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Questions concerning recent PPID diagnosis


anneefrancis@...
 

I've been doing a lot of amazing reading while formulating my plan for managing Tricana's recent PPID diagnosis.   

I have a couple of questions. 
#1.  Would you start off with Pergolide and L-Thyroxin to counter the weight gain?  I've also read of people using Metformin, thoughts?  
#2.  What companion blood tests would you run?  I'm going to do a consult to make sure I'm meeting her nutritional needs.  Dr. Kellon do you still do this?  Or any recommendations?
#3. Regarding the Pergolide veil,  I'm interested in APF but Tricana also has DSLD and IR and is on Dr. Kellon's protocol - AAKG 2:1 and Jiaogulan.  Would you stop the protocol and use only APF or could I do both?  It sounds as though APF works similarly?
Finally, #3.  Fellow Canadians, where do you source APF from?

Thank you in advance,

Anne and Tricana
May 2016

https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana


Sherry Morse
 

Hi Anne,

  1. Metformin is for control of insulin levels that do not come down with diet and exercise. Until you know what Tricana's current insulin level is you won't know if she's a candidate for metformin or if just a diet adjustment is in order.
  2. Thyro-L can help with jump starting weight loss but I would look at tightening up the diet first. More on this below.
  3. I believe you said your vet already pulled blood for insulin and glucose although I don't see those results in your file.  If not, those are the only 2 things you need to check at this time.
  4. Assuming that you are looking to balance your hay you can find a list of people who can do this in the HayBalancing.pdf file here: https://ecir.groups.io/g/main/files/6%20Diet%20Balancing
  5. APF is not available in Canada as per recent discussions ( https://ecir.groups.io/g/main/message/255925) so you're fine to continue on the current supplement program
As far as the current diet, we recommend a TOTAL intake of hay and concentrates that is either 1.5% of current weight or 2% of ideal weight - whichever is higher.  For a horse that's meant to weigh 900 pounds the higher of those two amounts is 18 pounds a day which is 7 pounds less than you are currently feeding.

Before looking at Thryo-L my suggestion would be to get the diet tighter - if you're using the ODTBC to carry supplements, can you do less? 

Brooks Enhancer - if the numbers here are correct (https://madbarn.com/feeds/enhancer-brooks-feeds/) this is not a suitable feed for an IR horse and based on their own feeding chart (http://www.brooksfeeds.com/pdf/products/Enhancer.pdf) you're feeding much more of it than needed. It would be best to cut that out completely and have your hay balanced to determine what vitamins/minerals are needed for Tricana.

Then, whatever the difference is between the amount of ODTBC you're using and the 18 pound total can be made up in hay, but it should be weighed so that Tricana is only eating a set amount each day.  That should help with weight loss without needing to add in Thyro-L.




anneefrancis@...
 

Thanks Sherry,

I'm looking at the Brooks enhancer on MadBarn - am I adding NSC + Starch?  I always understood that EWC + Starch = NSC.  I'm not clear how to do the math with the units that they present but I'll take your word for it.  It's so funny (but not funny at all,)  I've had the Brooks representative defend this product up and down, telling me that it's acceptable. 

I've also always understood that AAKG loses its potency completely when mixed with water so I've always mixed my sups with Cocosoya (probably too much) and the Brook's Enhancer.   I would happily feed her a mash of the ODTBC with her sups if possible or I see that Madbarn has a couple of products that might be suitable instead of Enhancer.  

This might not go over well, but she is free fed hay in a tight hay net based on the idea that she's not stressed by hunger.  She doesn't gorge but it sounds as though it's far too much.   Feeling like I have to start at ground zero.  First step is hay balancing and I'm having it tested this week to get that ball rolling.  

Thanks for the guidance!

Best,

Anne 
May 2016

https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana


Sherry Morse
 

Hi Anne,

We look at ESC+starch.  For the MadBarn page that total is NSC (sugar+starch).  If you've been in touch with Brooks directly you can ask them for a guaranteed analysis including the ESC+starch numbers and see if they have that (according to the website they do).

I can't speak to anything with regard to AAKG but again, you've listed that you're feeding the balancer at almost 2x the recommended amount by the manufacturer so cutting that out would be a good first step to getting the diet tighter.

To give you an idea of how much you are overfeeding - based on the numbers in your case history you're feeding a horse that you said was fat at 1000 pounds and currently overweight at 950lbs with an ideal weight of 900 pounds enough to sustain a 1350lb horse. 

Are you actually weighing what she eats right now? If not, I would start there.  You can feed several weighed meals throughout the day to create a more natural eating environment but we do not advocate free choice feeding here because IR horses very often will not self-regulate the way most horses will.



anneefrancis@...
 

That's a lot of calories.  I'm going to get a proper weight on her this week as well...and will cease killing her with kindness.

Anne
May 2016

https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana


anneefrancis@...
 

Hi Sherry,

I found the ration guide that I have been following for Tricana's feed and uploaded it in my case file folder.  I had a few things wrong like her weight (though this was a few years back so will revise)  for example and the amount of Enhancer we've been feeding.  Also, as I mentioned, I've taken to free feeding her hay.  It takes her 3 days to get through a small bale, which probably weighs 60 ish lbs so she's not gorging but I will weigh out a specific amount for her moving forward.  We've also been using Cocosoya to mix in her sups or she won't touch them - I suspect it's too much calorically.  We are testing this year's hay this week and I will upload the results when I get them.  

Warmly,


Anne and Tricana
May 2016
https://ecir.groups.io/g/CaseHistory/files/Anne%20and%20Tricana