Interpret Hay Analysis + Switch Diet
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Hi Jess,
If you can't guarantee that Clover will start breakfast at least 4 hours before the vet arrives, then you could ask the barn to give her extra (double?) hay overnight so she doesn't run out before breakfast. That will prevent the insulin spike that Sherry is referring to, and the vet can pull blood anytime. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Sherry Morse
What is the timing on blood work vs. hay being given? You want to avoid the insulin spike from being fed after fasting.
-- Thanks, 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 |
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Hi Sherry,
I think I managed to get the vets on board with doing the Metabolic panel for Cornell! I saw on the ECIR page it says Clover can have hay, so technically then he's okay and doesn't need to fast? It's an early vet appointment so my barn said they won't have his beet pulp ready before the appointment. -- Jess & Clover in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Clover/ |
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They told me he usually eats about 12lbs and some days he leaves some and doesn't eat it all, but I can certainly ask them to offer a little more. They also offer it in a net from when they soak it. Thank you Sherry I have read the link you provided.
-- Jess & Clover in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Clover/ |
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Sherry Morse
Is there a reason the barn is unwilling to feed him the appropriate amount of hay needed to maintain his weight? To maintain at 816 he should be eating 16.32lbs a day total, which includes hay as well as any concentrates like beet pulp which are simply to be used as a carrier for his minerals. This is based on 2% of body weight, some horses need that number tweaked to be at their ideal weight. If he's currently only being fed the 12lbs of hay referenced in your case history there's a lot of wiggle room there for his hay to be increased to get to that amount. In addition beet pulp can be used to help increase calories - again, read DDT +E – Diet | ECIR Group, Inc. (ecirhorse.org) for more information on this.
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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I'll make the edit to my form about his weight. My barn expresses concern to me that by cutting out the Purina without substituting it for something else, Clover will lose weight again. He used to eat the Timothy cubes but then he started leaving them and hates timothy pellets. So my only option is to increase the beet pulp or get something like Stabul1 to carry the minerals and try fenugreek, peppermint extract or cinnamon on top depending on what he likes. I requested two samples of Stabul1 from the company and they are sending them to me.
-- Jess & Clover in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Clover/ |
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Sherry Morse
Hi Jess, If you're asking about the salt the recommendation is 1 - 2 oz per day. Please review the emergency diet guidelines at DDT +E – Diet | ECIR Group, Inc. (ecirhorse.org). There's no reason to not just stop the Purina now and replace with an appropriate amount of beet pulp carrier. I would make that switch and then add in other things so you know exactly what Clover is objecting to eating. When you start adding in the other things do one at a time and in small increments so he has time to adjust to the taste. As far as weight - at 14.1 I would expect Clover to be about 800 - 825lbs so if the vet says he's good at 816 that should be his ideal weight, not 850. You don't want him to be over a 5 on the BCS scale.
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 I updated the form! Apologies I missed those areas. I got the dates confused, Clover had the vet out in August and they used the weight tape and told me it was 816 so I fixed that date. We are increasing the beet pulp and cutting out Purina. :) I have AminoTrace+and W-3 oil by Madbarn but Clover refuses to eat them so I'm bringing cinnamon up and peppermint extract this weekend as well as salt to add to his food. How much should I ask his barn to add in?
-- Jess & Clover in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Clover/ |
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Hi Jess,
Thanks for uploading your Case History form. There's not much I can say other than having bloodwork done now would be the most useful time. Please also ask for insulin and glucose, with the ACTH. I'm pretty sure Cornell has a "PPID" package that combines these 3 tests. Maybe if you tell your vet about the hoof tenderness and wanting to check insulin (and then might as well do ACTH, too!) they will agree to bloodwork now. The rationale behind checking ACTH at the peak of the seasonal rise is that it gives you an indication of how well the PPID is controlled at the riskiest time of year for laminitis. If ACTH and insulin are high, then you have the potential for laminitis/founder so you might need to take action, and be better prepared next year. We have found that keeping ACTH in the teens to low 20s even through the seasonal rise results in the best outcomes for horses diagnosed with PPID, so we advocate increasing pergolide in advance of the peak rise to accomplish this. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Sherry Morse
Hi Jess, A couple of things with the case history (although thank you so much for starting it). Can you please add:
You already know the Purina isn't good for him and could be replaced with minerals that will balance the hay and a safe carrier to get them into him (rinsed/soaked/rinsed beet pulp would be ok). We do not recommend Himalayan salt due to the impurities in it. Clover would be better off with loose salt added to his beet pulp.
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,
I look forward to reading the link you provided! I added the one form here that is required in the signature, I hope that could help get started for Clover. Images for his feet are scheduled for next Wednesday October 5th and farrier should be coming out shortly so I'll read this article and discuss it with her. They haven't gotten back to me on running the ACTH. Jess & Clover in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 https://ecir.groups.io/g/CaseHistory/files/Jessica%20and%20Clover/Clover%20Case%20History%20Form.pdf |
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Sherry Morse
Jess when you have a chance to get a case history done so all the diet and lab work information is in one location that would really help us help you. If you're stuck somewhere in that process please let us know. Both his hind feet are bullnosed in appearance which indicates a negative palmer angle. This is mainly a trim issue and can fixed relatively easily but does need to be addressed before it gets worse. You can read more about that here: Equine Therapeutic Farriery | Dr. Stephen O'Grady, veterinarians, farriers, books, articles (equipodiatry.com) His left front needs the toe brought back more than the right but they both should be addressed as his heels are starting to run under.
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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I've updated images, requested images of his feet and the vets are still saying we should wait until November for bloodwork so I've called another vet and left a voicemail to get a second opinion.
-- Jess in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 |
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Hi Sherry,
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Sherry Morse
Hi Jess,.
There are many vets who do not know as much as this group does about IR and PPID. They just don't have the exposure and experience that our members do. It doesn't mean they're not good as a basic vet but at the end of the day they are providing you with a service. If you want to pay for x-rays (for instance) they should be willing to provide that service. They should also be willing to do the blood work you request. Testing now will tell you if the current dose of medication is adequate for the rise. Waiting until after the rise in November or December will tell you if you need to up his dose again, which you almost certainly will need to do. Horses don't need less medication if they have better blood work results, but a large number of vets seem to believe that's the case. -- Thanks, 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 |
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Hi Kirsten,
Thanks so much for your help Kirsten, I look forward to reviewing the instructions again and really hitting the restart button on all of this. Plus learning how to navigate these questions with my vets. I can request from my vets that we test him not for ACTH and perhaps I can request images of his feet as well? |
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Hi Jess,
Lowering the pergolide dose at the start of the seasonal rise is worrying. What was the rationale for that? He's definitely positive for PPID and dropping him to 0.5 mg was not a good idea. BI's own research shows that 1 mg Prascend is not enough pergolide for 50% of the horses they tested. We know that the size of the equine is irrelevant; the correct dose is the one that controls ACTH. Are you able to test him now? As we are at the peak of the seasonal rise so that would give you a very good idea as to how well his current dose controls his ACTH through the most critical time of year. In a horse diagnosed with PPID, any rise in ACTH can be problematic, so we recommend keeping it in the mid-teens to low 20s even through the seasonal rise. It would really help us help you if you complete a Cass History document on Clover. That's where all the data go, including his meds, rather than as photos in the Case History Album. I'm going to send you the instructions again since it sounds like you need some help getting started. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Yes, he's been on prascend ever since he was diagnosed. Up until recently (July/August time), he was on 1 pill daily however in the summer my vet lowered the dosage to half a pill. I re-added the hay analysis with the top portion. I did the Equi Analytical 603 hay analysis.
-- Jess in New Jersey 2020 https://ecir.groups.io/g/CaseHistory/album?id=263154 |
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Sherry Morse
Is Clover on medication for his PPID? Do you have the complete hay analysis (including the information at the top on type of hay and what test was run)? The ongoing foot soreness could be caused by elevated insulin or due to the trim but we need the x-rays and hoof pictures to comment on that.
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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Yes Clover is PPID, his results from April are in there and we are testing him in November.
Thank you for your help, I will look to the balancer list and follow the emergency diet. |
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