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Latest Update on Vinnie and the Veil


Nancy & Vinnie & Summer
 

Hi all,

Just wanted to send another update. Vinnie is doing fantastic health wise. We are walking 15 mins per day and start 20 mins next week..

We are still dealing with the pergolide veil as he is still not eating his supplement bucket as he did in the past and I am bot giving him all the supplements he used to get because refuses some.   He is still on 10ml of APF pro per day. 

Based on how well his body responded to pergolide, I had this epiphany the other day that maybe he has been PPID this whole time since 2018  even though his bloodwork has consistent been negative.  He has just done too well body condition wise.  In fact, I feel like this week he got ever slightly cresty again and I attributed that to trying a small amt. Timothy hay that had more sugar, but now I am wondering if it is just more symptomatically uncontrolled ppid.  I was planning on stopping pergolide after seasonal rise, but now I am thinking I should keep him on his dose or maybe raise it slightly?  He is also getting CTB and since he falls into the majorly sensitive category I wonder if I should stop CTB because of the possibility of interference with pergolide?

I am also looking for new hay, while my current blue grass is low in s/s I am not happy with the iron and my gut tells me I need to mitigate all things that can be causing Insulin response so we don't have any set backs caused by "me".

I would like to get him in the uckele muscle eq to help with topline loss but, he won't eat it if it is in his mash.  I am already syringing, APF, vit e and HA because he won't eat them in his mashy any more.  So trying to think of a way to entice him to eat his mash better w/o introducing things that are bad for him.  His mash consists of a big cup of tc timothy balance cubes and a small cup of lmf low starch complete with his balancer, flax, salt ctb, chondroitin, wellpride fish oil made with a good amt if water so it is about oatmeal consistency. 

All feedback welcome.. thanks in advance
Nan
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Eleanor Kellon, VMD
 

Have you tried Anise oil? Few horses can resist it. Try just 2 or 3 drops mixed in well.  Agree with stopping CTB.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 


Eleanor Kellon, VMD
 

McCormick makes one so you  may be able to find it at your grocery store. Otherwise, there are dozens available online, from Walmart, Amazon, etc.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 


 

On Sat, Dec 5, 2020 at 08:17 AM, Nancy & Vinnie & Summer wrote:
His mash consists of a big cup of tc timothy balance cubes and a small cup of lmf low starch complete with his balancer, flax, salt ctb, chondroitin, wellpride fish oil made with a good amt if water so it is about oatmeal consistency.
Possible approaches I used over the past 8 years:
1. If you feed at night and it's all gone by morning, that's good enough. It's not necessary for him to gobble up the whole mash at one time immediately. Even my hooverer won't eat all her supplements if there's hay around, so I feed supplements before hay.

2. Restart with carrier + taste tempter only, with 1 T salt. Add in additions one at a time, starting with ground flax. You might sort out what he doesn't like. FWIW, the two nasties according to my mares are high amounts of poly copper (taste it and you'll understand what I mean) and phosphorus (it smells).

3. Try 50% more carrier. One "big cup" of ODTBC doesn't sound like much, tho it's impossible for me to know without weighing it. I give mine  200-225 grams/ ½ pound by weight, which is a large, heaping, packed mug this size: https://www.amazon.com/Tervis-Clear-Colorful-Insulated-Tumbler/dp/B084WCDLTC/

4. Try a different taste tempter such as  ½ - 1 cup Cavalor Fiber Force, FORCO or Nuzu Stabul1. A small 20 pound bag of Stabul1 is available directly from Anderson Feed so you won't get stuck with 50 lbs if he doesn't love it. https://shop.nuzufeed.com

5. Try softening and fluffing the cubes without turning them to mush. Add the taste tempter after the cubes are softened so they don't dissolve. He may like the texture variation. 

6. Try to eliminate the fish oil. He is getting Omega 3 fatty acids in ground flax.

7. Try a different pan or feeder. If you use an over-fence feeder, try a wide flat pan or bin that allows odors to dissipate and the opportunity to pick through the supplements a bit. 

 I never had luck with herbal taste tempters  (fenugreek, beet powder, anise), but fenugreek or banana Stabul1 do the trick. A heaping teaspoon of CocoSoya granules, which smells like vanilla cookie crumbles, is my last ditch taste tempter. 
 
--

Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


Eleanor Kellon, VMD
 

On Sat, Dec 5, 2020 at 03:39 PM, Cass in NorCal wrote:
A heaping teaspoon of CocoSoya granules, which smells like vanilla cookie crumbles, is my last ditch taste tempter. 
Doesn't have to be last ditch, especially in that amount. Several years back we did a field study with CocoSoya oil at 4 oz/day and there was no significant difference in insulin.
 
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 

Thanks Cass!  Today i tried just removing the balancer am he gets Glycocemic eq, and out that in a bucket with about a half cup of lmf. He ate that and then I gave the rest of the supps, flax, salt, chondriotin, gut, in the cubes with a half cup of lmf and he gobbled that up!!! success.. his am bucket is usually the easier one..he gets prascend at night in a cookie..

The nighttime bucket he gets the same carriers and have tried more or less tc balance cubes and some days he finishes over night sometimes he leaves the whole thing like last night. The night time balancer he gets is foundation formula so I think I will try separate that from the mix to see if that is the thing bothering him mixed in.  At night he gets coco omega, salt, another scoop of gut (since I ran out of absorb all), laminox and chondriotin.  I am going to try cocosoya after the anise oil.. if the latter doesn't work.  I could also get flax oil from big sky which is pure flax oil which he used to get and love but stopped when I went to the ground flax.

He does love the tc balance.cubes especially dry.. go figure.. so I always give him a follow up treat of those if he finishes his mash.

He gets cbd pellets too which he will eat out of my hand only .. again go figure.. 

I have a line( thanks to Anthie) on a nice meadow grass  that is low s/s and iron and looks overall better than what I have been feeding that that I am going to try.. i do not like the body changes the last week or so that I am seeing.. in the interim should I try to convert some lb of hay to tc balance cubes or should I stick with my current hay and soak and rinse until I can get some of the meadow next week?  I loaded an image from two days ago..check out the Oct image to now..subtle but metabolic are off..

He did seem a little more foot sore last couple days too..attributed that to some antics during our walk.. levade, bucking in place etc... (he was responding to a very loud gal boisterous gal in the arena (heehee)) but now I am wondering if this is all related to insulin spike?

OPTIONS: soak hay, add more lb of cubes to offset hay, add metformin or add a little more prascend?? I can confer with my vet too but ideas welcomed.


--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Nancy & Vinnie & Summer
 

Follow up question too. I have a couple bales if the timothy and about 15 .ore bales of the blue grass.. would it be better to soak the timothy (for less sugar) or keep him on the blue grass and soak that knowing I can't soak out iron but it is very dusty hay?  This would be another option which may produce.the best result.  He has been only getting the blue grass.  Both tests in my folder.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Nancy & Vinnie & Summer
 


 

Whatever you do, make the hay changes slowly. I’d be more inclined to add more cubes than to switch to a new hay. I introduce new hay a pound a day. At that rate you won’t get very far with adding timothy hay before you get the new meadow grass. If Vinnie (you slayed me with Zoolander) is footsore, I’d definitely soak - to rinse off dirt and to reduce ESC. 

Just want to alert you that I view late season hay with caution. My experience is that ESC can be low but nitrates can be high, requiring— you guessed it — soaking to make the hay safe. 
--

Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


Nancy & Vinnie & Summer
 


Tamara Gonsor
 

Cass, thank you for your details suggestions above on food. I have tried most of what you mention but there are a few in there that I haven't. Will be trying today to get my boy eating again. 

Thank you!
--
Tamara G. in Arizona 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Tamara%20and%20Malik
Malik Photos: https://ecir.groups.io/g/CaseHistory/album?id=252564


Kirsten Rasmussen
 

I hope someone will correct me if I'm wrong, but technically Vinnie should be past the veil from his last dose increase in October, should he not?  I wonder if he really does need more pergolide.  Maybe what you are seeing, Nancy, is not a veil but are instead signs that his dose isn't high enough?  You mentioned noticeable improvement on pergolide, but consistently normal ACTH means the only way you can adjust dose is by signs, and if his crest has gotten bigger recently it could be a combination of the timothy hay and a need for a higher pergolide dose?  Just a thought.

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


Nancy & Vinnie & Summer
 

Thanks Kirsten,  I kinda think the same. He only got a small amt of the Timothy for about a day and I noticed a change in crest, but it didn't go down even though I stopped it..so that made scratch my head a little and then we trimmed his left front on Wed and he was really naughty during the walk that evening, and then the next day he seemed a little foot sore.. So I chalked it up to antics..but then I took a step back and looked at all the small subtle changes and it just confirmed what my gut had been feeling for a while now about the blue grass and the iron and maybe as Cass notes maybe this hay has high nitrates (haven't tested that). Just too many coincidences.. The fact that soaking one meal produced a positive change too, and I did some acupressure on foot points and got some.massive releases last night makes me think that hopefully we averted a disaster. 
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


 

I defer to Dr Kellon on Vinnie's potential PPID diagnosis. I don't see symptoms that indicate uncontrolled PPID as opposed to EMS. We are at the end of the seasonal rise for normal horses, and if he lived here, I'd want updated ACTH, insulin and glucose testing. It's easier to know what you're dealing with than to manage him for an unconfirmed condition in an information void. 

I say this after working for several months to check Diamond for ACTH after she was cresty and round-bellied. It was hard to get a reliable lab test because she works herself up whenever unfamiliar vehicles drive up. It turns out that the post-TRH stimulation result was pretty clearly non-PPID. She's lost some weight, and what's left is a smaller crest that looks larger to me than Vinnie's and no pot belly. EMS. I uploaded a current photo with full protective coloring in contrast to Nancy's beautifully turned out pair.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos 


 

That’s been my thought as well, Kirsten, but I was concerned about my possible reputation as a pergolide peddler so I thought I’d wait.  Assessing again after tightening up the diet sounds reasonable to me.
--
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
 

Vinnie's age alone puts him at high risk for PPID, and there are certainly many early cases with normal endogenous ACTH, but I agree with Cass that you need better diagnostics. You stated earlier you were planning to retest in December. I would make that a TRH stimulation in January instead, after having him off pergolide for a month.

Of all the hormones elevated in PPID, ACTH is by far the lowest. Studies looking at ACTH vs alpha-MSH, another of the POMC hormones, have found ACTH is just as good for diagnosis but these were full blown cases, not early. I can't say for sure it's 100%, but TRH stimulated ACTH should be far more sensitive.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nancy & Vinnie & Summer
 

Thanks Dr Kellon, I will definitely tplan to do the TRH stim in Jan. After talking with my vet recently about how Vinnie responded to pergolide she felt TRH stim may be the way to go diagnostically.  I am worried if we stop pergolide for a month especially now when he is going through some mini episode of something.. Notably (much better today after soaking 3 meals and replacing about 2 lb of hay with odtbc ( even my mare is responding and I only soaked her large hay portion for over night).

If I stopped pergolide now to test in Jan would that be risky or should I wait to drop til end of dec after Christmas and test around the same time in Jan? 

Would it hurt to pull values.acth, insulin and glucose now, just to see where we are at and if any of the values have improved.while on pergolide and wpuld that be worthy of something conclusive or just to settle my.mind?

Uploaded an image of today after soaking all hay except early feed yday and stopping ctb yday.  His muscles are softer his back see.s more relaxed and he definitely is less sore in the feet.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Eleanor Kellon, VMD
 

No problem with waiting until the end of December to stop the pergolide. Also no harm in pulling blood before you stop but any ACTH drop could be from the seasonal rise abating and insulin levels are multifactorial -  could just as easily be lowered by soaking hay.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001