Mya - waiting on trim - has abscesses - diet /pain please advise


Lori Ricigliano
 

Hello 
this is in regards to mya - foundered almost 2 yrs 19 yr old half arab/half saddlebred -  I need to help her - all in my files / 

I have drastically changed her diet in the past 2 weeks & she seems a little better but she is still in a good amount of pain. I have updated my folder to show new pics & info . She is still on 2gr bute am & pm - no grain - soaked beet pulp - no sugars . I know I need to pull her from bute - but What can I put her on & amount ??

I did just find a pure grass hay source yesterday so she is now getting soaked grass hay (20lbs total a day ) instead of grass /alfalfa soaked 

she has significant hoof sole abbesses in front part of sole -  I’m trying to treat - I started resoaking  them yesterday with mix of warm water epson salt & betadine . They are not actively draining just look like smelly dark holes u can see into them as they have opened - just necrotic blk hoof 

She lives in cloud boots - baby powder and socks changed daily so feet are dry with no rubs 

I don’t know if I should pack the abscesses - they really aren’t draining just look like a hole in the foot & black with “life data hoof clay “between soaking daily ? I feel they can be opened more with a trim of the toe  but my farrier is worried it will weaken the rest of the foot if we take off too much ? 

the updated sole pictures with abscesses are in my photo file 

I’m waiting for the suggested first trim from
Lavenia so I can schedule my farrier who is doubtful it will help her - I can see she is extremely long toes high heeled - he’s worried if we trim down her heels she will drop her pedal bone - become extremely sore / or have it absess out bottom as some as her absessing is larger to the front - she is tight in the front right check tendon ligament - I’m now massaging daily with linamint - he also thinks it’s looks bad and by lowering heels we could have joint come thru coronet band? See current X-rays 

hes doubtful that what I will do for her with a trim will do anything but make her more in pain - he says he will try & trim her to the recommendation when I get it 

QUESTIONS : what is the mg/kg of magnesium I should be giving her per day ? I can get it from grocery & grind ? 


im Also giving her 2 vit e 1000 iu oil pills in her beet pulp daily & im getting her the flax today as well - she’s a little light body score 3 & Id not crazy about the soaked beet pulp so I’m getting the triple crown Timothy cubes to soak & try for her today . 

I have her now on metformin- I just added her last Thursday .13 ground up 1000mg tabs 2x a day fed with maalox via syringe .  I got the blood tests from Cornell - they actually pulled all this blood back in may but didn’t send in til last week because they really thought I shouldn’t waste my Money on tests just put her down - but she was still eating drinking and standing 80 % of day 

She does have a slight crest but the bloodwork says she doesn’t have PPID ? Just IR? 

Her levels prior to me adding metformin & soaking hay removal of starch/sugar (I gave her safechoice special care ) were: 

insulin: 66.85 ( normal range 10-40)

Glucose 105 ( normal  71-122) 
ACTH 9.30 pg/ml

The complete Cornell results are in her file . 

she is on equinity supplement 1scoop - bute 2gr am/pm - 2 1000iu vit E - soaked hay & soaked beet pulp - 2 grams thyrol L - (last thyroid test last week TT4 3.3) 

what should I do as I wait for the hoof trim directions ? What else can I do to help her with pain ? What else in diet ? 


thank you for any help you can offer 
lori 





--
Lori R in MN - 2022

Owner of 3 Metabolic Horses 

MYA Photos:

 https://ecir.groups.io/g/CaseHistory/album?id=276519

MYA CASE HISTORY :
https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History


OLIVER CASE HISTORY LINK:
https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER 

OLIVER PHOTOS: PEND 



Sherry Morse
 

Hi Lori,

1 - Bute (or any other NSAID) will slow down the mobilization of abscesses which often leads to the situation you have found yourself in.  As it will not help with pain due to laminitis caused by IR and has this effect we recommend stopping it as soon as possible.  You need to taper her off of it (see: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf) and you can replace with Devils Claw or PhytoQuench with Devil's Claw (see https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/Pain%20control,%20switching%20from%20Bute%20to%20Phyto-Quench.pdf)

2- Magnesium is dosed by weight as outlined in the emergency diet (DDT +E – Diet | ECIR Group, Inc. (ecirhorse.org)) - 1.5g per 500lbs.  You can use the human version or buy MgOx from a feed mill as that's much cheaper.

3 - She is definitely IR and since the blood sat since May you don't know if that reflects her current insulin level or not.  You should have bloodwork redone 7 - 10 days after being on Metformin to see where her level is now.  The current pain level could be due to the insulin being higher than the test results or related to the trim issues and the possibility of abscesses that are not mobilized. Getting her trim in order should help her quite a bit.

4 - Equinety is a waste of money.  Dr. Kellon summed it up best here: https://ecir.groups.io/g/main/message/270686

5 -Unless Mya has lost a drastic amount of weight since the beginning of this month she's not a 3 but closer to a 4.5 -5 BCS in the pictures you posted.  I would expect a 14.3 NSH to be closer to 950-975lbs than a 1000.  Regardless of that, she does not appear overweight enough to be on Thryo-L so I would suggest weaning her off of that (1/2 tsp less per week) as her Thyroid level should straighten out once you get the IR under control. 





Lavinia Fiscaletti
 

Hi Lori,

I'm working on your mark-ups, should have them up later today. Saw the latest sole shot with the abscess hole. The abscess is visible on the rads, so no surprise it is starting to open. The bute is keeping the abscess(es) from draining and resolving fully. The abscesses themselves could easily be a large part of her discomfort. You can put a diaper over the foot to absorb any exudate. Poulticing her soles with Numotizine might also help draw out the abscesses without softening her already thin soles.

https://www.bigdweb.com/product/code/294.do?gclid=EAIaIQobChMIv6X8trWF-QIVaPbjBx1E7gGqEAYYAiABEgIX3vD_BwE

To stop the bute you will need to taper the dosing so she doesn't get an NSAID rebound effect - increased pain due to withdrawal:

https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf

Her toes can most certainly be backed up and her hinds look like there is a lot of excess overall hoof length that can also be removed. As soon as the toes get backed up, a large area of those abscesses will open up immediately. NO, her joint will not come thru her coronary band by trimming off excess amounts of hoof. By restoring the proper balance and mechanics, she will become more comfortable and the hoof capsule will be better able to support her.

The Equinity is a waste of your money:

https://ecir.groups.io/g/main/message/256187?p=%2C%2C%2C20%2C0%2C0%2C0%3A%3Acreated%2C1%2Cequinity%2C20%2C2%2C0%2C77442528

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


Lori Ricigliano
 

THANK YOU I needed that guidance 

I’ll taper her bute and pull & add the devils claw 

I saw in the files Jiaogulan? Would that be something for her ? Dosage ? 

Called my feed mill they have Mg Ox - how do I dose that correctly for her weight at 900lbs? So like roughly 1 oz of this magic added to beet pulp .

Oh beet pulp I rinse first then soak - should I rinse again after I soak ? Why ? I use unsweetened plain pellets from our beet factory 

I will wean her slowly off thyrol L 

In regards to bloodwork -just check her insulin levels ? By her bloodwork she doesn’t appear to be ppid even though she has a creasty neck ? 

Thank you for advise 
Lori 




On Jul 19, 2022, at 11:55 AM, Sherry Morse via groups.io <sherry_morse@...> wrote:


Hi Lori,

1 - Bute (or any other NSAID) will slow down the mobilization of abscesses which often leads to the situation you have found yourself in.  As it will not help with pain due to laminitis caused by IR and has this effect we recommend stopping it as soon as possible.  You need to taper her off of it (see: https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/How%20to%20Taper%20Off%20NSAIDs.pdf) and you can replace with Devils Claw or PhytoQuench with Devil's Claw (see https://ecir.groups.io/g/main/files/Pain%20Medication%20and%20Alternatives/Pain%20control,%20switching%20from%20Bute%20to%20Phyto-Quench.pdf)

2- Magnesium is dosed by weight as outlined in the emergency diet (DDT +E – Diet | ECIR Group, Inc. (ecirhorse.org)) - 1.5g per 500lbs.  You can use the human version or buy MgOx from a feed mill as that's much cheaper.

3 - She is definitely IR and since the blood sat since May you don't know if that reflects her current insulin level or not.  You should have bloodwork redone 7 - 10 days after being on Metformin to see where her level is now.  The current pain level could be due to the insulin being higher than the test results or related to the trim issues and the possibility of abscesses that are not mobilized. Getting her trim in order should help her quite a bit.

4 - Equinety is a waste of money.  Dr. Kellon summed it up best here: https://ecir.groups.io/g/main/message/270686

5 -Unless Mya has lost a drastic amount of weight since the beginning of this month she's not a 3 but closer to a 4.5 -5 BCS in the pictures you posted.  I would expect a 14.3 NSH to be closer to 950-975lbs than a 1000.  Regardless of that, she does not appear overweight enough to be on Thryo-L so I would suggest weaning her off of that (1/2 tsp less per week) as her Thyroid level should straighten out once you get the IR under control. 





--
Lori R in MN - 2022

Owner of 3 Metabolic Horses 

MYA Photos:

 https://ecir.groups.io/g/CaseHistory/album?id=276519

MYA CASE HISTORY :
https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History


OLIVER CASE HISTORY LINK:
https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER 

OLIVER PHOTOS: PEND 



Lori Ricigliano
 

Thank you Lavinia
Surprising enough her soles are not too soft as I’ve been crazy about powder and changing socks on her every single day as she lives in cloud Boots

I’m starting to taper her bute starting today and will replace with Devils claw & ilm try the poultice Numotizine

Thank you so very much for your help

On Jul 19, 2022, at 12:14 PM, Lavinia Fiscaletti <shilohmom@...> wrote:

Numotizine


Eleanor Kellon, VMD
 

Lori,

Magnesium is not magic. No supplement is. Get your hay analysis in place ASAP for minerals.

Rinse BP again after you soak because surface iron and molasses traces may not have been fully removed. You want clear rinse water.

Yes, Jiaogulan could help her greatly but she has to be off bute first and have a good trim in place plus a good trim interval established because it will make her feet grow faster.

The cresty neck is caused by insulin resistance, not PPID.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Lori Ricigliano
 

Dr Kellon 

I will get hay tested - finding an extension that I can borrow a hay borer so I can get the proper samples of our hay 

You mentioned on my other horse Oliver (see link below ) that he should be put on Prascend in addition now even though not showing PPID in bloodwork  - would that benefit mya or not in this case ? And why him and not her - the insulin or glucose level ? 

He is doing better on metformin since Thurs the pounding digital pulse has stopped .


Thank you so very much 
Lori 




On Jul 19, 2022, at 2:18 PM, Eleanor Kellon, VMD <drkellon@...> wrote:

Lori,

Magnesium is not magic. No supplement is. Get your hay analysis in place ASAP for minerals.

Rinse BP again after you soak because surface iron and molasses traces may not have been fully removed. You want clear rinse water.

Yes, Jiaogulan could help her greatly but she has to be off bute first and have a good trim in place plus a good trim interval established because it will make her feet grow faster.

The cresty neck is caused by insulin resistance, not PPID.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Lori R in MN - 2022

Owner of 3 Metabolic Horses 

MYA Photos:

 https://ecir.groups.io/g/CaseHistory/album?id=276519

MYA CASE HISTORY :
https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History


OLIVER CASE HISTORY LINK:
https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER 

OLIVER PHOTOS: PEND 



Eleanor Kellon, VMD
 

Oliver's breed and late in life onset of laminitis are highly suspicious of PPID.  The same may be true for Mya but her genetics predispose her to EMS. How long have you had her?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Lori Ricigliano
 

Dr Kellon , 
I’ve owned mya for 8 years - she never had an episode of founder in that time - she was always “club footed funny” on her right front though …..

but a year an half ago in late august I gave her her fall vaccinations- she had a slight crest to her neck - but had that for a few years - not bad & not a fat horse she was in condition  ridden 4/5 times a week - she was eating the same as she always was - Purina equine senior & a grass/alfalfa mix hay - nothing else new - within two days of the vaccinations she was showing extreme lameness & bounding digital pulse  in both front feet - she was in shoes at the time & looking back & knowing what I know now  I should have insisted they remove them - farrier didn’t & she absessed out of both coronet bands first & I made him pull shoes & started to soak feet & then she absessed out soles & coronet bands started to heal . This was horrific. I didn’t start soaking hay til I joined this group as I was told just to feed grass hay instead …. Such bad advice - I feel horribly. 


On Jul 19, 2022, at 3:14 PM, Eleanor Kellon, VMD <drkellon@...> wrote:

Oliver's breed and late in life onset of laminitis are highly suspicious of PPID.  The same may be true for Mya but her genetics predispose her to EMS. How long have you had her?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Lori R in MN - 2022

Owner of 3 Metabolic Horses 

MYA Photos:

 https://ecir.groups.io/g/CaseHistory/album?id=276519

MYA CASE HISTORY :
https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History


OLIVER CASE HISTORY LINK:
https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER 

OLIVER PHOTOS: PEND 



Eleanor Kellon, VMD
 

Mya's issues are also highly suspicious of PPID. Is you vet amenable to putting her on pergolide at least for the seasonal rise then testing her after that?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Lori Ricigliano
 

Yes if I let her know that you are recommending it she will follow your guideline I'm pretty sure - start both mya & Oliver at 1 pill prescend a day ? 

If there is a more economical option (compound company ) I’m sure she would be fine - I just haven’t used Prescend for several years so I don’t know what’s new out there . 

Please advise 
Thank you 


On Jul 19, 2022, at 4:14 PM, Eleanor Kellon, VMD <drkellon@...> wrote:

Mya's issues are also highly suspicious of PPID. Is you vet amenable to putting her on pergolide at least for the seasonal rise then testing her after that?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Lori R in MN - 2022

Owner of 3 Metabolic Horses 

MYA Photos:

 https://ecir.groups.io/g/CaseHistory/album?id=276519

MYA CASE HISTORY :
https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History


OLIVER CASE HISTORY LINK:
https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER 

OLIVER PHOTOS: PEND 



Kirsten Rasmussen
 

Hi Lori, 

Here is the list of compounding pharmacies we recommend. 
https://ecir.groups.io/g/main/wiki/ECIR-Links

However, to start it might be easier to use Prascend because you can adjust the dose more easily by halving and quartering the pills.  The most common starting dose is 1 mg Prascend a day.  We recommend titrating up to the prescribed dose to avoid/minimize the pergolide 'veil', a series of temporary side effects including lethargy, inappetence and depression.  Start with 1/4 pill and increase it by 1/4 every 3-4 days.  Some horses have a very strong 'veil' and go off their feed entirely.  These horses will do better if you give them APF a few days in advance and through the titration process.  After 3 weeks at the prescribed dose we recommend redoing bloodwork to see if it's enough.

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


Kirsten Rasmussen
 

Lori, when you update your Case History, can you add the insulin value to the Bloodwork table?  TIA!

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


Lori Ricigliano
 

Thank you so much - I will start with that & go slow . 
Lori 


On Jul 20, 2022, at 9:16 AM, Kirsten Rasmussen <kirstenrasmussen3@...> wrote:

Lori, when you update your Case History, can you add the insulin value to the Bloodwork table?  TIA!

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

--
Lori R in MN - 2022

Owner of 3 Metabolic Horses 

MYA Photos:

 https://ecir.groups.io/g/CaseHistory/album?id=276519

MYA CASE HISTORY :
https://ecir.groups.io/g/CaseHistory/files/Mya%20Case%20History


OLIVER CASE HISTORY LINK:
https://ecir.groups.io/g/CaseHistory/files/LORI%20and%20OLIVER 

OLIVER PHOTOS: PEND