!
Nancy C in NH
February 2003
Moderator
http://www.ecirhorse.com/
--- In EquineCushings@..., "lonestarquarterh" <mostlyaggies@...> wrote:
Yes, it is VERY tiring--especially when one of the vets you are 'fighting' is your husband, who happens to be funding the whole endeavor!
I have also used homemade cookies. Lots and lots of cookies! They call me 'the cookie lady' at the vet clinic!
muff747
Thanks Nancy, I will.
I'm just praying that *you* will be able to rely on these results and get a definite answer.
Chris/Matty UK 07/09
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I'm just praying that *you* will be able to rely on these results and get a definite answer.
Chris/Matty UK 07/09
--- In EquineCushings@..., "goddess03259" <threecatfarm@...> wrote:
Hi Chris
So take a break, have some tea and breath deeply. Go groom Matty, take him for a walk and give him many, many big hugs.