31 yr old mare newly diagnosed PPID/IR


HBRancher
 

Hey everyone!
I’ve been a member for years but never had to post my own case. I guess there’s a first time for everything!  

My 31yr old mare has been diagnosed with PPID/IR. First blood draw this past December came back high. Did TRH Stim test
ACTH pre-21.7 pg/ml
          post->1250 pg/ml
Insulin - 77.5 uIU/ml
Second blood draw & TRH Stim 5-10-22
ACTH pre-18.3 pg/ml
          post-1176 pg/ml
Insulin - 126 uIU/ml
Glucose - 92 mg/dL
Her only symptom is chronic laminitis, which she has had off & on since I got her at 15yrs old. I have kept her on a diet for a metabolic horse for the last 10 years & trimmed her accordingly with boots for riding.
She really has been barefoot pasture sound until this last summer/fall. I guess it’s catching up to us.  
Now I’m in need of advice - vet has prescribed Pergolide & maybe Metformin. Help would be very appreciated!

Mary & Vandy 


Mary
May 2022,  Holden, Louisiana
Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Vandy  .
Vandy's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=275053  .


Eleanor Kellon, VMD
 

She definitely needs pergolide; should have gone on it after the first test. Since she is a QH, there's a good chance her insulin resistance is coming from the PPID so if you want to try pergolide and tight diet  first before adding metformin that's reasonable but access to grass has to go.

Also, our study is almost filled but if you would want to start her on pergolide now (at least 1 mg) and retest her on or before June 30 we will reimburse you $300 toward the cost of the retest. Send me a mail at drkellon "at" gmail.com if you are interested.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Sherry Morse
 




HBRancher
 
Edited


-- 
Hi Sherry
 
Oh so many questions!!!
I will try very hard to answer them all. 
*I have not started her on any meds. My husband’s mother had been very sick this month & died this past Saturday. So I haven’t made time to get things going. 
*Yes. She is right at 14.2. 
*Yes. She’s was on Previcox from right after Christmas until a couple weeks ago. I took her off when I knew we were going to do another blood test. and I haven’t started it back. 
*I am not weighing her hay daily but I will start. She doesn’t eat much. More like 2-4 lbs each nite. 
*Hay is not being soaked.
The Bermuda (4.6%esc+starch) 
                   (Fe 137ppm) & 
Bahai (4.9%esc+starch)
            (Fe 100ppm)
have been tested & are both acceptable. I have not tested her Timothy hay. It is the Standlee compressed bales. 
*I need to balance again but I am going by previous tests that were actually higher than my current tests. I also balance to the grasses she eats, especially in the summer. her pastures were tested a few years ago. 
*She eats between 1-2lbs beet pulp/day - when she wants to eat it!  It is R/S/R - and rinsed again until the water is clear. 
*I am feeding her at least 4 lbs Standlee Timothy pellets. I’ve been cutting back on the  TC Senior to just 2 cups sprinkled on top of her supplements. She also gets at least 4 lbs TC Timothy Balance Cubes. 
It will be very hard to stop her Timothy pellets as she quids most all hay except alfalfa. But I am not feeding alfalfa. 
*X-rays-She has had her ski-tips forever. Like since her first X-rays were done almost 20 years ago!  Her toes have been brought back since those X-rays were taken. I am her farrier. She had her clogs on at that time & I was leaving them on a bit longer than usual because she was so comfortable in them. 
*I will go with Dr Kellons advice & start her on Pergolide & take her off grass before I start the Metformin. I sent her an email regarding the study. 

Thanks,
Mary & Vandy

Mary
May 2022,  Holden, Louisiana
Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Vandy  .
Vandy's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=275053  .


HBRancher
 

Thanks Dr Kellon. I have sent you an email regarding the study. I will be glad to participate.  

As I wrote in the email, I know Vandy will be a picky eater when it comes to the meds. Any advice on APF & what I need to get to help her in that way?  

Thanks again
Mary & Vandy
--
Mary
May 2022,  Holden, Louisiana
Case History: https://ecir.groups.io/g/CaseHistory/files/Mary%20and%20Vandy  .
Vandy's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=275053  .