Date
1 - 10 of 10
Savannah’s new trim pics uploaded
|
Pat Gauvreau <pgauvreau@...>
I know the volunteers are very busy with so many horses to help, but I haven’t had any feedback for some time concerning her trim.
Her diet is tight (tested hay) and nothing but soyhulls to mix Vit/min and JHerb in. Pergoloide increased from 1.5 mg to 2 mg daily this fall and she’s still sore. Vet will only say the compound pergoloide isn’t working. He’s not happy I switched from Prascend. Would really appreciate another assessment. Thanks. -- Pat and Savannah Vancouver Island, British Columbia, Canada January 2018 Case History: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Savannah Photos: https://ecir.groups.io/g/CaseHistory/album?id=22028&p=pcreated,,,50,2,0,0 |
|
|
|
Hi, Pat - the break-over seems to have sneaked forward a bit since the last trim, but I don't think it is enough to be causing soreness.
I do know you are on a fixed budget, so here is my "fixed budget" protocol for this situation (when you can't test the ACTH).. Diet looks good as far as ESC and starch go, and the mineral tweaking is pretty minor, and unlikely to be causing a huge issue (leaving aside iron overload for now). Trim has improved enormously over the last year, compared to where she was before. There are two red flags for high insulin and possibly too-high ACTH: the foot pain, plus the fat pads over the eyes. We are left with: Uncontrolled ACTH, for which the test is to increase the pergolide; or even, if you can bite the financial bullet for a couple of weeks, give 3 mg Prascend and see what happens (then go back to the compounded). Going to Prascend for a few weeks is likely less expensive than an ACTH test (maybe). If your vet would like to contact me, I can give some numbers for pergolide potency from that pharmacy (independent laboratory testing). Alternatively, mare issues (but those really are rare) God forbid, the circulation in the feet is damaged, so you have ongoing pain from that, plus neuropathic pain (more on that later). However, going on the tried-and-true axiom that "hoofbeats are usually horses, not zebras", the most likely cause for what you are seeing is uncontrolled ACTH. If you can convince your vet to increase the dose, I would certainly do that. I apologize for not remembering, but did you get your hay balanced by someone (ie, me?). I can't find you in my hay balancing files, or documents, nor can I remember it, but it doesn't mean I haven't done it. Or did you get your hay balanced by someone else? Or, even more likely, did I say in a post that the Mad Barn Amino Trace + would balance your hay? Truly, though, even if the hay isn't perfectly balanced right now, and you are still working through iron over-load issues, the fact that Savannah improved, then got more foot-sore, leads to a high index of suspicion for uncontrolled ACTH. -- Jaini Clougher (BSc, BVSc) Merlin (over the bridge), Maggie, Gypsy, Ranger BC 09 ECIR mod/support https://bit.ly/2MlAtPd https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy . https://ecir.groups.io/g/CaseHistory/album?id=34193. https://ecir.groups.io/g/CaseHistory/album?id=39711 |
|
|
|
Pat Gauvreau <pgauvreau@...>
On Wed, Oct 31, 2018 at 08:45 PM, Jaini Clougher wrote:
-- Pat and Savannah Vancouver Island, British Columbia, Canada January 2018 Hi Jaini Hope this goes to right place. Had some trouble when clicked the reply button ??? Thanks very much for responding. To tell you the truth, I’m getting concerned we can’t afford to meet all of Savannah’s medical needs. It’s the high cost of the never ending tests. My Vet suggested when he came to take the ACTH tests that we consider euthanasia because of the increasing expense involved. He thought Xrays would have been a better choice, over the blood work, since I couldn’t afford both. I told him I don’t want the euthanasia talk. I was quite upset as he got my husband on that topic which I shut down whenever he brings it up. My husband and the Vet never read ECIR stuff so dont have the same faith that she’ll improve. My Vet reluctantly prescribed the compound pergoloide with his reason being it’s not as good as Prascend. Anyways, I’ll go through your response to her current problems. Re the breakover. I haven’t had any feedback from Lavinia for a while so my farriers just doing her own thing. I’m concerned with the dish at toe and underrun heels and forward bars, which I’m not sure are improving. Also the heels aren’t even on each foot. I thought heels should be back to the widest part of frog but on one side it is and the other (on same foot) is quite a bit forward. I’m no expert but I do see a lot of pictures of how a healthy foot should look from solar view. The laminitic rings do seem to be disappearing to bottom third of foot though. This is a positive sign isn’t it? Re red flags. My Vet thinks 2mg pergoloide is a lot so he’s not likely to increase dose. He’ll likely say the compound is at fault. Not sure he wants to get more involved in Savannah’s case to the point of contacting you. I’ve sent him information about ECIR in the past and all he said was in a nutshell, not scientific research and what “published” documents has Dr Kellon got to her credit? I felt it was a slight to all of us and all the years of trial and error to come up with tried and true info that has helped lots of horses. “You can lead a horse to water” comes to mind. Anyways it’s hard to argue with non believers. How do you tell if there’s damage to circulation in feet? What is neuropathic pain? As far as increasing pergoloide I can do it without telling my Vet. I would have to try to split a 2mg capsule in half to enable an increase to 3mg/day. I’ll run out of her prescription sooner doing this though. Would a recent increase from 1-1/2 mg to 2mg a month ago to now jump up to 3mg daily be hard for her to adjust to? Re hay balancing. No the minerals haven’t been balanced. I forget who it was but recall the Mad Barn Amino Trace Plus was okay to continue with if I couldn’t figure out the calculations myself (which is not something I’d even tackle). She gets 3/4 Cup a day. I dont think the well water at this new barn is too high in iron because it’s clear without smell. The last time I asked the barn owner if they ever had their well checked for iron content I was asked to leave. Don’t want that to happen again as this place is the best I’ve found in our area. Re bumps over eyes thos I see weird because one day they are visible and other day no sign of them. When her head is down eating hay in the tub, I can see the bumps moving in and out. i wash her eyes every day and if needed I put Vetrycin eye ointment in to clear irritation and at night I keep a fly mask on her to keep sand out of her eyes. One thing I’d like to note is her lack of movement possibly causing her lameness. Could be loss of muscle and strength in hind end. I’ve tried opening gate to let her choose to go into pasture even with muzzle off to encourage her to move but now she doesn’t even try. I always remove my other mare to make sure she doesn’t get bothered. I was hand walking her before but I’m concerned that might damage her coffin bone if fragile. Ive been putting Ichthamol on her coronary band to make sure any abscess can drain. She does have a few spots I suspect to be abscess but they could also just be sores from sand rubbing while laying down or caused by the now wet weather. With overcast weather do you think I could let her go in pasture just for the movement she’d get from grazing for an hour while I’m there to watch? She has no life in a small sand box. Too much standing around. So many things to factor into what’s best or when it’s time to give up. Thanks so much for all the time you spend on Savannah. I so appreciate it. -- Pat and Savannah Vancouver Island, British Columbia, Canada January 2018 Case History: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Savannah Photos: https://ecir.groups.io/g/CaseHistory/album?id=22028&p=pcreated,,,50,2,0,0 Case History: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Savannah Photos: https://ecir.groups.io/g/CaseHistory/album?id=22028&p=pcreated,,,50,2,0,0 |
|
|
|
"My Vet reluctantly prescribed the compound pergoloide with his reason being it’s not as good as Prascend. "
I'd like to see his evidence. -- Lorna in Eastern Ontario, Canada
|
|
|
|
Pat Gauvreau <pgauvreau@...>
He’s just one of many vets that don’t like compounding. My friends horse is on Prascend and needs to increase dose but can’t afford to pay for Prascend so asked me how she can get a prescription because her Vet will not prescribe compounded pergoloide. So this is what you run into sometimes.
-- Pat and Savannah Vancouver Island, British Columbia, Canada January 2018 Case History: https://ecir.groups.io/g/CaseHistory/files/Pat%20and%20Savannah Photos: https://ecir.groups.io/g/CaseHistory/album?id=22028&p=pcreated,,,50,2,0,0 |
|
|
|
We hear that all the time here .
Marketing trumps evidence in the minds of some vets. Not all vets are like that,though , so a change is often in order. For the horse's sake. -- Lorna in Eastern Ontario, Canada
|
|
|
|
Hi Pat
Just want to add to the thoughtful responses you had here. When you are trying to figure out what is going wrong and where to spend your efforts and cash, using DDT+E is a proven road map. Diagnosis -- It would appear her PPID is not controlled and needs further pergolide. This is the first step to health. Removing the trigger. Without it the rest is not going to help you. Diet -- You have stated it is tight, but it is not tight if it is not balanced. Diet is the primary control for hyperinsulinemia (high insulin). Sometimes drugs are needed as in the case of PPID not controlled, mare issues or lyme disease, but you cannot treat high insulin without a strong approach to the diet. Trim -- Along with removing the trigger, getting the correct trim is key to controlling pain. It sounds like you have a handle on what is needed or at least that you have learned that the feet are not as good as they could/should be. If she were here I'd be having a good conversation with my trimmer to get things fixed and be picking up the rasp in between visits. She should be better after the trim. Exercise -- the fact she does not want to move is due to pain. From Dr. Wiki -- Neuropathic pain is pain caused by damage or disease affecting the somatosensory nervous system. Our horses can get this from long term assault to the feet. It comes about in cold(er) weather. Please see Dr Kellon's proceeding on Winter Laminitis. She may need cold protection. https://www.ecirhorse.org/proceedings-2015.php -- Nancy C in NH ECIR Moderator 2003 DDT+E = effective treatment for PPID and EMS/IR equines: https://bit.ly/2J4ZgYT
|
|
|
|
celestinefarm
Pat
The following is from Dr. Kellon's website regarding her professional credentials. I've cut out some of it in order to highlight the answer to your vet's question of "what has she published?" Her field trials are an attempt to bridge( as is ECIR) the "perfect" world of university research and the real world of horses. I would like to know if your vet believes that the tightly controlled, heavily financed conditions of peer reviewed research are actually attainable by the average horse owner, or does using the results of the research and applying it as much as possible to real life situations make more sense and produce more results? Professional Publications: Dr. Kellon has also contributed to professional publications and professional meetings. Her topics frequently include muscle disorders, thyroid disorders, and nutrition. Her most recent have been: Contributing author on laminitis and dietary therapy of insulin resistance in Equine Podiatry, WB Saunders Co, 2006. Use of the Herb Gynostemma Pentaphyllum and the Blue-Green Algae Spirulina Plentensis in the Horse. Third European Equine Nutrition and Health Congress, Gent, Belgium, March 2006. Iron Status in Hyperinsulinemic/Insulin Resistant Horses. Third European Equine Nutrition and Health Congress, Gent, Belgium, March 2006. Treatment of Equine Metabolic Syndrome, Compendium of Continuing Education for the Practicing Veterinarian, Vol 26(2) February 2004. Books: As a best-selling author, her books are compelling, easy to read and informative. They include: The Older Horse, Breakthrough Publications Keeping the Older Horse Young, Breakthrough Publications Raising and Feeding the Perfect Horse, Belvoir Publications Guide to First Aid for Horses, Breakthrough Publications Equine Supplements and Nutraceuticals, Breakthrough Pubilcations Equine Drugs and Vaccines, Breakthrough Publications Horse Owners Veterinary Advisor and Record Book, Breakthrough Publications Horse Journal Guide to Equine Supplements and Nutraceuticals, Globe-Pequot Press Field Trials: Best known for her field trials, Dr. Kellon continues to break new ground with her findings. A few are summarized below. In 2000, Dr. Kellon published, in Horse Journal, the results of the first field trial on Chastetree Berry (Vitex Agnus Castus) for horses with Cushings syndrome. For more information, visit: http://www.equiworld.com/uk/horsecare/veterinary/cushingssyndrome/ In 2000, Horse Journal published Dr. Kellon’s field trial on the use of magnesium supplementation in horses with cresty necks and laminitis. In June 2000, Dr. Kellon published, in Horse Journal, the first warning against feeding organophosphates to horses. Ultimately, this created awareness amongst horse owners and brought about some changes in common feeding practices. In March 2006, Dr. Kellon was a guest speaker at the European Equine Health and Nutrition Congress in Belgium. Her presentations included "The use of Jiaogulan and Spirulina in Horses" and "Iron Status of Hyperinsulinemic/Insulin Resistant Horses". For more information on Jiaogulan for laminitic horses, visit: http://www.naturalhorsetrim.com/Jiaogulan.htm In Aug. 2006, Horse Journal published Dr. Kellon's article on DSLD's Devastation, which included the results of a field trial treatment plan to help alleviate the pain and symptoms of this disease. In Dec. 2007, Horse Journal published an article on the use of Acetyl-L-Carnitine in horses with chronic laminitis. This was another ground-breaking field trial on the use of supplements for a chronic condition -- Dawn Wagstaff and Tipperary Saline, MI 2003 |
|
|
|
Hi, Pat - the only real way to tell if there has been damage to the circulation is by doing a venogram, which is very expensive, and so is out of the question.
I know this is tough for you. I really think you need to pull out all the stops and find a new vet. Alternatively, ask if you can sign a waiver stating that there is no fault coming to the vet clinic if a higher dose of compounded pergolide causes any issues. You can also have a look at the file Getting Your Veterinarian on Board (scroll down) https://ecir.groups.io/g/main/files/9b%20Pulling%20it%20Together -- Jaini Clougher (BSc, BVSc) Merlin (over the bridge), Maggie, Gypsy, Ranger BC 09 ECIR mod/support https://bit.ly/2MlAtPd https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy . https://ecir.groups.io/g/CaseHistory/album?id=34193. https://ecir.groups.io/g/CaseHistory/album?id=39711 |
|
|
|
Hi, Pat - just looking again at Savannah's hoof photos, and I really do think your trimmer is doing a great job. There appears to be no depth at the front of the foot, so no way to remove height at the toe area. Removing any more heel height will result in a very broken-back HPA, and negative palmar and plantar angles, with resultant pain.
Have a read of this page of Pete Ramey's: http://www.hoofrehab.com/HeelHeight.html -- Jaini Clougher (BSc, BVSc) Merlin (over the bridge), Maggie, Gypsy, Ranger BC 09 ECIR mod/support https://bit.ly/2MlAtPd https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy . https://ecir.groups.io/g/CaseHistory/album?id=34193. https://ecir.groups.io/g/CaseHistory/album?id=39711 |
|
|