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nikkibob1994@...
 

Darby is going through a laminitic episode, no change in circumstances. Negative for Lymes, ACTH is 28.8 and his last insulin was 50.
Darby started Metformin 3 days ago, still waiting for the Prascend (as per Dr. Kellon's recommendation). How soon should I be seeing an effect from it?, My vet said she wanted to test his insulin again in 7 days after reading on the ECIR site that we should. , but I thought it was not wise to test insulin when the animal is stressed? Which he is from his ongoing bout of laminitis.
 I also bought a glucometer, but am unsure when to test, when is the best time to get the appropriate sugar reading? 
I know it has been  repeatedly said that IR horses will not start feeling better until the insulin is controlled and that NSAID's like bute are useless. BUT, every day for the last week he has been unable to walk out of his stall in the morning until I have given him bute (2 grams) and within an hour or so he is visibly more comfortable, less stressed and happy to walk outside( from a deep bedded stall and he wears boots 24/7). Could this be something else I am dealing with?
Nikkibob1994
Wisconsin, Sept 2018

https://ecir.groups.io/g/CaseHistory/files/Nikki%20and%20Darby 
https://ecir.groups.io/g/CaseHistory/album?id=77396


Eleanor Kellon, VMD
 

I did answer this privately so sorry if it's a duplicate.

Your vet is correct to test at 7 days. There is no effect of stress on insulin in chronic conditions and the metformin effect won't get any better than it is at 7 days **unless** PPID is helping to drive it, in which case you will need pergolide on board (same for Invokna BTW)

Sugar is best tested when you pull insulin to see the relationship between the two but if you just need a baseline check any time 4+ hours after first meal of the  day.

It's not that NSAIDs are entirely useless just that they have minimal effect. What you are seeing could be from him being up and moving around for an hour. Try skipping it to see what happens.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


nikkibob1994@...
 

Sorry you had to answer this twice, I never got your email about this. Thank you for the info, I will follow up on your suggestions. 
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Nikkibob
Wisconsin, Sept 2018
https://ecir.groups.io/g/CaseHistory/files/Nikki%20and%20Darby 
https://ecir.groups.io/g/CaseHistory/album?id=77396