Topics

Request for help for Storm


hdavis
 

Hello,

I previously posted Storms latest blood tests which I updated to her case history.  I need some guidance with how to proceed with her care and lameness issues.

She has never tested positive to acth in April 2019 not this fall. However due to fall lameness issues we started her on a trial of prascend with seemed to improve her lameness this spring which was a good sign.  She became lame again this early fall late summer again so we decided to increase prascend and retest.  She is on 2mgs of prascend and her ACTH this fall was 3 vs 3.1 in spring of 2019.  Her insulin tested at 199 pmol this fall which from is below the level to cause foot pain from my understanding.  My question is should I co time the Prascend for her asked on these results?  


She still suffers lameness issues mainly with her LF.  It comes and goes and putting boots on her and pads sometimes helps and other times doesn’t. Since her insulin is too low to cause laminitis issues and the vets have it found anything to point to what could be wrong with her and agree upon it I am at a loss as to what to do.  No ,after what I try I cannot get her to land heel first on this foot.  I have noticed that it is terribly hard to get her to flex this foot in her Pastern area and it is almost like a knarled up hand suffering from arthritis...but according to vets no arthritis.  Since this is the foot she was diagnosed with a DDFT in years ago which then lead to her being shoved with wedges and high heels to unload the heel.  Decided to remove shoes when it no longer seemed to be effective.  What I was wondering is could she be suffering from scar tissue on this foot and possibly healed in away that does not allow her to flex that foot properly to allow for heel to landings. And if so what can I do to help my poor girl.

Please give me your suggestions.
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

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

 Photos

https://ecir.groups.io/g/CaseHistory/album?id=8819&p=pcreated,,,20,2,0,0  .


Storm

Case History



photos

 
 

 




Sherry Morse
 

Heather,

For the sake of our volunteers (and to free up space on the server) can you please combine Storm's albums so all her photos are in one location and then delete the extra album and fix your signature.  It would be quite helpful.

Her x-rays from 2018 look very clean in terms of any visible arthritis, does she have any newer films?




hdavis
 

Sorry I can do that.  But not sure how I combine them as I don’t have the actual pics anymore as they were on my phone from the hoof album ones.  Ideas or how does one combine the albums?

No I don’t have recent xrays and the last ones are from
my current vet who didn’t say any issues with the xrays to indicate navicular in her opinion. She was the one that suggested perhaps we are dealing with some scar tissue or improper healing of the DDFT.  I have given her previcox for her arthritis pain when she gets flair ups but it doesn’t seem to help with her RF lameness at all which again leads me to think maybe a tendon scarring issue?


--
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


 




hdavis
 

Looking for advice on my mare Storm and if I should be continuing her Prascend or if it is needed based on her last blood results.  She is on tested and balanced mineral, dry lot year round and no unapproved treats. She has reoccurring lameness in spring and early fall. She suffers stifle arthritis which I do think has caused increased issues with the left front which is also the foot she was diagnosed with a DDFT injury years back in 2014.  If prascend is not needed I would like to discontinue it but would like feedback.  We put her on it as a trial to see if it would help but she still has the reoccurring lameness which gets worse when the cold weather agrivates her stifle arthritis.

I had asked about how to combine my albums but didn’t hear back so will just work on moving the pics over somehow and deleting the other album.  Thanks and looking forward to hearing some guidance.
--
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


 




Kirsten Rasmussen
 

Hi Heather,

Your Case History states that Storm's body conditiom improved when you started Prascend.  What kind of improvements did you see?  Are any of them improvements to signs of PPID, or just to EMS/IR?  If not, and given that her insulin isn't lower on it, I personally don't think it's worth continuing.

You have removed her from grass completely but have you been soaking her hay?  I know my horse gets sore in the spring (not the fall thankfully) and his hooves generally lose all the improvements we will have made over the winter.  Now that this has happened 3 years in a row I've learned it's not enough to feed him 1.5% ideal BW in low sugar hay, and that his hay really must be soaked at that time of year, too.  (He actually does best if I soak it all summer, too).  His hoof pain coincides with things greening up, usually mid-April here, even though he is on a truly dry lot and does not get any grass other than maybe the odd blade or two that pops up before I see them.   I think there is a hormonal component that increases his insulin in mid-April, although I've yet to see anything officially mentioned here (other than the finding that the spring equinox can also affect ACTH in PPID horses, which Shaku is not). 

Beyond that, maybe trying her on invocana?

If she can manage regular exercise before the spring and fall episodes, then maybe that could help prevent them.

I'm not sure what else to suggest for Storm.

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


hdavis
 

Hi Kirsten,

Thanks for replying.  As for physical differences in Storm’s appearance I would say her pot bellied and somewhat ribby appearance got better. She never has had any IR fat pads or filled with eye orbits and if anything her eye orbitals have always been very sunken in.  She also seemed to have less periods of loose manure.

She is off grass and has been on tested low sugar and starch hay for almost 2 years.  I can’t soak hay where I live and not possible in these temps with no heater area to do so.  So unfortunately not an option.  I have tried this in the past with her when it was not as cold and it didn’t seem to make any difference to her lameness. Perhaps she is dealing with other issues such as poor healing or scar tissues in her DDFT too? Not sure.

If I was to take her of prascend do u slowly wean her off? Just seems weird as I me that her insulin has not changed that much since the spring to the summer so thought maybe something else was driving it up.



From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Kirsten Rasmussen <kirstenrasmussen3@...>
Sent: Friday, October 23, 2020 8:27:15 AM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] Request for help for Storm
 
Hi Heather,

Your Case History states that Storm's body conditiom improved when you started Prascend.  What kind of improvements did you see?  Are any of them improvements to signs of PPID, or just to EMS/IR?  If not, and given that her insulin isn't lower on it, I personally don't think it's worth continuing.

You have removed her from grass completely but have you been soaking her hay?  I know my horse gets sore in the spring (not the fall thankfully) and his hooves generally lose all the improvements we will have made over the winter.  Now that this has happened 3 years in a row I've learned it's not enough to feed him 1.5% ideal BW in low sugar hay, and that his hay really must be soaked at that time of year, too.  (He actually does best if I soak it all summer, too).  His hoof pain coincides with things greening up, usually mid-April here, even though he is on a truly dry lot and does not get any grass other than maybe the odd blade or two that pops up before I see them.   I think there is a hormonal component that increases his insulin in mid-April, although I've yet to see anything officially mentioned here (other than the finding that the spring equinox can also affect ACTH in PPID horses, which Shaku is not). 

Beyond that, maybe trying her on invocana?

If she can manage regular exercise before the spring and fall episodes, then maybe that could help prevent them.

I'm not sure what else to suggest for Storm.

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


--
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


 




Sherry Morse
 

Hi Heather,

The fact that you noted she was slow to shed, pot bellied and ribby make me wonder if she's one of those horses that doesn't test as PPID but responds to pergolide.  As far as the lameness there are a lot of factors at play for her - it could have nothing to do with PPID/IR or that could be just one element of what's going on with her.




hdavis
 

Oh yes and the slow shedding I forgot about that.  So do you think I should leave her in her dose of 2mg if prascend right now?  I bumped it up to 2 from 1 due to seasonal rise.  Any suggestions?  
--
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


 




Eleanor Kellon, VMD
 

Do you have radiographs? Doesn't sound likely this is laminitis. If you are going to stop or reduce pergolide I would wait for November.

 The small bump in insulin could be related to weather.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


hdavis
 

Hello,

yes I have xrays but they are not current and from 2018 as well as back when she had her DDFT injury.  They are under her hoof album and I will get these moved over to one album soon.
--
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


 




Eleanor Kellon, VMD
 

You might want to consider a work up with nerve blocks and new radiographs. Be sure to include navicular views.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


hdavis
 

Ok thanks Dr. Kellon.

The last xrays according to my vet didn’t show issues with her navicular bone or anything to lead us to her lameness issues. As it is primarily her right front foot that is the issue and the fact that she can not stretch out her pastern making her lower foot almost curled like a claw shape, I wondered if perhaps it could be due to how her DDFT heeled especially since she was in the high heeled wedge shoes for years after the injury.  Would this be something to look at?


--
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


 




hdavis