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New blood results not good - advice pls


lamarleau@...
 

Hello

I updated the case history and added the blood works from January and February.  I am discouraged.

In January, I tried changing to 2 soaked and 2 dry meals 2 weeks before the blood test and also reduced his metformin to once a day 1 week prior to the blood test to see if he was going to eat his supplement (he refuses everything else than hay).  It was not good, glucose was still in the range and insulin went back up.

So as of mid-January, I went back to 4 soaked meals for 1 hour in cold water and for his size (295 pounds) 8 metformin AM and PM (16 total).  His glucose went down and remains in the normal range, but his insulin went up again.  January insulin was 581 H and now worst in February 653 H (normal 0-301). 

My hay is 10.31 ESC + starch and I soak it for 1 hour.  I did start to give him coco soya and 1/4 cup of Purina Integri-T to hide his Madbarn supplement.  I'm in Quebec and it's cold.  

He is happy, not in pain, running and playing, but with this high insulin, something is going to happen again.  He has been on Prascend for almost 2 yrs - ACTH tested in November 2020 - 2.8 normal (mid-Nov to July below 6.6 is negative to PPID).

Does this mean that metformin is not working anymore for him?
Any advise would be appreciated. 

Thank you
--
Francine & Magic in Quebec Nov 2020
Was a member 10 yrs ago with Shamy


Sherry Morse
 

Hi Francine,

When did you add in the cocosoya and the Purina?  How many mg per day of metformin is he currently getting? It may be that the metformin isn't working, but without knowing if he's getting the right dose for his weight we really can't say for sure.



lamarleau@...
 

He gets 30mg/kg twice daily.  He gets 8 x 500 mg morning and night.  He weights 133 kg.

I looked at my calendar and started integri-t at the beginning of January. Before the jan blood works.
Cocosoya started last week of January so Before this blood test.

😯
--
Francine & Magic in Quebec Nov 2020
Was a member 10 yrs ago with Shamy


lamarleau@...
 

I could not find the info. Is invokana available in Canada?  My vet never heard of this.

I have stop integri-t and cocosoya. The only thing he liked. So discouraging.

I guess I can also stop Metformin at this point. Insulin keeps going up anyway.  Poor little guy. 
--
Francine & Magic in Quebec Nov 2020
Was a member 10 yrs ago with Shamy


Lorna Cane
 


Here Francine. Message from Dr. K.
261445, I hope


"Do a Google search for Invokana    Canada

Loads of options and pages like this one that do comparisons https://www.pharmacychecker.com/invokana/#! . There is a huge variation in prices and it changes all the time."
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Kirsten Rasmussen
 

I would not stop the Metformin until you have the Invokana on hand.  There can be an element of pain relief from it and since he is sound despite the high insulin, it could be it is helping.  See the last paragraph in this summary:

https://ecir.groups.io/g/main/files/4%20Insulin%20Resistance/Metformin/Metformin%2008.08.20%20FINAL.pdf

Also, Dr Kellon can email some information on Invokana to your vet if you request it.  Use of Invokana in horses is so new so there's not much information out there yet for your vet to read.

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


lamarleau@...
 

Thank you Kristen.  Will try Wirx as well.  Sent the info on invokana to my vet.
At least he is well. 
--
Francine & Magic in Quebec Nov 2020
Was a member 10 yrs ago with Shamy


Lorna Cane
 

Hi Francine,

Are you planning on trying the two at the same time?
If so,it might be better to try them one at a time, so you have an idea of the efficacy of the  one, or maybe both .
You're probably ahead of me on this.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php