DR KELLON &/or LAVINIA please - no hope for DIXIE?
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I have sent several messages over the last couple of months yet cannot find them when I search terrie and dixie so not sure what is happening to them as they appear on the main ECIR groups.io listing that I receive several times a day, and on occasion I do not receive a response from the group, but that is of minor importance as I have now received two reports over the past week from an equine veterinary farrier and also from a rehab facility, both of which advise that there is no hope for Dixie. I forwarded a section of the report from the veterinary farrier with my last message to ECIR asking for input, and I am now forwarding the report from the rehab facility, because while I do not think Dixie is improving, I have not noticed a drastic change in her either. The report I forwarded to ECIR last week was requested by my own vet and based solely on the latest rads and nothing more, and he blamed my trimmer. I then sent all of the information regarding ECIR diet and protocols I have followed plus latest rads and hoof photos to a well respected rehab facility in another Australian state who provided a very insightful response. I would be most grateful for input from Dr Kellon or Lavinia regarding the prognosis of both the veterinary farrier from last week and the rehab facility that appears below. I apologise for the length of this message but I simply have nobody else to turn to now.
Hi Terrie,
I hate to be the bearer of bad news but if we compare this to many other cases we have dealt with over the last 15 years, we feel after reviewing the radiographs there is no possibility of recovery. The pony has sunk and rotated and there is no chance of growing back a proper connection. There is also substantial bone loss, and this is often ongoing in advanced cases like this.
You have been getting assistance and advice form the ECIR group and we respect and admire these people. The medications tried are often very effective with other cases but have not arrested your ponies downward demise. The reasons why could be a multitude of things. But most likely the tumour is not under control. Often this is genetic and often some bloodlines do not live as long as your pony has.
Your dietary advice I do not agree with for many reasons and in initial stages of laminitis I could have definitely helped you but it is too late to remedy this in this case.
Just in case you have other ponies I will let you know that the jury is currently out on just feeding Teff hay on its own as it is a single species (cropped with spray and mineral deficiencies over time). Although if it is grown and harvested under the right conditions, it is a low NSC hay and as it is less palatable horses take longer to eat it. But it is high in oxalates which bind calcium and prevent horses from absorbing it. In your area Teff would also increase the oxalate load your horse is already getting from the C4 grasses where you live. You can’t just feed some Lucerne hay to counteract the low calcium, as the oxalates will bind the calcium in the Lucerne. You would need to feed them a few hours apart. Teff is also low in minerals esp calcium and magnesium and does not have enough protein (poor quality protein for horses) required for body protein synthesis. You could feed some teff but not as the sole ration. A positive is that it is naturally alkaline. A negative is that teff is +ve for Synephrine which is a stimulant to increase HR and causes vasoconstriction. This is a Banned Substance (Specified Substance*) on the FEI's Equine Prohibited Substances. You really need a mixed native pasture hay or a mature dryland hay with cocksfoot/phalaris/ bromes/bent grass/sweet vernal and native species. Weed, dust and endophyte free...
In regard to your trimmer, you can’t fix in the feet what is not coming from the feet so there is no remedial trimming that will help this pony. Terrie H in Australia 2021 Case history: https://ecir.groups.io/g/CaseHistory/files/Terrie%20and%20Dixie https://ecir.groups.io/g/CaseHistory/album?id=268416 |
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Hi Terrie
I feel for you in this very difficult situation and it sure looks like you are working so very hard to do everything you can for Dixie. Just a quick note to say that I could find your posts by searching "Terrie" instead of "Terrie and Dixie". Also, I am currently trying to support my mom's foundered pony Jack. He has pretty bad hooves and x-rays as well. In addition, he is fed only teff hay and was recently started on Metformin, so am interested in the replies you receive from others. Take care! -- Hilary and Amika Prince George, BC, Canada Joined July 2019 NRC+ proficient grad January 2022 Amika's Case History Folder Amika's Photos Folder Jack's Case History Jack's Photos Folder |
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Terrie, I don't know of any analyses of teff hay that show high oxalates. There is one published study on Feedipedia of teff straw. I'd be asking the facility to provide you with proof that all teff has high oxalates.
I feed tested teff hay and it has never been low (as in, not meeting daily requirements) in calcium or magnesium--some batches do need extra supplemental calcium to balance to phosphorous. Plus I do feed a bit of lucerne to Indy, who tolerates it, and Dangles gets other calcium supps because lucerne gives him FFW. They show no signs of protein deficiency. I would not beat yourself up about the teff at all. You have not let her down. The non-arrival of the ertugliflozin is more of a worry. Can you track the shipment? My inclination would be to go back to the metformin until it arrives, but of course I bow to more experienced moderator opinion. Hang in there. -- Maxine and Indy (PPID) and Dangles (PPID) Canberra, Australia 2010 https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles
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Hi Terrie
Here are two more ways to find all your messages: (1) When on the ECIR groups.io web page, in one of your messages, look at the lower part of the screen for an icon that looks like stack of coins. Open that link and look for "All messages by this member". This is a link to all your messages to date. https://ecir.groups.io/g/main/search?q=posterid:60279 (2) Use your poster ID in the search window. It is posterid:60279 I agree with Maxine about the Teff comments. The reality is that you just don't know unless you test. I can't speak to what else may be going on with Dixiet that complicates your picture, but wanted to offer this post from Dr Kellon from 2011. Ponies are amazingly resilient. https://ecir.groups.io/g/main/message/121823 Unfortunately the links to photos/rads are no longer viable. I am still looking for the rads. They were far, far worse than your rads. Here are links to Billie the wonder pony's photos and CH that Dr Kellon mentioned and his CH https://ecir.groups.io/g/CaseHistory/album?id=13696&p=Name,,,50,2,0,0 https://ecir.groups.io/g/CaseHistory/files/Juldie%20and%20Billy/Billy%20Case%20History.pdf -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President/Treasurer 2021-2022 |
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Hang in there, Terrie. You have not let Dixie down. In fact, you are going above and beyond what most owners will do.
It seems to me that things were on the upswing on Ertugliflozin, after you increased pergolide and came out of the seasonal rise. Even though her insulin was fairly controlled, we really don't want ACTH to go above the mid-20s in these horses, so being very proactive or aggressive with pergolide is going to be important. You will have to evaluate her quality of life and Dixie's desire to carry on or give up, and make your own decision based on what you see in front of you, not on reports from vets and others who haven't seen her, and that includes us. But getting her medications in place (you are starting to get there, but the job isn't done yet with both pergolide through the seasonal rise and Ertugliflozin, especially with the setback of not getting your latest shipment) and maybe some trim adjustments could make the difference. It seems to me her heels are a bit high on a couple feet, putting more pressure on to the tip of her coffin bone, and I wonder if she might be more comfortable if her heels were a bit lower, but of course you should wait for Lavinia or Dr Kellon's advise. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Thanks Maxine, since receiving the bad news I have been glued online trying to find a solution. FeedXL have Teff oxolate content at 10-12g/kg with Rhodes grass hay only 2.5-3g/kg and I have been able to source some Rhodes which is low in sugar & starch too. There also seems to be discussion regarding the oxolate content in teff preventing effective absorption of the DCP that is in Dixies diet meaning that she could be calcium deficient, so it is hard for me to know what to do now. There has been a big upheaval at my vets and the one that usually looks after all my animals is away for 6 weeks so I suspect that the Ertugliflozin was not ordered. As my compounding chemist is unable to make it, it has to be ordered through the vet from BOVA, giving me no way to find out what is going on, so I will re-start the Metformin tomorrow morning as the Ertug took 2 weeks to arrive the last time it was ordered. Was instructed to wait 2 weeks after the Metformin was stopped the last time before starting the Ertug so didn't know if that was the criteria when going the other way. Thank you for your kind words. I hope I can get Dixie through this. -- Terrie H in Australia 2021 Case history: https://ecir.groups.io/g/CaseHistory/files/Terrie%20and%20Dixie https://ecir.groups.io/g/CaseHistory/album?id=268416 |
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Thanks Nancy, I have not given up on Dixie, I just was not expecting such a dreadful prognosis when Dixie is not showing any different behaviour, so it has certainly rattled me. I have only had the one delivery of hay since joining the group and that was tested, with the diet balanced to that, but only have a couple of bales left. -- Terrie H in Australia 2021 Case history: https://ecir.groups.io/g/CaseHistory/files/Terrie%20and%20Dixie https://ecir.groups.io/g/CaseHistory/album?id=268416 |
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Sherry Morse
Hi Terrie, 1 - if you have it on hand, restart the Metformin at the 30mg/kg 2x a day rate. You do not need to wait to restart it so get her on that ASAP. 2 - I can't remember who's doing your diet balancing but would recommend you get in touch with Carol Layton if you are using somebody else. Carol is familiar with the ECIR protocols and would be the best option locally to get in touch with for balancing. As Nancy has said we've seen ponies with much worse x-rays than Dixie. Were she mine I would see about getting the trimmer to follow markups from Lavinia as you have all the other pieces in place right now.
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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Thank you Sherry. Carol Layton is the person who prepared Dixies diet and I have asked Lavinia for markups but they have not arrived yet. Re-started the Metformin this morning. Will battle on.
-- Terrie H in Australia 2021 Case history: https://ecir.groups.io/g/CaseHistory/files/Terrie%20and%20Dixie https://ecir.groups.io/g/CaseHistory/album?id=268416 |
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Terri, Rhodes is a good option too but transition slowly as it can be quite fibrous, depending on the variety and the level of maturity when cut. You could email Nerida at FeedXL and ask her for the studies or hay tests she bases those figures on. In fact, I might do that myself. Tweaking the trim, as Kirsten and Sherry mentioned, will be important too.
Canberra, Australia 2010 https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles
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jenbegg@...
Hi Terri,
Although i am only new to ECIR and still doing the steep learning curve so cannot offer you much help ,but would like to say as a fellow Aussie with pony in similar situation I have also been told about teff being unsuitable due to reasons you have stated ,when i questioned further i got blocked and have had no further comunication.teff is the only hay I can source that is even remotely acceptable as i live in dairy country and it is all rye,clover,lucerne and cereals or mixture of these,so teff it is going to have to be . .I am feeling your pain inreguards to letting my pony down as I find it so frustrating with all the conflicting advice i have been given by vet,dietitions farriers and other so called horse experts i have contacted My pony started on Ertugliflozin last thursday and unless it is my wishful thinking I will say he is moving alot more and even trotted up lane for dinner tonight so am feeling hopeful that we might finally be on right track . Wish you all the best with Dixie and am sure like most of us we are just trying to do the best we can for our equines. -- Jenny B in VIC joined 2022 https://ecir.groups.io/g/CaseHistory/files/Jenny%20and%20Wally https://ecir.groups.io/g/CaseHistory/album?id=275488 |
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