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Update on Vinnie- Post Hospitalization for Hypertriglyceridemia

Nancy & Vinnie & Summer
 

Hey all, thought I would send a quick update in Vinnie to let everyone know how he is doing.

He came home on March 17th and then three  days later roof replacement began at the barn where we board (timing of planned renovation changed I guess..) so with the roof being torn off, new framing etc and the lack of usable space for a horse recovering from ICU stay, we decided to move to a friends house temporarily.  We had to make changes to that stall to make it laminitic recovery friendly and Vinnie settled in really well.

We started a diet of a mix of two hays one is 10.1 esc+starch and the other is 6.4 esc+ starch to make sure his total esc+starch from the hay is about 8.8%, he gets his odtbc cubes and his lmf low starch as a supplement mixer.  For.the first week he was still a little off and on with his food intake so.I really monitored to make sure he was getting enough  calories.  We redid his bloodwork on day 5 after coming home and his triglycerides had come down from 121 to 85 (at the hospital they were as high as 1554) glucose 111 but insulin had jumped up to 49.4 (was 30 on the test before hospital admission).

He is still sore in his front feet especially on hard surfaces, but we are not sure of this is from chronic laminitis, collections or other variables related to bone loss and arthritis (lf). On soft surfaces with low dose of banamine he is comfortable enough to walk and meander for a couple mins here and there.  He is ambulatory in his stall which is bedded heavily.  We tried to wean off rx pain, but right now he is in a place where I don't want to incur more stress so will wait til we move home to our boarding facility when the roof is complete ans once he is stable again try to wean off rx meds at that time.

We plan on running bloodwork again this week to see where his insulin, glucose and triglycerides are currently and then make decisions about next steps with Invokana etc.

Vinnie is engaged and alert and feeling more like his normal silly self.  All those weird neuro type symptoms have abated and he is starting to fill out a little bit where he looked a little too thin.  We will keep him close to about 935 to 950lb. (He came home from the hospital at 897lb)

Dr Kellon is working closely with me and my vet and is just an amazingly wonderful person!! I am so incredibly thankful for the guidance and support, thank you so much Dr Kellon.

I have an updated CH but am working on more updates as things settle diet wise etc.

Thanks all, Nan


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Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Lynn
 

That's wonderful news Nancy!!!!!! So happy for you!
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω

hdavis
 

Sherry Morse
 

Hi Nancy,

That's wonderful news.  So happy to read this and hopefully there will be more good news as the weeks go by.

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



Bobbie Day
 

Ahh Nancy
Wonderful news, glad he is feeling himself.
Hope to see video updates soon, such a beautiful ham ❤️


--
Bobbie and Desi
NRC Plus March 2020
Utah, Nov 2018

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi

https://ecir.groups.io/g/CaseHistory/album?id=78821

Joy V
 

So happy to get an update on Vinnie, thank you for sharing!


--
Joy and Willie (PPID/IR)
Nevada County, CA - 2019

Case history:  https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Willie
Willie's photo album:  https://ecir.groups.io/g/CaseHistory/album?id=242526

Trisha DePietro
 

Thank you for the update. Glad to hear things are going well!
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder

Nancy & Vinnie & Summer
 

Quick update latest bloodwork from 4/1 from Cornell 

Glucose 109
Triglycerides 71 (whoohooo]
Insulin 68.1

Vinnie is finally eating and acting like himself again. We begin the slow decrease of the higher sugar hay from the 65/35 ratio which was about an 8.7 eac+starch to more of a 50/50 to see how he fares.

We are waiting on  conferring with Dr Kellon on next steps.  With insulin creeping up I suspect we will be on a mission to get this back down soon

His feet are recovering. We pulled sneakers temporarily to allow for some solepacking for resolving am area that had some serum draining.  We are deciding on next steps tomorrow once we get a look to see the progress of that potential area.  We had a slowdown of hoof growth too which I am sure was related to the health scare he went through so hoping we start trending better on that front as well. 

Thanks Nan
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Cass in NorCal
 

Thank YOU for keeping us informed. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Lynn
 

So glad to hear he is continuing to make progress! He is a trooper and so are you Nancy. Thanks for the update!
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω

Nancy & Vinnie & Summer
 

Hi all, with Vinnies insulin increasing my vet and I decided to add back Invokana at 1/8 of his previous dose and monitor. We don't want to risk another acute laminitis or any more damage to the laminae. 

Will update with results when I have them.

Thx Nancy 
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Nancy & Vinnie & Summer
 

Sherry Morse
 

He's looking great Nancy!  Just curious if you have any idea what his weight is now compared to when he was checked at Davis?  I'd want to see a bit more weight on him ideally but not a whole lot more.  My curiosity on this point is mostly driven by my own experience with Scutch and him weighing more when he was fit than I thought he did when he was out of work and 'flabby'. 

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



Nancy & Vinnie & Summer
 

Thabks Sherri!!

Dr Kellon, had me tape him when he got home to compare the tape weight with the check out weight and it was almost spot on..about a 4lb difference (lower) 893 vs 897.

I taped him again on 4/1 and he had gained to 923. I would like him at about 950ish, even though the hospital didn't want him to gain any weight. 

What we are doing inovkana wise:

We are on a 37.5 mg dose of invokana and we may go to every other day. I noticed  some of the body changes after about day 4 at this dose

We decided to skip yesterday's dose when we pulled blood  (yday am) because we did notice a slight change in serum color:  closer to the 3/22 pull.  It will be interesting to see what the triglycerides are doing based on that observation.  

I also added free choice of the 6.4 hay at night beginning lthe evening of 4/12 based in Dr Kellon's note to all of us.

I am hanging water buckets to trend about much water he is consuming. I began this when he came home from the hospital on 3/17.

Will post the updated bloodwork numbers when we get them.

Thanks again!! Dr K, sending lots more healing energy and light for a speedy complete recovery.💙💜💙
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Lynn
 

Nancy! He looks amazing to me! Thanks for sharing the video. And I appreciate you chronicling this whole journey for us with everything else you had going on - it's been quite the learning experience - invaluable!
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω

Sherry Morse
 

Well if he's still in that 925 range the 25lbs is about what I would want to see on him too if it doesn't come with an insulin spike.  My one thought on that point is that once you have a new 'ideal' weight for him please update that on the CH (and I'd maybe make a note as well on the change).  I know that I had overestimated Scutch's ideal by quite a bit to start and had to revise it down.  My weight tape adds 20lbs to the scale so knowing that helps with doing weights regularly.

Thanks so much for doing such a great job documenting everything going on with Vinnie.  It's hard to keep straight sometimes so good to have the very detailed CH to look back to.

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891


Nancy & Vinnie & Summer
 

Lynn, thank you so much!! It has been a crazy year..my mare is hospitalized at UCD since Sunday with peritonitis with the source maybe being an abcess near the left ovary...today we will know more.  

Sherry, great idea, thank you!! I will update the CH with note on weight for sure.. I am in the middle of the latest updates since things were changing pretty quickly, I have been keeping the chronicles but need to post the latest  :)
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Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

Jennifer Murphy
 

Nancy, just curious - how are you getting the 37.5 mg dose of Invokana?  I'm trying to imagine cutting those tiny pills into even tinier fragments and can't even wrap my head around that.
--
Jennifer in NH
2020

CH - https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Flea

Photo album - https://ecir.groups.io/g/CaseHistory/album?id=251041&p=Name,,,20,1,0,0

Nancy & Vinnie & Summer
 

Jennifer I purchased a pill cutter with very sharp blade and I scored with flat side down once I made the second cut.  Added an image to my folder.


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Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

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