Seasonal rise and fall...slowly increase mid-July and slowly taper in November??? Also feeding advice...


Jennifer
 

Hello All!  I hope everyone is doing well!  

So I am looking at the seasonal rise and fall of ACTH...and am trying to search in here about how you all go about increasing and then tapering off Pergolide to coincide with the seasonal rise/fall...

I have observed issues starting in late July for my boy, Lou...  So I would start an increase slowly mid-July?  Then slowly taper off starting in November?  Going by the state of the animal in front of you??

**My vet said to me once I increase him I won't be able to go back at all with the meds...that can't be right, can it??

This is my first full year with Lou being PPID/on meds...so obviously I was NOT on the ball about the seasonal rise (or about anything in the beginning...).  We got behind and from previous posts you all will know I thought I would have to put him down.  Thanks to YOU ALL he is doing well now!! :)  He has completed ulcer treatment (I used AbPrazole tablets:  https://abler.com/abprazole) and is on 2.5 Pergolide per day. (Before this episode late summer he was on 1 Pergolide/day).  He has stopped pacing except when he sees me in the food wagon coming around...and we are now on a much better schedule of 3 buckets per day.  I am in the process of updating his case history which will show what he gets fed per day (divided into 3 buckets):

8# Triple Crown Balancer Cubes
8# Triple Crown Senior Feed
1.5oz CocoOmega Oil
2.5 T NaCl
5000IU Vit E (Uckele)
2 scoops TriAmino (Uckele)
1/3 scoop Ocean K (Uckele)
1 cup Horseshine
1 T Mg (according to my calculations his Mg is super low so I am increasing this slowly)

I am now looking at adding Muscle EQ, Tendon EQ, and am looking at options to get him OFF the TC Senior Feed.  I have read many recommendations on here to get Stabul 1 (maybe Stabul 1 Plus since Lou is NOT an easy keeper) but it is out of stock at Chewy.  I am thinking of slowly switching over the calories from the TC Senior to a combination of soaked (and rinsed) Beet Pulp and Alfalfa cubes.  I can add supplements (vitamins/minerals) as needed to replace what he is currently getting from the TC Senior as well.  

Does this sound like a good plan or am I missing something?  

He is on pasture almost 24/7, and when he comes in he has free choice mixed grass hays (yes, I do test my pastures and hays) but I am feeding him like he is NOT getting any hay or grass at this point...he just picks at his hay and I am not sure how much pasture he is getting...plus it is fall and the grass here has stopped growing...

Any and all advice is so appreciated!  Thank you so much!



https://www.thelaminitissite.org/ppid-faq/acth-interpretation


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Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou

Photos:
https://ecir.groups.io/g/CaseHistory/album?id=277881


billie hinton
 

I’m not sure if this feed could be right for your horse, but my not-IR, PPID 33.5 year old gets timothy/orchard hay + 3 wet feed tubs per day. We had been feeding him the timothy balance cubes wet with his supplements for his wet tubs, but maybe three years ago he seemed to not be holding his weight, mainly during the summer months. I was planning to go the route of Dr. Kellon’s complete senior horse diet (fed this 4x/day to our sweet mare Salina in her final years) but it’s definitely labor intensive due to needing alfalfa pellets, crimped oats, wheat bran, and beet pulp, rinsing/soaking/rinsing the beet pulp, etc. I was alerting our feed store owner that I was going to be needing the specific brand of alfalfa pellets I’d used previously, and bemoaning that I was back to this intensive 3x/day diet, and she told me about the Triple Crown GMO-free Natural pelleted horse feed. It actually had all the ingredients of the senior diet I intended to make, so I tried it - just added one scoop to his AM/PM wet timothy balance cube tubs and at mid-day gave him 3-4 scoops of the wet pellets. It’s done a great job for us. He loves it. Because it doesn’t have any molasses I also use the pellets for treats sometimes for the other also not diagnosed IR but easier keeper equines. It wouldn’t be appropriate for IR horses, though. 

I’ll say that I just checked the ingredient list to be sure they haven’t changed it, and found they have taken out the beet pulp, which I hadn’t realized until today. He’s still doing very well with me using it as an easy additive. You can see the breakdown of ingredients here:


Hope this helps.
Billie in NC


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Billie Hinton
NC 
Member since 2010


Eleanor Kellon, VMD
 

The fall laminitis with positive PPID means he also now has elevated insulin.  If you are mixing the balance cubes with senior at each feeding you may be OK with insulin response but the only way to find out for sure is to test. With the diet you describe the best thing would be to schedule a glucose and insulin check 4+ hours after a meal.

Beet pulp and alfalfa as a substitute for TC Senior is not a good idea. I would be almost impossible to balance. You could go to Stabul 1 but if your combination doesn't cause an insulin rise as above you can leave the present diet the same until you encounter problems.
--
Eleanor in PA

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


Sherry Morse
 

Hi Jennifer,

If Lou is only PPID you have some more wiggle room with safe feeds.  To know if he is IR or not you'd need to do a full metabolic panel on him at some point.  Until you do that I wouldn't change anything with his diet unless you're advised by Dr. Kellon or whomever is balancing your hay. 

Until you test him I wouldn't change anything with his pergolide either.  Once you test him and see if his ACTH is controlled on the 2.5mg you'll know if you can possibly try decreasing the dose for the spring or not.  Looking at your test results he was not well controlled on the 1mg (as per the TRH Stim results) so you're looking at having him on at least 1.5 or 2mg as a baseline from now on from the last test results.




 

Hi Jennifer,
You can always decrease the pergolide but the fact is that you may not want to.  PPID is a progressive disease.  Some horses seem to do just fine on a 1 mg tablet of Prascend for what seems like forever but that wouldn’t have been mine.  I would generally test in July to see how things stand and then again in early spring to see how they weathered the rise.  I have five horses here on pergolide and I can’t recall any time when I decreased the dose.  When you test, be sure to include insulin and glucose as insulin is the important one to follow in terms of laminitis.

Unless you are planning to do a large increase in dose in July, I would increase it by 0.5 mg and then again by the same amount a few days later.  I don’t seem to need APF any longer when making increases now that the increases are a smaller percentage of the total dose.  Same with the decrease if you find one is warranted.

When my senior WB would lose weight in the fall, it took me awhile to understand what was happening.  I would treat him for ulcers, test him for Lyme (which is a huge problem here), and then finally test his ACTH, which was always too high at that point.  His insulin did not rise with increased ACTH so I didn’t have that to worry about or as guidance.

I didn’t look through all your notes so this might not be helpful but I find TC Timothy Balance Cubes or their Ontario Dehy equivalent to be hugely helpful in adding weight.  And Cocasoya oil, which you are already feeding.  If the ACTH was high, more pergolide was needed to make any weight difference.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo
 


Jensmccabe
 

Thanks Martha for that additional info.

My gelding dropped weight this fall and yep his ACTH was too high (at 39 now on 2mg compounded Pergolide and Metformin). 

How old was your senior warm mood when he had this symptom?


--
Jen McCabe
Laytonsville, Maryland 
Joined 2022
+ Odin (2010 BLM Mustang Gelding - IR, dx 2022), Bella (2008 BLM Mustang Mare - PPID/Cushings dx 2000) + Fiki (2015 Arabian, ok so far!)
Odin and Bella Case Histories


Lesley Bludworth
 

Jennifer,  were you ever able to test Lou's insulin?
--
Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Jennifer
 

Thank you for all of the ideas/thoughts and time reading through my post!

I will have insulin/full blood panel done next time my vet is out, and will also check his ACTH in the spring and July.  I love the look of the TC Naturals Pelleted Feed and will order some of that and switch over--I was feeding 6-7 buckets per day (just for Lou) but I have 9 horses and many other animals...and care for my entire property myself (50+ acres)...so I really need to try my best to get Lou what he needs but also keep my own sanity!!! 

It is so comforting to know I am not alone--not that I want other owners/horses to go through these kinds of things...but hearing you all's stories and experiences makes me feel like we (here) are going to be ok.  I try to get things perfect and have a strong need to be able to plan for everything.  I hate making mistakes.  These are probably not the best qualities to have being any kind of animal owner/care giver...but I am going to give myself a break and not judge myself too harshly this time around.  Make good use of the knowledge I am getting and do what I can to get my horses to be happy and healthy!

Have a great weekend everyone--and thank you again!  
--
Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou

Photos:
https://ecir.groups.io/g/CaseHistory/album?id=277881


Frances C
 


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- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382