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Louis the mini - Starting on Pergolide

Glenys
 

Hi all

As Louis has been confirmed PPID (10yo - refer case history) the vet has prescribed prascend / pergolide at 0.5mg per day.  He had his first one yesterday which I put between two tiny slithers of carrot ('til I can figure out another non-sugar treat today) which he ate happily.  However, I've been reading the 'the P veil' and am looking for advice on how slowly to introduce the pergolide please?  Of course the vet didn't mention this and I can't be bothered having the discussing with her as it's been push push push the whole way, including getting my 10yo mini tested for PPID.  

Anyway, before I give him his second pergolide pill today, I am hoping you can suggest the quantity I should intro him with?  Bearing in mind that splitting the pill into anything less than quarters will be problematic (I do have a pill cutter).

I can't imagine my little mini will go off his feed and I guess it would help him drop some weight, but I want him to get his minerals daily as well so I'd rather avoid this.
--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Eleanor Kellon, VMD
 

 The appetite suppression doesn't always happen. Since you have started it already you could just continue and see how he does. If he goes off feed, stop for a few days then restart. You can dissolve a half or quarter tab in a 5 ml syringe filled with water to get lower dosages.  Store in the refrigerator.
--
Eleanor in PA

www.drkellon.com  2 for 1 course sale until January 31, 2020
EC Owner 2001

Glenys
 

I am getting Louis' feet xrayed late today, and I expect to have the files by Saturday.  I'll post them as soon as I have them.  In the meantime, I've taken more photos of his feet (in his files within next 5 minutes) and I'm hoping Lavinia you can start to get me on the right track particularly with his heels.  I trimmed his feet 5 days ago, which was 4 weeks after the Trimmer.  I have held off getting her to do more until the xrays are through.  I have a continued concern about his heels.  He is still in boots & pads as he is continues to be tender without them.  He is in the yards (on carpet to stop the grass shoots) and deep bedding available in a stable.  He is with his mate another mini.

He is on day 5 of the Pergolide and so far he continues to eat.  I have had the hay analysed and Dr Kellon has done a mineral balancing and advised the hay is okay, however she recommended I continue to soak to reduce the calories.  She believes he is 50kg over weight.  However he has lost 8 kgs since I last weighed him.  I'll update his CH to reflect this.

I'm keen to get advice / your opinion about his heels in particular (feet generally of course) so I am well armed prior to the vet and trimmer.  My vet has been adamant we shouldn't drop  his heels much if at all as it will ' put pressure on his DDF'.  I have now had advice from Dr Kellon that this is basically a nonsense as he doesn't have any conformational issues (eg forward at the knees).  

Thank you so much.  I don't know how to specifically tag Lavinia into this so if someone can help me get the message to her quickly that would be appreciated.
--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Lavinia Fiscaletti
 

Hi Glenys,

Thanks for adding more pix.

Whether the heels need to be dropped or not is going to depend on what the rads tell us regarding the alignment of the bony column. The "pressure on the DDFT" argument is a persistent belief that just won't die. There is absolutely no actual research to support that theory.

It looks like he has a lot of extra hoof capsule in general, but there is also a significant amount of sinking that needs to be accounted for as well. Lots of evidence of past problems but at the moment, there is nothing horrible that warrants major changes before the rads are done. The heels are somewhat underrun, so that will need to be addressed moving forward, breakover may need to move a smidge further back but lets wait for the rads to make the decisions on exactly what needs tweaking.

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

Glenys
 

Thank you so much Lavinia that helps my blood pressure.  I have seen the xrays (on the machine) and I can tell you he has rotated on both and the toe clearly needs to come back a lot.  The vet continues to give me the blah blah about the pressure on DDFT and started quoting other sources so I just shut my mouth.


My trimmer is coming tomoro.  The vet is going to mark up the rads and send thru b4 she gets here.  I’m now thinking perhaps I should ask for the xrays without her markup to start with and get your advice prior to the trimmer coming.  She will be more open to other opinion.  So I could hold off getting her here til Sun or Mon maybe? 



--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Sherry Morse
 

Hi Glenys,

Yes to the unmarked x-rays if at all possible. Hopefully there won't be any quibbling over it (if anything I'd say you want both versions so you have a clear set to review in future and to compare to past).  



Lavinia Fiscaletti
 

Glenys,

If you can put off the trimmer for a couple of days and get unmarked copies of the rads, that would be very helpful.

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

Glenys
 

Hi Lavinia and others

I have now posted the latest x-rays taken yesterday.  They are here https://ecir.groups.io/g/CaseHistory/album?id=239216-

The trimmer is still coming tomorrow otherwise i can't get her before I go away for a few days late next week.  I know she will definitely take the toe back with the nippers (which I am unable to use at this stage).  So I'd be so grateful if you could mark up the rads when you are able to and I'll show her.  I'm thinking that even if she doesn't want to do what you suggest, I can still monitor and then post photos of the trim afterwards.  I'm capable of tidying the trim as long as it doesn't need nippers.  

I look forward to your advice from here.

On a positive note, I think the pergolide, diet and the Eva pads are making a difference finally, as he is much more comfortable, despite his rotation.  He's back to his cheeky self and moving much more freely, albeit still restricted in his space.  We are on day 7 of the pergolide and seemed to have by-passed the 'veil' period safely.  So now to get the trim sorted. 

I open to any feedback / suggestions.

Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Cindy Q
 

Hi Glenys

Great that little Louis is feeling better. Do you have collateral groove depths to share? (haha I know you do but maybe forgot to mention)
--
Cindy and Glow - Sep 2017, Singapore
ECIR Primary Response




Lavinia Fiscaletti
 

Thanks, Glenys.

I'm on my way out the door - I'll put up a couple of quick mark-ups later today.

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

Glenys
 

Thanks for the reminder Cindy.  

His CG depth on both fronts is 15mm at mid-bar.  There is no ‘depth’ at POF, rather the frog is raised and there is no groove to speak of at that point.  


I have been starting to clear the back of the CGs away from the heel area to open it in order to see true heel height.  Let me know if u need further info.

--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Lavinia Fiscaletti
 

Hi Glenys,

I've added a couple of mark-ups to Louis' album:

https://ecir.groups.io/g/CaseHistory/album?id=239216&p=Created,,,20,2,0,0

RF needs to have the heels lowered some but not drastically. Both need to have the toes backed up but need to be careful NOT to remove any sole depth as both are borderline. Although there appears to be excess vertical hoof capsule height, this is misleading as there is a significant amount of sinking that makes it necessary to maintain more overall height so that the bony column inside remains covered.

RF Lateral: There is a slight amount of bony column rotation that needs to be addressed. Blue lines are the trim lines, all others are for reference only. Lower heels some and bring the toe back to get the breakover into a better location. Yellow lines denote the sinking as they should align with one another. Pink line ends where the sole depth should be at ground level. Red is the area NOT to remove any vertical height/sole depth from.

LF lateral: No bony column rotation so leave the heel height where it is, just need to bring the toe back to the correct location. Blue lies are the trim lines, others are for visual reference only.

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

Glenys
 

Thank you so much Lavinia.  I've also replied to your private message.

Can you or someone tell me how I can save these files to my desktop so i can send them in an email to my trimmer please?  She is very interested in seeing your recommendations / markups.  I can't seem to download the actual rads you have marked up and when I send the link of course she can't see it.

--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216

Lavinia Fiscaletti
 

You need to download each of the pictures to your computer in order to save them.

On a PC: Click on an individual photo in the album to open it. Then click on the Download button beneath the picture. When that opens, right click in the photo then choose "Save Image As" to save to your computer or "Email Image" to send it to someone.

Sorry, don't know how for any other devices.

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

Glenys
 

Hi Lavinia

https://ecir.groups.io/g/CaseHistory/album?id=239216

Thank you so much for your comprehensive instruction and the mark-ups.  My trimmer came today and she was fantastic.  We spent time going over the mark-ups together, she was totally in agreement and supportive and got to work.  I have taken photos (link above) to hopefully capture the end result.  She was careful to not take sole off either off them.  She did use her nippers, as she thought it would be quicker and less stressful for him, then she rasped to tidy it up.  She is very open to feedback about this trim and is actually going to join the group which I'm so happy about.

So I will share any comments you make back to her and as I said, she is keen to hear your feedback / suggestions if anything else needs tidying, or if you think this is too much.

We agreed I will do a maintenance rasp at least every 2 weeks, if not weekly.  

If you need any other photos, just let me know.

He is back in his boots & eva pads.
--
Glenys and Louis 
January 2020, Paekakariki, Wellington, New Zealand

Louis CH -https://ecir.groups.io/g/CaseHistory/files/Glenys%20and%20Louis
Louis Photos -https://ecir.groups.io/g/CaseHistory/album?id=239216