Lori, thanks be for our good farriers! I'm new at this, but my IR mare has improved so much since learning management strategies from this group/site. I'm sure your farrier pointed this out, but isn't protection of the sole part of the benefit of the boots? Plus it would seem to me that correcting the heel would take the pressure off the hoof wall; one of the symptoms of sore-footed horse is that they "flip" their hoof toe up as they extend their stride outward at the walk to try to keep pressure off. This was very noticeable with my mare ...  My farrier likes that the boot (without the restriction of a metal shoe) allows flexion/stimulation of circulation as they move about.
Back in January 2021, when she had the first "laminitis" episode, as soon as I got boots on my mare she was obviously moving a bit more comfortably right away, though she was still sore and not wanting to move much or stepping sideways & still "flipping" her forefeet. This was immediate, even before new hoof growth. She had foundered the winter before, was tested IR, and for that year the Thyrol-L the vet prescribed, plus free choice untested grass hay and a grazing muzzle for turnout were not enough to control her insulin and she foundered again in January 2022. I found this group and have changed strategies. Now I've got hay that tests under 10% ESC + starch, I'm measuring her hay -  the new hoof is growing in without the rings/expansion, and my farrier is very happy with her progress.
It does take nearly a year for the hoof to fully generate new growth, so I'm learning patience, and that IR is not "curable" so my mare Shorty will always need me to pay attention to her condition. ... she's off her boots now and moving very well, but I plan put them back on with some felt liners and/or hoof socks, fleece shipping boots and blanketing this winter, hoping to avoid founder again this winter. Turnout with her pals will be with a fully enclosed muzzle so she cannot eat any grass.
I am so grateful for this group and the years of experience to be found here!
My farrier says the strategy is small changes more frequently.
He suggests to simply say "we're working on it" or "I'm considering that" or something of the sort if your strategy is criticized rather than disagreeing, which most people don't like! I ran into that when a dear friend and Walking Horse trainer took my new Walking Horse mare in for a couple months training. She had very specific ideas how to trim/shoe a gaited horse - different from what my farrier does (he and his wife have gaited trail horses & put many miles on them, barefoot, including overnights in the mountains, lol). I sure did not want to antagonize my friend who is very good hearted person but has quite strong opinions!
 The farrier is here every 4 weeks for Shorty, ideally more often would be even better, or for me to learn to correctly make the small adjustments. So much to learn! As my vet is supportive, and noticed right away the quality of the farrier's work, I don't know what I'd do to keep a positive relationship when needing to go against what my vet advises.
Hope I haven't gone on with too long a story, hope it might help you navigate gracefully all the sometimes contradictory info we get, so we can find out & do what is best for our horses.
--
Jean Hurrle
Illinois; 2022
https://ecir.groups.io/g/CaseHistory/files/Jean%20&%20Shorty%20aka%20VG%20YSA%20Tstar

Hi Lori,

Feel free to start a New Topic when you have new questions, as this one is quite old and long already.

The only way to know a horse is ok on a lower dose is to lower it, wait 3 weeks, then test ACTH.  This can be risky, so usually we leave them on their prescribed dose year-round if cost is not a factor.  I prefer to err on the side of caution and overdose slightly as the consequences of under dosing can be more serious and immediate.

As Martha said, we don't really know if they become less sensitive to pergolide the more we give them, but we do know they need more with time as the PPID progresses.  Some rare horses don't respond to pergolide from the start, others at very high doses seem to stop responding to it, but that could just be due to the advanced state of disease.  There's a lot we don't know about PPID, we just do the best we can with the knowledge we have now and adapt when new information becomes available through research.

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

Snickers' Case History
Snickers' Photo Album

Hi Lori,
I would have the vet come out to draw blood before running out of pergolide.  The next day I’d increase the dose if I thought it was needed.  If the results return suggesting the increase wasn’t warranted, I would decrease it but that was rarely the case for me.  You really should test about 3 weeks after making the change to see if it was enough.  The seasonal rise is close enough to being over that I wouldn’t let that stand in the way.

If she’s been taking 2.2 mg of pergolide from your initial order for the past many months, I would be concerned that it was no longer very effective.  I get 2 months of pergolide at a time.

I’ve had the same question about whether excess pergolide would increase the need for more further down the line and haven’t seen an answer so I’m guessing there is none for that question.  It’s rare to see an issue with taking more than “enough” pergolide.
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Good morning all,  I have a quick question about pergolide dosing.  I have had Abbey on 2.2mg of compounded pergolide for many months now, I need to re-order and am going to have her tested now that the seasonal rise is almost over, but I don't have time to do that and get the results back before running out.  Are there any side effects or reasons why it might be bad to have her on a higher dose than she needs (if that is the case)?   I understand it's important to make sure she is on a high enough dose to treat her, but am just wondering if it so happens that she doesn't need that high of a dose, does keeping her on that make it less effective over time and will make it so she needs higher and higher doses over time (which I know may happen anyway, but I don't want to do anything to rush that)?

Thank you for your insight!


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Lori J in NC 2022
Abbey's Case History: https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey 
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Good point Martha, I will be calling them tomorrow morning and will ask them what date they received them and how they are stored (without ticking them off hopefully :)).

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Lori J in NC 2022
Abbey's Case History: https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey 
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Hi Lori,
I would pick them up if they were close by but mine come from NYC.  They are always shipped overnight and to my house, not my mailbox.  You could have them shipped with a cold pack, if they’re protected from condensation.  Keep in mind that they were shipped to your vet somehow and undoubtedly sustained some heat if that process as well.
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Hi Martha,  I have only gotten them once so far (she was on the powder when this first started back in June before I found you all) and they were from the vet.  I didn't think to ask her at the time how long she had them, but the expiration date written on the container says December for whatever that's worth.   I will ask them on Monday how long they have had them and also ask if I can order them myself from the pharmacy so I don't have to go through this with them every time, it's very painful because they are so unorganized.   I have been reading in other posts about shipping in the heat/cold, how do you deal with that?  Or do you actually pick them up from the pharmacy yourself?

Thank you for your feedback!

Lori
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Lori J in NC 2022
Abbey's Case History: https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey 
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Hi Lori,
How do you usually get your capsules - from the pharmacy or the vet?  My concern would be how long those capsules might have been sitting at the vet’s and under what conditions.  Could they have been purchased for someone else who didn’t collect them?   I’ve been getting mine directly from the pharmacy for many years, with different vets and different pharmacies.  If that’s an option, I’d recommend it.  As Sherry said, the dosage difference itself isn’t likely to make a difference - but fresher drugs might.
--

Thank you Sherry,  that makes sense... both on the case history and the dosage.  
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Lori J in NC 2022
Abbey's Case History: https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey 
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Hello,   I have a quick question to the group to see if I am maybe over analyzing what my vet is telling me is okay for dosing pergolide for Abbey.  The situation is, I have her on 2.2mg right now, I am getting low, so I asked her admin person if she could order that for me, she said she would yesterday.  She just called me a little bit ago and said she has 2mg in stock and I could come get that.  I told her I didn't want to go down in dosage because of the seasonal rise, so she called the vet to see what she thought, called me back to say the vet said .2 is not going to make a difference.  I have no idea if this amount is even the correct dosage for her, I am going to have her retested in a couple weeks just to see, but it seems like I shouldn't change it, especially lowering it?

Thank you,
Lori
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Lori J in NC 2022
Abbey's Case History: https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey 
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Thank you Sherry,  My gelding actually looks really good right now, he has no fat pads (and never has) and his neck is not cresty, he's basically on a semi-diet because of what happened with Abbey.  I did have him tested a few years ago and he was not IR, I know that can change, but he doesn't really have signs of being IR like she did.  May be worth it anyway just for peace of mind, it is a good suggestion.

What I really wanted to know is given the hay tests I posted in my files, is it safe to not soak?  I just want to make sure I am looking at the right values to determine that for both types, because as I said she does sometimes eat a little bit of the fescue. 

Thank you.
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Lori J in NC 2022
Abbey's Case History: https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Good afternoon,   I ended up having the timothy/orchard tested via the wet chem test to make sure it was okay to not soak, at the same time I sent in a sample of the fescue I have been feeding to my other two horses (I know it's not recommended, but I have been feeding this hay to them for at least 8 years without an issue) just to see what the numbers would be because sometimes my morgan gelding has a cresty neck.   It looks like both are under the 10% for ESC and Starch, so both should be safe to feed without soaking?   I have not been feeding Abbey the fescue, although she does end up getting some at night (it is soaked) because she is the boss of the herd and I don't have an easy way to separate her from the boys.  What should I be looking at for the protein values?   Are either of them too high in that regard?    I would like to avoid having my gelding go through this, although he is looking pretty good since he has been restricted to smaller pasture areas where Abbey can see him at all times :).  

I posted the results here:
https://ecir.groups.io/g/CaseHistory/files/Lori%20J%20and%20Abbey/EQ151480.pdf 

Thanks so much!

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Lori J in NC 2022
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Lori,

We don't know the actual ESC or starch level of your hay. The 8.45 is an educated guess based on the NIR test results. That's why you still need to soak.
--

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/Scutch%20Case%20History.pdf

https://ecir.groups.io/g/CaseHistory/album?id=78891

Thank you Nancy, That is helpful, I am curious though, if it was indeed at 8.45 for ESC, isn't that good since I thought we were looking for under 10?   This hay stuff is confusing!  Or, maybe you are just saying she will need it soaked because of how high her numbers were?    Unfortunately it's really difficult to find a supplier who actually tests their hay at all, this place boasts having hay low in sugar.  I have never used them before, so I am not really sure how fast they sell their hay or if they would hold it.    I am feeling like I need to get something better than fescue quickly even if I do have to soak it :(   and as you said, this hay does seem to be nice quality.  I have been giving her copper and zinc for years, I just bought some of the Triple Crown ground flax, will that give her enough calcium and phosphorous?   I think I read 4 oz. is the suggested amount to give?

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Lori J in NC 2022
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850 

Hi Lori

Not sure if this will help but....

I just got my wet chem results back and they are indeed 26% higher for ESC than a quickie NIR test I ran earlier. I use the NIR in this case so I could decide if it would be low enough to proceed. I use the 30% rule applied to NIR to see if I am still safe. I was. This helps me get back to the grower more quickly.

If we apply the "30% rule" to your NIR test that would put you at 8.45 for ESC. Given her current status you'll probably need to keep soaking at least in the foreseeable future. To add to confusion, some folks have not had the issue with variable ESC results when testing side by side NIR and Wet Chem. If you have good supply options to look elsewhere, that would be your safest bet.  Would the the grower hold the hay for you while you test wet chem?  Long shot, I know.

It's nice hay as far as palatability and digestibility go.  Protein good. Will need calcium and phosphorous, copper and zinc to balance.

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022

Thank you Sherry.

Martha, this is what I heard back from EA:  Unfortunately we do not have this sample anymore as we are only able to retain samples for 2 weeks.  If you would like a wet chemistry test performed we will require a new sample.

So I guess that means I either need to keep looking or buy the hay and send another sample and keep soaking until I get results?
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Lori J in NC 2022
Abbey's Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=276850