www.drkellon.com

Pergolide

Eleanor Kellon, VMD - 10/28/2011

Well, folks - the rumor is true. This is from a National Institute of Health web site, posted yesterday:

http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=54508

It will take a while for the drug to make it to distributors and from there to the vets.

The future of compounded pergolide from bulk is uncertain. Although the FDA has taken the stand that compounding must be done from approved drugs, the legality of that opinion has been questioned:

< http://www.cov.com/files/Publication/bf009d35-3d55-4608-9d69-fa4a26a30c10/Prese\
ntation/PublicationAttachment/5140f663-b9a9-4136-a6c9-ff2d7d4d2ff1/679.pdf>

http://www.courthousenews.com/2011/10/11/40528.htm

This issue may ultimately play out in the courts.

On the flip side, it would be nice to see stability data on the Prascend. There are significant stability questions with the compounded products and our need to use very high doses in some horses may be at least partially related to that. Back in the days before Permax was pulled off the market, we did encounter horses that were poorly controlled on the compounds but responded to a lower dose of the Permax.

There's a lot to work through here. As always, input from our members/owners will be invaluable.

The Afterglow - Thoughts on the No Laminitis Conference

Eleanor Kellon, VMD - 8/18/2011

The Equine Cushing's and Insulin Resistance No Laminitis conference was truly fabulous. It was the culmination of a process set in motion over 10 years ago by an owner, Robin Siskel, who wanted to find more information and answers for her mare with Cushing's Disease, Tina (Night Flight). The group has grown to over 10,000 members.

The http://pets.groups.yahoo.com/group/EquineCushings/ group has never been a “chat” group. The goal is, and always has been, to collect clinical information, laboratory data on actual cases and to follow the pertinent scientific literature. The focus has always been to help the horses. We're not averse to trying different approaches, but never on the basis of marketing claims alone.

The success of the group is due to the dedication of the individual owners and to the volunteer efforts of a core team who work tirelessly 24/7/365 to greet and orient newcomers, keep conversations on topic, maintain files and web sites, direct members through the mountain of information in our files and generally keep the peace.

While it's a labor of love, keeping things flowing smoothly on a list this large is also very, very hard work. The support staff are all owners who have been through the challenge of helping horses with these issues themselves. Both the staff and many owners stay on the list to help “pay it forward” to the next person needing help and information.

Having a common dedication really unites people. You can grow quite close interacting intensely over the years. That bond sprang to life over the conference weekend. We smiled until our faces were cracking, and hugged enough to almost break ribs.

The conference itself went amazingly well, especially considering there were only a few short months to pull it together. The committee did a wonderful job and we had a good turnout. Attendees had a multitude of good questions and comments. There was a lot of interaction and enthusiasm.

The usual description is “A good time was had by all”. It doesn't come close.

Sneak Peek - Impaction Colic

Eleanor Kellon, VMD - 7/19/2011

As mentioned last week, The Horse's Mouth e-zine

http://www.drkellon.com/thehorsesmouth.html

will include a monthly feature on veterinary research. I scan articles, newsletters, etc. weekly looking for studies that have practical impact for horse owners. That can be an exercise in frustration many times, but every now and then something comes along that is really useful.

This article in the Vet Learn Compendium: Continuing Education for Veterinarians is a good example

<https://s3.amazonaws.com/assets.prod.vetlearn.com/0e/7d0540a7d211e087120050568d3693/file/PV0711_Blikslager_TIP.pdf>

It focuses on impactions of the cecum, the first part of the large intestine, but it applies to colic/pain in general and is particularly relevant to impactions. The Behavioral Pain Scoring System on page 2, Table I is excellent. It's an easy to do, objective way to grade pain that is not related to the pawing or rolling we typically associate with colic. It would be a great thing to print, laminate and hang in your barn.

The article also reminds us of other useful facts, such as it is never normal for a horse to have less than 3 bowel movements a day.

As impactions are developing, it is common for the horse to continue to pass manure since there is manure already present in the digestive tract in areas behind the impaction. Therefore, seeing manure is no guarantee there is no impaction. It is also important to monitor the amount passed and frequency of movements.

Pain and inactivity can contribute to changes in the motility of the bowel that may predispose to impactions. Horses recovering from surgery, or on stall rest for serious injuries, are at risk. The article recommends making sure pain control is optimized to eliminate the potential effect of pain on gut motility. At the same time, it recognizes that pain control could mask some signs of impending impaction/colic.

The Horse's Mouth - Just the Facts

Eleanor Kellon, VMD - 6/28/2011

Instead of the usual “letter to the editor” option, all subscribers will have immediate access to a message board where they can post questions at any time, on any topic, and be answered quickly.  If a question requires an in-depth answer, it will be turned into a feature article. Subscribers may also suggest topics for articles and all subscribers will be given the opportunity to express their interest in those suggestions to determine which will appear first.

Article Topics:

The Many Faces of Lyme Disease

The Physiological Trim

Demystifying Detoxification

The Many Uses of Acetyl-L-Carnitine

Vitamin E Confusion – What Form and How Much

Sorting Through Muscle Problems

Navicular/Caudal Heel Syndrome

How to Become a Medical Detective

Insulin Resistance

Reading Feed Tags and Hay Analyses

Rehabbing Soft Tissue Injuries

...And more...