Cold and laminitis
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Hi Nancy,
We have seen horses move to lower doses, or every 2nd day dosing, of the SGLT-2 inhibitor drugs once their hooves have improved enough to be in regular work. I don't know of any that have come off them because their horses didn't need meds anymore, but these are new medications and we've only been using them here for 2-3 years. The Exercise piece cannot be rushed; although it's critical, it's the last piece to put in place. It takes time for the hooves to heal, and Dot needs his trim tuned up first, esp his right front. -- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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Nancy & Dot
I promise to not share with anyone, nor attempt to use it without my veterinarian involved 100%.
Thank you for the clarifications on the drug. Right now Dot is getting little to no exercise, to my great disappointment. I am hoping that improves considerably once the weather warms up and he is not tender footed. -- Nancy O, Colorado, 2022 https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Dot https://ecir.groups.io/g/CaseHistory/album?id=280596 |
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Nancy,
I can send you a copy when I send it to your vet but I have to ask you NOT to give it to anyone else. The reason is that information needs to be in the hands of the treating veterinarian. Steglatro is ertugliflozin; Invokana is canagliflozin. Ertugliflozin is easier to source and less expensive in the UK and Australia. Except for the current UK postal strike, I don't think there are currently any issues with getting the drugs but if ordering from an international pharmacy you have to allow enough time for delivery. They are not a cure, so unless you can drastically change management, particularly exercise, it is likely to be for life. I'll let members actually using it speak to how they give it. -- Eleanor in PA www.drkellon.com |
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Nancy & Dot
His weight is 827 by tape. My vet suggested Stelgatro last fall. I wanted to get his diet under control and weight down before going that route. The info sheet the vet gave me, as well as posts I see in the daily digest, made me reluctant to move forward with that until all other options had been eliminated. I am confident my vet will work with Dr K’s instructions, but I would like a better idea of what to look forward to.
I have increased the Prascend to 1.5 pills, prepped by me and wrapped in aluminum foil packets. Thanks so much - you all are THE BEST!!!! -- Nancy O, Colorado, 2022 https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Dot https://ecir.groups.io/g/CaseHistory/album?id=280596 |
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Hi Nancy,
Given that insulin was very high all fall, that's likely the problem now. His previous Metformin dose was appropriate for an 800 lb horse, so if that's his weight and it didn't help then the next step would be and SGLT-2 inhibitor like Invokana or Stelgatro to get his insulin down. I would make sure everything in his diet is tightened up as best as possible, retest insulin-glucose-ACTH, and also do the preliminary bloodwork Dr Kellon recommends for trying an SGLT-2 inhibitor. You need to email your vet's email address to her to get her protocol for SGLT-2 inhibitors. drkellon "at" gmail "dot" com Yes, you can prep Prascend that way, and yes, a small rise increase is warranted to get his ACTH into the mid teens or low 20s (middle of the reference range). But I doubt that will normalize Dot's insulin. -- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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Nancy & Dot
Despite warmer weather for the last week (40’s & Colorado sunny) Dot is still foot sore. In January we had deep snow and unusually cold temps. He has been turned out with Cloud boots for the last month plus wool socks, plastic bags & leg warmers. Back in December he was comfortable barefoot. His feet feel warm & toasty when I bring him in. For the last month he does not want to walk in the soft sand arena barefoot, but will with the Cloud boots. He’ll even try to run when at liberty, but the boots are too clunky. In Dec barefoot walking had not been an issue. About 8 weeks ago he was moved to a larger paddock with sand footing, although now it is snow and somewhat compressed due to daytime melting. He has 2 mares along side so he moves a lot visiting them and going back to the hay net in the far corner. Overall he seems quite happy. I suspect his insulin is still high but have not retested since the weather has been cold. I truly expected him to be comfortable barefoot again once the weather warmed up and am confused as to what is causing his discomfort now. He gets trimmed every 2 weeks and is very cooperative during the trim. Does anyone have any suggestions? |
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Hi Nancy
Dr Kellon recommends aakg in the archvied message: https://ecir.groups.io/g/main/message/284089 -- Nancy C in NH ECIR Moderator 2003 ECIR Group Inc. President 2021-2022 ECIR Group NEW Case History site open to Early Adopters.
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Nancy & Dot
Does anyone have any thoughts about adding AAKG?
-- Nancy O, Colorado, 2022 https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Dot https://ecir.groups.io/g/CaseHistory/album?id=280596 |
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Suitability has a pattern for tall shipping boots if anyone wants to try making a custom pair. I was planning to do just that for a large pony but haven’t finished collecting the materials still..
-- Martha in Vermont
ECIR Group Primary Response July 2012
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)
Martha and Logo |
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Nancy & Dot
Thank you for the prompt reply Dr K. I will add the bags & vet wrap. Also wondering if I should be giving AAKG in addition to jiagulan, at least while it is so cold.
Lorna, he has fleece lined shipping boots that come down over the hoof boots. When he steps down in the snow it still goes up and under. I studied gaitors also, but they don’t look like they would be any better. We need someone to make knee high equine boots! 🤣 Thank you, Nancy -- Nancy O, Colorado, 2022 https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Dot https://ecir.groups.io/g/CaseHistory/album?id=280596 |
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Hi Nancy,
Look for shipping boots which come down over his hoof boots. Gaiters also work. -- Lorna in Eastern Ontario 2002 |
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No, it won't help but putting his feet into empty break bags (over socks, before boots) and securing the tops under his leg warmers will help. Also try wrapping the top of the boots with a few layers of Vetrap.
-- Eleanor in PA www.drkellon.com BOGO 2 for 1 Course Sale Through End of January |
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Nancy & Dot
Dot was recovering well until we got deep snow about a month ago. We also have 2 days of single digit temps now. The cold is clearly affecting his comfort. He goes out with Cloud boots, wool socks, fleece lined leg warmers and a blanket. Also has a lot of hair. Unfotunately the snow gets in the boots and then they are cold & wet. About 2 hours after coming in he is much better. I’m wondering if I should add devils claw back in to his supplements. Would that help with the pain from the cold?
-- Nancy O, Colorado, 2022 https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Dot https://ecir.groups.io/g/CaseHistory/album?id=280596 |
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