For the last 2 weeks Scooter has been suffering from hoof abscesses in both front feet. Sometimes both, sometimes just one. They seem to come and go in varying degrees. Nothing has changed in his diet. I have had to stop exercising him for the last two weeks but he is still living outside 24/7. Can the cause be PPID? Can I increase his Prascend dosage? Currently getting 1 mg once per day.
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     

Hi Rhonda,

His insulin and ACTH results were very high last year.
I don't see any test results for this year.
Have you tested him recently? If so,can you put the results in his case history?

He's living in his dry lot, yes?


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Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php

Hi Rhonda,

In looking at Scooter's bloodwork from April his insulin was elevated and it looks like he was being fed either free choice hay or 25lbs of hay a day AND 2 quarts of timothy balance cubes a day.  IF he is eating 25lbs of hay plus 2 quarts of cubes (which are meant to be fed at a 3:4 ratio as a hay replacement, measured in pounds) - he's eating more than he should be for his ideal weight.  If he's eating free choice hay he could also be eating more than he needs and both of those scenarios could cause his insulin to remain elevated in the danger zone of laminitis.

Have you actually seen evidence of abscesses in his feet?  If not, I would be concerned about laminitis due to elevated insulin at this point and I would look at getting his diet tighter. 

If you could add current trim pictures and a body picture to Scooter's album that would be helpful for us to help you.

While I'm thinking of it - could you please update your signature with the link to Scooter's photo album?  https://ecir.groups.io/g/CaseHistory/album?id=258159

To do that:

1) Go to this link to amend your auto-signature: https://ecir.groups.io/g/main/editsub
2) Look at the bottom of that page for the window with your current signature and click your cursor to the line under your case history link
3) Paste the link to your photo album in that line.  You may need to hit the space bar or the return key to make the link blue (live)

4) IMPORTANT: Scroll to the bottom and hit SAVE

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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/Scutch%20Case%20History.pdf

https://ecir.groups.io/g/CaseHistory/album?id=78891

He was tested in April 2021 and the results are in his case history. The insulin number was high (384Pmol/L) and this was discussed in this group when I received the results.  (ACTH=4.9 Pmol/L) ( Glucose=5.1 Mmol/L). The blood draw was done at 6:00 PM.  Scooter is in a large boarding barn and I had asked to feed him hay for 4 hrs previous but obviously something went wrong. He was out in his dry lot.
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

Scooter lives in a large boarding barn.  I have tried to get them to weigh hay but they just eyeball the amounts and I eyeball it as well.I have been matching the hay amount to his desired weight which is 1200 lbs and his exercise level as well.  He is getting free choice timothy hay and his current weight is 1193 lbs. (There is no 25 lbs of hay listing in his case history because I have never known what the weight is).  He is eating his free choice timothy hay plus two meals of 1 qt of timothy cubes (not balance cubes) mixed with 1 qt of beet pulp soaked.  His morning meal is the carrier for his AminoTrace+ and other supplements.
Evidence of abscesses in his feet for the last 2 weeks:  There can be a noticeable pulse on either the lateral or median side of each front hoof. Sometimes one front hoof or both. The abscesses seem to be breaking out of his front feet frogs/heel areas.  He has been absolutely fine since his April 2021 testing and before that as well.  it seems a strange coincidence that hoof abscess coincide with the ACTH rise. My farrier came on July 29  and did his regular trim and I had asked him to check for any abnormality and there were none. It was at this time that he had general hoof soreness but on this day he was sound. I was thinking of doing more blood sample testing at this time but it usually takes 3 to 4 weeks before I get the results. I will try and upload recent hoof pictures and body pictures.  Any help would be appreciated.
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

Rhonda,

PPID could be involved but there are many other factors. EMS leads to weakened laminae even when there is not an obvious acute laminitis episode. If his white line is stretched, as most of them are with EMS, this is a portal for infection.  Other contributing factors include:

- Recent trim or change in trim. This alters the forces inside the hoof and strains encapsulated serum/infection pockets.
- Very wet or dry weather - challenges white line integrity.
- Inadequate trace mineral balancing.
- Inadequate lysine and methionine intake.

Those last two are hay balancing issues. I understand he's at a boarding barn but if you talk to the owner and/or the hay supplier you may find the hay is always coming from a limited number of suppliers. This could make a hay testing strategy possible.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Hi Rhonda,

Thanks. Sorry, but I can't see them in his case history. Nothing is reported for 2021....or I need to junk my computer,maybe.

Nice to see his numbers coming in lower than last year. I know you would like his insulin to be even lower.

Maybe you have updated his diet for this year,too ? I'm not sure why I'm not seeing 2021 data.
Will explore further.

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Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php

Thanks for the response!  There has been no change in trim.  I have a very good farrier (who lectures at the University of Guelph Vet College and he is the one who noticed the laminitis in my horse in April 2020) and started this journey.  It has been exceptionally wet this entire spring and summer.  The barn's dressage ring has been unusable as it has turned to a lake.  I rely on Mad Barn AminoTrace+ for his minerals(https://madbarn.com/product/aminotrace/).  He has been receiving 1 cup every day for over a year now.  Lysine min. 30%CP with 10 g per 200 g.  Methionine min. 18%CP with 6 g. per 200 g.
The hay is coming from one supplier but the barn owner cannot tell the difference between Timothy and Alfalfa and the supplier knows this and calls the hay whatever he wants and the barn owner will buy it. He sold her several loads of very late cut alfalfa and called it grass hay! The latest hay supply is in 1000lb square bales.  I may sneak around and see if I can grab some samples. 


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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

Thanks for the reply!  I will update it to today an upload on the weekend.  Last update was April 19,2021.

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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

I guess you must be talking about the bloodwork folder .

The CH doesn't have any data for 2021 recorded that I can see. 
Great that you're able to update it.....the case history. Is very helpful to see the details in one place.

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Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php

Hi Ronda,

Do you mean he is receiving 1 "scoop" of Amino Trace+?  Their scoop is 100g, so that's 5g lysine and 3g methionine.  They also offer a 3 Amigos product that adds lysine (10g), methionine (6g) and threonine (4g) per "scoop", that you could add if you don't want to increase the Amino Trace+.  But if his hay isn't tested, I would feed the recommended 2 x 100g scoops of the Amino Trace+ if you are not already.  It was designed to meet trace mineral depletions for most hays and it's more likely he needs the full amount, not half.

Also, it's time to test ACTH again to make sure it is still within range for the seasonal rise.  An increase in pergolide may be warranted and the abscesses (or perhaps they are little laminitic flareups, since both fronts are affected, variably) might be an indication of this.  Because he is EMS as well as PPID, his insulin can go up quite quickly if diet AND medication aren't ideal.

Are you worried about Scooter's current weight?  Is there anyway you can hang a fish scale on Scooter's gate/fence with a big muck bucket hanging from it to put the hay in and ask the barn to weigh his hay?

--
Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Scooter is receiving 1 cup(2 scoops) of AminoTrace + which is the listed dose for a 500KG horse which he is (1193 lbs according to my weight tape measure.) I am not worried about his current weight.. He is very muscular looking! Thanks for your response.  I think the only way out of this situation is to get him tested.The disadvantage to this is that it takes 3 to 4 weeks before I will get a result.
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

Hi Rhonda,
Your case history mentions that you stopped his dressage work in 2019 due to hoof abscesses.  Has that been an issue all along or did it improve with pergolide?  My suggestion would be to increase the pergolide for the rise and test him sometime after the rise to help decide whether to drop back again.
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Rhonda,is there a reason the test results take so long to get back to you?
I've never had to wait that long over the years ,either from Cornell directly or IDEXX.

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Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php

The farrier gave him his usual trim July 29.  I had chatted with him and asked him to let me know if he found anything of note in his feet.  Nothing was found.  Abscesses do not show up on x-rays.  However my vet is coming this Friday to collect blood sample for metabolic testing. I will ask her to x-ray his front feet.  The hoof abscesses have not improved but neither have they got worse.
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

The hoof abscesses started in July 2019 while he was at a show competing.  Took him home and called my vet.  I had her do a metabolic panel.  Results were all in the normal range.  The hoof abscesses continued off and on for months.  I called her again about the hoof problems.  Her only comment was"Oh". The hoof abscesses finally went away in November.  I was worked on getting him fit and he was doing well but by February he had hoof abscesses off and on again.  Vet was no help again. Due to Covid all boarding barns in Ontario were forced into lockdown(no owners allowed).  My Farrier came to do a trim and told me my horse had laminitis episodes.  I called the vet service and again to come and x-ray his feet and the diagnosis was founder, seedy toe, white line disease, hypothyroid, IR, EMS, PPID.  Knowing what I learned from ECIR, I would have put him on Prascend in July 2019.  But I didn't know anything and neither did my vet service!  The hoof abscesses stopped when he was put on 1 mg Prascend in late April 2020.  I think I need to up his dose of Prascend to 1.5 mg?  And then test him again in November?
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

I have been using University of Guelph animal lab but I think from now on I will switch to Idexx.  I actually found their phone number and talked with a technician.  Their method is to save up the metabolic testing and send it out once a month to an outside lab! (I wonder if they send it to Idexx!)  So I was paying a premium for nothing. The vet is coming on Friday to collect blood samples and x-rays.  Based on results I may increase his Prascend dosage from 1 mg to 1.5 mg?
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Rhonda Turley
Brampton, Ontario
April 2020
Scooter and Rhonda     
https://ecir.groups.io/g/CaseHistory/album?id=258159

Hi Rhonda,
So it appears that there is a relationship between the hoof issues and PPID?  The reason I suggested increasing the dose now and testing later is that the dose increase will become less effective as you move into the fall rise.  If you can get your results back in a day or two, as I can, it will matter less.
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