New & Updated Case History help please


~NeanPiggy~
 

So Cricket's Case History was updated.  Without the IR Calculator I don't know how to interpret his blood work.  I don't understand the values shown.  I was actually surprised at how number went up considering he is finally getting steady exercise since his asthma & allergies are well controlled finally.   He is not overweight anymore and he does not have any hoof issues.

The donkey, Chispa - this is his first set of blood work since me adopting him. I contacted the rescue to see if they had any from when he first arrived here for hoof rehab, I don't remember. I especially don't know how to translate any values since they are for horses not donkeys.  He is healthy, a good weight and no hoof pain.  His numbers say his insulin is a little high and his leptin is off the chart but he does not have the starving gene.  He will walk away from food so I'm guessing donkey values are not the same?? He is about 36" tall.
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Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHisthttps://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy/Cricket/Cricket%20Case%20History%202021%20pdf.pdf
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


Nancy C
 

Hi Jeannean

I can't speak to donkey values, but go to this page and scroll down to G/I, MIRG and RISQI info.

https://www.ecirhorse.org/DDT+E-diagnosis.php

More discussion recently about the proxies in this thread

https://ecir.groups.io/g/main/topic/76039404#262863

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room


~NeanPiggy~
 

Thank you Nancy, I actually found that later after posting.  So if I am understanding this correctly I ran my numbers and basically had to look up the results on my own instead of the box next to the values.    Cricket (horse) has compensated IR or Severe IR??    He is a high laminitis risk.  I do not understand the MIRG, it doesn't give ranges .  It just states High or Low.  The reason I ask is simply to see if changing anything in my management can help.  For example I'm feeding steamed tested hay (8.1 + 7)  but should I soak it on top of that?   Steamed for asthma/allergies - I know it does nothing for sugars but it has helped immensely with breathing.


--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


Nancy C
 

Hi Jeannean

The further you go down the scale for G/I  or RISQI the closer to laminitis risk you are.

For G/I the lower the ratio, the higher the laminitis risk. Cricket's is 2.80.  Ideal G/I is 10:1

MIRG measures insulin sensitivity and to my mind really comes into play when a patient becomes diabetic. A high MIRG = EMS.  A low MIRG means you have passed into diabetes. You have a high MIRG.

Cricket's RISQI is 0.17.  "A RISQI of less than 0.2 indicate severe IR and the horse is at high risk of laminitis." Your RISQI is 0.17

So let's look at DDT+E as a road map.  I would want to see Cricket's ACTH lower than 30 in April.  MY QH's is very similar to where you are.  I was cautiously leaving things alone but will test again in July to make sure PPID is controlled, but am second guessing myself. Not fully shed and looking gaunt. He's on 3 mg of pergolide.

I took a quick look at Cricket's Diet. The ESC may be too high, but balancing can help with insulin sensitivity.

Hope this helps.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room


~NeanPiggy~
 

Hmm, OK.  So I am slowly figuring this out, haha.

So you are suggesting Cricket start Pergolide (Prascend)?  His feet are drop dead gorgeous.  The only time he had a hoof issue was when he was on the DEX.  And that presented itself with chipping walls that took a few months to grow out, no pain.  Nicole S, has balanced his diet for me :)  I don't notice any other physical signs of PPID but I want to be pro-active.  I am trying hard to avoid the rabbit hole because I am fully aware it can strike like lightening.  I am off today, I can try to get updated photos of him.  He is not fully shed out so he looks a bit ratty, maybe I can bathe him today and blow out as much hair as possible with the shop vac???   He might be thinner than I expect since his exercise has greatly increased so he just may need a little more hay for his "athletic" calorie needs.  I was so hoping that all of our hiking would have helped his numbers as well as his weight :( 

The vet suggested insulinwise.  I did my reading and see it is effective only about 50% of the time.   Honestly I'd rather soak hay in the warmer temps if we think that would help with the ESC than put him on a drug.  I cannot soak in the winter, did that many years ago for my pony and it's just too cold here in the winter.  They don't have a real barn that maintains temps above 0c. 

So how do I find out about the donkey, Chispa?  Without knowing about how his numbers look I don't know if there is anything better I can do for him.  He lives with Cricket.  The only time they are separate is when he goes in his stall to eat his Stable 1/Vitamins,  Cricket can't fit under the railing.



THANK YOU SO MUCH :) 




--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


Nancy C
 
Edited

Jeannean

(EDIT) Sorry -- I need more coffee. Meant to include these links and explanation. Deleted by mistake.

Have a look in the message archives as Donkey variable has been discussed on several occasions.  Hoping owners will also chime in. It is primarily the ACTH.

https://ecir.groups.io/g/main/search?q=posterid%3A58231++%2Bdonkey+%2BACTH
https://ecir.groups.io/g/main/message/165442

At a minimum I might suggest you retest Cricket in July. What prompted me to test Skip (my QH) in 2019 was the ever-so-slight loss of fullness at the withers. He was 19 at the time. I think many folks would call it a protein issue, but it was not. He was only just above lab reference range @ ~40.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room


Nancy C
 
Edited

One more bit about diet effects, since it appears Liz and Onyx are having the same issue.

If your hay (Feb 2021?) was tested via NIR vs wet chem, your ESC and Starch may be higher than what is reported. Since it was in the 8%+ range, this would concern me. Some members have found as much as a 30% difference between the tests.  If I have these details correct, I would retest the hay. I may have missed something, bouncing between folders.

I am not seeing any listing of the major minerals for Cricket.  I would review those with your diet balancer and bring the calcium;magnesium ratio to 1.5:1 if it is not already there.

I would also want to make sure the trace minerals are tight at 3:1:3 - Iron:copper:zinc. Zinc is a really important aid for insulin sensitivity.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021
Join us at the 2021 NO Laminitis! Conference, August 13-15, ECIR Virtual Conference Room


~NeanPiggy~
 

HAHA, yes Liz & I are friends.  We commiserate together, we have the same taste in IR prone horses.  :)  We buy hay together, use the same vet & I also trim her herd.   We will retest hay. 

I'll send the mineral info to Nicole. 

I have started looking at the donkey info, thank you so much. I did not come across many of those threads in my search, you know the shortcuts!  From what I gather he is "slightly" PPID so he should be started on pegolide/prascend??  He is at 52 & should be lower than 30.   As I sort through it more I will pass the info on to my vet. 


--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


~NeanPiggy~
 

p/s I added photos in crickets file. 
--

Jeannean, Cricket, Chispa de Vida (& Prince Willy over the rainbow) Mercuri ~ PHCP Barefoot Trimmer
Ridge 2011

https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Prince%20Willy
https://ecir.groups.io/g/CaseHistory/files/Jeannean%20and%20Chispa%20de%20Vida 

https://ecir.groups.io/g/CaseHistory/album?id=79126 


Sherry Morse
 

Hi Jeannean,

Cricket's a cutie and I have to say I agree with Nancy about maybe waiting and testing in July so you're not behind the curve.  He's still in the realm of normal for ACTH but the weight loss could be a PPID issue and not just an activity increase.  It's hard to guess and of course we always focus on PPID and IR here so that's always what we think of first.  I would see how he sheds out and use that as a guide as well.




~NeanPiggy~