8 am vet appointment, xrays, & boot pad suggestions


Lesley Bludworth
 

Hello,
The vet will be coming at 8am this Saturday to check blood for pergolide response, insulin and take xrays.
Should I feed just hay at 3:30 am or also the feed with metformin as well?
What angles should I get for xrays?  Should I get all 4 feet xrayed?

I will post hoof pics and xrays after vet visit.
she has been wearing 
clouds up front (pads to be replaced as soon as they arrive, and gloves with 12 mm green pads (easyride) on the hinds, they are mostly flat.
  There is no hoof wall in contact with the ground on any hoof except the heel area which I rasped the wall as much as I could, no loss of height just wall thickness until I could not see any defect in the wall sole junction. 
She is overtly landing on her RH lateral toe when she walks and has a bruise up the wall to show for it.
I read a suggestion Lavinia made for another person to wedge/pad only the frog/sole area and "float" the wall area.
I cut soft pads the size of the sole and taped them under the already flattened frog conforming blue pad (easyride pads).
There is not a wedge but there is height/increased thickness the entire foot sole on both hinds, the bars are included in the pad and a little heel buttress. 
I have the red, black and green/blue pads as options.  Red is firm, black less so and green soft.
Is this okay or should I work to wedge the pad underneath?   
Should I get clouds for the hinds as a better option as the glove will not really take a thicker pad?
Easyride makes a wedge that can fit the cloud but its 5 degrees.
Thank you

--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 

Hi Lesley,

If you can't keep hay in front of her from 2am on getting up to feed hay at 3:30am is a solid plan.  Wouldn't do metformin until your normal feeding time but others may have different opinons.

See https://ecir.groups.io/g/main/wiki/1571 for information on x-rays.




Kirsten Rasmussen
 

Once you have your xrays, Lavinia can advise you on whether heel height is needed or not.  If it's not needed, you really don't want to add it.

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


Lesley Bludworth
 

Thanks Sherry,
She used to eat every thing I gave her in just a few hours,
But yesterday, 2 hay nets of unsoaked hay for 2 horses  lasted 6 hours or so. 
Is eating slower a sign of pergolide effectiveness ?
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Lesley Bludworth
 

Thank you Kirsten.
I'll just double the pad for now then. They flatten kind of quickly.
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Eleanor Kellon, VMD
 

Reduced appetite is a side effect of pergolide. Is she on APF?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Lesley Bludworth
 

Dr Kellon,
She was on APF for the 1st 2 weeks or so.
She is eating, just not like she used to.
She used to eat everything until it was gone.
Now she comes and goes on the hay net.
Should she stay one the APF as long as she is on pracend?
I could only get her to .5 mg prascend. Even with the APF and only a 1/4 pill increase above the 5mg she would stand in the barn with her head in the corner ears back and not eat. Did that for 5 days and I couldn't stand it any more.  Dropped her back to .5mg and she was fine again.
After Saturdays ACTH test, I guess I'll know if its doing anything.
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 

The better control with appetite is more likely tied to Leptin than anything to do with a pergolide veil.  Test results will be helpful at this point.




Lesley Bludworth
 

Sherry,
I did have her leptin tested before. It was slightly higher than normal range.
I know its not recommended to test but should I see if its come down to know if thats a part of it?
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 

Hi Lesley,

Personally I wouldn't worry about it, was just adding why you may be seeing her not being so much like a vacuum when it comes to food.




Eleanor Kellon, VMD
 

What does she weigh and how much is she actually eating? No, they don't need to stay on APF as long as they are on Prascend, just until they adapt. Did she eat normally when she was on it? Saturday's test may not be reliable since we are still well within the seasonal rise. I'd wait until December.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Lesley Bludworth
 

Dr Kellon,
She weighs 1000 lbs approximately.  She is turned out with a buddy and they eat about 20 # of hay together during the day,  so Im not sure who eats more.  They are both ribby.   She gets 4 # of TC timothy balance cubes a day to take her supplements in.  He gets hay at night and 6# of cubes.
She was on Pracend in the summer and I think I got her up to 1 mg but she was not eating on it even with the APF, and with the stress of the move back to the heat and the stress of the heat and her pain was so high the vet recommended I take her off of the pracend and she did start eating again. (other vet had started her on the pracend even tho she had the equivical level but since her insulin levels where not getting into better ranges with diet and metformin)   
She went back on the pracend 3 weeks ago due to the abnormally elevated ACTH during this time of year and she took the .5mg with no issues on the APF, then when I added 1/4 pill more she stopped eating hay for 4 to 5 days.  She would eat some TC cubes with the metformin but I couldn't add anything else back in. 
She looked miserable at .75mg for 5 days and then I dropped her back down to .5mg and she was fine.  No APF at the moment.
Will get blood work for ACTH and insulin as I just started feeding non soaked hay.
Should I give her the metformin at 3:30 am or at 7AM before the bloodwork at 8?
She usually gets it at 7am

--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Lesley Bludworth
 

Sherry,  Yes that makes sense. 
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Kirsten Rasmussen
 

The pergolide really can effect appetite.  If Sophie is losing too much weight or really stops eating, backing off the dose a bit as you are doing is fine.  You can titrate more slowly (ie wait a couple weeks before increasing) or use APF a bit longer.

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


Lesley Bludworth
 

Kirsten
Okay, I am in no hurry to increase it as It wasn't just the loss of appetite that was so worrisome.  Her buddy had a pergolide veil when he started years ago but he just looked kind of dazed, didn't eat a few days. 
She looked miserable.  Head down, ears back, standing with her head in the corner of the barn like she had a headache, that was on .75mg, increased .25mg after a week on .5mg.  But on .5 mg she seems to have an okay appetite, not her old self looking for every last blade of hay but interested in food.  She is very thin famed.  She has lost weight, no more fat pads at tail but the tape measures the same from July to now.  the other day I thought she looked too thin but today she looks okay.  Where is the best place to weigh your horse? 
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 

Hi Leslie,

You can reference https://ecir.groups.io/g/main/files/Case%20History%20Tools/Tools%20and%20How-To%20Help/Horse%20Weight%20Calculator.xlsx for information on determining weight.  Beyond that the Google will give you lots of examples of how to use a weight tape.




Lesley Bludworth