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Flame labs & balancer question


 

I was a little late on getting Flame titrated up to his Fall Pergolide 5mg dose & getting his labs drawn, but I just got results back:
Glucose 108 mg/dl, ACTH 13.2 pg/ml, insulin 56.97 uiu/ml & leptin 5.19 ng/ml. (I put them in his case history too so you can see the trends.) 

I gave pergolide & metformin @ 6am. Also, at 6am Flame was fed his normal soaked bermuda w/ his mineral mix, salt & ground flax sprinkled on it (as usual) & he had enough that he was able to eat all the way up until I drew his blood @ 10am. I did not exercise him before his blood draw. Could someone please look @ his labs & tell me how I'm doing? I'm happy with his ACTH but not so happy with the insulin that appears to be creeping up. Is the Metformin starting to not work? 

Last year I tested a batch of hay from a local feed store, did a custom mineral mix & I've been feeding that, but I'm almost out. I live in a non hay growing state & all our feed stores are basically distributors for hay which is grown in other states all over the west part of the country & then shipped in Las Vegas to be sold. I talked to a couple of the feed store managers today & they sell the batches of hay that they get within 2 weeks usually. So I've decided that testing hay is a waste of money for me, as I can't afford to test several batches every month. I have been looking at the list of acceptable ration balancers & need help picking one. Since I don't know where the hay I feed comes from what do I do about manganese & selenium? Do I pick balancers that have them in them? Or buy the manganese & selenium separately & feed them? Thanks in advance for help & suggestions!
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




Eleanor Kellon, VMD
 

I can't get your case history to open so guessing here but if you have been using metformin a month or more it may very well be losing effectiveness.

If not testing hay you will have to soak it and without knowing where it came  from can't even venture to guess at balancing. I would look into buying a ton or  two from a broker, such as http://silverstatehay.com/ . You can store it on pallets virtually anywhere - shed, lean-to, extra stall, even under tarps.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Hi Dr. Kellon. Flame has been on Metformin since 4/35/2020. Is it worth continuing & rechecking or should I just stop it? I have been soaking his hay for years & will continue to do so. The barn I’m at won’t give me a discount on board for providing my own hay & there is no where to store it there or at my house. I guess my question is should I add selenium & manganese to the ECIR approved balancer that I choose? And if so how much would a standard dose for each of those be? Thanks!
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




 

Oops that’s supposed to be 4/25/20. I updated my case history last night so it should be good to go  


Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




 

Would Invokana be an option to help control Flame’s insulin? 
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




Kirsten Rasmussen
 

Keep in mind that this is very generalized advice that can not take in to account appropriate mineral ratios, and might not be suitable for your hay.  But if you are adding a decent balancer you are miles ahead of most horse owners IMO.

I would look for a balancer with minimal iron and manganese, no more than 2mg (preferably 1 mg) selenium, and decent copper (~300 ppm) and zinc (500+ ppm) contents.  You won't know if it's a good fit but at least you can minimize the usual excesses and increase the usual deficiencies.  1 mg selenium added to whatever is in your hay is likely to still be safe and meet the minimum requirement.  I'm assuming you meant magnesium in your first post (not manganese?) because it is important for IR horses.  You won't know if your horse needs more magnesium without a hay analysis because it's not as likely to be glaringly deficient in hay like copper and zinc.  Most balancers add enough magnesium that it's not likely to be outright deficient, unless the calcium in the hay is really high (it probably isn't overly high in grass hay).

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


 

Hi Kirsten thank you for your response. I did mean manganese. I’m looking at the ECIR website & specifically the “List of acceptable ration balancers”. It mentions that manganese & selenium might need to be added depending on the area the hay is coming from. I know this won’t be exact like a hay analysis would be but I’m trying to do my best for Flame. You’ve already addressed my question about selenium but I’m not sure if I should add manganese or not. I used to feed Flame California Trace Plus but he got to where he wouldn’t eat it anymore which lead me down this worm hole of deciding to test one batch of hay each year, having it balanced, getting a custom mix made for him & then feeding it until the next year. I know that’s definitely not fool proof but it seemed the closest I could get at the time. I was getting ready to do the same thing again & the feed store manager mentioned that this batch would’ve gone within 2 weeks & it made me realize how useless it was. So now I’m back to finding a ration balancer that the group recommends & seeing if I should add manganese & selenium like the “List of acceptable ration balancers” suggest. 

It also sounds like his Metformin has stopped working so I’ll discontinue it. I read up on Invokana from this group over the weekend & I don’t believe I can afford it. Where are group members buying it from & how much is everyone paying? I’m seeing 30 300mg tabs for $500+ on the Internet. I would love to buy it for Flame but I can’t afford that. 
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




 

Kirsten- I reread your message. You answered my question about the manganese- low amounts (<2mg). Thanks!
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




Nancy Kitchen
 

Hi Beth
You ask about Invokana pricing, one of the members here recommended PriceProPharmacy.com  I get my horse's Invokana there.  Good service and the price is $ 270 for 90 days.  and I have them add tracking to the shipment.  This medication has helped lower my horse's insulin when nothing else would.  All the best to you and your horses.
--
Nancy K
Smoke and Tucky
November 2018, Southeast, MA

Smoke Case History:  https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Smoke
Smoke Photo Album:    https://ecir.groups.io/g/CaseHistory/album?id=94122
Tucky Case History:  https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Tuck 
Tucky Photo Album:


 

Thanks Nancy! Those are much better prices than I found!
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




Lavinia Fiscaletti
 

Hi Beth,

Not Kirsten here but that <2mg was referencing additional selenium, not manganese.

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


 


Kirsten Rasmussen
 

Dr Kellon posted this a few months ago:
Most people are using a Canadian based pharmacy which gets it down well below $200/month, e.g. http://www.globaldrugsdirect.com/DrugMoreInfo6983.aspx . There can be a 2 to 4+ week delay in receiving it.
There might be even greater shipping delays now due to COVID, but maybe our members can let you know how long it takes to get their prescriptions...

Sorry about the Mg / Mn mixup.  I live in an area where Mn is very high so my concern is always reducing it.  When you were testing hay, how much Mn were you seeing in it?  Do you know roughly where the hay comes from (ie West vs east?)?  Dr Clougher wrote in here a long time ago that anywhere affected by Mt St Helen's ash has high Mn in soil levels.  I bet there is a Mn in soil map of the continental US online that you could look at to see where it might be depleted.

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


Lorna Cane
 

I always recommend Island Pharmacy ( Shawnigan Lake, B.C., Email Kathryn : shawnigangirl@... TOLL FREE: 1-877-743-6944 ), but am always interested in other sources.

I can't find pergolide in a search there. 
http://www.globaldrugsdirect.com/DrugMoreInfo6983.aspx

Wondering what I'm missing?

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


 

Thank you for the info & replies. I thought I had the hay analysis on my phone but I don’t. I can see from emailing one of the ECIR hay balancers that it was done a year ago. So even if I find it, I have no idea what the hay I’m currently feeding had in it. Hay in Las Vegas comes from a distributor & they get it from multiple states around us. I will definitely check out Invokana pricing at Canadian pharmacies & it’s good to know about the shipping delays! Thank you!!
--
Beth & Flame & Diana

NV Oct 2013

Flame Case History

Flame Pictures

Diana Case History: https://ecir.groups.io/g/CaseHistory/files/Beth%20and%20Diana  




Lorna Cane
 

Thanks to Kirsten, I now know I was missing the detail that it was Invokana being discussed, not Pergolide. That's why Pergolide didn't come up under Global Drugs .
Details.
I don't know about Island Pharmacy and Invokana but worth a try.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php