Urgent Advice Required (Part II)


Rebecca.speed@...
 

Hello again, 

Seeking urgent advice regarding recent bloods taken which result in an unusual Anti-mullarian hormone result. My previous topic here was ‘Urgent Adive Required’ where I outlined the extreme troubles Emme is experiencing with chronic laminitis. 

Any further suggestions in light of the iron results would also be much appreciated. All new blood work is in our file along with new photos and an up to date case history. Thank you x


Sherry Morse
 


Eleanor Kellon, VMD
 

The elevated iron is consistent with iron overload. You can address this over time with strict mineral balancing. Some have gone the route of venisection (blood removal) to quickly lower iron with good results.  The elevated anti-Mullerian hormone is consistent with granulosa theca cell tumor or PCOS.  They should be easy to tell apart with an ovarian ultrasound.  PCOS in mares with EMS responds well to estrogen.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

Here is a list of articles linking PCOS and anti-Mullerian hormone https://pubmed.ncbi.nlm.nih.gov/?term=pcos+anti-mullerian&sort=date .  There may be a vet in your area with small enough hands and forearms to do the exam (e.g. I can do horses/ponies her size!)

We obviously cannot prescribe for her but some options would be to remove 2 liters of blood (this likely needs to be repeated) and start her on estradiol 3 mg daily.

Is she off the Danilon yet?

--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Rebecca.speed@...
 

Dear Sherry, 

profuse apologies for only just replying to this. I did see your message. Thank you. I got distracted by completing her CH and getting photos uploaded etc. 
From her ATCH records, I too have also not been convinced she is PPID but it’s likely I’m wrong? Her or Prascend trial hasn’t made much difference to circumstances. Now that I have uploaded her ACTH records, would you consider her to be a PPID pony? 


More weight needs to shift. Absolutely and I’ve rationed her hay to the bare minimum and I’m soaking it for one hour. I uploaded the hay analysis to her files. 


Emme is currently on box rest on a very deep bed. She was out on the track in December with pads and boots but she struggled which is obvious due to the rotation and sinking. She has been stabled the last 4 weeks. Now between a rock and a hard place as light movement would help aid slightly more weight loss and circulation but she’s currently too uncomfortable. 

I’m just taking in Dr Kellons replies with regard to blood draining etc. 


Thank you for the suggestions and support. 
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Lavinia Fiscaletti
 

Hi Rebecca,

Thanks for adding the latest photos and case history.

Her trim has definitely improved improved but still needs to move the toes back at ground level even more. Also needs to stop trimming all the calloused frog material away as you don't want to expose the immature, waxy frog material. Getting the trim as tight as possible will also help her by eliminating any mechanical aspects that are contributing to her discomfort.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Rebecca.speed@...
 

Thank you Eleanor. I’ll digest the articles and pass this info onto my vet and hopefully pursue this route. 

I stopped the Danilon and I’m giving her 15g of Forage Plus devils claw and Jiaogulan. 
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Rebecca.speed@...
 

Thank you Lavinia, 

Her feet were looking so much better during summer ‘21. Pretty devastating we’ve regressed this way. 

My trimmer is due again in two weeks so I’ll pass this on and post new photos ASAP. 


thank you for taking the time to help.
--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Eleanor Kellon, VMD
 

You'll probably also want to show your vet this article on iron overload and EMS https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971364/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Rebecca.speed@...
 

Hello again, 

I was hoping to ask; looking at Emme’s ACTH/TRH results from her files - whether the labs are clear enough to determine if she does or does not have PPID. 

Thank you. 


--
Rebecca , Surrey UK 2021
Case History Folder https://ecir.groups.io/g/CaseHistory/files/Rebecca%20&%20Emme%20from%20UK
Photo Album https://ecir.groups.io/g/CaseHistory/album?id=271481


Sherry Morse
 

Based on those results she is IR, not PPID.