locked Urgent Advice Required (Part II)
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Rebecca.speed@...
Thank you Cass,
Would it be wise to ask we continue with an ultrasound? I think it’s important to check for PCOS or tumour and if nothing shows then at least my mind is at rest. Any advice would be much appreciated.
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Rebecca.speed@...
-- 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
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Rebecca.speed@...
Hello again, --
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Cecile Johnson
Hi, this is interesting as I too stopped Prascend on Olaf as he hadn’t been diagnosed with PPID. He shed his coat in late December and my vet wanted him back on Prascend. I reluctantly started him again. Did they know why he shed out his coat?
-- Cecile J in OK 2022 Olaf Case History: https://ecir.groups.io/g/CaseHistory/files/Cecile%20and%20Olaf Olaf Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=272407
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Sherry Morse
Without a positive test result and with her shedding as normal I'd still go with she is not PPID although she is IR and possibly has other issues occurring.
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
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Rebecca.speed@...
Thank you Sherry,
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Sherry Morse
Hi Rebecca, Yes on the dosage - we recommend rechecking insulin about 10 days after starting and if it's not coming down it's likely that metformin will not work for that particular equine.
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
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Becky Cash
What brand of vitamin E is recommended here
-- Becky Cash in TX 2020
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Sherry Morse
Hi Becky, Most people use human gel caps - the vitamin E needs to be in oil to be effective. You can read more about that here: https://www.ecirhorse.org/DDT+E-diet.php
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
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Rebecca.speed@...
Hello again,
Hoping for advice and insight into our ongoing case with Emme who has been showing slow and steady signs of progress but has recently regressed again.
Hopefully her case history uploaded here gives the necessary info for you to help with some guidance.
We have been having light trims every 3 weeks (cautiously taking back as much toe as possible) and my trimmer has been pleased with the progress, albeit slow and she’s noticing some positive signs but still concerned the event lines aren’t giving up.
We plan on taking new X-rays soon as last set were taken in January.
Following previous advice given here and due to her anti-mullerian hormone being unusually elevated, we scanned for any signs of PCOS/glanulosa tumour and nothing was detected. A follow up blood test showed the AMH had decreased and I’m due to re-test to check it’s continuing to decrease.
Our vet prescribed an Ertugliflozin trial (3ml/day) which we started on 23 February and after 14 days we noticed improvements until very recently when Emme slipped back to being slower with the usual very stiff and stilted gate with easily detected pulses again.
Observations of improvement since February have been slight weight loss, fatty pads decreasing slowly and less solid, finding light walking in pads and boots more comfortable, pulses less bounding, general demeanor very good, showing interest in everything and perky. Lying down to rest and not lying down in pain.
I was feeling hopeful we were getting somewhere but over the course of this last week, I see the same symptoms creeping back in.
I feel it necessary to test insulin, glucose and TRH again as I clearly haven’t eliminated the cause? Almost start over entirely.
Your thoughts and advice would be most welcomed.
Apologies if the advice given isn’t substantial and disjointed. I’m incredibly anxious I’m not doing enough for her and her comfort is in my hands and I’m failing miserably.
Regards,
Rebecca.
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
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She could have been the model for the horse discussed here https://hoofrehab.com/images/PHCP%20Handout%20%232%20--%202022.pdf and I would strongly encourage that approach.
I agree with repeating blood work and films. Is your ertugliflozin a liquid or did you mean 3 mg? -- Eleanor in PA www.drkellon.com
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Rebecca.fowles@...
Thank you Eleanor. Very useful and informative cases which we will heed the advice from. The Ertugliflozin is in a paste form and easy to administer via a small syringe. Hoping that dose of 3ml is agreeable with you?
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Do you know how many mg are in one mL of the paste? Yes NSAIDs can inhibit progress.
-- Eleanor in PA www.drkellon.com
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Rebecca.fowles@...
Thank you Eleanor - 5mg per ml
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Hi, Rebecca.
Cass here. I need to ask you, please, to post only from one single identity/email address. You and I spent some effort getting your information in place for Rebecca.speed@.... If you look earlier in the thread you're posting to, you can see that your case history and photo album all show up perfectly under your signature with that log-in information. We volunteers can follow your progress from December of 2021. But our jobs as volunteers are much harder if we need to track your posts as Rebecca.fowles@... too! The next time you post, please be certain that you have logged out of ECIR as Rebecca.fowles@... and logged back in as Rebecca.speed@.... Maybe you can put this information in your Address Book so you can find it easily in the future. Many thanks and good luck with Emme. -- Cass, Sonoma Co., CA 2012 ECIR Group Moderator Cayuse and Diamond Case History Folder Cayuse Photos Diamond Photos
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is there a reason you use this in paste and not tablets ?? how? why ? steglatro??
-- LJ Friedman Nov 2014 Vista, Northern San Diego, CA Jesse( over the rainbow) and majestic ‘s Case History
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Rebecca.speed@...
Dear Cass & team. I’m very sorry it’s taken me this long to sort out both addresses I have logged here. I’m hoping what I’m sending here is now using the correct one. I was hoping to check it Dr. Kellon had revived my vets email address so information regarding the use of Ertugliflozin could be sent to them. I followed a link to what I assumed was Dr. Kellon’s email address but perhaps I incorrect as both my vets tell me they haven’t received any info.
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Rebecca.speed@...
Hi helpful group, Hoping for some clarification if I may ask. I’ve posted Emme’s lab results here previously which showed her ACTH & TRH results as normal and it was suggested that she isn’t a PPID case and we are dealing with uncontrollabed IR but having read more info coming in via this group I am concerned the results are a false reading and I’m inhibiting her recovery by not using Prascend. Any advice would be much appreciated.
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Sherry Morse
Hi Rebecca, As we're still not quite in the seasonal rise for the northern hemisphere you could redo a TRH stim test on her now to get a better idea if she is early PPID. I see in your case history she was on Prascend last winter - has that been continued or did you stop using it? For Emme I would be less concerned about early PPID than getting her to a good weight and checking if the diet and weight loss were enough to get her insulin to a better number. If not, then I would be looking at medication for assistance unless a TRH Stim test came back with an elevated post-stim result.
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
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