holeymoley
Well-Known Member
I struggled with the title for this thread so it's probably not the best.
A bit of background. I have an EMS insulin resistant pony who had an extremely bad case of laminitis over 3 years ago. He had rotated pedal bones in front to quite a severe degree but no sinking. With scrupulous care and working alongside both my vet at the time and the best remedial farrier in the country, we got him sound and hooves all realigned. Blood all lowered and back to a normal range. I was told if I managed him correctly through diet and management he would be fine but I had to very strict on his care. It was the worst 9 months through the ownership of him emotionally and mentally and I promised myself and my horse that I would never let him suffer like he that again. For the last 3 years I have managed him through diet and been on top of everything. I've educated myself to the point it's something I'm quite passionate about. He's the best he's ever been too in our 18years together.
The vet who I had during laminitis, moved miles away to another practice, not long after my boy had recovered. We moved yards too so I had to change vet practice due to the area. I've rarely used this vet except for getting bloods done regularly to check his insulin levels- normally when he's due a vaccine or a routine check. For instance, he was checked in August last year before getting vaccines and came back with a very normal level of insulin and everything else. I had him tested for Cushings at the same time and his levels were slightly raised but we put it down to the seasonal high and agreed to get it done again in the Winter. I got him tested again for Cushings and done his insulin again in December there. It was quite unfortunate as the week I had him booked in for, we had very cold icy weather where I couldn't soak hay, nothing could get turned out or exercised as we had thick ice. He had also been given a bit of low sugar haylage to break up the dry hay. His insulin levels were quite alarming and came back at 300 (eeek!) vet immediately wanted to start on the new drug ertugifluzon. I said I was concerned about what happens once the course had finished- would he be more sensitive to sugars? was it a long term medicine? what were the side affects? to which he couldn't really answer as it's a fairly new drug. I said I'd be happier on something I've used before and know works on him(old vet had him on Levothyroxin for a couple of weeks to kick start his metabolism while on box rest and it worked amazingly). I also stated that the environmental factors of the last week prior and during the day the test was done, was very likely in my eyes to have had an impact on his insulin levels. I managed to avoid the proposed route of medication by saying I would return his management back to normal and somehow find a way to at least soak his hay while the cold weather continued and I would test him again in a month or so. (He was negative for Cushings on this testing so that was a good result)
So this is where I am now. I've had his insulin tested last week. He has came back with an amazing result of 14.5! So again, back to a normal range. This was reported by a junior vet who I've never dealt with before, I actually asked her if she had the correct results as I couldn't believe the difference. I had a call from my normal vet today who was quite blazé on the result (? surely it's something to be pleased about!) but instead said we should try him on Metformin. Why? 'because Spring is round the corner'. Now. I have my own views on Metformin, I done a bit of research in to it while going through laminitis and it seems to work on some horses and not on others. My old vet through laminitis didn't think much of it, he said he hadn't seen particularly amazing results with it and thought it wasn't really worth while. I really don't think my horse needs this. He has managed through the last few Spring & Summers and even Autumn grass growth. I politely declined the use of it this time around but said I'd keep it in mind. It's been shown over the last few years and certainly this that he can be managed by diet and general management.
I don't know how I feel about this, I almost feel my vet is almost trying to make sale on medication or something to that effect, I don't know if I can totally put my faith in to what he says now. Trust is obviously a big part of the relationship you have with your vet, and I'm unsure if I have that with this one.
A bit of background. I have an EMS insulin resistant pony who had an extremely bad case of laminitis over 3 years ago. He had rotated pedal bones in front to quite a severe degree but no sinking. With scrupulous care and working alongside both my vet at the time and the best remedial farrier in the country, we got him sound and hooves all realigned. Blood all lowered and back to a normal range. I was told if I managed him correctly through diet and management he would be fine but I had to very strict on his care. It was the worst 9 months through the ownership of him emotionally and mentally and I promised myself and my horse that I would never let him suffer like he that again. For the last 3 years I have managed him through diet and been on top of everything. I've educated myself to the point it's something I'm quite passionate about. He's the best he's ever been too in our 18years together.
The vet who I had during laminitis, moved miles away to another practice, not long after my boy had recovered. We moved yards too so I had to change vet practice due to the area. I've rarely used this vet except for getting bloods done regularly to check his insulin levels- normally when he's due a vaccine or a routine check. For instance, he was checked in August last year before getting vaccines and came back with a very normal level of insulin and everything else. I had him tested for Cushings at the same time and his levels were slightly raised but we put it down to the seasonal high and agreed to get it done again in the Winter. I got him tested again for Cushings and done his insulin again in December there. It was quite unfortunate as the week I had him booked in for, we had very cold icy weather where I couldn't soak hay, nothing could get turned out or exercised as we had thick ice. He had also been given a bit of low sugar haylage to break up the dry hay. His insulin levels were quite alarming and came back at 300 (eeek!) vet immediately wanted to start on the new drug ertugifluzon. I said I was concerned about what happens once the course had finished- would he be more sensitive to sugars? was it a long term medicine? what were the side affects? to which he couldn't really answer as it's a fairly new drug. I said I'd be happier on something I've used before and know works on him(old vet had him on Levothyroxin for a couple of weeks to kick start his metabolism while on box rest and it worked amazingly). I also stated that the environmental factors of the last week prior and during the day the test was done, was very likely in my eyes to have had an impact on his insulin levels. I managed to avoid the proposed route of medication by saying I would return his management back to normal and somehow find a way to at least soak his hay while the cold weather continued and I would test him again in a month or so. (He was negative for Cushings on this testing so that was a good result)
So this is where I am now. I've had his insulin tested last week. He has came back with an amazing result of 14.5! So again, back to a normal range. This was reported by a junior vet who I've never dealt with before, I actually asked her if she had the correct results as I couldn't believe the difference. I had a call from my normal vet today who was quite blazé on the result (? surely it's something to be pleased about!) but instead said we should try him on Metformin. Why? 'because Spring is round the corner'. Now. I have my own views on Metformin, I done a bit of research in to it while going through laminitis and it seems to work on some horses and not on others. My old vet through laminitis didn't think much of it, he said he hadn't seen particularly amazing results with it and thought it wasn't really worth while. I really don't think my horse needs this. He has managed through the last few Spring & Summers and even Autumn grass growth. I politely declined the use of it this time around but said I'd keep it in mind. It's been shown over the last few years and certainly this that he can be managed by diet and general management.
I don't know how I feel about this, I almost feel my vet is almost trying to make sale on medication or something to that effect, I don't know if I can totally put my faith in to what he says now. Trust is obviously a big part of the relationship you have with your vet, and I'm unsure if I have that with this one.
