Mouse and Ryn 6/7/2022 blood work results DR Kellon advice please


Kimberly
 

Bloodwork is not good news.  Both horses were on Metformin orally in food.  Ryn started 5/23 thru 6/5 but had stopped eating on 6/2 so was not getting much if any.  Mouse was started on 5/26 thru 6/6 but was not eating much, if any in beet pulp either.  Discontinued with both horses.  Neither is a good candidate for syringing in at this point so not an option.  
Ryn:  Glucose 110
ACTH 11.7
Insulin 73.66
Leptin pending
T4:   0.219

Mouse :  Glucose 112
ACTH:  9.25
Insulin:  116.75
Leptin pending
T4 :  1.50

I will do another case history on both asap.  Not sure how to add Ryn's to my signature?  My vet and I are looking for guidance on what to do to get their insulin numbers down.  They are both on the emergency diet and being fed 18 lbs each a day of soaked hay.  They are not getting any supplements of Vitamin E, Flax, magnesium as neither of them will eat s/r/s beet pulp.  We do not know what to do.  Is there anything else we can try to get insulin down?  thanks for any input.  Kimberly Ryn and Mouse 
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RynCaseHistory.pdf (groups.io)
https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia


Sherry Morse
 

Hi Kimberly,

You would create a folder for Ryn within your current case history folder and then add the link to that folder to your signature.  Another option is rename your main folder to "Kimberly Mouse and Ryn" but you would need to update the link in your signature to go to the correct folder.  We don't usually put a link to a PDF in a signature because each time you update the file the link will need to be updated as well.

Ryn's insulin looks like it's coming down with just the diet change although it would be better if he was getting the metformin as well. Has he lost any weight since you started the diet change?  

For Mouse his insulin level is still in the danger zone for laminitis so trying to get the metformin in him as well as the diet change is even more important than for Ryn.  

Have you worked with either of them on using an oral syringe?

As far as the supplements - the main thing right now is the hay centered diet and getting hay tested to so it can be balanced.  You can add salt to the soaked hay and may be able to do the same with some of the other supplements - had you introduced those prior to throwing the metformin into the mix?  If they were eating r/s/r beet pulp or Stabul 1 with nothing in it I would go back to that and let them start eating it again before adding anything else in.  Then add in one thing at a time so they have time to adjust to the new addition (and you may find they object to one thing but not others).  





Eleanor Kellon, VMD
 

For Ryn, exercise, exercise, exercise.  Otherwise, your next option is an SGLT2 inhibitor. If you e-mail me your vet's e-mail contact I will send information.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Kirsten Rasmussen
 

Have you tried dampened or soaked soy hull pellets, Stabul 1, or Triple Crown Naturals Timothy Balance cubes for a carrier?

For Ryn, I would also work on getting his weight down.  18 lbs/day is probably too much for him, especially if not being regularly exercised.  My 900 lb horse gets 15.5 lbs hay a day at maintenance, which is 1.7% of his ideal body weight.  At 18 lbs a day (2% of ideal body weight) he was 200 lbs heavier.  Is it possible Ryn is also eating some of Mouse's hay, too?

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


Kirsten Rasmussen
 

I should add that since the hay is being soaked, you can top dress it with their supplements.  Most of it will stick to the wet hay and be eaten.

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


Kimberly
 

Hi Sherry, we are encouraged that both of their insulin numbers dropped, just had hoped for a better result.  Both of  these horses can be wormed, take paste meds etc., but are both very sensitive.  They both cooperate but if it turns into a tussle, it will get worse not better.  I do not want to poison that well.  If it were once or twice that they had to be medicated and have their mouths rinsed out, we could do that but we are not talking about that here so that is not an option.  This will just make them more stressed and agitated than they already are at this point.  We grow our own hay and yes it has been tested.  ESC is 8.5 and Starch is 1.7 on this batch.  Both horses eat well and have been eating just fine (with all of their supplements) prior to adding Metformin.  Yes, I have been adding nothing to their food at all, beet pulp and Stabul 1, and neither will touch it, as that well has been poisioned:(  Yes, I will do a process of elimination but they have to be willing to eat first and at this point, neither will touch it.  I will try just Stabul 1 today with no beet pulp see what we get.  Thanks for the support.  I will try to figure out the case history thing as well.  Kimberly
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https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia


Kimberly
 


--I forwarded my VMD's information to your email.  She has been notified that you may contact her re this.  Thanks much. Kimberly


https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia


Kimberly
 

Hi Kirsten, I have not tried soy hull pellets, they are both on Stabul 1( but currently won't eat it) and have not tried Timothy Balance cubes as neither will eat Timothy hay but I can try them.  Ah, yes I can certainly drop Ryn's amount of hay and yes he has been slowly losing weight. I am wondering if his T4 number has anything to do with him not dropping weight any faster?  He has always had this issue.  Ryn and Mouse are separated so no, he is not getting any of Mouse's hay.  A question though on how you balance out the 15.5 lbs of hay?  I have been feeding small amounts during the day at breakfast, lunch, late afternoon, then the bulk of their hay they get in slow feeder bags overnight.  It is all weighed prior to feeding.  They are bored silly standing in a dry lot 24/7 so need colorful ways to break up the boredom.  Ryn is not under saddle yet but is in work, doing ground work only.  Thanks for the thoughtful questions and all advice is appreciated!  Kimberly 
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https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia


Kimberly
 


--I had to chuckle as I actually tried this just this morning and guess what?  Ryn decided he didn't need any hay either.  For a mustang, he is pretty picky when he thinks you are trying to slip one over on him.  


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Kimberly joined 7.17.2018 Virginia


Kirsten Rasmussen
 

Well I imagine mustangs have to be pretty smart to survive in the wild, so good luck "tricking" him!  I also put my horse off some of his favourite things by trying to feed him medications in it.  It took months before he would eat those treats from my hand again.

I feed 2/3 of the hay for overnight 10 lbs + 0.5 lbs TCNTB cubes + beet pulp w/supplements, then 2.5lbs for breakfast, and 2.5 lbs for lunch.  I know he runs out overnight and I have experimented with a timer to give him half of his evening hay at 1 am, and this worked GREAT for a couple months but then the timer burned out and I haven't been able to get a new timer working.

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


Kimberly
 

Yes, they are pretty smart and can easily be offended:) Good news they both ate their Stabul 1 this am with nothing else in it.  I was able to add salt to their soaked hay and will try to do that with salt/magnesium for evening meal.  I may look for a new flax source for those two as that may be the culprit.  Do you have a recommendation for when we should check insulin numbers again?  Thanks 
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https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
https://ecir.groups.io/g/CaseHistory/album?id=275222

Kimberly joined 7.17.2018 Virginia


Kirsten Rasmussen
 

You can recheck insulin 1-2 weeks after a diet or exercise or medication change is made.

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