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Is there a link between analgesics and elevated glucose or ACTH levels?


Mary Ann
 

I'm curious if there have been studies done to see if IV and topical analgesics and oral NSAIDs contribute to elevated glucose and ACTH levels in a known PPID horse? In the last 3 months, my mare has been sedated on a regular basis with the following during treatment of her Uveitis: Lidocaine, Rompun, Torbugesic, Alcaine, Carbocaine, and NSAIDs Phenylbutazone, Flunixin Meglumine, Firocoxib and the oral sedative Dormosedan. She is still on the Previcox. She has been on beet pulp and alfalfa pellets with her vitamin/mineral supplement, extra Vitamin E and ground flax since July and low starch/sugar hay as well. She has not been turned out in the pasture since her diagnosis in July, but there is grass growing around the perimeter of her paddock that she can reach under the fence. There is also a little bit a grass beginning to grow up through the crusher dust in her turnout paddock. All treats have also been stopped since July. I have now increased her Prascend to 1.5 mg beginning today up from 1.25 mg for the last 8 days. The vet is coming on Oct 16th to do her dental exam and also a recheck on her eyes so she will sedated yet again. 
--
Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Sherry Morse
 

Hi Mary Ann,

We do not recommend the use of sedatives before testing as it can have a temporary effect of blood levels.  You can reference these messages in particular:


As far as long term studies - not that I'm aware of, but you can always try doing a search on the Google for info.




Mary Ann
 

She has always been sedated during the blood draw process. Perhaps this is why her levels are so high on the second blood draw. She is VERY difficult to give any type of needle (vaccines or sedatives IV) so she must be pre-sedated with Dormosedan prior to the vet arriving so she is easy to handle as well as being twitched during any IV needles (even while sedated on 1 ml of Dorm gel). She cannot be twitched alone without sedative to have blood drawn. Three different vets have tried with zero success. She's a mighty force for a 14.2 hand 870 lb Arab.
--
Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Lorna Cane
 

Hi Mary Ann,

People have had success with behavioural mod types of activities, needles included.
Baby steps, getting her used to everything needle.

One thing that horses are very sensitive to,before anything even happens,is the odour of alcohol .Red alert.
My vets and I have often not used it,for that reason.

But before that it's a matter of association,and helping Rosie learn that  she can do this.

Baby steps, but worth it.


--

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


Eleanor Kellon, VMD
 

It's definitely having an effect but exactly what that is depends on the time after giving it:

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15747

This class of drug (alpha-2 adrenergic) can also lower ACTH in normal horses:

https://pubmed.ncbi.nlm.nih.gov/10971812/

although the effect in PPID is unknown.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

Benzodiazepines like  Valium (Diazepam) are the only drug class I know of that won't influence the results. You could try that along with blindfolding. There is no equine information on oral dosing but no reason to think it wouldn't work.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

It's definitely having an effect but exactly what that is depends on the time after giving it:

https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15747

This class of drug (alpha-2 adrenergic) can also lower ACTH in normal horses:

https://pubmed.ncbi.nlm.nih.gov/10971812/

although the effect in PPID is unknown.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

I had a mare who was very needle averse.  Blindfolding definitely helped her.  Also, I learned that she found dental floating to be quite relaxing so we did that part first.  And, I now know that my presence can generate lots of tension as I’m always concerned about how things will work out.  So, I tried to vacate the premises and let someone else hold her.  My friends who would hold her brought their own little tricks to try.   I’m perfectly fine holding horses I don’t also ride.
--
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


 
 


Eleanor Kellon, VMD
 

The good "old time" dentists used no mouth gags, no drugs, no restraint at all.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Lorna Cane
 

I'm fortunate enough to have one of those.
He's younger than I am ( no comment), but he sold his electric float devices years ago.
He has a way of saying, "You're ok. You're fine." ,which the boys totally believe.

--

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


Eleanor Kellon, VMD
 

It's called horsemanship.

Sometime around the 1980s a big push was put on sedating horses and essentially immobilizing them for procedures that before then would never have called for chemical sedation. I'm not sure why. It's a pet peeve...
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Mary Ann
 

Thank you for the blindfold suggestion Dr. Kellon. I'm going to give that a try during the next vet visit this coming Friday. She has had an aversion to needles from the time she was a foal. I was told by the breeder that she was seen as a weanling by a "small animal" vet who handled her very badly and she's never forgotten that trauma. We've tried nose and skin twitches but never a blind fold. As soon as she sees the vet's vehicle driving in my yard she begins to get agitated unless she's pre-treated with dorm gel. We've tried all types of behaviour modification techniques and I'm sorry to report that we've had no success with any of them. 

--
Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Lorna Cane
 

You've probably tried Rescue Remedy, Mary Ann, but just in  case.....

--

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


Bonnie
 

A trainer who also did tooth floating came to our town. "I don't use drugs or gags," he said. "I sing to them." Grasping the tongue of a pony named Pro, he started work, singing 'Pro, Pro, Whaddayou know, It's time to work so here we go..." The astonished pony listened to the song till the floating was done. No problem. The other horses had songs with their names in them too.
--
Bonnie and Lad
North Ontario
Dec 2008
 


Mary Ann
 

She's fine for the dental exam, she really doesn't need to be sedated for that in my opinion. It's just those darn needles. She will probably accept a blindfold rather easily because she has to wear a UV eye mask 24/7. My only concern is the blindfold will have to come off if the vet needs to do nerve blocks to the left eye to check if the corneal abrasion has cleared up completely. I've tried using positive and negative reinforcement techniques to put medication in her eye after the SPL was removed and I'm having some success. She's one smart little mare and she remembers voices, vehicles, smells, sounds and certain movements/touches.
--
Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Frances C.
 

Fantastic - now we need a singing farrier
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


Mary Ann
 

Lorna Cane, this is first I've every heard of Rescue Remedy. What is it and how is it used?

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Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
https://ecir.groups.io/g/CaseHistory/files/Mary%20Ann%20and%20Rosie


Lorna Cane
 

Hi Mary Ann,

Here is Rescue Remedy....
http://www.bachflower.com/rescue-remedy-information/

Their site explains far better than can I. 
But I always have it on hand ( Amazon.ca is a good source),in various forms,for horses,dogs,and myself.
I began using it years ago for a black lab , who knew a thunderstorm was coming about 20 minutes before it arrived. She was terrified. RR, dosed about 15 minutes before the storm( or right at same time,whichever I could manage) helped her immensely. Sometime I had to dose more than once. 
Sometimes with my horses I dose more than once,depending on horse, situation,etc. 

You will read the various ways to administer it on the site,all depending on your situation.
It's handy to have the non-alcohol based RR for the horses, but not necessary, IME.

As always,I recommend talking to the company if you have questions.They've been around a long time.
--

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


Mary Ann
 

Thank you for the info Lorna Cane. I will definitely look into this.

--
Mary Ann & Rosie - Nova Scotia, Canada - Joined August 2020
https://ecir.groups.io/g/CaseHistory/album?id=252134
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