Solar Penetration


Nicolle Dupont
 

Good morning,

I am seeking advice on treating solar penetration, what protocols have been successful.

Thank you.  
--
Nicolle D in BC Canada 2022


Bobbie Day
 

Hello Nicolle,
Thanks for reaching out and welcome to the group, I will be sending along your official welcome message which can be quite daunting at first but please give it a read and keep it for future reference, its full of great information that can, and will come in handy.
I'm assuming you have an IR/EMS, PPID horse or maybe both, since your here.
You are asking about solar penetration, are you experiencing that now with your horse? Could you possibly provide us with more information so our hoof experts as well as Dr.Kellon can advise? It would help us to help you with more details, if you're in an emergency situation please give us as much background as you can while you complete a case history, any x-rays and test results would help our team to better help you.
Now on to your message, please let us know if you have any additional questions. 

Hello 

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine (look under the Hay Balancing file if you want professional help balancing). If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 

 


Bobbie and Maggie 
Desi (over the rainbow bridge 7/21) 
Utah, Nov 2018
NRC Plus 2020, NAT, C&IR March 2021
ECIR Group Primary Response 

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie
https://ecir.groups.io/g/CaseHistory/album?id=271156

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi 
https://ecir.groups.io/g/CaseHistory/album?id=78821


Nicolle Dupont
 


Hi Bobby,

Thank you for the add. I have performed countless hours of research so am pretty up to speed with my mare's situation. Here is a somewhat lengthly history.

10 yr QH mare 15.2hh barefoot for seven years, good feet that has been living in a pasture board situation for 6 years. She has been somewhat overweight each summer and perhaps three days per week I put her in a small pen for 8 hours. Her neck was a little cresty the last two years but never unsound. I usually ride four times per week and some local shows.

On May 23 I found her standing in the field with fronts swollen to knee and reluctant to go forward. Brought her in, 2 grams of bute, off to vet in morning, swelling was gone. X-rays showed 2% rotation of coffin bone and good sole depth. ''Looks like you caught it in time' said the vet. Back to pen with soaked hay twice daily and boots with pads, area with bedding. She was ramped down from bute to meloxicam over the next 3 weeks and then to previcox.

I knew she could no longer live where she did and was moved on June 5 to a 30ft x 50ft dry paddock situation with shavings for her to bed down. Continued on soaked hay, boots w/pads, etc. Farrier came to do a light trim on June 14.

She appeared uncomfortable but not in pain. The last week of June I became concerned that she was really not improving. Her demeanor was listless and she moved around less in her area, right-front seemed worse than left. Vet visit on July 4, which is now 6 weeks from first episode. X-rays show 8% coffin bone rotation and 1 cm left of sole. He took a little off of her heels, bloodwork sent away, takes 5 plus business days.

Made pen 8ft x 20ft, back on Meloxicam, vet started on Prascend in case it is PPID. I cannot get the Prascend into her without a 1 1/2 tsp of molasses (I know it has a 70 Glycemic Index but I thought it better to get it into her). I did that for three days and am now dissolving in water and syringing in.

Spoke with another farrier, liked trim suggested cutting out pads to relieve pressure on sole, take away Redmonds salt (too much iron) and put an RV filter on her water supply to reduce iron. Yet another farrier said trim look good.

Was trying to get Mad Barn's Amino Trace pelleted minerals into her but she won't eat it straight so was putting in 1 lb feedings of alfalfa cubes (for 3 days last week). Yesterday received non-GMO organic beet pulp and will place increasing amounts of the minerals in there. I will also start to feed flax today.

The night of July 8 she was visibly worse and I could not change her pads on left foot as she cannot stand on right. Have been unable to do that since. July 9 bumped her up to 2 grams of bute 2x daily and it appears to make no difference to her comfort level. July 10 notice bulge on right sole which photo to vet confirmed that it appeared to be penetration. I stopped bute yesterday and was provided with gabapentin and acepromazine which I have not yet administered. She seemed a bit better last night (no bute for 24 hours) and I will see how she is today. Yesterday vet suggested coming out and considering euthanization due to penetration. Screw that.

Last night I soaked her right foot in hydrogen peroxide/water and wrapped in diaper, 2 pads, polo wrap, vet wrap and duct tape (no boot of course). Will see shortly how that made out. Still waiting on blood test results.

My two main concerns at this point are:
  • How do I keep right P3 penetrating foot from becoming infected?
  • How can I access her left as she will not let me have it due to pain in right? I have not changed pads for three days and boot is a bit twisted. My only thought was to utilize the drugs I have (gabapentin and acepromazine) to achieve access to left.
I have attached July 4 X-rays and foot pics, sole pic was after a little heel removed. July 10 right sole pic.

Thank you for any insight you can provide.

Regards,

Nicolle Dupont
1831 Parkcrest Ave.
Kamloops, BC  V2B 4W8
Cell:  250-644-4002
Fax:  855-288-9410


On Tue, Jul 12, 2022 at 1:03 PM Bobbie Day <2841days@...> wrote:
Hello Nicolle,
Thanks for reaching out and welcome to the group, I will be sending along your official welcome message which can be quite daunting at first but please give it a read and keep it for future reference, its full of great information that can, and will come in handy.
I'm assuming you have an IR/EMS, PPID horse or maybe both, since your here.
You are asking about solar penetration, are you experiencing that now with your horse? Could you possibly provide us with more information so our hoof experts as well as Dr.Kellon can advise? It would help us to help you with more details, if you're in an emergency situation please give us as much background as you can while you complete a case history, any x-rays and test results would help our team to better help you.
Now on to your message, please let us know if you have any additional questions. 

Hello 

Welcome to the group! 

The ECIR Group provides the best, most up to date information on Cushing's (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). Please explore our website where you'll find tons of great information that will help you to quickly understand the main things you need to know to start helping your horse. Also open any of the links below (in blue font) for more information/instructions that will save you time.

Have you started your Case History? If you haven't done so yet, please join our case history sub-group. We appreciate you following the uploading instructions so your folder is properly set up with the documents inside. Go to this CH message with info on how to use various devices and forms. If you have any trouble, just post a message to let us know where you are stuck.

Orienting information, such as how the different ECIR sections relate to each other, message etiquettewhat goes where and many how-to pages are in the Wiki. There is also an FAQs on our website that will help answer the most common and important questions new members have. 

Below is a general summary of our DDT/E philosophy which is short for Diagnosis, Diet, Trim and Exercise.

 

DIAGNOSIS: There are two conditions dealt with here: Cushings (PPID) and Equine Metabolic Syndrome (EMS)/Insulin Resistance (IR). These are two separate issues that share some overlapping symptoms. An equine may be either PPID or EMS/IR, neither or both. While increasing age is the greatest risk factor for developing PPID, IR can appear at any age and may have a genetic component. Blood work is used for diagnosis as well as monitoring the level of control of each.

PPID is diagnosed using the Endogenous ACTH test, while EMS/IR is diagnosed by testing non-fasting insulin and glucose.

The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin ECIR is not recommending routine testing for this hormone. Leptin is the hormone that says "stop eating".

In Europe, adiponectin is tested instead of leptin. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk

*Before calling your vet to draw blood for tests, we suggest saving time and wasted money by reading these details and then sharing them with your vet so that everyone is on the same page regarding correct testing and protocols.

*Please remember to request copies of the results of all the tests done rather than just relying on verbal information. Your vet should be able to email these to you. If you have previous test results, please include those as well. All should go in your CH, but if you are having any trouble with the CH, just post in the messages for now. 

Treatment: EMS is a metabolic type - not a disease - that is managed with a low sugar+starch diet and exercise (as able). The super-efficient easy keeper type breeds such as minis, ponies, Morgans, Arabs, Rockies are some of the classic examples. PPID is a progressive disease that is treated with the medication pergolide. Some, but not all, individuals may experience a temporary loss of appetite, lethargy and/or depression when first starting the medication. To avoid this "pergolide veil" (scroll down for side effects), we recommend weaning onto the drug slowly and the use of the product APF. The best long term results are seen when the ACTH is maintained in the middle of the normal range at all times, including during the annual seasonal rise. To accomplish this, the amount of medication may need to increase over time. Neither condition is ever "cured", only properly controlled for the remainder of the equine's life. If your partner is both PPID and IR then both medication and diet management will be needed. 

DIET: Almost all commercial feeds are not suitable - no matter what it says on the bag. Please see the International Safe Feeds List for the safest suggestions.

No hay is "safe" until proven so by chemical analysis. The diet that works for IR is:

  • low carb (less than 10% sugar+starch)
  • low fat (4% or less) 
  • mineral balanced  

We use grass hay, tested to be under 10% ESC + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt, and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E. This diet is crucial for an EMS/IR horse, but also supports the delicate immune system of a PPID horse. 

*Until you can get your hay tested and balanced we recommend that you soak your hay and use the emergency diet (scroll down for it).  The emergency diet is not intended for long term use, but addresses some of the most common major deficiencies. Testing your hay and getting the minerals balanced to its excesses and deficiencies is the best way to feed any equine (look under the Hay Balancing file if you want professional help balancing). If you absolutely cannot test your hay and balance the minerals to it, or would like to use a "stop gap" product until you get your hay balanced, here's a list of "acceptable" ration balancers

There is a lot of helpful information in the start here folder so it is important you read all the documents found there. The emergency diet involves soaking your untested hay for an hour in cold water or 30 minutes in hot water. This removes up to 30% of the sugar content, but no starch. Starch is worse than sugar since it converts 100% to glucose while sugar only converts 50%, so starch causes a bigger insulin spike. Make sure you dump the soaking water where the equine(s) can't get to it. 

What you don't feed on the EMS/IR diet is every bit as, if not more important than, what you do feed! No grass. No grain. No sugary treats, including apples and carrots. No brown/red salt blocks which contain iron (and sometimes molasses) which interferes with mineral balancing, so white salt blocks only. 

No products containing molasses. No bagged feeds with a combined sugar and starch of over 10% or starch over about 4%, or fat over about 4%. Unfortunately, even bagged feeds that say they are designed for IR and/or PPID equines are usually too high in sugar, starch and/or fat. It’s really important to know the actual analysis and not be fooled by a name that says it is suitable for EMS/IR individuals.

We do not recommend feeding alfalfa hay to EMS/IR equines as it makes many of them laminitic. Although it tends to be low in sugar, many times the starch is higher and does not soak out. Additionally, protein and calcium are quite high, which can contribute to sore footedness and make mineral balancing very difficult.

TRIM: A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot. Though important for all equines, it's essential for IR and/or PPID equines to have a proper trim in place since they are at increased risk for laminitis. After any potential triggers are removed from the diet, and in PPID individuals, the ACTH is under control, the realigning trim is often the missing link in getting a laminitic equine comfortable. In general, laminitic hooves require more frequent trim adjustments to maintain the proper alignment so we recommend the use of padded boots rather than fixed appliances (i.e. shoes, clogs), at least during the initial phases of treatment.

Sometimes subclinical laminitis can be misdiagnosed as arthritis, navicular, or a host of other problems as the animal attempts to compensate for sore feet. 

You are encouraged to make an album and post hoof pictures and any radiographs you might have so we can to look to see if you have an optimal trim in place. Read this section of the wiki for how to get a hoof evaluation, what photos are needed, and how to get the best hoof shots and radiographs.

EXERCISEThe best IR buster there is, but only if the equine is comfortable and non-laminitic. An individual that has had laminitis needs 6-9 months of correct realigning trims before any serious exercise can begin. Once the equine is moving around comfortably at liberty, hand walking can begin in long straight lines with no tight turns. Do not force a laminitic individual to move, or allow its other companions to do so. It will begin to move once the pain begins to subside. Resting its fragile feet is needed for healing to take place so if the animal wants to lay down, do not encourage it to get up. Place feed and water where it can be reached easily without having to move any more than necessary. Be extremely careful about movement while using NSAIDs (bute, banamine, previcox, etc.) as it masks pain and encourages more movement than these fragile feet are actually able to withstand. Additionally, NSAIDs (and icing) do not work on metabolic laminitis and long term NSAID use interferes with healing. Therefore, we recommend tapering off NSAIDs after the first week or so of use. If after a week's time your equine's comfort level has not increased, then the cause of the laminitis has not been removed and keeping up the NSAIDs isn't the answer - you need to address the underlying cause.

 

There is lots more information in our files and archived messages and also on our website. It is a lot of information, so take some time to go over it and feel free to ask any questions. If you are feeling overwhelmed, don't worry, you will catch on, and we are always here to help you! Once you have your case history uploaded, we can help you help your equine partner even better.

For members outside North America, there are country specific folders in the files and many international lists in the wiki to help you find local resources.

If you have any technical difficulties, please let us know so we can help you. 

 


Bobbie and Maggie 
Desi (over the rainbow bridge 7/21) 
Utah, Nov 2018
NRC Plus 2020, NAT, C&IR March 2021
ECIR Group Primary Response 

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie
https://ecir.groups.io/g/CaseHistory/album?id=271156

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi 
https://ecir.groups.io/g/CaseHistory/album?id=78821


--
Nicolle D in BC Canada 2022


Kirsten Rasmussen
 

Hi Nicolle, thanks for the added details. 

It could be an abscess, too, but if there's a chance of penetration, don't soak the hoof.   Let her lie down as much as she likes in a comfortable safe place and keep food and water within reach.  Keep it wrapped in a clean dry diaper, preferable in a padded boot.  Maybe when she's laying down you can access her left front hoof boot, but I wouldn't worry too much about it now.

Metabolic laminitis in a young QH is unusual.  Diagnosis of the cause is critical to how you are going to move forward.  You need to test for PPID, Lyme, and infection (white blood cell count)...there may be more, I'll let Dr Kellon elaborate if there is.  Does she have a fever?  In the meantime, follow our Emergency diet protocols in case this is metabolic laminitis.  I hope you're waiting on non fasting insulin, glucose and ACTH??

As for penetration, it is not a death sentence if you are wiling and able to go through the process and help your horse heal.  Read this story about Druid, a pony that suffered coffin bone penetration.  The possibility of infection is discussed there.

You cannot attach photos or documents to your message.  Instead, please join our Case History sub-group and in "Albums" create a photo album as described here: https://ecir.groups.io/g/main/wiki#Photos-and-Hoof-Evaluation-Help
Also in the Case History group, under "Files" you can create a case history folder for any documents you want to upload, like bloodwork results and a Case History. 

I hope that helps, others will also comment. 

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


Eleanor Kellon, VMD
 


Nicolle Dupont
 

Thank you Kirsten.

She is in a major amount of pain and has stopped eating.  I have Gabapentin and acepromazine.  I am thinking I will administer to give her some relief.
--
Nicolle D in BC Canada 2022


Eleanor Kellon, VMD
 

Put her back on an NSAID if she is in that much pain.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Trisha DePietro
 

Hi Nicolle. I read through Dr. Kellons post and the links she posted for you...is your horse getting any hay at all? If yes, does it come from the same pasture fields she had been eating in? Or close by? When you walk through her pasture where she was eating,..do you see any hoary allyssum? The links give excellent photographs for ease of Identification in both hay and fields. If this is the cause, it would be helpful for your vet to be aware of it too. Might help in next steps and decision making. 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


Nicolle Dupont
 

Is.gabapentin best then?  I was going to give her a acepromazine injection and hopefully she may lay down so that I can access her feet the change pads, boots.  She one boot on and one (the penetrating one) is wrapped in vet wrap, duct tape.  I haven't been able to access for a few days now.


On Wed., Jul. 13, 2022, 10:55 a.m. Eleanor Kellon, VMD, <drkellon@...> wrote:
Put her back on an NSAID if she is in that much pain.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Nicolle D in BC Canada 2022


Nicolle Dupont
 

Hi Trisha,

She has been on soaked hay only for 7 weeks now.

Regards,

Nicolle Dupont
1831 Parkcrest Ave.
Kamloops, BC  V2B 4W8
Cell:  250-644-4002
Fax:  855-288-9410


On Wed, Jul 13, 2022 at 11:05 AM Trisha DePietro <RN1016@...> wrote:
Hi Nicolle. I read through Dr. Kellons post and the links she posted for you...is your horse getting any hay at all? If yes, does it come from the same pasture fields she had been eating in? Or close by? When you walk through her pasture where she was eating,..do you see any hoary allyssum? The links give excellent photographs for ease of Identification in both hay and fields. If this is the cause, it would be helpful for your vet to be aware of it too. Might help in next steps and decision making. 
--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories
Dolly's Photos 
Hope's Photos 
Primary Responder


--
Nicolle D in BC Canada 2022


Nicolle Dupont
 

Trisha,

Yes, some of her hay has come from the same property although not the same field she used to live in.  We tried coarse grass at first but she wouldn't touch it and I thought something is better than nothing.  I am familiar with hoary alyssum but have not seen any here.
--
Nicolle D in BC Canada 2022


Nicolle Dupont
 

From what I have researched the gabapentin can take a few days to kick in.  Can I also give bute or previcox at the same time to give more immediate relief?

Regards,

Nicolle Dupont
1831 Parkcrest Ave.
Kamloops, BC  V2B 4W8
Cell:  250-644-4002
Fax:  855-288-9410


On Wed, Jul 13, 2022 at 10:55 AM Eleanor Kellon, VMD <drkellon@...> wrote:
Put her back on an NSAID if she is in that much pain.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Nicolle D in BC Canada 2022


Sherry Morse
 

Hi Nicolle,

Did you happen to check her temperature when all this first started?  As she's not a breed prone to IR without PPID (and she's young for PPID) and had swelling in her legs if she were in my area I'd be checking her for tick borne diseases.  What bloodwork did the vet do on the 4th? Insulin, glucose, ACTH or something else?  Would you be able to post x-rays and photos of her feet in a case history album?  

To do that you'll need to join the Case History sub-group (CaseHistory@ECIR.groups.io | Home) and then create a photo album (click on the "Photos" link on the left side menu after you join the group and then once you've gotten to CaseHistory@ECIR.groups.io | Photos click on the blue box at the top to create a New Album name "Nicolle and Horse Name".  That's where you would load any jpg files you have as this list does not accept attachments.

Is she still on Previcoxx right now?  

If you think her coffin bone is about to penetrate her foot you do not want to soak it but you do want to keep it padded as much as possible.  You can do these things with her laying down - just make sure you keep her food and water close enough for her to access it without a lot of unnecessary movement.




Eleanor Kellon, VMD
 

Yes, you can give NSAIDs at the same time but don't count on gabapentin kicking in. Our experience with it has not been good.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

Nicolle,

Don't hesitate to ask your vet to come out to sedate her so you can do this. You don't have to be on your own.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

I should add blocking her feet would be another option but sedating her so she's down would be preferable so she isn't putting weight on the worse foot or overloading the other one.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Nicolle Dupont
 

Still waiting on blood work results which I assume were all the ones you mentioned.  Temp right now is 100.4 F
.

On Wed., Jul. 13, 2022, 11:46 a.m. Sherry Morse via groups.io, <sherry_morse=yahoo.com@groups.io> wrote:
Hi Nicolle,

Did you happen to check her temperature when all this first started?  As she's not a breed prone to IR without PPID (and she's young for PPID) and had swelling in her legs if she were in my area I'd be checking her for tick borne diseases.  What bloodwork did the vet do on the 4th? Insulin, glucose, ACTH or something else?  Would you be able to post x-rays and photos of her feet in a case history album?  

To do that you'll need to join the Case History sub-group (CaseHistory@ECIR.groups.io | Home) and then create a photo album (click on the "Photos" link on the left side menu after you join the group and then once you've gotten to CaseHistory@ECIR.groups.io | Photos click on the blue box at the top to create a New Album name "Nicolle and Horse Name".  That's where you would load any jpg files you have as this list does not accept attachments.

Is she still on Previcoxx right now?  

If you think her coffin bone is about to penetrate her foot you do not want to soak it but you do want to keep it padded as much as possible.  You can do these things with her laying down - just make sure you keep her food and water close enough for her to access it without a lot of unnecessary movement.

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



--
Nicolle D in BC Canada 2022


Nicolle Dupont
 

I will post pics and x rays tomorrow.  Today is a gong show.


On Wed., Jul. 13, 2022, 11:46 a.m. Sherry Morse via groups.io, <sherry_morse=yahoo.com@groups.io> wrote:
Hi Nicolle,

Did you happen to check her temperature when all this first started?  As she's not a breed prone to IR without PPID (and she's young for PPID) and had swelling in her legs if she were in my area I'd be checking her for tick borne diseases.  What bloodwork did the vet do on the 4th? Insulin, glucose, ACTH or something else?  Would you be able to post x-rays and photos of her feet in a case history album?  

To do that you'll need to join the Case History sub-group (CaseHistory@ECIR.groups.io | Home) and then create a photo album (click on the "Photos" link on the left side menu after you join the group and then once you've gotten to CaseHistory@ECIR.groups.io | Photos click on the blue box at the top to create a New Album name "Nicolle and Horse Name".  That's where you would load any jpg files you have as this list does not accept attachments.

Is she still on Previcoxx right now?  

If you think her coffin bone is about to penetrate her foot you do not want to soak it but you do want to keep it padded as much as possible.  You can do these things with her laying down - just make sure you keep her food and water close enough for her to access it without a lot of unnecessary movement.

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response 
PA 2014
https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet 
https://ecir.groups.io/g/CaseHistory/album?id=78891



--
Nicolle D in BC Canada 2022


Nicolle Dupont
 

Hi, she had gabapentin, bute and acepromazine about 4 hours ago.  Cast herself in pen and folks got her over.  That was just over two hours ago.  Heart rate good.  Not sure if she is enjoying the drugs or dying.  Vet said to flip her over in an hour.  Has anyone had this before.


On Wed., Jul. 13, 2022, 12:24 p.m. Eleanor Kellon, VMD, <drkellon@...> wrote:
I should add blocking her feet would be another option but sedating her so she's down would be preferable so she isn't putting weight on the worse foot or overloading the other one.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Nicolle D in BC Canada 2022


Nicolle Dupont
 

She just got up on her own, so scary.  I thought she had given up.


On Wed., Jul. 13, 2022, 6:19 p.m. Nicolle Dupont via groups.io, <nicolle8383=gmail.com@groups.io> wrote:
Hi, she had gabapentin, bute and acepromazine about 4 hours ago.  Cast herself in pen and folks got her over.  That was just over two hours ago.  Heart rate good.  Not sure if she is enjoying the drugs or dying.  Vet said to flip her over in an hour.  Has anyone had this before.

On Wed., Jul. 13, 2022, 12:24 p.m. Eleanor Kellon, VMD, <drkellon@...> wrote:
I should add blocking her feet would be another option but sedating her so she's down would be preferable so she isn't putting weight on the worse foot or overloading the other one.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


--
Nicolle D in BC Canada 2022


--
Nicolle D in BC Canada 2022