Latest x-rays and episode - Zahr the enigma
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Mikaela Tapuska
Hi all,
My Arab gelding Zahr is coming up on 25 this year and was diagnosed with Cushing's in November 2020, which we discovered when he experienced a bout of laminitis (x-rays at the time showed 11-12 degrees rotation, about 5mm of sole depth and some sinking). I'll give a brief history and skip many details for now, because he has had a lot going on since. He had another episode last summer in June with worsening of rotation and loss of sole depth, and a flare up of foot pain in November 2021 although we caught it right away and he bounced back reasonably quickly. X-rays from November showed no worsening of coffin bone rotation or loss of sole depth - for the latter, it was actually the best his x-rays had looked since this all started. With the transition of winter to spring and the freeze/thaw cycles, he has pulled up lame occasionally over the last couple of months, but always unilaterally on his left front without "his" classic symptoms for laminitis (he has not presented normally for laminitis right from the get go). First it appeared to be his shoulder, then a few weeks later it seemed to be a sprain in his lower LF with a little bit of heat and swelling in his medial pastern. I'll briefly make note that he has gone out all winter in his Soft Ride boots to protect his soles, but he is quite arthritic and does not have the muscle mass he used to so tends to hurt himself with the mud and ice right that are prevalent right now. My farrier hoof tested his left front 3 weeks ago (March 21) just to be safe, and Zahr didn't flinch. He was a bit sore immediately after his trim, but I chalked that up to his still sore left front leg and having to hold his legs up for a while as my farrier worked on him. Over the weeks he showed continual improvement in his movement, and his attitude remained bright and perky. I treated his lower left front as though it was a sprain and iced his pastern after our walks to reduce inflammation, and he responded really well to that. Last Monday (April 4) we did some more x-rays on him to see where he was at, and he got his strangles intranasal vaccine that day as well but no others. The vet checked his digital pulses and was not pleased because they were up, although they have persistently remained up since his first episode back in 2020 (I did try jiaogulan and PEA last summer/fall but had to get him back on previcox for arthritis pain after his Nov flare up). When he used the hoof testers, Zahr was very responsive on both fronts, the right slightly worse. And sure enough, the x-rays show we are right back to where we started with about 4-5mm of sole and approximately 15 degrees of rotation. I am totally at a loss right now, because he didn't present in any way that would have indicated his feet were in such a state. He's had the occasional tender day, which I'd expect as his feet heal and the weather bounces around, but nothing indicating another episode to this degree. My farrier was shocked when I sent her the x-rays, as well. Zahr's been on bute since the 5th to hopefully prevent the onset of a full-blown episode, and the farrier was out on the 8th to trim his feet according to the new set of x-rays. We tried putting shoes on this time as well, because she didn't think she could trim him as aggressively as needed and still have him remain sound if he was barefoot. She used a bar shoe with a pad and a pour-in gel frog support. Zahr stayed on bute to get him through the new change and did well the first day and the next two, but today is quite sore again. Whether it is simply a response to the change that will pass, or if his feet don't like the shoes is not known yet. Apologies for the lengthy post above, he has a lot of history and this latest change really does not make sense. Zahr's diet and meds are as follows: 1st cut brome mix grass hay (tested and within the realm of safety for sugars and starch), 1 cup of Nutrena SafeChoice Special Care with a bit of drained beet pulp 2x daily to be a carrier for his supplements, 1/2 scoop of Mad Barn's AminoTrace+ to balance microminerals, Spirulina, a double dose of Equine Choice probiotic, 1 cup of soaked psyllium husk (fed 1/2 am and 1/2 pm), 2 tabs prascend in the AM (via syringe) and 1/4 tab previcox. The probiotic and psyllium are for FFWS that has been an issue since October and we have struggled to get under control since. We last tested his ACTH levels in October and they were at the high end of normal, which was positive in that they were within normal range given the seasonal rise. The one thing that has been a concern as of late, however, is his white blood cell count - we did a general blood panel when he had his flare up in Nov to check kidney enzymes, and there were a few things slightly off but most notably his WBC were low. The vet said that may be due to an immune response to the flare up, not to be alarmed yet and to recheck in a couple of months. We re-tested at the end of January and his WBC count was even lower. I have yet to go ahead with internal diagnostics (ultrasound and rectal palpation) but am worried that it is something like cancer, which could explain the persistent FFW. But could something like that be why his feet continue to degrade, if there is a chronic underlying condition causing systemic inflammation? That's just a guess on my part, I don't have an official diagnosis yet, but it is the best I can figure seeing as he has no other obvious triggers. He is off the previcox for now while on the bute regimen, and I had hoped that I could transition him off the NSAIDs and onto PEA and jiaogulan again come summer when his arthritis tends to be more manageable. Is PEA something that can be given at the same time as an NSAID to help with the pain? I avoid mixing any painkillers, but with how he is today not seeming to do well on the bute I don't know if it would be worth a shot or not. I'll get a full case history uploaded, but for now these are the pressing issues that we are dealing with. Any help would be much appreciated. Is there something that we missed that could be setting him off? Thank you, -- Mikaela Tapuska in Calgary AB, 2021 |
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Milaela,
You will get a formal welcome soon but we need you to organize all his details in a case history. One thing that jumped out at me was the idea that bute - or any other NSAID - could stop an episode. It can't. The long term NSAID use could easily be why you have a problem with FFW. They cause colitis. I don't see any mention of his insulin. Is it being followed? That's what causes the laminitis. -- Eleanor in PA www.drkellon.com |
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Bobbie Day
Hello Mikaela,
Welcome to the group. Since you are a new member, and this is your first post I will be sending along your welcome message. Fair warning, there is a lot to read, so get comfortable and take your time, you can refer back to it if you keep it handy (as I still do). The blue hyperlinks will take you even deeper into the subject for more information as well. The ECIR's group's philosophy is DDT/E stands for Diagnosis, Diet, Trim and Exercise. I will try to address your questions but please know we have many experienced mods that will also offer their advice and guidance. It sounds like you have been diligent about testing Zahr, which is great because Arab's are one of those breeds that predisposed to IR and Laminitis. Please be sure you add all your lab results, x-rays, and pictures in your case history so our hoof experts can take a look as well. I do have a few questions Do you wrap his legs and cover his feet when it's cold? Anything below 50deg can be a problematic and cold induced laminitis is something we want to avoid; you can put socks on him while in boots and lined shipping wraps to help with that. You don't mention if his insulin was tested? High insulin could be driving his pain up as well. We don't advise keeping a horse on NSAIDS for pain relief from laminitis as it is not inflammatory. It's best to get off those and feed the Jiaogulan instead. BUT only if his trim is in order. You can also try LaminOx from Uckele. We don't recommend J-herb for a shod horse since it will require a more frequent trim. Uckele Health & Nutrition LaminOx 3.3 lb I'm not sure about shipping to Canada but I think other Canadian members are able to get it shipped. Pain Relief Alternatives to Bute and Banamine (groups.io) Is there a chance he could have an abscess brewing in that LF? If so, he needs to be off the Bute as that will delay the healing process. I really do understand your concerns about discontinuing the NSAIDS, I was in the same boat. But I used this product from Uckele and added additional Devils Claw for pain relief. If you need to give a pain reliever to make him more comfortable for a trim, then give it to him but it won't help with Laminitis. Uckele Health & Nutrition Phyto-Quench Pellets 5lb Just be sure to get the pellets not the powder as we don't advise using Yucca for our IR horses. When you say, "Low end of Normal" for our "normal" we want the ACTH to be in the teens or low twenties at most. Also, if he is having a hard time building sole it may be that something from his diet is missing. Has your hay been tested? Have you tried soaking his hay to see if that helps? Do you rinse/soak/rinse his Beet Pulp? Pergolide 101.pdf (groups.io) Laboratory Reference Ranges are NOT the Same as Normal | Dr. K's Horse Sense (wordpress.com) We want to be sure your numbers are good BEFORE going into the seasonal rise, you can always go back down afterwards if his tests indicate he has been controlled during the rise. Often Laminitis is a sign that they're not being controlled at their current dose. We advise dosing based on test results and Symptoms. I would stop the Nutrena right away and try either more beet pulp, Stabul-1 or something in our list below. Safe Feeds List and Sources - Google Sheets I will let others address your concerns about his blood work and x-rays but please let us know if you have any additional questions. Hello Welcome to the group! The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time. Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck. Orienting information, such as how the different ECIR sections relate to each other, message etiquette, what goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.
DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each. PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose. The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating". In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk *Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols. *Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions. No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:
We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. *Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it). The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine (look under the Hay Balancing file if you want professional help balancing). If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers. There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals. We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult. TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment. Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs. EXERCISE: The best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.
There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better. For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources. If you have any technical difficulties, please let us know so we can help you. -- Bobbie and Maggie Desi (over the rainbow bridge 7/21) Utah, Nov 2018 NRC Plus 2020, NAT, C&IR March 2021 ECIR Group Primary Response https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie https://ecir.groups.io/g/CaseHistory/album?id=271156 https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi https://ecir.groups.io/g/CaseHistory/album?id=78821 |
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Hi Dr. Kellon,
Zahr's case history is uploaded now, I filled it out to the best of my ability right now but there are a few details that I am fuzzy on so will have to update later. Also working on getting x-rays uploaded. I've not done any insulin tests, just the ACTH and general blood panels (also done to rule out infection when he had his first episode). But if laminitis is Cushing's related, and the meds are controlling ACTH levels, is IR still something to be concerned about? I thought that controlling the ACTH also controlled the insulin in a Cushing's case. Zahr has never been overweight since I've had him (17 years), and is kept on the leaner side now just to be cautious, approx. 4.5/9 BCS I'd say. His microminerals are balanced in his diet, so iron overload shouldn't be triggering it. And protein and sugars/starches in his hay are within safe levels to avoid an increased insulin response in a PPID horse (I can get the hay test uploaded to his case history, as well). I'll certainly look into it, it just wasn't something I expected would be an issue given the above. Re: the FFW, that would make sense and he has been on previcox a long time for arthritis. Although he did get a break from it for a couple of months at the end of summer/early fall in 2021, and that is when the problem was first noticed and gradually worsened, so the timing is a bit odd for that. He was on antibiotics 3 or 4 times last year too, for a stubborn sinus infection, so that certainly wouldn't have helped things. Is colitis something that can be resolved with proper management? Thank you! -- Mikaela Tapuska in Calgary AB, 2021 Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr |
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You have an Arabian, so high risk for EMS without PPID. The genetics haven't been completely worked out but let's say there is possibly "smoldering" IR pushed over the edge by PPID. In any case, diet control is essential in addition to pergolide. Being overweight is not the most common manifestation of IR. Laminitis is. Does he have a crest? Can you post some photos of him.
Did his diet also change end summer/early fall 2021? You're right that courses of antibiotics could also have compounded the FFW. Yes, colitis can be resolved. P.S. You need to get insulin tested! -- Eleanor in PA www.drkellon.com |
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Mikaela Tapuska
Hi Bobbie,
Thank you for the welcome info! I just uploaded some more files into Zahr's case history, so all of his x-rays and many photos of his past and current trims are up. Regarding your questions: Do you wrap his legs and cover his feet when it's cold? No, if we had gotten a lot of snow this year I would have gotten him some boot socks to try and keep snow out and his feet dry, but as it was it was a reasonably dry winter I didn't wind up doing that. He comes into a stall overnight so he does get a nice break from his boots and the cold. Would you recommend wrapping from the knee down in cold weather? You don't mention if his insulin was tested? It wasn't, only ACTH. But I will certainly be looking into getting that tested asap! Is there a chance he could have an abscess brewing in that LF? My farrier and I wondered if that was the case when she was out a few weeks ago (the day she hoof tested him). There was nothing picked up on his most recent x-rays, although I don't know if that rules one out or not. When you say, "Low end of Normal" for our "normal" we want the ACTH to be in the teens or low twenties at most. I don't have a copy of the lab results, but my vet told me his ACTH levels were about 10 picomoles (we have been aiming to keep him at 10 or less). I'll contact the clinic for his ACTH labs so that I have the actual numbers to share with you. Has your hay been tested? It has been, I just uploaded it to his Case History earlier today! Here is the link: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr/Hay%20Analysis%20-%20Aug%202021.pdf My calculations based on the results gave me NSC of 8.4% and an Fe:Cu:Zn:Mn ratio of 43:1:4:11 - the latter has been balanced with MB AminoTrace+. As fed crude protein is 9.4% so should also be within a safe range for him. Have you tried soaking his hay to see if that helps? We did try soaking his hay when he had his first episode, as his vet recommended we do so until we knew what the cause was. Unfortunately he won't touch soaked hay, so we have given up trying to get him to eat it. Do you rinse/soak/rinse his Beet Pulp? No, the best I could get was the water drained out of the beet pulp (he is boarded out, so I am not the one feeding). I know that is far from ideal, nor is that a good excuse for doing so, but I thought he'd be okay with that if his ACTH levels were controlled since he gets a very small amount daily. Perhaps back to the drawing board with that one... Interesting you say that with the Nutrena, and I do believe I remember something in the forums about that feed potentially having higher sugar levels than listed. He had been on a small amount of Hoffman's Senior feed prior and my vet recommended I switch him to this one. But Nutrena has stopped making it, so we were actually looking at getting him onto timothy pellets instead to hopefully help with his FFW and ideally eliminate that little bit of added sugar to his diet. I'll look into the feeds you have posted in the Safe Feeds list. I did forget one supplement in my initial message, and that is MSM. I remember reading about glucosamine being converted into simple sugars once in the body, so not to feed that to metabolic horses, and I think there were issues with MSM too but again thought that if his ACTH was controlled he'd be fine to take it. So will definitely get him off of that and onto some Devil's Claw. Does the group have any recommendations about a reputable company to go with for that particular herb? Additionally, are there any drug interactions to worry about for that one, and how long do the NSAIDs need to be out of his system before starting on it? Replying to Dr. Kellon: No crest, and I only have older photos of him right now so I'll get an up-to-date one to add to his album as soon as I can. His diet did not change then, the 2021 shipment of first cut hay that he eats arrived in June - though the 2nd cut that a lot of the horses were switched to in the fall did seem to cause a lot of GI upset, and there are still some that seem to be having wet farts more than they used to (not to his extent though). I think they came from the same field, which begs the question if perhaps the hay was sprayed with something, or if it was near another crop that was sprayed. Another 25 year old Arab (an EMS mare) was diagnosed with FFW at the same time, although hers came on more aggressively in August the timing for both of them is a strange coincidence. The only other thing that may have been off at that time was water, for so many horses to be affected, as it was a dry, hot summer so perhaps the water tables were low and nasty things started growing in there. I'll keep adding things to his file, and will work on getting that insulin test done! Thank you both for your help with this so far. -- Mikaela Tapuska in Calgary AB, 2021 Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr Photo Album : https://ecir.groups.io/g/CaseHistory/album?id=274255 |
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Sherry Morse
Hi Mikaela, If it's below 40F (10C) we recommend wrapping legs and keeping boots on horses that may have winter laminitis. That's true if they're inside in a stall as it's the temperature that causes issues, not just their location. Your hay test was done via NIR not wet chem so the numbers for ESC+starch can possibly be off by as much as 30%. Can you have the current batch of hay tested using wet chem or source the timothy balance cubes to use instead so you know he's eating below 10% ESC+starch for sure? The other option would be to soak the hay, let it dry and offer it to him that way. You can rinse/soak/rinse beet pulp ahead of time and bag it up to be fed as needed - if there's a fridge or freezer at the barn this makes things easier as it will keep in either for a longer period of time than having to do a fresh batch daily. You can read about changing from NSAIDs to Devils Claw here:
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 https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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You mentioned a low water table. Minerals get very concentrated under those conditions, including toxics.
-- Eleanor in PA www.drkellon.com |
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Mikaela Tapuska
That's a great idea for the beet pulp! Will do that. Not sure if I'll be able to source the ON Dehy timothy balance cubes though, as it sounds like they are pretty expensive to get here in AB with shipping across the country and different regulations/insurance between provinces. But I'll keep looking for them, in the meantime we may have to go with timothy cubes that can be sourced from closer to home. And I'll give that a shot with soaking and drying his hay, hopefully he'll eat it if it's been dried.
How do you tell on the hay analysis that it was done via NIR and not Wet Chem? That is a worrying potential difference in sugar content... Thank you! -- Mikaela Tapuska in Calgary AB, 2021 Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr Photo Album : https://ecir.groups.io/g/CaseHistory/album?id=274255 |
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Sherry Morse
Unless something has changed Dairy One only does NIR testing. Equi-Analytical does both but we always ask people to request Wet Chem as it's easier to know the numbers are correct.
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 https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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Dairy One has always done wet chemistry in addition to NIR. Wet chemistry is only used for fiber, protein and carbohydrate fractions. Minerals are always done wet chemistry.
-- Eleanor in PA www.drkellon.com |
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Mikaela Tapuska
This is the website from the lab I went with, they ran the 603 "Equine Trainer" forage analysis - https://sites.google.com/nutrilytical.ca/home/forage-testing/current-pricing
So then it sounds like those numbers should be accurate, if I'm reading that correctly? -- Mikaela Tapuska in Calgary AB, 2021 Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr Photo Album : https://ecir.groups.io/g/CaseHistory/album?id=274255 |
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Thanks, Michaela. The fine print at the bottom says the 603 is sent to Equi-Analytical/Dairy One in NY. Makes total sense because that is the test number we recommend when you send your samples directly to the lab in NY.
-- 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 |
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Lecia Martin
Hi Mikaela: You can get the Timothy Balance cubes at The Mill Store in Okotoks or from Feed Store to your Door in Edmonton. I get them by the pallet from Okotoks. Hope that helps.
-- Lecia Flyte and Flame Alberta, Canada |
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Mikaela Tapuska
Alright, I've gotten a couple other things uploaded tonight that may help out. Here is the link to Zahr's bloodwork for ACTH (also hematology/chemistry and serum iron from way back in Nov 2020): https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr/Zahr%20ACTH%20-%20Nov%2024,%202020%20to%20Oct%2012,%202021.pdf
It's in reverse chronological order, so the 1st page is his most recent ACTH test results and the original ones are further down the document. Dr. Kellon, there is a current picture of Zahr uploaded to his photo album now: https://ecir.groups.io/g/CaseHistory/photo/274255/3416174?p=Created%2C%2C%2C20%2C2%2C0%2C0 Switching back to the topic of Devil's Claw, even the Uckele DC pellets seem to have yucca listed as the first ingredient. One of the local stores here carries a straight devil's claw product, so I ordered that to try for Zahr. It's from the company Basic Equine Nutrition and is recommended to be fed at 25g 1-2x daily. It should be in by Wednesday next week; in the meantime, I am going to leave him on the previcox until I have the DC to get him switched over - going without anything right now for his other aches and pains would be too much for him, I think. He is off the bute, but even at a 1/4 tab of previcox seemed pretty uncomfortable again... Can cessation of bute cause a rebound effect in terms of pain, if they are on it for a while? I am hoping that may be the case, and that it'll only be a day or two for him to get it out of his system. The weather also turned horrible at the beginning of the week, so that very well may be contributing to his discomfort. I'll bring out some leg wraps to try with him tomorrow and see if that helps him during this cold snap. If it turns out the Devil's Claw alone is not adequate to take care of his joint pain, can PEA be fed in combination with it? And if so, would it still be at a dose of 3-4g 2x daily? Lecia, that is really good to know, thank you! So maybe a silly question, but do you order it from The Mill Store, or from ON Dehy directly and they arrange for it to go to the store? I ask because I called right away after I saw your message, but the lady I spoke to wasn't familiar with any of the ON Dehy products and said they didn't carry them. Not sure why, but I'll try again to see if I can catch the owner or someone who may know a bit more about those feeds. Lastly, Zahr has an appointment to have his insulin and glucose levels tested on April 25th, so hopefully that will give some answers. Thanks everyone, -- Mikaela Tapuska in Calgary AB, 2021 Case History: https://ecir.groups.io/g/CaseHistory/files/Mikaela%20and%20Zahr Photo Album : https://ecir.groups.io/g/CaseHistory/album?id=274255 |
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Sherry Morse
Hi Mikaela, Zahr's trim shows his toes are still too long and he has no sole to speak of so it's no real surprise he's as sore as he is. There's a limit to what medications of any sort can do in these cases which is why we recommend boots and pads for comfort and a trim that brings the toes back to correct alignment so there are no mechanical issues going on. As far as the DC pellets the amount of yucca in them should not be an issue. We have many horses here who use them with no ill effects. You can definitely see a rebound effect from stopping NSAIDs which is why we suggest weaning off of them. Previcoxx is also a NSAID though so just keep that in mind. You can read more about that here:
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 https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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Mikaela Tapuska
Thanks Sherry, that is good to know and I will ask my farrier about changing that when she is out. She's been fantastic through all this and has brought Zahr a lot of relief. We may very well wind up going back to boots too,, depending on how he responds to the shoes. |
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Hi, Mikaela. That one sample had very high ESC. The iron content is also high. I’ve been feeding lots of it for about a year and wouldn’t dream of feeding it without RSR. Quality changes from mill run to mill run. Dirt settles into the bottom of bags. You can review more analyses of BP in that folder. Speedibeet does provide a guaranteed analysis assuring a safe level of ESC. Speedibeet does have a level of iron that can be reduced by RSR. |
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Bobbie Day
Yes I second Cass, I also feed everyday to four horses and it definitely needs extra rinsing it can and is usually pretty dirty.
-- Bobbie and Maggie Desi (over the rainbow bridge 7/21) Utah, Nov 2018 NRC Plus 2020, NAT, C&IR March 2021 ECIR Group Primary Response https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie https://ecir.groups.io/g/CaseHistory/album?id=271156 https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi https://ecir.groups.io/g/CaseHistory/album?id=78821 |
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