Hi Everyone!
Ava's insulin and glucose are now within the normal range and TG and LDH are decreasing!  So very thankful for Dr. Kellon, this group, and my vet who was willing to give Invokana a try with my mare Ava!

Quick re-cap....Metformin did not help so we tried Invokana 300 mg on 4/11 and while she was sound within 3 days and her insulin level substantially decreased from 214 to 47 and glucose from 154 to 96 within 10 days, her triglycerides shot through the roof from 64 to 624 within 30 days of beginning Invokana.  I followed Dr. Kellon's suggestion of increasing her beet bulp and Stabul 1 and cutting Invokana in half.  More bloodwork 10 days later and her insulin was 52, glucose 104 and TG 132.  I added 10 grams of L-car and kept her diet the same and Invokana at 150mg.  Yesterday vet was here and her insulin is now 34, glucose 90 and TG 91!  TG is still high, but making its way back down.  So thrilled to see her insulin within the normal range on 150 mg of Invokana!  Woo hoo!  

She does have chronic SI and lower back pain - has for years and was kept at bay with Equioxx, chiro, and MagnaWave.  Her back soreness continues and with Equioxx off the table, I am wondering if I could hear from those that have used Pea or PhytoQuench for similar issues.  Years ago I tried Devil's Claw Plus and she broke out in hives within 3 days so I am hesitant to try that again.

Thank you all again!


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Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564

Good news, Heather!

I would ask for Dr. Kellon’s input on PEA.  I believe it interacts with the endocannabinoid system and I’ve read that she recommends not using CBD with horses with PPID.  How PEA might affect Ava’s need for pergolide is something that should be considered.  

Was the Devils Claw Plus pure DC?  DC is often combined with Phytoquench so I’d want to know whether the Plus in Devils Claw Plus refers to an additive or just more active component.  Smart Pak’s version of Devils Claw Plus contains yucca, boswellia and grape seed extract but I didn’t check other sellers.  It might not be the DC itself that caused the hives.
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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

PEA is OK.  The caution with cannabinoids is that they interact with the dopamine receptors. PEA may actually help protect the dopaminergic neurons https://pubmed.ncbi.nlm.nih.gov/29552727/ .

DC Plus does have other ingredients, including Yucca which is contraindicated anyway.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001

This is fantastic news!! How much BP and Stabul 1 are you feeding?  I want sure if the CH is updated?I am always curious s8mce I have been battling TG elevation for a while.

Thanks in advance,  Nancy :)
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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

Thanks, Nancy!  No, my CH is not updated…need to do that!  When the latest blood work was done she was on 3 pounds of b.p. (weighed before soaking) and 2 pounds of Stabul 1 split into 2 meals.  Yesterday, Dr. Kellon and I chatted via email and she said I could increase it, so last night I added a third meal of 1 pound of b.p. and 1/2 pound of Stabul 1.  Hopefully with that and giving L-car a bit more time we will see her TG drop down in the normal range.

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Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564

Thanks Dr Kellon!  How much PEA should I give?  She weighs 980.  Is there a place you recommend I buy from?
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Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564

Thank you Bonnie!  I did not know PQ contained DC, good to know!  Thanks for the link for the hemp product!
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Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564

Thanks Martha!  DC Plus does contain other ingredients so you are right, maybe it wasn’t the DC.  I have never heard of the endocannabinoid system, I need to read about that…I learn so much being a member here!  
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Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564

Haha, Heather!  You will learn a lot, but not nearly as much as I’ve learned through being a volunteer here.
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why is prevacox off the table?  
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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

 

Previcox is another NSAID.
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is this horse on a different nsaid?
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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

 

No, NSAIDs are not advised while on Invokana, too risky for kidney/liver damage.
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Heather W in WI 2022
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Ava
https://ecir.groups.io/g/CaseHistory/album?id=273564

PEA dose is 2500 mg twice a day. Get ultramicronized PEA from Elevation Terpenes.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001

I remember trying PEA years ago for jesse. Thought it did nothing. I also remember Jesse was on Preva cox with  Invokana and I don’t remember any contraindications. Has something changed?
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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

 

That contraindication has always been there and was in the materials sent to your vet. They double the rate of acute kidney injury compared to SGLT2 inhibitors alone.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001

This was the product for several years. I was using - 2500 mg per day so the 250 gram package lasted 100 days. I think a gram scale is needed for correct dosage. Packages contained very fine fluffy lightweight material and heavy weight lumps. At other times I would use human use capsules of micronized Pea (7 capsules of 400 mg each). Whether there is a difference between Pea that has not been put through the micronised or ultra micronised process is debated.  In any case I found it difficult to say if it was helpful as the pain levels in my mare are so difficult to ascertain due to DSLD and arthritis. As in some meds, such as Ambien (or physullum) they no longer become effective because the underlying issue has not been resolved and the body gets used to them but after laying off them  for a while they again become effective for a time. Would this be true of PEA? She was on PEA from Feb.2022 to May 2022. Will probably wait a month or so before starting up.
I wish I were more observant but know this. Devil's claw worked. Now if only I could get her to take it. I saw positive results from ashwagandha in a brighter and more alert attitude. Also added 1 teaspoon of Triphala and noticed improvement in manure -more moist.
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- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382

Frances,

Have you tried a liquid, like https://emeraldvalleyequine.com/product/btb-plus/ ?

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Eleanor in PA

www.drkellon.com 
EC Owner 2001

Thank you Dr. K. for the tip. No I have not tried any liquids. Looking at Emeraldvalleyequine product (devil's claw and hawthorn) it would take 75 ml twice a day for my girl's size. That would mean a syringe of at least 80 cc. Too big for my hands to manage. She's being so good with my 6 cc syringe for the Prascend that I don't want to mess that up.
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- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382