Date
1 - 12 of 12
Wally update on Ertugliflozin,,bloods good,going forward what can he have for extra energy
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jenbegg@...
Wally is doing really well has been back in work since october ,started slow and steady and now is pretty much back in full work and about to start back doing dressage comps.Last lot of bloods all good tg also in acceptable (0.6mmol/L (0.10-0.70 ref range) CH is upto date .on both new and old site
I am really happy with how he is going no signs of footsoreness much better atittude and seems happy and coping with medication . My only issue he is lacking a bit of energy (he has gone from fire breathing dragon to kids pony) dont need the fire breathing again but would like a bit of spark ,so would appreciate any advice on what would be safe to add for extra energy and when would it be best to be feed ? Current diet is on CH Thanks to everyone that has given me advice before it is wonderful to have my pony back and doing what he does best , Ertugliflozin has been a life saver for him -- Jenny B in VIC joined 2022 https://ecir.groups.io/g/CaseHistory/files/Jenny%20and%20Wally https://ecir.groups.io/g/CaseHistory/album?id=275488 |
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Anna.warzecha4@...
I found that Joker's energyc 8 mLwas completely gone on metformin. I gave him santa cruz vit B12 and noticed a change. I gave him a triple dose for a month. Then double for a month and now he gets a normal dose. He also switched to steglatro at some point in there because he was so lethargic and lost an extreme amount of weight while on the Metformin. He is now in full work with steglatro, vit B12 and stabul and a few other supplements.
-- Anna Warzecha, MI, 2022 Joker (IR) https://ecir.groups.io/g/CaseHistory/files/Anna%20Warzecha:%20Joker%20%28IR%29,%20Coco%20%28PPID%29 |
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Hi Jenny,
Are you following Dr Kellon's advice on feeding while on Ertugliflozin? Once back in work, feeding protocols change again. I would look specifically to her for advice on Wally, but usually a post-workout meal is added to replenish glycogen stores in the muscles. A 50:50 mix of beet pulp and oats is usually recommended, but you may need to make more adjustments of he's still running out of steam. -- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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His glucose is low, which is probably why he's more quiet. Exactly how much work do you do - duration, gaits? Is it the same every day?
-- Eleanor in PA www.drkellon.com BOGO 2 for 1 Course Sale Through End of January |
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jenbegg@...
He generally works every second day ,sometimes will 2 in row then miss 2 days ,length max 45mins but usually more like 20-30mins of which 60% will be working trot rest would be some warm up walking and training trot and occasional canter . we are in mid summer temps 30c + I try to work early morning before gets to hot for both his and my benifit he comes back generally just sweaty under gear and not blowing .
once a week he goes for hack around block approx 50 mins a walk and trot I have been giving him post workout feed of 100gram RSR beet plus 100 micronized lupins which is given wihin 40mins of workout I assume the ert is causing him to loose glucose through urine (dipstick test cetainly show top level) Long term I want to be able to do combined driving again which will involve marathon phase anything up to 25kms ,so hoping can find some way to get correct levels needed . -- Jenny B in VIC joined 2022 https://ecir.groups.io/g/CaseHistory/files/Jenny%20and%20Wally https://ecir.groups.io/g/CaseHistory/album?id=275488 |
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Thanks. For this level of work, let's try adding 50 mL of glucose syrup by syringe or added to a small amount of water immediately after work. When work gets more intensive in terms of duration or amount of working trot you will eventually be able to skip the medication on hard work days and maybe eventually completely. Keep in touch.
-- Eleanor in PA www.drkellon.com BOGO 2 for 1 Course Sale Through End of January |
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jenbegg@...
Thank you for your response Dr K ,I will try the glucose syrup and see if it gives him needed boost .The thought of being off medication completely I think fills me with both joy and fear ,would be great to think he could be managed on just diet and exercise ,although I fear relapse without it .My plan at moment is to bring him back doing dressage only comps for he next few mths then would like to be able to do some of next seasons CDEs (season starts sep2023) which would mean increased work load from about july/august depending on which comp I choose to do .
I will also try skipping meds on days that he works harder lesson/clinics and see how he goes. -- Jenny B in VIC joined 2022 https://ecir.groups.io/g/CaseHistory/files/Jenny%20and%20Wally https://ecir.groups.io/g/CaseHistory/album?id=275488 |
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jenbegg@...
Im not quite sure if I needed to start new post or keep it all in same thread (please advise if I should have started new post)
I have for the last 4wks been giving Wally the 50ml Glucose after working and also on those moderate-hard work days stopping his Ertugliflozin,Whilst his energy levels did rise a little and I initially thought the glucose had done the trick I am again now finding he dosnt have enough energy to sustain ,the amount of work i am now requiring . This last week he had 45min lessons on tuesday and wednsday got 50mil glucose imediately afterwards and skipped ERT ,thursday day off was given ERT ,Friday travelled 3hrs to event he was competing over weekend ERT was given as usual ,Saturday competed in dressage plus 25mins warm up Glucose given immediately afterwards and no ERT (amittadely it was 35c and I also struggled with heat but he was very flat during test and comments from judges were that he lacks implusion ) Sunday was meant to be another 2 dressage tests but I pulled him from comp as it was hot again and I felt he had had enough . Coming back from comp yesterday I was thinking maybe it is time to see how he goes stopping ERT altogether and see if he can be managed with just diet and exercise ,there is a low level CDE at Easter that i would like to do but at moment I think between the travelling (5hrs) and then 3 days of comp including roads and tracks and marathon that he wont have energy to go the distance . He seems happy within himself eating his normal amount of food ,loves the glucose hits ,just needs bit more pep to his step . Would appreciate any advise on either what extra can he be given to boost energy or if go the removal from ERT how is best way to do this ? -- Jenny B in VIC joined 2022 https://ecir.groups.io/g/CaseHistory/files/Jenny%20and%20Wally https://ecir.groups.io/g/CaseHistory/album?id=275488 |
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Traveling counts as exercise. If you ever rode in a trailer with the horse you would appreciate how much muscular bracing it requires. Don't give it on travel days, and don't give it any day he does significant work.
The missing information needed here is what his insulin and glucose are doing. Test before exercise or trailering. In the meantime you can double his syrup. -- Eleanor in PA www.drkellon.com |
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jenbegg@...
Thanks DR K
Did think afterwards that probably shouldnt have given ERT on friday and didnt give yesterday when he travelled home. will try doubling glucose next time . Not sure how to do testing before exercise and travelling ,apart from issues actually getting a vet at correct time to do bloods cost is going to be prohibative if I need to do on regular basis . is there some way i can do myself and more cost effective ? It cost nearly $600.00 each time i do insulin,glucose and trig ,Hence why has been stretched out to 3mthly between tests .While I am willing to do nearly anyhting to get things all as good as I can for him ,Im not sure I can supply the information you are asking for ,if it means I need to test this everytime he exercises or travels???? -- Jenny B in VIC joined 2022 https://ecir.groups.io/g/CaseHistory/files/Jenny%20and%20Wally https://ecir.groups.io/g/CaseHistory/album?id=275488 |
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Dr Kellon doesn't mean to test every time before exercise or travel. She just wants you to do a baseline test, but make sure you don't exercise or travel before that one blood pull, otherwise you'll skew the results. Knowing how his insulin is doing at baseline will help you decide if he can be off the medication. I'd test before he gets his Ert pill that day.
-- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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Kirsten is correct that I didn't mean test every time. If you know anyone with diabetes that uses a glucometer you could borrow it to check glucose immediately after exercise and 15 minutes after exercise. It should go up.
Don't interrupt his ertugluflozin/exercise cycle to do your baselines; just make sure they get pulled before exercise. -- Eleanor in PA www.drkellon.com |
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