locked Urgent Advice Required (Part II)


 

Hi Rebecca,
You are correct.  You need to upload a pdf.  Not everyone here uses an Apple and, while we iPad users can read their files, they can”t read ours.  So, until you load the pdf, most of those here won’t be able to open it.
With Pages opened to the case history file, look for the small circle with three dots in the upper right corner.  Click on that and choose export.  An option there is ‘pdf’ and that’s what you want to choose.  Tell it where you want to save it.  I use the Files app to contain folders for stuff I don’t want to lose.  I have an ECIR folder - and then numerous sub folders.

I was able to open it and I realize I need to go back through all these posts to remind myself what I should be looking for there.  It will be nice to have a new topic.
--
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


 
 


Rebecca.speed@...
 

Thank you for the guidance Martha, 

I have updated the case history and added the file but I now realise it’s not in PDF format as my iPad wouldn’t convert for some reason. I’ll keep trying and once it is in the correct format. I have not deleted our old CH but will do once I know the new and updated version is as you require it to be.  I’ll post my new question about balanced diet once it’s correct. 


Thank you, 
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


 

Hi Rebecca,
There is no way to update your case history materials directly on the web.  You need to locate the original word processing document on your computer and make your changes there.  Once you are finished editing, you print or convert to a pdf and save the new pdf version, deleting the old.  Knowing how to find your Case History file on your computer is crucial to keeping the update current.  Some people update their WP document frequently, much as a journal is done, and then update the file online when they need to post a question.  I’m not that organized but I can see how that makes it easier when there’s a need for immediate feedback from the group.  You don’t need to inform the group of the update until you have need of advice.
--
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


 
 


Rebecca.speed@...
 

Completely understand and I will do that - thank you. Sorry to be a total luddite but how do I go about making amendments to my case history and then re-uploading to the group?

Mnay thanks, 
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Kirsten Rasmussen
 

Hi Rebecca,

It would be helpful if you could start a new message thread when you have questions unrelated to the original question.  This thread really started with addressing the anti-mularian hormone, but now we've move on to diet and trim topics.  Generally we like to see a New Topic started when the questions change focus.  When you get the xrays and ask about them, that's a good time to start a new thread.  Same with questions about Emme's diet.  Thanks in advance! 

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


Lavinia Fiscaletti
 

Hi Rebecca,

The March rads showed that Emme had some bony column rotation along with toes that were too far out ahead of where they needed to be. Sole depth was OK.

In the current photos, it appears as if the heels have been lowered, which needed to be done to address the bony column rotation, but it looks like the entire foot is being taken down as well. The toes are getting further and further out  ahead of where they need to be. Need to back up those toes at ground level substantially so that the breakover moves back, without lowering the vertical height.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Rebecca.speed@...
 

Thank you Sherry. 


I will update current feed regime and also bloodwork in our case history. I just added most recent trim photos and the X-rays (last taken in March) to our album.


I intend to get updated X-rays ASAP. 


many thanks, 
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Sherry Morse
 

Hi Rebecca,

Could you update your case history with the current feed program as well as the results from her March bloodwork. Based on that TRH Stim you're dealing with IR only at this time. 





Rebecca.speed@...
 

Hi Sherry, 

sorry only just replying to your message. I got lost in the thread and now see I only replied to Kirsten. 

Emme had a Prascend trial following vets advice towards the end of last year (and also around 2016 if I remember correctly) but following the ACTH & TRH results, we stopped for obvious reasons (also noticing no improvements to IR and comfort levels) so I do hope we have done the right thing. 

Are there cases whereby horses ACTH/TRH show as negative but they actually do have PPID? 

If now is the time to re-test TRH then we will do that. I’m hoping the March 2022 results appear in this thread as I think Cass very kindly uploaded that file here. I also added to our folder. 


Am I ok to post her daily rations here to check her diet is as good as it can be? 


Thank you all x

--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


 

Here's Emme's latest Liphook labs from March 28, 2022, including a TRH stimulation test (negative) and insulin (high):
https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK/Emme%20Speed%20Lab%20Ref%20544908.pdf 

--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Rebecca.speed@...
 

Thank you Kirsten, Your response is greatly appreciated. 


I need to upload bloods taken in March 2022 which include ACTH and TRH Stim and your thoughts would be much appreciated. Emme doesn’t present any signs of PPID such as curly coat/not shedding, excessive thirst or issues with urination. She does have some muscle wastage but that I put down to the fact she is often uncomfortable and active movement isn’t always possible. All blood results clearly show very elevated IR - I just wanted to triple check that it’s not a common occurrence for results to show false readings and that PPID could still be the root cause. 


Over the last few weeks she has lost some weight and her fat pads and crest have decreased for the first time since I have had her in my care. She is currently boot-less and on a grass free track and managing to mooch about relatively comfortably and it’s really encouraging to see her wanting to actively walk around. She is still struggling on harder ground but I realise this is a marathon and not a sprint and these smaller achievements are very positive. I also need to upload her latest X-rays which were taken in late April. She is very lightly trimmed every 3 weeks. 


I will upload the last bloods taken (if I remember how?!!). - I’ll do this today. 


Thank you for the support and lifeline. It’s greatly appreciated x
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Kirsten Rasmussen
 

Akso, did you also get bloodwork done recently?   I don't see it in your Case History.  The last labs in there are for Jan 4 2022.

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


Kirsten Rasmussen
 

Hi Rebecca,

As per Dr Kellon's recent post, if you're not seeing physical signs of PPID onset and you have a normal ACTH result (especially during the seasonal rise), you should not jump to the conclusion PPID is a factor.  EMS-related IR can also worsen with age as activity drops off and metabolism changes, which may be why Emme is having problems.  Plus, you have not noted anything solely indicative of PPID--such as excessive thirst/urination, shedding problems, topline loss or onset of soft tissue injuries--in your Case History.
https://ecir.groups.io/g/main/message/279263

Also, your Oct 2021 ACTH was perfectly normal, even towards the low end for a horse of nearly 20 years in age.  If Emme had early PPID we would expect to see ACTH well over 80 in Sep-Oct.

I think it's very unlikely PPID is a factor here, although you should monitor her ACTH annually now that she is entering her senior years.  Testing baseline during the peak of the seasonal rise, or doing TRH Stim tests outside of the seasonal rise, would be the most proactive, but watch for the physical signs developing.

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


Sherry Morse
 

Hi Rebecca,

As we're still not quite in the seasonal rise for the northern hemisphere you could redo a TRH stim test on her now to get a better idea if she is early PPID.  I see in your case history she was on Prascend last winter - has that been continued or did you stop using it?  

For Emme I would be less concerned about early PPID than getting her to a good weight and checking if the diet and weight loss were enough to get her insulin to a better number.  If not, then I would be looking at medication for assistance unless a TRH Stim test came back with an elevated post-stim result.




Rebecca.speed@...
 

Hi helpful group, 

Hoping for some clarification if I may ask. I’ve posted Emme’s lab results here previously which showed her ACTH & TRH results as normal and it was suggested that she isn’t a PPID case and we are dealing with uncontrollabed IR but having read more info coming in via this group I am concerned the results are a false reading and I’m inhibiting her recovery by not using Prascend. Any advice would be much appreciated. 


Thank you.
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Rebecca.speed@...
 

Dear Cass & team. 

I’m very sorry it’s taken me this long to sort out both addresses I have logged here. I’m hoping what I’m sending here is now using the correct one. 

I was hoping to check it Dr. Kellon had revived my vets email address so information regarding the use of Ertugliflozin could be sent to them. 

I followed a link to what I assumed was Dr. Kellon’s email address but perhaps I incorrect as both my vets tell me they haven’t received any info. 


Thank you x
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


LJ Friedman
 

is there a reason you use this in paste and not tablets ?? how? why ?  steglatro??
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 


 

Hi, Rebecca.
Cass here. I need to ask you, please, to post only from one single identity/email address. You and I spent some effort  getting your information in place for Rebecca.speed@.... If you look earlier in the thread you're posting to, you can see that your case history and photo album all show up perfectly under your signature with that log-in information. 

We volunteers can follow your progress from December of 2021. But our jobs as volunteers are much harder if we need to track your posts as Rebecca.fowles@... too!

The next time you post, please be certain that you have logged out of ECIR as Rebecca.fowles@... and logged back in as Rebecca.speed@....  Maybe you can put this information in your Address Book so you can find it easily in the future.

Many thanks and good luck with Emme.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Rebecca.fowles@...
 

Thank you Eleanor - 5mg per ml


Eleanor Kellon, VMD
 

Do you know how many mg are in one mL of the paste? Yes NSAIDs can inhibit progress.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001