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Help for Teeny Desperate for feedback


TERRI JENNINGS
 

Hello All,
Teeny has completed her course of antibiotics and seems to be in better spirits. However, she continues eating only part of her ration and she is getting skinnier by the day. 

My vet is stumped.  No current signs of infection, fecal was negative, Lyme test was negative. Ulcer treatment, Pre and probiotics did not help, APF is not helping and I’ve added additional beet pulp to her meals but her weight continues to drop. She has been seen eating shavings and has attempted to eat tree bark several times. 

I have updated Teeny’s case history and added a PDF with her bloodwork from earlier this week. 

We are all super concerned about her and the vet is unsure how to proceed.   Any help is greatly appreciated.  She is a very important part of our therapy program and I want to do whatever we can to help her. 


Thanks,

--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Eleanor Kellon, VMD
 

Terri,

The eating shavings and bark is fiber craving and can be associated with a gut upset of some type.

 However, the high T4 is also concerning. What was her dose before you weaned her off? If dose has been steady since 2017 it shouldn't have gone up like that. Thyroid carcinoma can occur in older equines (we've had one or two here) and would certainly explain weight loss. It looks like she's getting more than enough food. What does her pulse rate run? I would repeat her thyroid blood work and consider a complete panel from Michigan state.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


TERRI JENNINGS
 

Thank you Dr. Kellon,
I’ve been trying to up Teeny’s beet pulp to increase her fiber intake. But with her only eating about half of her overnight food I don’t think I’m getting enough food or fiber into her. Is there something else that is high fiber that would be safe for her given her metabolic issues and her poor ability to chew? 

I will get my vet out right away to do the thyroid testing you suggested. Teeny has been on a half scoop of Thyro-L for years. I thought it was strange that her thyroid was higher but chalked that up to getting her ACTH and insulin down.

I will check her pulse rate and get back to you. I would have done it earlier today but we are having a heatwave so it’s 90 degrees and very smoky from the wildfires today. 

Thank you so much for your help. She is still feisty with us grown ups (but never with the kids) so I know she’s not ready to go. She has done so much amazing work over the years with kids with autism. Including having many say their first words while riding her. I want to do whatever I can to keep her comfortable and happy until she’s ready to go. 

Terri
 
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


TERRI JENNINGS
 

I forgot to ask about Teeny’s Metformin dose. My vet mentioned something about it affecting her appetite and I found some posts about that in the files. Her decreased appetite did not occur when we put her on metformin or when we raised her dose. It also didn’t coincide with her last increase in Prascend.  Do you think it would be worthwhile to lower her dose or change meds? 


Thank you!
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


 

Terri, this may be grasping at straws, so to speak, but have you tried separating out the components of her meal?  I had to do that with Logo a few times and generally there was something I could exclude to make his meal easier to eat.  It could be a supplement (salt in an irritated mouth?) or a feed he no longer enjoyed.  My best wishes for Teeny and her little friends!
--
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


 
 


TERRI JENNINGS
 

Thanks Martha,

I’m willing to grasp at all straws for Miss Teeny. 
Yes, we’ve tried all different combinations and just plain Timothy cubes. I even put separate buckets of Timothy balance cubes and beet pulp. She still just picked at the different buckets leaving about half of her food. My vet is going to check her mouth for sores...again.   

we aren’t giving up yet!

Thank You


--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


TERRI JENNINGS
 

Dr. Kellon,
Teeny’s pulse was 36 beats per minute. 
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Eleanor Kellon, VMD
 

Good. That's normal.  Doesn't rule out a thyroid issue completely though.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


TERRI JENNINGS
 

My vet wants to do Cornell’s thyroid panel instead of Michigan State. Can you tell me what I need to say to justify using a Michigan State?

Also, I’m wondering if her metformin dose may be contributing to her lack  of appetite possibly?

Thank You 
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Eleanor Kellon, VMD
 

Cornell's panel doesn't include free T3, although in this case it doesn't really matter as far as we know.

If the metformin is causing oral ulceration that could definitely be backing her off eating.  Metabolically though, no.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


TERRI JENNINGS
 

Hi Dr. Kellon,
I just uploaded Teeny's thyroid panel to my case history.  I'd like your feedback when you have time.  

I did have her mouth checked for ulcers and had her teeth checked.  There were no problems found there.

Thanks,
Terri
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Eleanor Kellon, VMD
 

Her thyroid panel is most consistent with euthyroid sick syndrome. This is when the thyroid is normal but poor nutrition or chronic disease is resulting in suppressed levels.

Anything is possible at her age, including cancer, but it's worth trying to stimulate her appetite. Some possibilities:

- restart Jiaogulan if not still on it or try APF
- CocoSoya, 2 oz/day on food
- Cut up a few pounds of hay into 1 inch pieces with hedge shears, soak well before feeding
- Make alfalfa tea (boiling water poured over powder or pellets, steep, strain) and pour on her food
- Other flavorings - https://www.herbalcom.com/home.htm

Eleanor in PA

www.drkellon.com 
EC Owner 2001


TERRI JENNINGS
 

Thank you Dr Kellon. I’ll work on those diet changes that we haven’t yet tried. Is there something that would show up in her bloodwork if it is cancer?  I just feel like it might make a difference in how I handle things with her. Part of my issue coping is that it won’t just be a loss for me, but also for all the kids in our therapy program. Many of them are very concerned about her and I don’t have answers for them. 

Thank you!
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


Eleanor Kellon, VMD
 

Has a blood chemistry been done recently? That would be a reasonable place to start.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Sherry Morse
 


Doesn't show anything that jumps out as me as cancer but I'm not a professional :-)




Eleanor Kellon, VMD
 

The only thing in the bloodwork that catches my eye is the high end calcium (14 is not normal - it's that reference ranges do not mean normal thing!).  Some PPID cases have overactive PTH production and high calcium as a result. It can also be elevated by chronic kidney disease and some forms of cancer.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


TERRI JENNINGS
 

Just the one a few weeks ago. That was following a course of antibiotics. 
--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019


TERRI JENNINGS
 

Thanks Dr. Kellon,
We have already ruled out CKD and everything else anyone has suggested.  I think we most likely are dealing with some form of cancer.  In some ways it’s comforting to know what it most likely is and that I’ve gone down every other avenue. We will give Miss Teeny the best send off we can when she’s ready. I’m sure she will tell me. In the mean time I will stop stressing and just enjoy her feistiness with staff and her kindness with the kids. 


Thanks for all the help,--
Terri Jennings with Teeny, Finn and Elliott
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
Joined 2019