Date
1 - 10 of 10
WAS: New Cornell Results for Blessing NOW: UNCOMPENSATED IR WITH HISTORY OF FALL LAMINITIS
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Patty Franklin
I know everyone is at the No Laminitis conference, but I'm hoping Dr. Kellon or a moderator can suggest how to talk with my vet about increasing Blessing's pergolide. She is presently on 2 mg compounded.
Blessing had a blood draw on Wednesday, Oct. 11. Cornell Labs ran the tests. She still registers as uncompensated for IR and I'm very concerned about her foundering again this winter. ACTH: 20.9 pg/mL vs 48.4 pg/mL on June 26 Glucose: 116 mg/dL vs 136 mg/dL on June 26 Insulin: 71.19 ulU/mL vs 151.79 ulU/mL on June 26 Leptin: 6.05 ng/mL vs 23.85 ng/mL on June 26 T4: 3.67 ug/dL vs 2.08 ug/dL on June 26 Taped at 908 lbs vs 969 lbs on June 26. I understand that her ACTH is in the zone where we want it (9-35 pg/mL). But will increasing the pergolide help move her into the compensated category for her IR? If so, do you have a suggested range I can talk about with my vet? We plan to test her again in December. Blessing's CH will be updated to reflect this new data tomorrow. Thank you for all that each of you does to help us owners help our horses! -- Helen Connor and Blessing (IR/PPID) May 2017 Scappoose, OR USA Blessing's Case History: https://ecir.groups. Blessing's Photo Album: https://ecir.groups.io/g/ |
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Patty Franklin
Sorry. CH is updated now.
-- Helen Connor and Blessing (IR/PPID) May 2017 Scappoose, OR USA Blessing's Case History: https://ecir.groups. Blessing's Photo Album: https://ecir.groups.io/g/ |
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regina bruno
there is some improvement, which is great. hang in there.
-- 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 . |
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Hi, Helen - Well, the good news is that the insulin and glucose have decreased (though not normal yet). ACTH looks like it is fine - I am not convinced that this is PPID-driven, but with this level of anxiety over the seasonal rise, increasing by 1.0 mg isn't a bad idea. Some PPID horses need to have their ACTH in the teens, rather than around 20 pg/ml.
The diet looks damn' near perfect (except for the carrot tops - no more of those, sorry). So, we are faced with a persistently high insulin in the face of a tight diet, and controlled ACTH. I have to wonder if mare issues are involved. Have a look at Dr. Kellon's presentation on Ovarian Abnormalities in Mares with Refractory Insulin Resistance in the 2015 NO Laminitis Proceedings (free to download): https://www.ecirhorse.org/proceedings-2015.php The other potential player is iron overload. The blood has to be sent to Kansas State University to get a diagnosis of this. The trim is contributing in a big way to any foot issues, unfortunately. Is there any chance of getting x-rays? -- Jaini Clougher (BSc,BVSc) Merlin (over the bridge) ,Maggie,Gypsy, Ranger BC 09
ECIR mod/support
https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy
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Patty Franklin
Hi Jaini,
Thank you for your considered reply to my request for help. Sorry about the anxiety. I've had this horse for 10 years and only finally discovered what was wrong with her last year, not that I hadn't been searching each of those years. There's a lot of misinformation out there and a lot of kind people who don't really know what they are talking about but think they have the answer to your horse's problem. I think I ran into all of them. I have essentially never been able to ride Blessing, due I think to pain in her feet. With the help of Cornell and all of you at ECIR, I allowed myself to think we might get enough recovery to ride someday or at least take up groundwork. Now it appears to be slipping away again. I decided about six months ago will not put her through another round of founder with no clear path to recovery. So no hyperbole here. Thanks for the note on carrot tops. I thought only the carrots were a problem. I tried to download Dr. Kellon's paper on ovarian issues through the link you provided, but it's timing out and posting a failure notice. I'll try again later. I will investigate iron overload through her water. We are on a well that it is drilled into basalt, so it's is a possibility. Her low sugar hay was analyzed with 101 ppm Fe this year. I'm using 160 mg Cu and 500 mg Zn to balance, except that she doesn't eat her supplements very predictably. I'm going to try Beet-E-Bites crumbles to see if that will entice her to eat them. What exactly do you mean that the trim is contributing to any hoof issues? The trim pictures are several months old now. Her feet look better (the wedge has grown out completely) but she is developing thrush in LF this week. I'll try to get more images taken and posted soon. She is even starting to redistribute her weight onto all four feet lately instead of looking hunched up, which I thought was a good sign. The natural concavity is returning. We are focused on keeping toes short and allowing the heels to grow out (she was run down). Please share any specifics you'd like to see addressed Unfortunately, X-rays are a luxury I can't afford right now. The vet calls for blood work are maxing me out at the moment. Sorry. Thank you, Jaini, for your thoughtful comments. I appreciate the link to the article on ovarian issues and I'll see what I can do on the iron test through Kansas State. -- Helen Connor and Blessing (IR/PPID) May 2017 Scappoose, OR USA Blessing's Case History: https://ecir.groups. Blessing's Photo Album: https://ecir.groups.io/g/ |
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Patty Franklin
Jaini, one more thought. Our water doesn't show the telltale rust spots on laundry and porcelain that are usually seen here in iron-rich wells. BUT we do have a lot of calcium -- enough that it clogs small openings in machinery over time and builds up on bathroom fixtures. Could Ca be binding Fe and other minerals in Blessing's feed as it goes through her system? In some way, could it be exacerbating the IR condition?
-- Helen Connor and Blessing (IR/PPID) May 2017 Scappoose, OR USA Blessing's Case History: https://ecir.groups. Blessing's Photo Album: https://ecir.groups.io/g/ |
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Hi, Helen - A horse can build up iron over-load over time, from hay and other feed sources. It doesn't necessarily have to be the water. It takes up to 2 years (sometimes 3) on a balanced diet to get a bit of control over that. For now, save your money on the KSU bloods, because the only other thing you could do to deal with iron over-load besides her balanced diet is to get your vet to do some blood-letting (I have done that with one of my mares, and it is a PITA - but maybe your vet is more clever than I am about these things)
However, she could also have a functional magnesium deficiency, if you have a bunch of calcium in your water. This happened to my horses, despite my very meticulous balancing of my own hay. If you still have the Uckele magnesium oxide, add a teaspoon a day. This is not a magic bullet, but it may help. If it turns out to be too much magnesium, she will just have soft poops; then reduce it to 1/2 a teaspoon. Hang in there, Helen. -- Jaini Clougher (BSc,BVSc) Merlin (over the bridge) ,Maggie,Gypsy, Ranger BC 09
ECIR mod/support
https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy
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PS - several of us were discussing the ethics of putting an older horse through bouts of laminitis, if they are a difficult case and it is proving tough to get a handle on it. You are currently doing what you can, which is all anyone can do. If, God forbid, she founders again, please know that humanely letting her go because you are all at the end of your emotional and financial resources is the best thing. Make that decision with grief, but no guilt. There are times when refractory pain is just too much for these horses. But, please don't let the numbers freak you out just yet. Yes, she is at increased risk, but that doesn't mean that she is doomed to another laminitic episode. Her numbers have been improving.
More on the trim later, as Dr. Bowker continues his presentations. -- Jaini Clougher (BSc,BVSc) Merlin (over the bridge) ,Maggie,Gypsy, Ranger BC 09
ECIR mod/support
https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy
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Patty Franklin
Thank you.
-- Helen Connor and Blessing (IR/PPID) May 2017 Scappoose, OR USA Blessing's Case History: https://ecir.groups. Blessing's Photo Album: https://ecir.groups.io/g/ |
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Patty Franklin
Hi Jaini, Thanks so much for sharing your thoughts on how I might help Blessing with this iron and IR problem. She has been getting a small amount of kelp daily for the last year. My thought was that, along with iodine, she would get some beneficial micronutrients from the kelp. A few weeks ago, I saw Dr. Kellon's note on iron in kelp and stopped using it. I'm now using iodized salt. And in fact, for several years, Blessing had access to Himalayan salt, which also has iron. Since you mentioned that Fe can build up over years, I'll bet that her Fe problem has been largely caused by my not understanding the risk I was putting her at. Thought I was doing some good for her, but actually was harming her. Well, it's water under the bridge now. I can add the magnesium oxide and monitor the manure. I'll keep my fingers crossed that we see further improvement with the December blood work. Again, thank you for taking time from the conference to respond.
The trimmer comes again on Wednesday. I'll try to get a full set of updated images into the photo album by the weekend. -- Helen Connor and Blessing (IR/PPID) May 2017 Scappoose, OR USA Blessing's Case History: https://ecir.groups. Blessing's Photo Album: https://ecir.groups.io/g/ |
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