New Lab results


k frog
 

I have updated my case history. If someone could take a moment and gently advise me as to what I can try next.
--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994

 

 

 

 

 

 

 

 

 


 

Hi, Karen - How maddeningly frustrating for you and Splash.  According to the case history, the synopsis is this:  dry-lotted and on tested hay with minerals balanced to hay since autumn of 2016. (balanced minerals since 2014, but on some pasture up until 2016).  Initial laminitis in fall of 2016 probably a combination of injury, dex, IR and pasture.  Another laminitis in the fall of 2017 despite diet etc being in place.  Insulin typically indicative of IR in Jan 2017 and July of 2017, but really very high in late January 2018 (145.3 uIU./mL).  Starting Prascend may or may not have helped in the autumn 2017 laminitis, ACTH normal Jan 2016 and Jan 2017.  Improvement noted at about the same time as switching hay and starting to feed in slow feed nets 24/7 (how much are you giving, do you have an estimate?)  

Well!  Dr. Kellon, this bud's for you.  My thoughts are:  1) Mare issues  (see Ovarian Abnormalities in Mares  in the 2015 proceedings https://www.ecirhorse.org/proceedings-2015.php  )     2)  Early PPID  (two fall episodes of laminitis) - but you will need the TRH stim test to parse that out, as you have already suggested.  3)  The hay?  The 2016 hay was on the upper edge for ESC plus starch, but the 2017 hay looks like it should be absolutely okay.  This is grasping at straws a bit.

Hang in there. You are doing everything right, and still Splash is having issues, so diagnosis is going to be key.
--
Jaini Clougher (BSc, BVSc)
Merlin (over the bridge), Maggie, Gypsy, Ranger
BC 09
ECIR mod/support
https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .


quatzie_baby@...
 

Hi Karen, I didn’t see your “own” hay test analysis on your current hay or your purchase from Steffen hay.

I always re-test what I purchase to verify the analysis from supplier. I had to take back hay in 2016 to Steffen because it’s was higher than the analysis they provided to me. It was a mix up from another field. With your horse being sensitive to sugar/starch that is something that I would recommend, best to confirm. 

 

Jeannie DeLay

Salem, OR 2010


k frog
 

Hi Jeannie,
In 2016, when Splash has her initial episode of laminitis, I did retest the hay from Steffen Hay because I could not make sense of her laminitis. It retested basically identical to the test Steffen Hay had provided me. Since then I haven’t questioned their tests.
The hay I’m trying currently is a blue grass straw. I’ll post the test for that as soon as I can. It is very low WSC,ESC, and Starch.

Sent from my iPhone

--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994


k frog
 

  I will likely continue to feed Splash this blue grass straw, as long as she continues to be stable. I will put the hay test in her case history and eventually get her back on minerals balanced to this hay. I’m trying to think positive here.
 Until then, fyi, ESC is 5.2, Starch is .4, WSC is 7.1, CP is 6.3.
 I should have an average of her daily hay consumption soon.
--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994

 

 

 

 

 

 

 

 

 


k frog
 

 Hi Jaini,
 Thank you for your reply. You summed up my situation well, frustrating:)
 I am currently focusing in on ‘mare issues’. I have never noticed any of the typical signs that would have indicated that this was the culprit, but by process of elimination, this is one I knew was left on the list. Her last bout of footiness/subclinical laminitis was the first week of January. Since this time of year mares are typically in anestrus, cycles will be irregular, if present at all, and it will make it difficult to match up her symptoms with her cycle. She has never been a mare that shows her heat cycles.  
 You mentioned the TRH stim test as something still worth trying? I had crossed this off my list because I felt PPID, even early PPID was out of the picture, due to the fact that she was on 1 tablet Prascend from October 7th to January 29th, and during that time had at least the one bout of foot soreness. Maybe 1 tablet was not enough?  She was on Prascend for the January labs, and still insulin was greatly increased, although ACTH was normal. I guess my understanding was that if a horse is early PPID, not testing with a indicative high ACTH, but insulin is not regulated, if this type of horse was put on pergolide insulin would become more regulated not less regulated. My vet consulted with our university equine medicine vet on Splash’s situation and his thought was that her insulin was high due to the fact that she was a non-PPID horse, on pergolide, which has never been tested for the effects it can have on a non-PPID horse, and this was a possible cause of her high insulin. This felt a bit like grasping at straws to me. 
 I agree, a diagnosis would be a great tool to have to help Splash. I really appreciate your input. I don’t have anyone else to ask and it means a lot to get your feedback. If I can’t find a way to help her, I can’t watch her suffer. 
--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994

 

 

 

 

 

 

 

 

 


 

Karen, which test package did you purchase from Equi-Analytical? Was it the 601 Equi-Tech or the 603 Trainer?
   
--
Bonnie Snodgrass 07-2016

ECIR Primary Response 

White Cloud, Michigan, USA

Mouse Case History, Photo Album


 

Hi Karen, not a moderator, just hoping to help.

Any chance you have more recent hoof photos that are not in your album??  And or more recent x-rays?   Might help rule out something 'simple' causing her pain (appears that she has had thin soles, rotation and P3 remodeling in previous x-rays)   

--
Ellen
Pal & Savvy
N. Alabama
08/10/13.


Paula Hancock
 

On Mon, Feb 26, 2018 at 08:05 am, k frog wrote:
Her last bout of footiness/subclinical laminitis was the first week of January. Since this time of year mares are typically in anestrus, cycles will be irregular, if present at all, and it will make it difficult to match up her symptoms with her cycle. She has never been a mare that shows her heat cycles.  
 You mentioned the TRH stim test as something still worth trying? I had crossed this off my list because I felt PPID, even early PPID was out of the picture, due to the fact that she was on 1 tablet Prascend from October 7th to January 29th, and during that time had at least the one bout of foot soreness. Maybe 1 tablet was not enough?  She was on Prascend for the January labs, and still insulin was greatly increased, although ACTH was normal. I guess my understanding was that if a horse is early PPID, not testing with a indicative high ACTH, but insulin is not regulated, if this type of horse was put on pergolide insulin would become more regulated not less regulated. My vet consulted with our university equine medicine vet on Splash’s situation and his thought was that her insulin was high due to the fact that she was a non-PPID horse, on pergolide, which has never been tested for the effects it can have on a non-PPID horse, and this was a possible cause of her high insulin.
Hi Karen,
Well, getting the first step of the DDTE is rather challenging at the moment with her.  I can't speak to the mare issues, but good to explore as Jaini mentioned.  Not sure if anyone suggested it yet, but Lyme's would be another test worth doing if there is any chance of that in your area. 
As Dr. Kellon mentioned, not all horses with PPID have high ACTH, so it is good to keep that possibility in mind, but if insulin is being pushed by ACTH, I would have guessed both the pergolide and the end of the seasonal rise would have improved things.  I couldn't find any reference to pergolide raising insulin levels, but maybe your vet or the other vet could provide references?  Her leptin is at the high end of normal, which would make me review diet although it sounds like you have that pretty under control.  When leptin is normal but insulin is high, it makes me focus on non-diet factors more, like PPID and Lyme's.  
How is her attitude?  Hang in there!
 
--
Paula with Cory (IR & PPID?and Onyx (IR/PPID)

 

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx

 


k frog
 

Hi Bonnie, 
 If you are referring to the ‘Blue Grass Straw’ I am currently feeding, I did not purchase that analysis. It was purchased by the grower. I would assume it is the 601 Equi-Tech. I don’t know of any way to tell from the results, besides calling Equi-Analytical, which test was run. 
--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994

 

 

 

 

 

 

 

 

 


k frog
 

Hi Ellen,
 I have posted the most recent hoof photos I have. They are only of the front soles, as I was trying to document the bruising. The most recent complete photos I have date back to October. I trim her every 3 to 4 weeks. Her trim is tight, although one of my concerns is that I am over trimming her. I don’t believe this would cause her insulin to be high, but it could make her foot sore. I never touch the sole.  I had a farrier look at her feet mid January, and her comment was that they looked short. So, I am backing off the trim schedule. She was in Easycare’s Cloud boots mid January to mid February. 
 I have not taken radiographs since July 17’. 

--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994

 

 

 

 

 

 

 

 

 


k frog
 

Hi Paula,
 Lyme disease is not something we typically see in this area. I will check with my vet and see what he thinks. I worked in the Equine Vet field from 2001-2016 and never heard it discussed as an issue for us here in the PNW. Doesn’t mean it’s impossible, but it hasn’t been on my list. 
 Her attitude is fair. She has good days, and bad days. She is not the horse she used to be before this started. She has always had a bit of an attitude, but she was never dull. Now it seems she is dull more often than not. I wish she could talk, or I wish I could hear better:)
--
Karen F

 

October 2013

Molalla, Oregon

Case History for Splash: https://ecir.groups.io/g/CaseHistory/files/Karen%20and%20Splash

Photo Album for Splash: https://ecir.groups.io/g/CaseHistory/album?id=1994

 

 

 

 

 

 

 

 

 


Paula Hancock
 

On Mon, Feb 26, 2018 at 05:26 pm, k frog wrote:
Her trim is tight, although one of my concerns is that I am over trimming her. I don’t believe this would cause her insulin to be high, but it could make her foot sore. I never touch the sole.  I had a farrier look at her feet mid January, and her comment was that they looked short. So, I am backing off the trim schedule. She was in Easycare’s Cloud boots mid January to mid February. 
Hi Karen,
It looks to my amateur eye that the trim could be tighter just based on the sole photos, but I will leave that to our gurus to comment. 
Is Splash more comfortable with boots than barefoot? If so, that might make her day better to continue with that while you figure out what is going on.  Have you discussed metformin either with Dr. Kellon or your vet to see if that brings relief?
 
--
Paula with Cory (IR & PPID?and Onyx (IR/PPID)

 

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx

 


 

Karen,

Your CH is remarkable, and so is your dedication to Splash.  At each step you tackle the problem with her comfort in mind!   Boots, pads, tight trims, diet.

 

I would do a full set of photos, for your own reference if nothing else. 

 

Most farriers I know would think her feet looked over trimmed and short (from the July lateral shots).  But they are used to seeing long feet, so to them long is ‘normal’.    

 

Interested to see what the hoof guru suggestions will be as to what changes you can make to increase her comfort level. 

 

Like you, I wonder what has caused her to go from a ‘High Insulin Responder at 13’ to a “Poor Insulin Responder at minus 30”, in the course of a year.   Hoping Dr. Kellon can help you through this.

 

Best wishes for you and Splash!

 

 


--
Ellen
Pal & Savvy
N. Alabama
08/10/13.