spoke to a new vet today.  here's the takeaway:
-This vet worked with Boehringer in the development of Prascend, and says that it was tested on fasted horses ++ THUS
-he uses, and insists on fasting protocol, testing weekly for a few weeks --
-states that he doesn't see these types of horses as diseased, but as a metabolic type ++
-feels most concerned with Smokey's foot and see's a spot on P3 that looks like an old puncture, sees something above sesmoid (small circular) that could be soft tissue, recognizes navicular changes ++ did not mention the ring bone --(please note that Smokey is no longer showing any visible lameness while being kept in small dry lot, only walking, wearing rasped soft rides, and losing about 25 lbs) ++
-he would like to see egg bar shoes with pads on smokey--
-he does not have a digital radiograph machine --
-understands grass better than other vets i've run into ++ 
-recognizes the things that have been done incorrectly ++

Thoughts?  feedback?  

my tendency is to get the digital x rays Lavinia requests from old vet, continue with farrier with more detailed info on a proper trim to guide him, hold off on the shoes....that's where i am so far

thanks in advance

Regina and Smokey
June 26, 2017
Laurelville,  Ohio

 https://ecir.groups.io/g/CaseHistory/files/Regina%20and%20Smokey  .
https://ecir.groups.io/g/CaseHistory/album?id=8316  .

From what you just listed, I would stay with my existing vet. Lots of vets and medical professionals can claim to have "worked" with a drug manufacturer. In essence, all they did was report to the manufacturer what they administered and what either test results were or their observations as per the manufacturers design of their trial. They didn't "develop" the drug.. This is added into the FDA application from the manufacturer. We already know that BI FDA testing results were done for one year and I believe only 75% of the horses achieved a normal ACTH during their FDA trials, which is not acceptable IMO. They were only given 1mg., which is why vets think 1mg is the magic cure for PPID. 

Lots of red flags in the list you posted above. Digital xrays are so much better and are able to be emailed, etc. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Repeating a flawed protocol doesn't make it right! At least one study found fasting artificially lowered ACTH:

https://www.ncbi.nlm.nih.gov/pubmed/?term=horse+ACTH+fasted

Agree IR is a metabolic type, but not PPID. The pituitary changes are an abnormality.
--
Eleanor in PA

 

www.drkellon.com 

EC Owner 2001

Great feedback Dawn.  thank you.
--
Regina and Smokey
June 26, 2017
Laurelville,  Ohio

 https://ecir.groups.io/g/CaseHistory/files/Regina%20and%20Smokey  .
https://ecir.groups.io/g/CaseHistory/album?id=8316  .

Agreed Dr. Kellon.  thanks for the link.
--
Regina and Smokey
June 26, 2017
Laurelville,  Ohio

 https://ecir.groups.io/g/CaseHistory/files/Regina%20and%20Smokey  .
https://ecir.groups.io/g/CaseHistory/album?id=8316  .

Regina, what part of Ohio are you in?

--
LM
March 2013
Ohio/Colorado

Hi Lauren.  I'm in south central--Laurelville area.  Near Circleville.
--
Regina and Smokey
June 26, 2017
Laurelville,  Ohio

 https://ecir.groups.io/g/CaseHistory/files/Regina%20and%20Smokey  .
https://ecir.groups.io/g/CaseHistory/album?id=8316  .

Hi Regina, were you the person I promised to get some referral names to back there in OH?

I do know of a pretty darn good vet, intectually, Bedside manners come and go and I do not know if he is all up to date and on board with the ECIR program or not but he takes great x-rays for some past clients of mine and he does have some pretty good farrier skills. 

And I do know some good farriers, a little mainstream but well educated in the Columbus area. They may travel out to your area if that is of any help let me know.

Wishing you and Smokey good progress.
--
LM

Shineys Little Pistol
March 2013
Ohio/Colorado

Hi Laren.  I don't thin you promised but said you were from here.  I found someone in Columbus but while very helpful through email, he wouldn't come out this far.  The referrals he gave me were even further. I understand that.  A lot of the good ones can go to a barn with multiple horses and make a ton of money.  It never hurts to have resources, though, so if your hAve aNY names that wold be great.   Things change....so who knows.  my vet's office brought in a new vet from colorado.  She is a great balance of able to listen and also give her feedback.  That has settled me down condiderably.  I got Smokey at 45 and he was 3.  I didn't grow up around horses and he was healthy so I don't have much experience dealing with equine health problem.   Having a low key, smart, consistent vet and a very fine farrier can make a huge difference for someone like me.   So, if you know of anyone. Let n me know.  And thanks.
--
Regina and Smokey
June 26, 2017
Laurelville,  Ohio

 https://ecir.groups.io/g/CaseHistory/files/Regina%20and%20Smokey  .
https://ecir.groups.io/g/CaseHistory/album?id=8316  .

Hi Regina,
sorry, I thought somewhere in here was a way to contact you. You could e-mail me at buddhabela@... and I will give you that vet's name and if you want to give me your contact info I can send it to some farrier friends and see if any of them want to pick up an IR horse.

--
LM
March 2013
Ohio/Colorado