locked Urgent Advice Required (Part II)


Rebecca.speed@...
 

Thank you Cass, 

I agree with your advice above. Companionship aids the healing. My set up is a bit of a juggle but I’m making the necessary changes and today saw Emme and her friend sharing the same hay box which was lovely to watch. 


I need to upload the latest photos from the recent trim which I will do next but also wanted to ask; 

My vet spoke with an endocrinologist who looked at Emme’s latest bloods and agreed EMS but thought the raised iron and AMH were incidental. I’m tending to disagree as I think these latest results show more going on, especially as we have been following a tight EMS protocol and have regressed rather than seen results. 

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. 


Thank you all x
--
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
 

I agree with the ultrasound.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Rebecca.speed@...
 


Rebecca.speed@...
 

Hello again, 

sorry to ask again but my vet wants to access the dose on the Prascend trial but I’m seriously doubting this drug is necessary. I stopped the Prascend as I agree with you above Sherry; that this is not a PPID case. Emme started shedding her winter coat last month. Would you agree that I have done the right thing by stopping the Prascend?

--
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


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


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.




Rebecca.speed@...
 

Thank you Sherry, 

I am currently discussing with my vey using Metformin again (trialed this back in 2016 but not much change). Can I please check the dosage for a pony @250KG? 30mg per kg given twice daily I am told. 


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
 

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.




Becky Cash
 

What brand of vitamin E is recommended here


--
Becky Cash in TX 2020


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




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


Eleanor Kellon, VMD
 

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 
EC Owner 2001


Rebecca.fowles@...
 

Thank you Eleanor. Very useful and informative cases which we will heed the advice from.

New bloods being taken on Monday so I’ll upload as soon as the results are back. 

The Ertugliflozin is in a paste form and easy to administer via a small syringe. Hoping that dose of 3ml is agreeable with you?

Are NSAIDS prohibiting any progress? There are days when the pain is severe and she shows signs of more comfort and ease when on them but from what I’m learning here, obviously my goal is to wean off completely and with IR, NSAIDS are not actually helping achieve anything?


Eleanor Kellon, VMD
 

Do you know how many mg are in one mL of the paste? Yes NSAIDs can inhibit progress.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Rebecca.fowles@...
 

Thank you Eleanor - 5mg per ml


 

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


LJ Friedman
 

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 
Jesse's Photos

 


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. 


Thank you x
--
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@...
 

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. 


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
 

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.