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Question for Dr. Kellon and Invokana dose for Riosa


hdavis
 

Hello Dr. kellon.

I am awaiting Riosa’s blood results for her insulin, glucose and triglycerides and hoping we will have them maybe this week.  I was wondering should I be reducing her Invokana dose until they come back?

I have been feeding her about 1:1 lbs of Ontario Dehy Balance Cubes and oats within an hour after working her but noticed she seems a bit laggy in our hikes, lunging sessions and am wondering is this maybe a sign her glucose levels are low. She seems to have lost some of her spunk and forward was but doesn’t appear foot sore at all just a bit draggy and slow energy. Or should I feed her some hay before her workouts to help maybe?  Or ideas?
Thanks in advance.
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


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Case History


 




hdavis
 

Was just thinking could adding the oats/ODTB cubes mixture have perhaps caused her to be a bit doggy due to being foot sore. Adding in oats to her feed is somewhat terrifying for me as she had been such a struggle to get her insulin under control so was just thinking shoot did I maybe cause this!?!? 
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Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


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Case History


 




hdavis
 

I don’t think she is foot sore at all as went out last evening and took her out into the arena and we had a little play on the ground and she was full of beans. Not soggy at all and very forward and playful. Looking forward to hear back from Dr. kellon and will need to get on buying a glucometer. 
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


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Case History


 




 
Edited

Hi, Heather.
Not Dr Kellon, and I can't address any of your questions about Invokana.
I need to update my comments on glucometers based on my recent experience. Initially, I had no problems using a glucometer to check a drop of Cayuse's blood drawn by my vet. Starting last fall, I started getting error codes every single time. It works fine with my blood, so there's nothing wrong with the glucometer. I've tried new test strips, calibrated it, changed the battery. Error codes keep on coming with Cayuse's blood. 
After some reading about humans and veterinary glucometers, I found there are factors that will make your glucometer refuse to read the glucose in the blood or provide inaccurate results:
https://www.fda.gov/medical-devices/in-vitro-diagnostics/blood-glucose-monitoring-devices 
1. Low temperature. The blood must be and remain fresh and warm! A cold day can cause problems.
2. Hematocrit outside the usual parameters for humans
3. Finicky test strips that you buy by the dozen but use a few times a year.
4. Impact of drugs or vitamins that confound the results. 
There are probably more. In short, while my glucometer worked well initially, it no longer works consistently with Cayuse's blood. 
There's another issue we need to think about. Even working perfectly, glucometer accuracy isn't fantastic. It can be working perfectly within the specifications required by the FDA, and it can still give results that are plus or minus 15mg/dl of the actual blood glucose.  Cayuse's results, when the glucometer worked for her, were about plus or minus 5 mg/dl of lab results.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Nancy & Vinnie & Summer
 

I just wanted to note from our personal experience that Vinnie's glucose was never low during our case. He was always in the upper 90's prior to hospitalization and during hospitalization on glucose therapy he remained at the high end of normals.

After he came home during both tests monitoring glucose his glucose was.111 and 109 on the last two tests.

I was puzzled by this too because I would have expected him to be hypoglycemic when he was in the middle of the hypertriglyceridemia episode but he was not.

Thx Nancy
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


hdavis
 

Thanks Nancy and Cass for your feedback!  I was going to go buy a glucometer but they are pricey little suckers if you don’t have a subscription for one and if I can save some money then that helps.  Maybe the best bet is to just continue regular blood draws with my vet.  Hoping to get blood results back this week but suspecting it won’t be until next week.  

She continues to be in good spirited just seems a bit lazy and doggy when we go for walks if she hasn’t had food for an hour or so.  She was super perky last night after her supper so that was good news.  She also had the oat/hay cube snack after her before supper exercise. Wonder if that helped her have more energy for our little after work liberty play? Thanks again for all the help and feedback!
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


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Case History


 




 

Here is just a thought for folks using Invokana, or those concerned about actual diabetes in their horses. Urine sticks are fairly cheap. Of course, the zillion dollar question is: how to collect the urine? I have found that my crew have a fairly predictable pee schedule, in that when they are called up for their supplements, they often stop to pee before they come up, or half-way through the walk. Ideally, you would hold the stick under the pee, or hold a soup ladle under the pee. Even just dipping the stick into a fresh puddle would be better than nothing.

Heather, you are amazing in how you have managed Riosa over the years. You are in a new territory of : feed and blood glucose providing energy, balanced with Invokana and insulin. Clearly, the higher insulin levels are potentially more detrimental. Thanks so much for giving us all more information on the use of Invokana for our IR horses.
--
Jaini 
Merlin and Maggie (over the bridge), Gypsy, Ranger
Smithers, BC 09

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy .
https://ecir.groups.io/g/CaseHistory/album?id=34193  
https://ecir.groups.io/g/CaseHistory/album?id=39711


hdavis
 

Hey Jaini!!

Hope all is well with you and the crew and it has stopped snowing on you!

Good tips about collecting the urine and paying attention to their habits.  Thanks for sharing. If you would have asked me 4 years ago what are my horses urination or drinking habits or how much food they exactly eat,  I would have been clueless but these days I can tell you that and a whole lot more!   Nice to be in a group where we all understand that the importance of noting all these things and don’t just think we are neurotic horse owners!

A huge thank you for your compliments regarding my care for Rio. Means the world to me as it has been a struggle at times but if it wasn’t for folks like you and this group I truly don’t think my sweet sassy little mare would be alive today, much less getting back into saddle work!  


And yes you are absolutely correct about more new territory now with back into work and balancing the glucose, invokana and feed to hopefully result in low insulin levels, keeping enough energy for riding and controlling glucose.  Fingers crossed that insulin has been the root of all our past issues snd if we can  continue to keep it down we can have an enjoyable many years together and with many under saddle as well!  

I am always full of questions, as many of you on here I’m sure have come to realize, and just hope that my questions can help others out too!  

Thanks again everyone for all your feedback, advice snd support with our challenges and helping Rio and myself over the years.


 

--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




 

On Thu, Apr 8, 2021 at 10:09 PM, Jaini Clougher wrote:
I have found that my crew have a fairly predictable pee schedule, in that when they are called up for their supplements, they often stop to pee before they come up, or half-way through the walk.
Exactly! And if you can whistle, whistle when you call your horse for urine collection. It took exactly once for Cayuse to get with the program. I call her to an irresistible freshly bedded stall. After a clean catch, every so often I stuff a horse cookie in her face as she walks out. 
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos