Salsa gimpy, new ACTH levels and Aloe Vera question


Tracy
 

Hello all -
Salsa has not done well the last 3 or 4 Septembers -  with laminitis last September that we've been battling ever since.
September 2021 I bumped him up to 1.5 Prascend a day (was on 1 a day before that).

March 2022 - new farrier (used by a few others on this group) - glue on shoes.  March labs Salsa's ACTH was at 15.6 pg/mL (Cornell range 2-30) and insulin (hay only - NO grass) 50.58 uiU/mL.
Dr Kellon at the time felt the laminitis was likely mechanical based on pics and xrays I posted - didn't love that insulin number - but it's not as high for him as it had been in the past.

Fast forward to now.
August 10th I had vet out to look him over and pull blood for ACTH.  It came back 14.9 pg/mL - Cornell again - same range as above.  Salsa is still on 1.5 Prascend.  Salsa still gets no grass - out with a muzzle that I have blocked ALL around.  This month's ACTH is the single best results he's ever had. 

He has good and bad days.  Today is a rough one - he wanted out of his dry lot and was gimpy - but went out.  Gimpy when I pulled him back up.

I have been giving him about 2ml of Banamine most days (he weighs about 830 lbs) - I try to not give it whenever possible.   He's ok going over 24 hours without it sometimes.  I can only watch him gimp 'so much' before I cave in and get some pain med onboard.  I hit that threshold a month ago - Salsa was too gimpy and too uncomfortable.  Not loving giving him the banamine.

Phytoquench hasn't touched Salsa's pain.  I was grinding it and trying to hide it in hay - not sure how much was getting into him that way - but no difference with it, tried feeding it etc...

I have a large syringe that I can give him aloe vera juice with.  I add some aloe to his water - but that's in a trough.   I spray some in his hay flakes along with salt.
How many mLs or cc's of Aloe juice can I syringe into Salsa to help buffer the impact of that banamine?  Would it be better to syringe in some aloe juice twice a day?  Or is once ok?
Should I just buy some UlcerGuard instead?

Could I try "plain" old Devil's Claw from like - bulksupplements dot com or another supplement place?  A plainer form than the Phytoquench and just syringe it into him mixed in some water?  If so - how much to give him?  Once a day?  Twice a day?? 
Is there anything else I can try for him to take the edge off the pain?

His hay is tested etc...he is a wicked picky eater.

Thanks -
Tracy
--
Tracy and Salsa (1999 model year Paso Fino)
Middle TN USA, September 2019
Case History  https://ecir.groups.io/g/CaseHistory/files/Tracy%20and%20Salsa
Photos https://ecir.groups.io/g/CaseHistory/album?id=95827


Sherry Morse
 

Hi Tracy,

Have you tried Metformin to bring his insulin down?  Did you test insulin when the ACTH was tested this month?  Are you using Phytoquench Plus (with the Devil's Claw) or just regular PQ? 

If you did not test his insulin I would start there and if you are not using the PQ Plus I would either try that or just source straight DC for him.




Tracy
 

Didn't check insulin in August.
It is the PQ Plus with devil's claw.
I haven't tried Metformin - but would be game to consider this.  His insulin is always high/high-ish and years ago when I checked his leptin - it was high too.

I plan to have vet out later this fall when the weather is cooler for yearly stuff.
Farm calls have gone up to $125 right now -bleh.

How much plain Devil's Claw (mg or grams) a day would I give Salsa (about 830 pounds)?  I'd like to get enough DC on board to stop with the banamine - but I'm not sure how much DC that would be.

And can I syringe some aloe vera juice into him while I am using the banamine?  How much?
--
Tracy and Salsa (1999 model year Paso Fino)
Middle TN USA, September 2019
Case History  https://ecir.groups.io/g/CaseHistory/files/Tracy%20and%20Salsa
Photos https://ecir.groups.io/g/CaseHistory/album?id=95827


Eleanor Kellon, VMD
 

Tracy,

You are approaching this in the wrong way. The goal is to stop the CAUSE, not chase after the SYMPTOMS. Banamine is not helping anything. If there are any unresolved abscess/fluid collections, this is preventing them from exiting and prolonging his pain. The root cause here is obviously high insulin. That causes high endothelin-1, a potent vasoconstrictor, which is at least part of the cause for the hoof pain. You need to gradually, but consistently, stretch out the interval between doses by 12 hours at a time and start Jiaogulan https://mybesthorse.com/info_jiaogulan.html .  Aloe won't block the negative side effects of long term banamine. Also try metformin and if that doesn't work go to canagliflozin or ertugliflozin.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."


Tracy
 

Yes...time to really ROOT CAUSE Salsa's issue.
I just texted my vet to please let me know when we can talk because I'm interested in metformin for him.
Found the info in the Files section about dosing etc.
Hopefully my vet is game for this.

I will get j-herb ordered asap.

Tracy

--
Tracy and Salsa (1999 model year Paso Fino)
Middle TN USA, September 2019
Case History  https://ecir.groups.io/g/CaseHistory/files/Tracy%20and%20Salsa
Photos https://ecir.groups.io/g/CaseHistory/album?id=95827