Dr. Kellon - thoughts on use of Joagulan for Pilgrim

Suzanne and Pilgrim

I recently posted xrays of Pilgrim’s last trim. They illustrate that his toes are long. I hope to take photos tomorrow to send to Lavinia for markups before the farrier returns next week. 

Lately Pilgrim has become dangerously spooky. This came about overnight. I now suspect that he has been becoming increasingly foot sore since the spring. I will be putting him in boots starting tomorrow. 

Pilgrim has recently been diagnosed with PPID and he is only 12!  He is an extremely easy keeper and is constantly ravenously hungry. I work hard at trying to keep weight off him. The flies proved to make him highly reactive this summer - more so than in previous years. So bugs, extreme heat and then a 3rd suspensory injury (luckily only a strain) prevented us to from moving and exercising as much as we wanted this summer   Pilgrim’s eyes have also started tearing a lot  about à year ago. 

I’m wondering if some Joagulan in Pilgrim’s supplements could help regulate sugars,  reduce his cortisol and 
skin sensitivities  Currently I am giving him a daily dose of insulin Wise hoping to counter any increase in his sugars should that occur  

I just saw that there is no true evidence that Insulin Wise has that desirable action. Could I substitute some Joagulan for Insulin Wise? 


Lavinia Fiscaletti

Hi Suzanne,

Thanks for adding the latest rads.

You're correct that his toes are out ahead of where they should be. Soles are thin and heels are underrun all around. Fronts have a slightly broken back HPA while the hinds have ground parallel coffin bones.

Let me know when you have the photos up and the date of the farrier's appt, please.

Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR

Eleanor Kellon, VMD

Hi Suzanne,

Good looking horse, and he's a good weight too.

How was he diagnosed as PPID?  The only elevated ACTH was on 9/9 which is seasonal rise time. I would take him off Prascend in December and do a domperidone stimulation a month later.

There is no convincing evidence of laminitis on his radiographs, including coffin bone quality. He does have sinking but that's a trim issue. He also has changes in the left navicular bone, not suprising with the hoof configuration. All should be very fixable with the right trim and time. His last insulin was normal so diet seems to be controlling that well.

He doesn't appear to need any help with regulating sugars and I would expect his cortisol is normal too. Jiaogulan has been shown to help with lung allergies but there are inconsistent results with skin. Jiaogulan will help the suspensory issue but don't start it until the trim is corrected.
Eleanor in PA

EC Owner 2001

Suzanne and Pilgrim

Hi Dr. Kellon,

When do you suggest I take Pilgrim off Prascend in December? I've never heard of a domperidone stimulation test...  Is that the same as a stem test? (somebody mentioned I do that test - I have to find the thread of conversation.
When would you suggest I take the domperidone test in January?

Thank you in advance for your assistance,


Suzanne, I think I may have been the one who recommended a TRH stim test.  I had forgotten that the necessary drug for that isn’t available in Canada.  I was happy to see Dr. Kellon’s post about domperidone because it reminded me that that is one reason we ask you for your location in your signature.  I looked up domperidone then to make sure it was the substitute for TRH and indeed it is.  You can do a Google search on something like ‘domperidone equine’ for more information.  I don’t want to recommend one link over another because I honestly don’t know enough about it.
I would think that the waiting time between dropping the pergolide and testing would be the same for either test.  It’s a matter of clearing pergolide and it’s effects from the system.  If you schedule your blood testing for early January, you can count back three weeks from your appointment and stop pergolide then.  This is a good time of year for testing because it’s the end of the rise and her need for pergolide is less.  Plus, it gives you time to sort out your steps before the next rise, lol.
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