Mouse's partial bloodwork


Kimberly
 

I am still unable to figure out how to upload my Case History without losing it.  If someone could help me that would be very much appreciated.  I sent an update case history file to Kirsten.  Mouse's insulin is thru the roof.  We are still waiting on Leptin and T4.  His Glucose is 109, Lipemia is 7, Hemolysis 4, and Icterus 1, Cobas 2.  His ACTH baseline is 4.24, Insulin Baseline is 169.57.  We are waiting on Leptin and T4.  He is in a stall, with hoof support, soaked hay (although it tested safe), flax, magnesium,vitamin E, Stabul 1, soaked/rinse/soaked non-molasses beet pulp, weighs 950 is 14.2, ribby but has fat pockets at shoulders and tail head. was trimmed last week, putting heartbars on today, lame only on RF with bounding pulse, LF has intermittent medial pulse.  I uploaded x-rays from 2017 and last week yesterday to the photo file under Mouse's name.  Not sure I was supposed to do that but wanted them somewhere in the data base.  I am sorry I am not doing any of this very well but having trouble navigating the system on my old desk top.  I truly appreciate the support I am getting from all of you.  Kimberly and Mouse 
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Kimberly joined 7.17.2018 Virginia


Kirsten Rasmussen
 

Hi Kimberly, 

You're almost there!

To upload your Case History, go to the folder you made here:
https://ecir.groups.io/g/CaseHistory/files/Kimberly%20and%20Mouse
Click on the blue "+New/Upload" button.  Choose "Upload File".  Then navigate to where the file is saved on your computer and select it.  I like to save things where I know I can easily find them, like on the desktop.  If you can change your Word file to a PDF that would be helpful, too, but since you're in a crisis just upload what you have for now.

I found your photo album, too.  It is here:
https://ecir.groups.io/g/CaseHistory/album?id=275222


Can you add the links to your Case History Folder and your Photo Album to your auto-signature?  Here are instructions on how to do that:

1) Go to this link to amend your auto-signature: https://ecir.groups.io/g/main/editsub

2) Scroll down to the window with your name etc in it, and paste the URL links to your Case History Folder and Photo Album below your name.  NOTE: When you are adding a link to your Case History or photos, make sure you make it "live". Adding a space after your link, or hitting enter on your keyboard will turn it blue.

3) Make sure you still have checks in the 2 boxes saying "Use Signature for Web Posting" and "Use Signature for Email Posting”.

4) IMPORTANT: Scroll to the bottom and hit SAVE!


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


Lavinia Fiscaletti
 

Hi Kimberly,

Here is the link to your photo Album:

https://ecir.groups.io/g/CaseHistory/album?id=275222

Your ACTH is very good, so no need to change the pergolide dose. The insulin is way too high, which is not going to be helped by raising the pergolide dose. You need to get that insulin down so starting on Metformin, at least for the near future, would be recommended. Dosing is 30mg/kg, given twice daily. Here is a link to the file on Metformin:

https://ecir.groups.io/g/main/files/4%20Insulin%20Resistance/Metformin

The rads show that Mouse has thin soles, RF heels are too low, toes were somewhat further out ahead of where they should be but not drastically so. Shoes would NOT be advised with active laminitis as they are going to make it nearly impossible to tweak the trim as often as will be needed. They also suspend the horse from the very lamina that are already damaged by the laminitis. Boots and pads provide better support plus give you unlimited access to the feet for trimming and treatment.

Hang in there.

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


Kimberly
 

Thanks so much.  I will work on this as soon as I can this am to try to get it uploaded.  In the meantime wanted to give final numbers.  Mouse:  Glucose 109 Lipemia 7, Hemolysis 4, Icterus 1,  cobas interface, cobas 2, ACTH 4.24, Insulin 169.57, leptin 21.26, T4 0.925.  I will stay on 1 Prascend.  Would Thyro-L be advised?  
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Kimberly joined 7.17.2018 Virginia


Sherry Morse
 

Hi Kimberly,

Thyro-L will help jump start weight loss but will not do anything for insulin numbers.  I would suggest tightening up his diet and starting on metformin as Lavinia already mentioned. In addition he needs to be in boots as he has very little sole.  Putting shoes on him is probably going to result in more soreness not less so I would NOT go that route.




Kimberly
 

Thanks Sherry.  My vet is looking into Metformin and my vet and farrier both felt pretty strongly about putting Mouse in Heartbar shoes yesterday.  He is barefoot and has always been so except for about 10 years ago for two weeks on rough terrain.  With the heartbars on the front, he was immediately sound at the walk.  He is being kept in a deeply bedded stall and has a matted shed-row that he can walk out on.  He is bright, eating well and seems comfortable.  Don't know if I can post a picture of him somewhere but Mouse is actually pretty thin in my opinion.  thanks for the info.  On another note, I have a second horse from the same HMA as Mouse (he is a Kiger mustang also) that I blood tested the same day as Mouse out of an abundance of caution as he is over-weight as was Mouse at his age.  He has no history of laminitis or problems but genetically, they are so similar.  Should I start a case history form on him?  All I have is bloodwork but no other history to report?  His name is Ryn, pronounced like the bird Wren.    His insulin was rather high, he is always in a muzzle, same time out as Mouse, same diet, etc., whom I now have on dry lot to keep a close eye on him.  On both of them their T4 was was under the reference interval.  Just curious if I should do the file for him.  Thanks 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


Eleanor Kellon, VMD
 

If applied after a proper trim (big if), heart-bar shoes are actually pretty well documented to be helpful. They are basically shifting support to the hind foot where it belongs.

Yes, start a case history for Ryn.

The low T4 is secondary to the metabolic issues, and possibly iodine and/or selenium deficiency, and will resolve with control of insulin and a balanced diet. It's not causing anything.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Sherry Morse
 

You can post pictures of Mouse and his current trim in your photo album.  They would be helpful, particularly the body shot as you have his ideal weight at 900 in his case history but then list him as thin at an estimated 950lbs.  So one of those numbers is not correct.

Are you weighing his hay or guesstimating how much he's eating? If his ideal weight is 900 he should be eating 18lbs a day.  If his ideal weight is actually 950 he should be eating 19lbs a day. That amount includes all hay and concentrates. How much beet pulp is he eating?  Did you mean .5lbs a day?  How much Stabul-1 is he getting?  I know it seems onerous, but we really do need to know all these details to tell you where we think his diet can be tightened up.  

The most obvious spot is that he needs to be off pasture and in a dry lot unless he's wearing a completely closed muzzle.  We find in many horses that making that change alone can make a big difference in their comfort level and it sounds like you have Mouse off grass at the moment so keeping him off going forward is probably going to be important for him.




Kimberly
 


--Thanks so much for the response.  He is on iodized salt and not sure how to see if he has selenium deficiencies?  


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
 

Yes, I know that was a bit of a mess trying to get something uploaded and in the crisis did not review.  I can do a better calculation and take pictures to post.  I weigh everything our horses eat, as with Mustangs, they have to be managed.  He is currently on 18lbs of hay a day which I weigh dry.  It is much heavier after soaking so not sure that is a consideration.  I have been soaking hay for years and have never asked if the weight is wet or dry?  He gets 1/2 lb of beet pulp per day weighed when dry.  He gets 4 ozs of Stabul 1 only as an additive to the beet pulp to make it more palatable.  I know the feeding rate is so much higher but none of our horses need that much grain.  He has been off pasture and is not in a dry lot, but being currently stalled as he still has DPs.  He is not over-weight and I will get some photos posted.  I so appreciate all of the guidance so far.  
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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


Sherry Morse
 

Hi Kimberly,

We look at dry weight for the hay so at the moment you're feeding him the right amount for a 950lb horse.  If he needs to lose weight you'd want to decrease the hay amount by a pound per day.  Again, we look at the total fed per day of hay plus any concentrates (concentrates being both the beet pulp and Stabul-1).