Vinnie Update November 2021 - high tryglicerides again


Nancy & Vinnie & Summer
 

Hey all,

Vinnie started to get foot sore again on 10/30 and am still waiting on getting all.my lab results but preliminary his tryglicerides are high again at 481, glucose is 103.

He looks like a horse with unmanaged PPID at this time.  Even though his Sept labs indicates he was controlled on 1.8mg CP.  I have a suspicion that he goes longer into seasonal rise and may need a bump of CP by another 1.2mg.

He was on 175mg invokana,l daily, but based on his recent weight change, attitude change and lab results I have put his invokana dosage on hold for the last 2 days and plan to do so until ACTH and Insulin.come i so we can reassess.

I am extremely worried. He has pulses all around and endocrine response was high during acupuncture today.

This is all very reminiscent of his crash in March and the leading changes I witnessed in February.

Please keep him in your thoughts. 

I do need to update CH.

Thanks 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


hdavis
 

Oh no Nancy!  I am so sorry to hear this about Vinnie!  Sending big hugs to both of u and have u in my thoughts and prayers. 
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




Nancy & Vinnie & Summer
 

I will add today he decided to completely boycott his beet pulp.  He had been slowly eating it sporadically but was consuming about 2.6 lb per day til today.

I have replaced the BP with odtbc cubes and stabul 1 to get his calories up.  
--
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
 

At least this time Nancy you are armed with information you didn't have the first time around. I'm hopeful that will help you and Vinnie avoid another incident. I was curious - when you say..

He looks like a horse with unmanaged PPID at this time.

What do you mean specifically? I'm curious to know what visual symptoms you are seeing [as he looked so good in the last video]. I think it would be helpful to people since managing these horses seems to be a constant effort of keeping everything sorted out. 
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Nancy & Vinnie & Summer
 

Lynn, he suddenly dropped quite a but of topline, got ribby and has been urinating quite a bit more and has guard hairs all over his body. His coat is rough ans he usually has a silky coat.  He has grown about 6 times the coat he normally does this time of year ans I have already body clipped him one time.

His BCS has changed probably from a 4.5 to a 4 or maybe 3.5 pretty rapidly and because I am throwing quite a bit of feed at him I feel like he should be gaining.

In his case the hypertriglyceridemia seems to set off foot soreness.  And he seems tomgwt other clinical symptoms that other horses are not seeing in the same conditions.   We should know more once we get acth and insulin back shortly.


--
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
 

Forgot to note, his appetite began to change too where he was just not as interested in his mashy as he had been.. very inconsistent..some days he would devour his BP and some days he would look at it like it was an inconvenience.

I have recently switched to a new hay that is a bit lower I sugar as per the NIR. But that should have been better for him theoretically.  I should have the 603 back next week.
--
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


Eleanor Kellon, VMD
 

Lynn,

Please put up some photos. We have seen multiple times that Invokana cannot compensate for uncontrolled PPID. The triglycerides are from not eating enough soluble fiber.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

Switching to a new hay he wasn't eating well is what pushed him over the edge last time.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

He doesn't need the unpalatable low sugar hays with Invokana.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 

Hi Dr Kellon, he is eating the new hay better than the older hay that was last years cutting. I think it will come in around 8 based on the NIR.
 
I can go purchase a higher sugar hay, but am wondering while off Imvokana if I should stay the course.
I do recognize that the lower sugar hay was the trigger last time too.

He seems to be having a metabolic episode he is sore in both front feet the RF is the worst, pulses in all 4.  This is all very reminiscent of the episode in feb/March.

ACTH is 18.1 insulin still pending.

I am not really sure how to proceed feed wise.

Will post a new pic.

--
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
 

Posted an imaged from just now, he does look better today than he did last two days because he has been off invokana and I would imagine the energy balance js starting to improve.  His clinical symptoms are sore feet, slo mo like movements walking like he is not steady behind, almost looks like sore in all 4. But he isn't doing the traditional laminitic stance.  He could have an abcess brewing but pulses are not really worse in one foot or another.  He doesn't really have heat in the feet either.

It is so much like the Feb lead up to March..coincidence??
--
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, like everyone else I've been following Vinnie's story - I'm so sorry he's having a hard time right now.  I hope you figure out what's going on and he's on the mend soon; he's a lucky boy to have such an attentive owner!
--
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


Eleanor Kellon, VMD
 

He's a solid BCS 4.5 but can't really see topline. Please take a video of him moving.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 

Here is 10/31
https://youtube.com/shorts/hSgL8di4txA?feature=share
https://youtube.com/shorts/z3KHweOyrQg?feature=share

Here is today just now;
He is on 250lb dose of banamine which helped a lot. He was much more trepidatious about walking when I arrived this morning and was laying down.

https://youtu.be/hTtJp48Yoho

I could get him to the arena but the footing is hard on the way and there are Bunch of lessons going on too and don't want to creat a spectacle... I can get some more video a bit later.

--
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
 

Vinnie was a bit improved tonight, he was alert and much brighter. I am hoping this positive response continues.. I have put some socks on some we are dropping I to the mid 40's just in case he is having some cold response in his feet. Although it hasn't been too cold here in the last two weeks.

He didn't want to eat much if his beet pulp again tonight, but did finish the morning ration which is equivalent to about 1.3lb dry.

I am holding my breath ...until tomorrow..here is some video from tonight.  He is on low doses of banamine so I am.not forcing any walking.
https://youtu.be/X2qBoCuXPzw
Thanks 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


Eleanor Kellon, VMD
 

Glad he's feeling better.

Vinnie has a history of coming up sore if he overdoes it and it's not even necessarily laminitis related. He has extensive arthritic changes in the left pastern and ground parallel coffin bones on last check which strains the deep digital flexor and navicular area. Elevated triglycerides do not cause lameness.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 

Thank you.

So when Vinnie goes back on invokana in the future once his energy balance is closer to normal, is there a range of hay esc+starch that would be considered safe? 

He is not going to eat 4lb Beet Pulp. I have tried to no avail. He at best consistently will eat 2.6 lb dry when he is feeling well.   I tried the wheat bran option but that also seemed to coincide with footiness so I stopped that immediately and he still didn't consume more than 2.6 lb even with that in the mix.

I am using stabul 1 and tc balance cubes which he will eat well. To try to keep his calories up given that he really is challenging me on the BP.

Thanks in advance.
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


Eleanor Kellon, VMD
 

When he is on an effective dose of Invokana he should be able to tolerate ESC/starch of up to 10.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 

Vinnie's update, the remaining labs came in,

Insulin 30
Acth 17.4
Tg 481
Glucose 103

He has an abcess in his RF. We are poulticing and seeing a good amt of draining.

We haven't restarted him on Invokana yet, we trying to decide what dose and intervals are appropriate for him based on the TG #.

Uploaded my new hay tests and definitely need help balancing because both horses have officially vetoed uckele ubalance foundation after eating it for months.  I still have them on Glycocemic eq and
Tri aminos, but suspect we will need copper and Zinc added to the mix..  They do like Micro-phase so I am thinking that could be a good option. 

Thanks 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


LJ Friedman
 

ca trace plus  often well received,  
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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