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GAVI is bad to worse ,Im worried and need next steps please


Tara Smith
 

Dear All ,Hi Just an update that is not feeling good at all. Im DEEPLY concerned for Gavi .since our last mess. of concern and being  advised ,we are still declining. We just reached 4 mg on pracend tabs 3 days ago with little to no improvement yet during the adding in from 2 to now 4 mg.we will try and wait 3 weeks and test again .He was neg .for lyme and I still have yet been able to get a current urine sample .I just received the Laminox but he wont eat it .Can laminox be put into a syringe with a bit of water if necessary?We are on 300 ivonkana and making sure hay is wet before salting.I started getting in  1 dose   of metformin im shooting for 2 xs a day.He could barely move today and he keeps biting at his boots and bell boots soft rides  ,and socks .Its all annoying him or he itches or feet hurt so much.The farrier was here 2 weeks .Where do we go from here please?Do I try and wait the 3 weeks to see where we are with symptoms and acth number then?Anything for pain?I DNT WANT THIS TO BE THE END...PLEASE SAY THERE IS MORE TO DO AND TRY?He loves when  I message his feet 
.Is it time for new xrays or try to hopefully get over this hump first?Fondly, Tara


--
Tara and Gavilon
Mass.  Nov 2017
https://ecir.groups.io/g/CaseHistory/files/Tara%20and%20Gavilon
https://ecir.groups.io/g/CaseHistory/album?id=11449


Eleanor Kellon, VMD
 

Tara,

Important to get that urine ASAP. How much is he drinking? Do you know how to do the skin pinch test for hydration? Also pick up his upper lip and press firmly on the gums with your thumb,  count the seconds it takes for the color to come back. Has the amount of urine in his stall changed?  Yes, you can syringe in the LaminOx. You can give him PhytoQuench or Hemp Joint for pain, no drugs with Invokana. Definitely time for films. Does he have any heel rubs? How does he walk out of boots?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy Kitchen
 

Tara
Just a member here but I can offer some moral support.  Time moves terribly slow when we are in crisis but remember to breathe. 
--
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:


Tara Smith
 

Hi ,thank you for responding so quickly.I see him drinking well ,I will do the thumb press today ,I will try for urine again I keep missing it .If i see him urinating im not close enough to jump the gate to get there in time .From what i see,its alot of pee and clear looking doesnt seem concentrated. WHAT ABOUT CBD the strongest natural pain option please?He cant walk far with boots taking steps right now is horrible .He cant step without boots at all.He navigates the ground carefully watching where to step and creeps.He is 24/7 turnout .He has pea stone beneath his feet ,his warm water ,free choice hay in slow feeder and tons of shavings behind the slow feeder box that the 2 horses love and bed down in all the time. They cant wait for me to refresh it all the time. SO AT THIS TIME  he stays  by choice in a small space that is specific to his needs ,but can walk away at anytime he wants .Has anyone here every used romania the herb My friend used romania 11 for her horse and he does very well on it.Also my farrier mentioned rasberry leaves ? 
-- I will try for urine really hard today.Also metformin. Im not here with him for 10 hrs everyday and way to offer 2nd dose of met. Any sooner. I dnt want to get him into trouble with colic risk or anything offering to much to soon.Tgank you  Tara
Tara and Gavilon
Mass.  Nov 2017
https://ecir.groups.io/g/CaseHistory/files/Tara%20and%20Gavilon
https://ecir.groups.io/g/CaseHistory/album?id=11449


Sherry Morse
 

Hi Tara,

This is where having an up to date Case History, current test results and current pictures of his trim would be helpful.  Biting at his feet to me would be an indication that they are bothering him - either from the boots not fitting quite right or because they hurt internally.  However, without pictures we can't help you assess that.  Since your last x-rays (at least as far as what's in your photo folder) are over 2 years old and at the time his toes were quite long, it may be a good idea to get a new set to see what's going on internally. Were he mine, I'd start with posting current trim pictures and then x-rays and plan on getting bloodwork to check his ACTH and insulin again.

Out of curiosity - how is his weight right now?




Tara Smith
 

Also no heel rubs.Dr kellon ,i kmow you mentioned 1 pain med could be used with Ivonkana it began with a D .i cant remember do you ,he is in agony
--
Tara and Gavilon
Mass.  Nov 2017
https://ecir.groups.io/g/CaseHistory/files/Tara%20and%20Gavilon
https://ecir.groups.io/g/CaseHistory/album?id=11449


Eleanor Kellon, VMD
 

Tara,

Is he spending most of the time down? Could you post a short video of him walking?  Raspberry won't help. I think you meant Rehmannia? That's an herb for fatigue or anemia. The D I mentioned was probably Devil's Claw. That's the active pain reliever in PhytoQuench pellets and Hemp Joint. If your vet thinks the pain warrants it he/she could prescribe Tramadol 10 mg/kg twice a day. Also need: insulin, glucose in urine, ACTH, radiographs.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Tara Smith
 

Hi again ,ok just scheduled
-- xrays for friday ,my farrier is going to try and come a protocol of whats needed would be great.This vet coming is not who i want for xrays but the only avail so he needs detailed directions and isnt gonna be happy about it .His gum test returned within seconds,he is up and down but sticking to a small area.He is shaking in fronts when getting up and lifting legs in an alternating pattern .I took boots off for tonight to see if he keep biting at them .I cant get history up as Im not tech savvy and have a major issue .Id pay someone to help me. His insulin is 200 and acth /stim was 348 ,without stem.18.not sure how to send video.Still trying to get urine sample.I know gavi is a difficult case ,typically when his cushings level.is up he then has higher insulin with pain ,thats his pattern.Does this mean the tumor is not responding or to soon to tell  and how much pracend can a horse be given and still  be supportive to the  horses disease.The vet said he can have metformin every 8 hrs is that ok?can I give laminox and the hemp blend along with ivonkana and  pracend? ..oh yes I remember we spoke about tramadol its very expensive with the amount he would need.Any cheaper more affortable ideas on that.also  I had a private consult with Dr kellon last year because I couldnt upload into case history   and sent everything to date to her .My farrier kathleen even cumminicated with her and said dr kellon said  trims were perfect.He is still getting that trim every 5 weeks without fail based off his symptoms. I HOPE THIS COVERS MOST INFO..NEEDED IN THIS MOMENT
Tara and Gavilon
Mass.  Nov 2017
https://ecir.groups.io/g/CaseHistory/files/Tara%20and%20Gavilon
https://ecir.groups.io/g/CaseHistory/album?id=11449


Nancy & Vinnie & Summer
 


Sherry Morse
 

Hi Tara,

The information on how to get good x-rays is in the Wiki here: https://ecir.groups.io/g/main/wiki/1571. We have several horses on this group who have been on 20mg (or more) of Pergolide without issue.  When was the TRH test done?  If it was during the rise the results are not going to be accurate.

For pain relief you can use Phyto-quench with the Devil's Claw as Dr. Kellon has already mentioned.





Tara Smith
 

Hi sherry ,acth was just done maybe 3 weeks agobecause he has been uncomfortable and getting worse not better out of fall rise and He gets puffy fat pads above eyes when Something  is going on an and starting.Before the fall.rise he was amazing low insulin for gavi ,low 30s and we didnt do atch with stim but watch regular acth because when its 17 or above we know he up tjere om a stim test .when its lower which it was we know it was down,and hes been as happy as a clam until now,well past few months ..we didnt have the best fall rise experience thos year but not anythong close to his worst.Should I order phyto quench or hemp blend recommend?Dr kellon also mentioned the tramadol which I may try if little risk with that..Thank you all so very much..im not ready to give on on my fight for him  I pray we get through this...
--
Tara and Gavilon
Mass.  Nov 2017
https://ecir.groups.io/g/CaseHistory/files/Tara%20and%20Gavilon
https://ecir.groups.io/g/CaseHistory/album?id=11449


 

Tara, it’s my understanding that you took the endogenous (not stim) ACTH in late December and it read 348.  Did you increase the pergolide at that point?  I’m one who had to go to very high pergolide doses, even higher than Sherry suggests, to get ACTH control.  Finally, I could no longer control it with pergolide and I switched to cabergoline.  It had been my ‘plan’ to increase pergolide as needed until I reached a crossover with Cabergoline, with respect to cost, but before I reached that point, his ACTH level appeared to be independent of increasing pergolide.  You’ll only know by testing after increasing pergolide.
--
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