31 yr old mare newly diagnosed PPID/IR


HBRancher
 

 
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 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 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. I tested her pastures 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 and her heels have been lowered a bit 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 about 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
 


Sherry Morse
 

Hi Mary,

I'm so sorry to hear about your MIL.  As you haven't started Vandy on meds you may want to start her on APF and then titrate her up to 1mg of Prascend as outlined in your welcome letter, but you do want to get her started on that ASAP.  When you have a chance you'll want to update the CH to show she's 14.2 and that the previcox was stopped as well as adding in her dose of Prascend and what the start date for that is.  

Once you are weighing her hay please update that information in the CH as well and include a date.  Was the hay tested via NIR or Wet Chem?  Do you have the actual test results? 

As she has elevated insulin she should not be on pasture at all unless you are able to turn her out in a closed muzzle.  It is very important with an IR horse that they eat a very controlled diet which means you need to know exactly how much she's eating of each product per day.  We ask all these questions because this is where we identify where the diet can be tightened up.  

If she's quiding hay and her teeth have been checked and are in decent shape you can replace her hay ration with the timothy balance cubes.  Those are fed at a 3:4 ratio to hay so if she is eating 2lbs of beet pulp a day and should be eating 17.2lbs of hay you would feed her 12.9 lbs of cubes per day - no more timothy pellets (which may or may not be under the 10% ESC+Strach numbers we look for) and no more TC Senior (which is definitely NOT under the 10% limit).  You would then only need to add salt, vitamin E and flax in as the cubes are balanced to themselves.  Those can be added to the beet pulp so again, no other concentrate needed.




HBRancher
 

Hi Sherry

 

*Prascend & APF have been ordered & should be here by the weekend. 

*I will update the CH accordingly. 

*I have always used EquiAnalytical Test 603. I will add those results as soon as I can. 

*She has a wonderful equine dentist at LSU Vet School who has helped me keep her teeth in great shape for her age. She always has hay available to her 24/7. She “plays” with it. It’s really difficult to tell how much of it she actually eats. 

*I have also always fed California Trace Plus not only to balance the Cu & Zn to Fe in her hay & pasture but for the extra amino acids, iodine, & yeast for digestion. You are telling me that is no longer necessary??  If so, should I add iodized salt instead of plain white?  And extra methionine & lysine also?

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  .


Sherry Morse
 

Hi Mary,

One of the ways you can tell how much hay is being eaten is to weigh it before you put it out and then weigh whatever's left after 12 or 24 hours.  If you do that for a few days you should be able to get a good idea of what is being consumed and it'll probably be pretty consistent from day to day.

If you feed the Timothy Balance Cubes they are balanced to themselves and only need salt (yes iodized), vitamin E and flax added in.  If you're still using hay you'd want to balance that and CA Trace may or may not be appropriate depending on test results.




HBRancher
 

Hey everyone 
I am just getting ready to start my 31yr old girl on the Prascend & I have soooo many questions. 

Her only outward symptom is her being sorefooted. She has thin soles & foundered before I got her at 15years. So she’s been this way forever. She has always been sound in boots until this past year. 

Then we have her insulin & ACTH post TRH Stim numbers - which are sky high. 

I read where so many go by symptoms & not by the numbers. I am so apprehensive about putting her on meds that will make her lose weight (960lbs & looks great), go off her feed(she’s picky as it is), feel lethargic(she feels great now), etc etc!!!  

 I have resigned myself to at least try her on Prascend.  Meds should be in by Wednesday so I am starting her on APF today. I ordered the APF Pro and I see now that it doesn’t have the  Echinopanax elatus

in it which looks like it helps control glucose. Should I reorder the regular APF ?  And what size?  How long to use it?

What’s a horse mom to do???

Thanks
Mary & Vandy 

🐎Mary'nEddie HBR Ranch🐗

--
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  .


Maxine McArthur
 

Hi Mary
From one horse mum to another, I’d say the best course of action for you is to treat the major and potentially life-threatening symptom your horse has (sore feet, that is, laminitis) and not worry about things that ‘might’ happen. Your numbers tell you that your horse’s symptoms are serious—don’t ignore them. 


Neither of my horses lost their appetite when I started them on pergolide. Both of them got more energy when their PPID became controlled. Neither of them lost weight, but their toplines improved. Not all horses have problems starting pergolide, and the odds are good that your mare won’t either, especially if you start her on the APF. APF Pro is fine, don’t worry about glucose—it’s the insulin you need to control, and that is done through diet regulation as Sherry says below. 

For more information on APF you can search the Messages and Files. You should start it three days before you start the pergolide.

It seems complicated at first, but if you keep Diagnosis, Diet, Trim (and Exercise) in mind, it will get easier. 
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Eleanor Kellon, VMD
 

Maxine is exactly right. The most important thing is to FOCUS on the major issues and DDT will help you do that https://wp.me/p2WBdh-1iO .
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Hi Mary,
I wanted to weigh in on the symptoms vs numbers comparison.  I use symptoms a lot but …  I test ACTH several times a year and adjust the pergolide dosage to keep the test results low.  If I see symptoms which I know to be valid assessments of my horse’s PPID, I increase the dose a bit.  I never decrease the dose.  When you’re starting this journey, you have to do it totally by test results because you don’t have the experience yet to know what to look for. 
--
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


 
 


HBRancher
 

Thanks Martha 
I will be starting her on Prascend as soon as it gets here - hopefully by Wednesday. I gave her the first dose of APF yesterday. I’m tightening up her diet as much as I can & keeping her off grass. That’s not hard right now because we have dive-bombing horseflies all over & she doesn’t want to leave her stall!!!

 A question about feed - I see that Stabul is on the recommended list. Can I sprinkle a cup over her beet pulp to help her start eating it?  I was doing that with TC Senior but that NSC is too high so I’ve stopped it.  

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  .


Sherry Morse
 

You can use the Stabul-1 with the beet pulp, just remember to take it into account when figuring out total intake per day.




Kirsten Rasmussen
 

Hi Mary,

I just want to add to what Maxine said.  Getting my horse on pergolide initially resulted in lethargy and decreased appetite.  I didn't have APF so we just titrated up slowly to a 1mg starting dose.  However, after a few months, getting the pergolide dose high enough (4mg) to reduce the muscle loss and keep his ACTH in the low 20s has actually increased his energy.  He never did get back his "I'll eat anything" appetite but he has no problem putting on weight when I over feed him on the foods he likes (hay, TC Timothy Balance cubes, plain rsr beet pulp).  Some mornings he comes galloping in for his breakfast when he sees me coming...this from a horse that never moved above a walk in his paddock, unless spooked.  It's so obvious that he feels good and I've seen these positive changes come from controlling IR thru diet, and controlling PPID with the right dose of pergolide.

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History
Shaku's Photo Album