Hoof Evaluation 1st time and UPDATE/HELP


Tamara Gonsor
 

Hoof Evaluation:

I have updated my case history and uploaded hoof pictures for 1st evaluation. If my trimmer is not doing what is necessary I will need to make changes on my own, which I am willing to do. 

 

His diet is dialed in according to the group. However, I am having the worst time with his taste for food. I have read so much on what to mix and try, all so far have failed.  His feet continue to improve but he is still very sore without boots and pads (walks well with them). He is still lethargic.

Since writing this, he will eat his supplements in beet pulp. Hope this lasts.  

 

BLOOD DRAW:

My case history is updated with what we had done last year and to current, but the vet I had didn’t realize the importance of having all (ACTH/glucose/insulin) done at the same time. I think now I have found someone who is somewhat on board with what I’d like to do to follow this group, it has been a great challenge finding a vet who will work with me on all my requests. 

 

He was started on Pergolide 11/12/2020 and has now gotten up to just over 2mg, so we are going to draw blood again very soon. I just have a few questions to ask here so that I can get all needed. This is all so very expensive so I’d like to get all done at the same time. 

Based on where we are so far I’d like to know if I should have anything else tested while we draw blood?

 

I'd like to get a good history this year. What are the best times of year to test ACTH/glucose/insulin for PPID? 

 

PERGOLIDE:

I posted this in a separate message and received a message from another pharmacy didn’t get any responses of other members having the same issue, so posting in here as well. 

He is on a little over 2mg which is the 1.4mg fro Pet Health Pharmacy of pergolide because I can't get the 1mg of the active ingredient from them. They only compound 1.25mg OR 1.4mg, a little over or a little under of active ingredient. 

Question: He was on a little under 2mg of active ingredient (1.25mg each capsule) and then switched to the little over 2mg of active ingredient (1.4mg each capsule). Would this give me the veil? I mean, do they experience the veil with every dose increase/decrease? He has been on APF for 3 months now at highest dose 10ml.

Before I make any more dose changes wanted to get feedback here. 

 

He is still ribby which I now believe is because he is in pain. Any comments here would be good. He still has too many off days. From what I understand it is a matter of getting him really well managed? His body has changed for the better and his fat pads are disappearing, very slowly, since starting the NRC Plus class I understand why now. His cresty neck looks so much better. His mood and energy are still lacking. We are able to walk daily because he is comfortable to walk in padded boots.

 

 

 

 

Other questions:

  • How do I protect his kidneys from the drug? These drugs have to take a toll on other organs? 

  • I'm wondering if I am missing something with his ribbiness?

  • All in CH, I have him on uckele absorb all (daily) and the Psyllium Husk Fiber (per directions on bucket), should he be getting this daily?

  • I was wondering about putting him on the Phyto-Quech for the antioxidant properties and protection against oxidative stress? 

  • You can see from his “front” photo that his belly is quite big still. Anything else I can be doing OR is this more exercise? 


--
Tamara G. in Arizona 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Tamara%20and%20Malik
Malik Photos: https://ecir.groups.io/g/CaseHistory/album?id=252564


 

Hi Tamara,

I attempted to answer your pergolide question awhile ago.  Don’t know if you didn’t see it or I just did a really poor job of answering but I’ll try again.  Here’s what I would do.  Next time you decide on a pergolide increase (or have your prescription refilled), I suggest increasing it to a whole (or half) number of mg compounded pergolide, to help maintain your sanity.  It looks like you’re giving two capsules with 1.4 mg in each, for a total of 2.8 mg.  You recently increased the dose by 0.3 mg of compounded pergolide.  In my experience, that would not cause a veil but it might in a very sensitive horse, not already on APF.   Depending on your next blood test results, you could increase to 3.0, 3.5 or 4.0 mg.  Try not to get too caught up in comparing the Prascend to compounded pergolide - it’s exactly the same drug, but the weight is calculated differently.  Vaguely like comparing feet to meters.

I would suggest testing soon and then again in late July with testing in between if you need more guidance.  The ribbiness  might indicate he needs more pergolide.  Or his feet might well hurt, which I will leave to someone else to address.  Has he been comfortable at all since his mid October laminitis event?  Do you know what precipitated that event?  His insulin is very high which predisposes him to more laminitis.  When your vet sends the next blood sample to Cornell, if he lets the lab know that the results might exceed 200 and you’re interested in knowing the actual value, they will accommodate you.


--

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


 
 


 

Another answer...  about Psyllium.  Per this post which arrived in my email box today, Dr. Kellon suggests adding psyllium to every meal for older horses.
--
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


 
 


Tamara Gonsor
 

Martha, thank you to all. I did not see your response to the pergolide dosages but this is very helpful, thanks again. 
I will be testing again next week. Also, thank you for the psyllium info. I will keep him on that with every meal. 

His feet do hurt but not as much as they did. I have pictures in for some advice on his trim and will know more when I get his blood results back with him being on current pergolide dose. 

I apparently need to get this dialed in more which is why I'm back here for more help. 


--
Tamara G. in Arizona 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Tamara%20and%20Malik
Malik Photos: https://ecir.groups.io/g/CaseHistory/album?id=252564


Sherry Morse
 

Hi Tamara,

I'll leave it to Lavinia to give you specific trim advice but what jumps out at me is that he has no sole to spare, but it looks like your trimmer is still dressing the sole.  Until he has more sole it's very important to not touch it at all unless there's something Lavinia specifically has asked you to do with it.  Both of his front feet need a large trim adjustment with the right front being worse than the left.

Bloodwork - you want to make sure if possible you do the blood draw on a day when the temperature is over 50 and non-fasting - meaning 4 hours after being fed hay for the first time in the day if he's not allowed free access to hay overnight. 

Martha's already addressed the timing on the blood draw as well as your concern about the amount of pergolide per dose.  The veil effects every horse differently and some do experience a veil with each dose increase while others do not.  There is - as Martha mentioned - the possibility that PPID or pain could be effecting his appetite as well.  Which it is can be hard to figure out.   Were he mine I wouldn't do any more adjustment to pergolide dose without a test to see where he's at with his current dosage.

If you're asking about kidney function being affected by pergolide I don't think that's been found to be an issue with the majority of horses on pergolide - even at dosages much, much higher than were you are right now.

As far as the ribiness but still looking round from the front - I'd expect that's more due to lack of conditioning right now.




Tamara Gonsor
 


Tamara Gonsor
 

Lavinia, how do I go about getting on your schedule for hoof picture markups?

Thank you.
--
Tamara G. in Arizona 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Tamara%20and%20Malik
Malik Photos: https://ecir.groups.io/g/CaseHistory/album?id=252564