Date
1 - 20 of 26
Updated Files for Ponies #photo-notice
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Mialisa@...
Hi I have also added photos for Joshua's trim and am asking for help with the toe. Should I take it back more? I think I have his break over better because he is walking almost heel first barefoot consistently (which used to be only booted). |
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Mialisa@...
CaseHistory@ECIR.groups.io | Files
CaseHistory@ECIR.groups.io | Files Try these links. I will check on this later to see if I uploaded them correctly or missed a step. This sure is an enigma?! -- Rene` in WI 2021 https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Mialisa@...
OK...I have added the Case histories to the links below.
-- Rene` in WI 2021 https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Sherry Morse
Hi Rene, Please add the link to your photo album ( https://ecir.groups.io/g/CaseHistory/album?id=273978) to your signature. Also please see the directions in the Wiki for taking the most useful pictures (https://ecir.groups.io/g/main/wiki/1482#Photos-and-Hoof-Evaluation-Help). At a glance you still have a good deal of toe to remove but clear pictures would be best for a full evaluation. Can you also please post pictures of both ponies. At 10 hands and about 400 it's not likely either of them is too thin. Is Isaac on Prascend? If not, he needs to be. If he is, he needs more. Are they being fed hay with alfalfa in it? If so, you would be better with a straight grass hay or feeding them the Timothy Balance Cubes in place of hay. Are they still eating the Dumor product? If you have the diet as tight as it can be both of them are candidates for Metformin but I would get Isaac started on Prascend now and see if that has any effect on his insulin levels as well since he is PPID as well as IR.
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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Mialisa@...
Hi Sherry,
Thank you for all the info. I have added the link to the photos for Joshua to my signature and added his body photo to the album. I apologize for the quality of the photos. I have long suspected that my phone does not give the best quality. If you have any tips that would be great. I did recently read a response on facebook suggesting taking photos from further away and then cropping them. I will try that with Isaacs photos and try to get those uploaded as soon as I can. Does before and after trim photos help? I have 2 horses besides the ponies and I usually trim one per week, so a four week schedule. Unless something upsets the apple cart!! Their height at 10 hands is truly a guess. I will double check that. But neither of them are fat, and do show slight rib. Isaac is not on Prascend. Last year the Vet said he does not have Cushings as she usually sees the numbers in the thousands for ACTH. So nothing further was done and diet alone has been the work in progress. Yes, they are being fed hay with alfalfa in it. The Hay in itself is such a long story. The hay I bought first did not go over well and I had to search for different hay last fall. When i found the current hay that they are on the supplier said no alfalfa, but I kept asking and he said it was a newly seeded field and the feed mill could tell me exactly what was in it. By that time I had already tried the ponies on the hay for a week and saw improvement in them not being foot sore or stiff and I bought enough tor the winter. The supplier said with it being a new seeding there was not much alfalfa. Either way the ponies have done well on the hay over the winter. This year I will put more effort in finding all grass hay. I have found a supplier that does multiple fields with different mixes and two of those fields are with out alfalfa. As a side note I did try a week of those when I was searching last fall and I didn't see an improvement in the ponies. They were still foot sore and stiff. As a scientist I do wonder if maybe I did not give the hay enough time to see results as I only bought enough for a week to see how they would do. TSC did run out of the Dumor product so we have switched to the Stanley timothy pellets. Could you give me a little more detail about why Isaac is PPID? My vet appointment is early May so I will discuss with her, but I would like to be prepared. I have read all of the articles and will probably read them again on the website for EMS and PPID. Isaac has no other symptoms. He sheds out every year and he doesn't drink more than Joshua or urinate a lot. He has always been the same. BUT he has always overgrown his feet and really does grow quite the heavy coat in the winter. His Body photo is here. I will move this to his Photo album when I get the photos of his feet. CaseHistory@ECIR.groups.io | Album I can't tell you how much I appreciate the help. -- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Sherry Morse
Joshua is very cute and while he's perhaps a bit skinnier than some people would like to see, until you have his feet under control that's better than him being overweight which we see in a lot of horses. If you'd like help with the trim follow the directions in the Wiki and post pictures at least 10 days before a scheduled trim so Lavinia has time to get markups done for you. Redoing the pictures after trimming can help you see if you've actually trimmed as much as you needed to do. The one a week schedule sounds reasonable to me although sometimes you can do more by doing small, frequent trims when the feet are really in need of attention. I'm a bit shocked that your vet thinks that levels above the Cornell reference range are not a reason for treatment. Short version - ACTH is the only hormone that's used for diagnosing PPID but it's not the only one involved and usually by the time it's high enough to be an issue the others are already up. The curly hair coat is a late sign of PPID, not an early one so waiting to treat until that's seen is again waiting too long. IMO a vet that's waiting to treat horses until she sees numbers in the thousands is doing a huge disservice to the horses who are in the early stages of PPID which is a progressive disease. Any horse with an ACTH level over 35 now - which is time when you'd expect to see numbers at their lowest - is going to have an even more extreme rise in the fall and likely to develop fall laminitis. Were this my pony I'd be having a frank discussion with the vet about treating sooner rather than later and the fact that elevated ACTH can drive up insulin in some cases and since Isaac's insulin is already over 200 AND he's laminitic something needs to change on that front. You can read up on this at Cushing's Disease / PPID | ECIR Group, Inc. (ecirhorse.org) and the associated links. The hay you're currently feeding has alfalfa which many IR horses can't handle and is 9.7% ESC+starch which is under our 10% cutoff but also can be too rich for many horses. If you're not already soaking it I would try that and I would definitely try to source straight grass hay. Again, if you can source the Triple Crown Naturals Timothy Balance Cubes you can use that instead of the hay (at a 3:4 ratio as the cubes are more calorie dense). Using Stabul-1 or rinsed/soaked/rinsed beet pulp as a carrier for minerals would be better than using timothy pellets which can be an unknown ESC+starch. The reason both ponies are sore is because their insulin is well over the level we see laminitis developing at so that needs to be brought down. The first step to doing that is tightening up the diet and getting the trim optimized to eliminate physical pain. If diet changes alone don't bring insulin down we recommend using Metformin. For Isaac who is clearly PPID you also - again - need to get his ACTH down to the upper teens/low 20s which means he needs to be on pergolide (Prascend).
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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Hi Rene,
I took a look at Isaac’s case history and the ACTH for the two tests you ran, this year and last, were both elevated. In order to be considered normal, the ACTH needs to be about mid way in the reference range or high teens to low twenties. Isaac’s levels for both tests exceeded the reference range. We have seen a few horses with values in the thousands but most people seem to recognize the problem before the ACTH gets that anywhere near that high. Inappropriate shedding is one of the signs of PPID that comes later at a more advanced stage of the disease. -- 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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Mialisa@...
On Thu, Apr 14, 2022 at 12:27 PM, Sherry Morse wrote:
So much information. Thank You Sherry, Joshua appreciates the compliment. I have spent so much time adjusting their diet the last 1.5 yrs and they are definitely doing better. I will definitely source straight grass hay this year. I will see if our TSC has the recommended diet changes. I found out the Vet we had last year is no longer in our area. The Vet we are working with now is an independent that we have worked with in the past. I have never discussed the test results with her. Still, I want to be prepared. Thanks again so much!! -- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Mialisa@...
Thank you Martha! We will be having a discussion with the Vet in early May.
-- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Mialisa@...
I am re-reading the articles on PPID with more than a casual interest now. I have a question: Would Chasteberry be an option for trial before going straight to pergolide?
Asking this in reference to this commment: "The conclusion was that Vitex agnus-castus was not a substitute for pergolide, but could provide symptomatic relief in mild cases of PPID." Would my pony Isaac be considered a mild case? OK two questions :). -- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Mialisa@...
Sorry, I should finish reading an article before jumping on the horse. Thanks anyway!
-- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Sherry Morse
Hi Rene, No, Isaac is full blown PPID and the only treatment that will stop the tumor from growing is pergolide. More recent studies have found that Chasteberry can interact with pergolide so we do not recommend using the two together.
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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Mialisa@...
I have texted my Vet and she will get Isaac on Prascend at our May visit and do a TRH response test on Joshua. As always thank you for your help!!
-- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Super, Rene. That speaks favorably on behalf of the vet’s judgment so, imho, I would call that a win.
-- 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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Mialisa@...
Seriously, I think way too much! I have another question. Would it be possible that the high IR is driving up the ACTH? Then the real reason the Insulin is high would still be a mystery. Obviously I am not a vet. Just overly analytical.
I have had these ponies since they were 6 months old. 90% of the time they are good, so when they have gotten sore in the past, I question everything that I did for them. Most often I was over feeding their hay and when it was reduced by .25 pound increments until I saw an improvement then that is where we stayed. I used to, of course, guess that they weighed 500 lbs. and they have never been with out a meal. I. just. couldn't. do. that. All this winter they have not been sore on this hay and I think that is because I am finally feeding them according to their true weight with hay that does not bother them. Thank you so much. -- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Sherry Morse
Hi Rene, Elevated ACTH can drive up insulin but we have not found it to work in the other direction. IR in ponies is not rare as they are bred to be thrifty doers and not supposed to be eating a lot of supplemental feeds. Once they're old enough to have PPID that can drive the insulin higher than it would be otherwise.
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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Mialisa@...
Thanks Sherry. I wish we would have known all of this sooner. I have been searching for answers for so many years.
Speaking of breeding. I used to board by an old school Cowboy, who was a professional trainer all his life. He always kept a small herd of Shetland ponies for breeding. Six mares and one stallion. All of them foundered from that herd year after year. He was always bringing ponies in to help them. So I know my ponies did genetically earn their problems. I would help halter break the weanlings so he could sell them every year. Most of what I learned to care for my ponies was from him. So...knowing that it is a genetic problem still leads me toward EMS. -- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Mialisa@...
Hello all you wonderfully helpful people. Both Joshua and Isaac have been started on Prascend. Isaac was recommended at 1/2 tab and Joshua at 1/4 tab. I still have Isaac at 1/4 tab and his disposition has changed. He is back to his pushy little self. He also is walking very well and is even known to kick up his heels, trot and canter in the round pen on his own initiative. My Vet has recommended waiting 4 months to retest ACTH (September) before the seasonal rise. Joshua has just started his dosing. What determines the dosage? Could Isaac remain at 1/4 tab?
-- Rene` in WI 2021 CaseHistory@ECIR.groups.io | Album https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Isaac https://ecir.groups.io/g/CaseHistory/files/Rene%60%20and%20Joshua |
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Sherry Morse
Hi Rene, You can retest ACTH 3 weeks after reaching the target dose. Waiting until September (which is the height of the rise) is NOT a good idea as at that point you would be 'chasing the rise'. The idea is to have ACTH well controlled before the rise, not trying to play catch up by trying to bring elevated ACTH in line in the fall. Prascend dosage is not based on the size of the equine but on the amount needed to control ACTH. With Isaac's ACTH already having been elevated in prior testing and quite a bit higher this year I would think he will need to be on a minimum of a .5mg/day dosage but possibly he may need a 1mg/day dosage. If he were mine I'd get him to at least the .5mg dosage and then retest 3 weeks later. Once you do that test you can make a decision then on whether or not he needs a bump up to a full pill per day (1mg). Do keep in mind that we want to see a PPID positive equine with an ACTH in the upper teens to low 20s outside of the seasonal rise to consider them well controlled. If his next test comes back at 30 that would indicate you're on the right track but still need a dose increase.
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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