Jasper's Lyme Results


Eleanor Kellon, VMD
 

Since both the pattern and the magnitude of Jasper's Lyme titers don't fit with anything that has been described for horses with Lyme, it might be wise to ask your vet to get a consultation with Cornell for interpretation of the results and suggestions for treatment and monitoring.  Hopefully you can get it in writing so that we can all see because things can get lost in second and third hand accounts of conversations.

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



corrine haffner
 

Thank you, Dr Kellon

I will have my vet call cornell and consult with them on result and what to do for treatment. Will be a while before that happens vet is gone out of country for 2 weeks. Another vet is there to do the farm calls and emergency calls,not sure he or she would want to do the consult with cornell or not.

So might have to wait till jasper's regular vet is back.

Corrine & jasper
MN 4/2014


corrine haffner
 

Hi 

I called cornell and blood for lyme test was more then likely missed handled to get the results jasper had. I then called vet clinic and talked to them,and the blood samples were not taken care of in a timely fashion.

 So test results are worthless and vet will come back beginning of october to draw blood, for multiplex lyme test free of charge. Was able to talk to him directly he has his cell phone with and had service where he was.

And jasper choked again last night when i gave him extra cubes had stuff running out his nose coughing head stretched out and a panic look. Ended up have vet out a 1.30 am choke was clearing and jasper was becoming more agitated. Vet that came said 12 hours with no food of any kind,he doesn't seem to be hungry this morning any way.Took vet 45 minutes to get blockage passed with the tube.
Corrine & jasper
MN 4/2014


Nancy C
 

Hi Corrine

Please look at the consistency of the cubes when you feed them. My gelding with no teeth successfully ate them  very loose - a mash really -  and by adding psyllium which makes them more slimey and easier to swallow.   It took getting used to.  With slow transition and patience i finally won out and he did great on them.

Also review his dental needs.  The above gelding needed the dentist every six months to keep what he had left as good as possible.

Nancy C in NH
ECIR Moderator 2003
FACT: The VA Polytechnic Pony Study is the only study to look at IR and laminitis under natural conditions. Learn more at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8.
Guest Speakers

 








---In EquineCushings@..., <sassafrass45@...> wrote :


corrine haffner
 

Hi Nacy

His teeth were done last fall,vet checked his teeth while she was here last night his teeth are good. I checked cube consistency there are some hard dark green shinny ones in the bag. I didn't notice them last night but it was late. I haven't been soaking them he seems to do fine most of the time,i scatter them on the ground and put some in his feed bucket. 

He thinks he's starving when i give more cubes at 11 pm so takes huge mouthfuls,two mouthfuls into to it last night and i knew he was in trouble. If i don't do the 11 pm feeding he goes 9 to 10 hours with nothing to eat,so he getting close to 30 lbs a day in cubes.

With no hay in diet i feel like i need to give more then 22 lbs of cubes,i know i run the risk of him getting to fat,i don't know what else to do other then feed 30 lbs a day.He hungry all the time...


corrine haffner
 

HI Nancy,OOPS sorry i missed spelled your name, i missed that typo before i hit send.


Eleanor Kellon, VMD
 


---In EquineCushings@..., <sassafrass45@...> wrote :

I called cornell and blood for lyme test was more then likely missed handled to get the results jasper had. I then called vet clinic and talked to them,and the blood samples were not taken care of in a timely fashion.

= = = = = =

Could you be more specific?  Exactly how was the sample mishandled?  What is "taken care of in a timely fashion"?  What effect did these sample handling errors have on the results?

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


Nancy C
 

IME, hungry all day is part of uncontrolled IR.

You need to do what you need to do to avoid choke. 

Some members have used large rocks in the feed pan/bucket to slow them down. Psyllium previously mentioned.

Nancy C in NH
ECIR Moderator 2003
Join us at the 2015 NO Laminitis! Conference, Georgetown TX, November 6-8, 2015
 
www.nolaminitis.com




---In EquineCushings@..., <sassafrass45@...> wrote :



With no hay in diet i feel like i need to give more then 22 lbs of cubes,i know i run the risk of him getting to fat,i don't know what else to do other then feed 30 lbs a day.He hungry all the time...


corrine haffner
 

I put a few big rock in his feed dish today slowed him down some,he searched out cubes that were scattered and ate those first.  Had 5.5 lbs gone in an hour,i put out another 3 lbs of cubes scattered out around corral to keep him busy.  

Or he starts eating on the wood rails and posts this is new in just the last 2 days,if he cant do that he eats on salt lick or eats dirt.  This is all new stuff he's started doing since hay has been cut out of diet. He spends his day looking for stuff to eat. I am soaking cubes i put in feed dish the rest i just throw out on ground around corral. When he's out of cube i put out more or he's looking for trouble..not sure keeping cubes in fornt of him is ideal??

Do i up his pergolide another 1 mg or wait a few more days??


Nancy C
 

Hi Coririne

Can't tell you about the pergolide.  You need to look at symptoms and work to the plan you have with your vet. The goal is to control ACTH.

Some folks use these to slow down cube consumption.

nose-it

 



My concern would be that he has choked twice on hard cubes. 

Will all the posts, I honestly have lost track of why you stopped all hay.  If it's low sugar hay, putting a pound or two in a slow feeder might keep him busy in between cube meals

You are going to have to experiment.

Nancy C in NH
ECIR Group Moderator 2003

Why do herbal remedies not control PPID? To learn more about the understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available.http://www.nolaminitis.org/index.php/program-schedule/guest-speakers



---In EquineCushings@..., <sassafrass45@...> wrote :

I put a few big rock in his feed dish today slowed him down some,he searched out cubes that were scattered and ate those first.  Had 5.5 lbs gone in an hour,i put out another 3 lbs of cubes scattered out around corral to keep him busy.  

Or he starts eating on the wood rails and posts this is new in just the last 2 days,if he cant do that he eats on salt lick or eats dirt.  This is all new stuff he's started doing since hay has been cut out of diet. He spends his day looking for stuff to eat. I am soaking cubes i put in feed dish the rest i just throw out on ground around corral. When he's out of cube i put out more or he's looking for trouble..not sure keeping cubes in fornt of him is ideal??

Do i up his pergolide another 1 mg or wait a few more days??


 

I understand this post may stir up a hornet's nest -- again -- but being an open forum where advice is commonly solicited and anecdotal reports from owners are encouraged, Im sticking my neck out FWIW....

From careful studying of my two very sensitive IRs, and their experience consuming varying %BW of ODTBC, that IME/IMO, I would try putting Jasper back on the soaked hay only (no cubes) Emergency Diet until there's clinical evidence that his PPID is under control with the increasing pergolide dosages.  Now compounding in the choke episode and the questionable Lyme status to the unabating PU/PD, ongoing hoof soreness, unsatiable appetite, etc.

I do not have published research to provide.

I did not ask Dr Kellon's opinion prior to posting this.

I am not a moderator. 

However, I've observed from direct experience that when my mare's PPID was not controlled, she could not handle the ESC & starch in the cubes in *any* amount fed (even <1lb).  Her insulin normalized only when I found her target dose of pergolide and she consumed the Emergency Diet. Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well).

My IR gelding does well at 0.5% BW (6lbs/day for a 1200-lb horse), but any higher % of BW he gains too much weight and his insulin climbs.  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble.  If his weight does ever increase, I will decrease the % of cubes.  Luckily, so far, his weight has dropped or held steady at each weighing.

Again, FWIW...my purpose in posting is only to try to get Jasper on the road to recovery. I mean no ill will by offering advice that may appear puzzling or unsolicited. Im just hoping to throw some observations out on the table to possibly help Jasper. That is my only intent.  My apologies for invading your inboxes if this post was unwanted :)

Kerry in NY
Sept 2014


Sent from my iPhone

On Sep 21, 2015, at 1:15 PM, threecatfarm@... [EquineCushings] <EquineCushings@...> wrote:

 

IME, hungry all day is part of uncontrolled IR.

You need to do what you need to do to avoid choke. 

Some members have used large rocks in the feed pan/bucket to slow them down. Psyllium previously mentioned.

Nancy C in NH
ECIR Moderator 2003
Join us at the 2015 NO Laminitis! Conference, Georgetown TX, November 6-8, 2015
 
www.nolaminitis.com




---In EquineCushings@..., <sassafrass45@...> wrote :



With no hay in diet i feel like i need to give more then 22 lbs of cubes,i know i run the risk of him getting to fat,i don't know what else to do other then feed 30 lbs a day.He hungry all the time...


corrine haffner
 

Hi Nancy

Took hay out of diet because of unknow  minerals, Lavinia felt i needed to tighten up his diet due to the numbers on test going up quite a bit from test in August.  I had the choice of testing current hay getting it mineral balance or going to all ODTB cubes.

Testing hay is not an easy option big rounds stacked roof high can only get to maybe 4 to core and test. That's on hay from one field. Hay on other side of hay barn comes from 2 different fields, so i felt going to all cubes made more sense. 

Yes i'am working with vet right now he's gone so kinda on my own. He still peeing excessively and drinking excessively so still out of control PPID or IR or both,reason for major diet change,so that's not part of problem.

Vet that came last night isn't the best i don't have alot of faith in her or he ability she over tranqed him and he went down,while he had tube down his nose. So i'am not real appt to have her back i thought jasper was going to die last night. Took him 2 hour before he got back up i demand vet stay till my horse got up and was ok,she did so willingly. I wasn't rude i was just a very worried horse owner and dealing with a very emotional daughter who was freaking out,so that was how my night went NO sleep...


Lorna Cane
 

>>Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well

<snip>

>>  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble. 


My understanding here  is that  horses who are working are being compared to a horse who is not in work.

I'd like to see either all horses working, or no horses working  .


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

 




Nancy C
 

Hi Kerry

Good caveats.  :-)

Every time this comes up I am still left with the same question.

Did her insulin come down because she had better controlled ACTH or because she got off the Cubes.  I don't think that has been separated out. 

As discussed in other recent posts, the symptoms of uncontrolled IR and uncontrolled PPID overlap. I kow you know that.

Improvement of foot comfort can come in a matter of days from increased dosages of pergolide, just as it can when switching from high ESC&Starch feeds/diet to lower ESC&starch intake. 

As I understand it you did both at the same time.

Just to be clear for new people ODTB Cubes are not high ESC&starch adn this report is unusual so it is why we are pulling apart the confounding factors. A process that our founder Robin established as and ECIR keystone so long ago.

My take of Dr Kellon's response to this and my own personal experiences is that diet is critical to controlling IR, but the system can be overwhelmed by uncontrolled diseases driving insulin levels far beyond anything you can control with diet alone.  It takes control of the diseases to control the IR.  If you don't control the disease, no amount of diet tweaking will fix hyperinsulinemia.

Just like pergolide will not fix "insulin resistance related to genetic predisposition, obesity, diet or any other nonpituitary cause", diet alone will not fix IR from disease states like PPID.


I'm paraphrasing but I think Dr Kellon described it as when ACTH, Lyme, Mare issues, iron overload and other are out of control, no feed will be low enough to control hyperinsulinemia.  You have to address the disease. As you did. 


As for your gelding, It would be helpful to see the rest of the diet and well, you know,,,,,a CH.


In any event, in the last go around, it was suggested that Corrine use soaked hay and the emergency diet if she felt that was the best for Jasper, until he was more stable or at least there was a clearer picture of his dx, 


I offer this Kerry, with all respect for the work you have done with your horses.


Nancy C in NH
ECIR Group Moderator 2003

To learn more about the impact of fructan, understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available. Guest Speakers





---In EquineCushings@..., <Twinoats@...> wrote :



However, I've observed from direct experience that when my mare's PPID was not controlled, she could not handle the ESC & starch in the cubes in *any* amount fed (even <1lb).  Her insulin normalized only when I found her target dose of pergolide and she consumed the Emergency Diet. Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well).

My IR gelding does well at 0.5% BW (6lbs/day for a 1200-lb horse), but any higher % of BW he gains too much weight and his insulin climbs.  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble.  If his weight does ever increase, I will decrease the % of cubes.  Luckily, so far, his weight has dropped or held steady at each weighing.



corrine haffner
 

Dr Kellon 

I'll have an anwser to your questions in a day or so, not trying to avoid it, i just honestly don't remember a thing that was told to me over the phone with cornell,or my own vet. Read my last post to Nancy last part of it.


 

Nancy and Lorna (and anyone else who has gotten this far):

Thank you so much for your responses.  I think I cant help my butting in because Im trying to understand a key point to Jasper's scenario. Instead of my anecdotes as evidence, let me instead ask a question, which arose from following Jasper's long history:

If Jasper (or a theoretical horse) has been definitively diagnosed with IR & PPID and is showing overt clinical signs of IR/PPID (PU/PD, foot soreness, insatiability, etc), and an effective pergolide dose has NOT been determined as yet, then why does the horse in the scenario NOT go on the Emerg Diet of soaked hay, etc, esp if he's showing laminitic symptoms?  Furthermore, why would this horse not STAY on the diet until IR symptoms satisfactorily abate?  That's what Im having trouble understanding. 

Also, very importantly, Im in no way saying the cubes are bad--please! no one think Im casting shade on the very useful ODTBCs--they are the foundation of both of my well-controlled IRs' diets at present. The ODTBC are a true godsend!

(Nancy Ill address your finer points under separate cover; I was just so eager to ask my question!  You remarked on several interesting points re: my horses' scenarios and I'd like to learn more with dialog [poor Nancy])

Thx so much,
Kerry in NY
Sept 14

Ps, sorry i could not delete attached past msgs --doing a million things at once


Sent from my iPhone

On Sep 21, 2015, at 5:23 PM, threecatfarm@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Kerry

Good caveats.  :-)

Every time this comes up I am still left with the same question.

Did her insulin come down because she had better controlled ACTH or because she got off the Cubes.  I don't think that has been separated out. 

As discussed in other recent posts, the symptoms of uncontrolled IR and uncontrolled PPID overlap. I kow you know that.

Improvement of foot comfort can come in a matter of days from increased dosages of pergolide, just as it can when switching from high ESC&Starch feeds/diet to lower ESC&starch intake. 

As I understand it you did both at the same time.

Just to be clear for new people ODTB Cubes are not high ESC&starch adn this report is unusual so it is why we are pulling apart the confounding factors. A process that our founder Robin established as and ECIR keystone so long ago.

My take of Dr Kellon's response to this and my own personal experiences is that diet is critical to controlling IR, but the system can be overwhelmed by uncontrolled diseases driving insulin levels far beyond anything you can control with diet alone.  It takes control of the diseases to control the IR.  If you don't control the disease, no amount of diet tweaking will fix hyperinsulinemia.

Just like pergolide will not fix "insulin resistance related to genetic predisposition, obesity, diet or any other nonpituitary cause", diet alone will not fix IR from disease states like PPID.


I'm paraphrasing but I think Dr Kellon described it as when ACTH, Lyme, Mare issues, iron overload and other are out of control, no feed will be low enough to control hyperinsulinemia.  You have to address the disease. As you did. 


As for your gelding, It would be helpful to see the rest of the diet and well, you know,,,,,a CH.


In any event, in the last go around, it was suggested that Corrine use soaked hay and the emergency diet if she felt that was the best for Jasper, until he was more stable or at least there was a clearer picture of his dx, 


I offer this Kerry, with all respect for the work you have done with your horses.


Nancy C in NH
ECIR Group Moderator 2003

To learn more about the impact of fructan, understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available. Guest Speakers





---In EquineCushings@..., <Twinoats@...> wrote :



However, I've observed from direct experience that when my mare's PPID was not controlled, she could not handle the ESC & starch in the cubes in *any* amount fed (even <1lb).  Her insulin normalized only when I found her target dose of pergolide and she consumed the Emergency Diet. Once on the correct pergolide dose for a few weeks, she was able to consume at least 1% BW in ODTBC and even did well on 2% BW thru the hard winter while living out 24/7 and still working (she's on 1% BW at present and doing well).

My IR gelding does well at 0.5% BW (6lbs/day for a 1200-lb horse), but any higher % of BW he gains too much weight and his insulin climbs.  I weigh him monthly at a local equine clinic and any higher than 0.5% BW in cubes and/or a decrease in work sends his insulin into trouble.  If his weight does ever increase, I will decrease the % of cubes.  Luckily, so far, his weight has dropped or held steady at each weighing.



Lorna Cane
 



>>If Jasper (or a theoretical horse) has been definitively diagnosed with IR & PPID and is showing overt clinical signs of IR/PPID (PU/PD, foot soreness, insatiability, etc), and an effective pergolide dose has NOT been determined as yet, then why does the horse in the scenario NOT go on the Emerg Diet of soaked hay, etc, esp if he's showing laminitic symptoms?  Furthermore, why would this horse not STAY on the diet until IR symptoms satisfactorily abate?  That's what Im having trouble understanding. 




  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

 

 






corrine haffner
 

Hi Kerry & everyone else

Here's the post from lavinia # 196567 this is why i'v put him on all ODTB cubes my hay isn't mineral tested so i decided to go to all cubes for his diet. He's on 6 mg of pergolide don't remember date is in CH ,hasn't been even a week he's been on this dose.
 
I feel i need to stick with current diet whether it's right or wrong i don't know,i know testing current hay isn't worth the hassle. I'am doing the best i can have a good vet, fired the farrier doing jasper's hoofs myself and spend many sleepless nights worrying about jasper. 


 

Corrine and Kerry, I'm not piling on. Heaven knows it's taken me years to get things straight in my head, much less get DDT&E dialed in. I know how hard this is to hear when you're already dealing with a host of horse problems and chores. PPID is a moving target.

Dr Kellon said it the best (and this is a crude paraphrase of her actual words that got it through my thick head):  If PPID is uncontrolled, all the dietary interventions in the world will not fix your horse's insulin resistance. 

I'm working on this very problem right now (again!). Diet is tight with tested low S+S hay and balanced minerals. Management is tight in a dry lot. Trim is tight. But my mare's insulin tests at a level that is twice as high as any earlier result. So because  my horse has PPID that is usually poorly controlled, the first order of business is to limit the variables and make sure ACTH is within an acceptable range all day long. When the symptoms won't go away, I know of no way to do that without testing or involving your vet in experimentally adjusting the dose of pergolide (which some are very reluctant to do).

After weeks of temperatures in the 90's and 100's, I more fully appreciate the logistical difficulties of handling spun down plasma for accurate ACTH testing. Keeping a sample at 39 degrees is a practical impossibility for a hard-working vet like mine who leaves the office at 7:30 AM and gets back after 6PM (or 8PM or 9PM). Which is why I bought my own simple centrifuge on Amazon to help out. I know that's extravagant, but around here, $165 for a centrifuge is $100 less than a farm call, shipping and lab testing done with mishandled blood. With an ice bath available at the time of the blood draw, we can spin down the blood here, draw off the plasma, store it in my freezer, and my vet can pick it back up later in the day on the way back to the office/lab. 

I wish both you and your horses all the best.

Cass for Satra
Sonoma County, Calif. Oct. '12
---In EquineCushings@..., <threecatfarm@...> wrote :

Every time this comes up I am still left with the same question.

Did her insulin come down because she had better controlled ACTH or because she got off the Cubes.  I don't think that has been separated out. 



 

Hi Nancy,

Here's more clarification, drawing quotes from your prev post (please note that if I use CAPS it is merely for emphasis)

-----------------------------------
....."Every time this comes up I am still left with the same question.

Did her insulin come down because she had better controlled ACTH or because she got off the Cubes.  I don't think that has been separated out."....

>>>  Ok, a quick synopsis of Pinky:  diagnosed IR in late summer 2013, a full year before I found this group.  I was able to manage her by soaking her grass hay when her insulin came back high, and eventually found a chopped grass hay made by Lucerne Farms ("Premium Hay") that repeatedly tested at 6-7.5% ESC+Starch (although bc i didn't know better I was using NSC as my "high number").  I would put her on the soaked hay for about a week, would see a visual "drop" in weight (esp crest), and then ease her back onto the unsoaked Premium Hay until the next high insulin test.  In retrospect I think I got her thru the fall of 2013 (with as yet undiagnosed PPID) because she was working HARD -- hunter paced every weekend, 10+ miles each, etc.

Spring 2014 -- same as above, not having as much trouble with insulin.  Still in heavy training.

Summer 2014 -- did well on the same above Premium Hay with some added Hi-Fiber Gold and Chaffhaye (b/c she needed calories for high speed work -- remember, I still hadn't found ECIR group yet).  Mare was a superstar at Fitch's Corner, actually won our division(!!) which was mid-July, 2014.  At Millbrook (last weekend of Aug) is when she started going downhill (and that was only evident by her refusing a jump).  By the Championships in mid Sept, she had completely crashed metabolically.  Looking back, I now understand that it was her undiagnosed PPID that was worsening the IR even though she was working about as had as an amateur-owned horse can.  Her insulin drawn right after the Champs was 130mg/dL so I immed put her on soaked hay only.  She stabilized, as she had done everytime in the past that I put her on soaked hay only.  However, as the rest of Sept wore on and Oct began, she became increasingly lethargic and depressed no matter what I fed her (remember, still not diagnosed PPID).  I still kept her in full work but she was not right -- everyone told me that it was just her age catching up to her.  We only did one more event at the end of Sept (she finished double clear but it was a struggle).  By this point I had discovered ECIR and every "safe" food I tried sent her right back into crisis (b/c of her still undiagnosed PPID; at this point I still thought she was "just IR").  While I was busy reading ECIR info Pinky got worse and worse (while on soaked hay only) until one day in mid-Oct her legs blew up, she had digital pulses, and was stumbling badly.  I had radiographs done by my local vet b/c I was so worried about laminitis (note: this mare is extremely stoic & was never lame).  I floated the possibility of PPID with my vet as a rule-out of the refractory hyperinsulinemia and somehow the subject of consulting with Dr Kellon came up b/c Pinky did NOT look anything like a "Cushing's horse".  Furthermore, her ACTH drawn late Sept 2014 was only 36pg/mL.  Thankfully Dr. Kellon deemed a trial of pergolide worthwhile and she immed improved but it took some months to find the right dose to fully control her insulin.  THAT IS DURING THAT TIME THAT I TRIED THE ODTBC & HER INSULIN SPIKED.  It was well-after the seasonal rise and she was not on enough pergolide yet.  However, when i put her back on soaked hay only, the insulin stabilized.  THAT'S THE POINT I'M TRYING TO MAKE!  By that evidence I understood that her PPID wasn't controlled and I increased the perg., tried the cubes again, same result (deduction:  Pinky must be extremely sensitive to ESC&starch over 6%, the batch of cubes I had at that time must've been betw 6%-10%).  Once I got her up to 2mg pergolide by January, she was able to eat the ODTBC no problem, BECAUSE HER PPID WAS FINALLY CONTROLLED.  As I mentioned before, I put her all the way up to 2% BW of cubes through the harshest of winter (living out) and her insulin behaved and she felt great under saddle! 

----------------------------------------------------------------------------

....."As discussed in other recent posts, the symptoms of uncontrolled IR and uncontrolled PPID overlap. I kow you know that.

>>> Yes :)

....."Improvement of foot comfort can come in a matter of days from increased dosages of pergolide, just as it can when switching from high ESC&Starch feeds/diet to lower ESC&starch intake. 

>>>> Yes, completely agree, have witnessed both scenarios...

...."As I understand it you did both at the same time.

>>>> No, and that is the crux of the matter.  I did the "cube trial" well-before I had found her target perg. dose.  The scenario was this:  was on 1mg perg, seemed OK, tried weaning her off soaked hay and adding ODTBC, insulin spiked, usual symptoms returned, reverted to soaked hay only, symptoms resolve (I did these observations and changes over weeks at a time; it was not just a day or two; I gave each time a cahance to fully integrate).  I bumped her to 1.5mg.  Tried easing her off soaked and back again onto ODTBC -- same thing happened, sore feet, stumbling, etc  Bumped her up to 2mg perg, gave it a few weeks, tried the cubes and at this point she was fine.  This was done over many weeks betw Nov'14. and midJan'15. 

--------------------------------------------------------------------

....."Just to be clear for new people ODTB Cubes are not high ESC&starch adn this report is unusual so it is why we are pulling apart the confounding factors. A process that our founder Robin established as and ECIR keystone so long ago."....

>>>> Yes, absolutely!  Hopefully as i illustrated above, my mare was the "problem", not the cubes.  She's doing great on the cubes NOW THAT HER PPID IS CONTROLLED.  She was just unusually sensitive to ESC+starch being over 6% BEFORE HER PPID WAS CONTROLLED.

---------------------------------------------------------------------

....."My take of Dr Kellon's response to this and my own personal experiences is that diet is critical to controlling IR, but the system can be overwhelmed by uncontrolled diseases driving insulin levels far beyond anything you can control with diet alone.  It takes control of the diseases to control the IR.  If you don't control the disease, no amount of diet tweaking will fix hyperinsulinemia.

....."Just like pergolide will not fix "insulin resistance related to genetic predisposition, obesity, diet or any other nonpituitary cause", diet alone will not fix IR from disease states like PPID.


....."I'm paraphrasing but I think Dr Kellon described it as when ACTH, Lyme, Mare issues, iron overload and other are out of control, no feed will be low enough to control hyperinsulinemia.  You have to address the disease. As you did. 


>>>> Yes, yes and yes, all agreed & understood.


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....."As for your gelding, It would be helpful to see the rest of the diet and well, you know,,,,,a CH."....


>>> Ahh, yes, my gelding...he's a wacky one in so many ways :)  His CH is almost UTD; I've just been waylaid by my own poorly controlled Lyme disease and some epic migraines of late.  :(((  Between the horses and myself, it seems I'm always reading about some affliction or another


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....."In any event, in the last go around, it was suggested that Corrine use soaked hay and the emergency diet if she felt that was the best for Jasper, until he was more stable or at least there was a clearer picture of his dx, 


....."I offer this Kerry, with all respect for the work you have done with your horses.


>>>> Nancy and all, I cannot thank you enough for responding so thoroughly and for putting up with my incessant interloping into this thread.  Im only inserting myself b/c I'm trying to learn and/or understand on a deeper level.  My "wanting to give back" aspect probably could be reined in some ;) but it comes from a good place :))


Thank you a thousand times over,


Kerry in NY

Sept 2014