Thursday, November 03, 2011

Prascend® PPID (Equine Cushings Disease) Treatment Approved by FDA for US Horses


Maybe I'm biased, but I thought that the CSI (Cushings Scene Investigation) ad run by Boehringer-Ingelheim Vetmedica in British horse magazines was the most clever horse ad so far this year. It heralded the introduction of Prascend to treat Cushings-suffering horses; Prascend will soon be available in the USA.

The following press release is not an ad, it is published here as a "heads up". Anyone involved in the world of Hoofcare + Lameness is going to hear about this. Farriers and veterinarians will be asked questions by horseowners about this medication, and you need to know about how pergolide has evolved into Prascend®.

Prascend has been available in the United Kingdom for a few months, and Boehringer-Ingelheim Vetmedica has launched an awareness campaign there to urge horse owners to have their horses tested for PPID. I don't know yet what B-I has planned in the USA, but I feel confident in saying that "this is news".

In 2007, this blog reported that a potential crisis loomed for horseowners who were treating the symptoms of their horses' PPID condition with Permax (pergolide). (See links at end of this blog post.) The medication was taken from the market temporarily because of problems with human prescriptions. Before long, it became available again in the compounded form, which many horse owners ordered directly and in different forms.

Compounding pharmacies have been at the center of a controversy in the veterinary industry. At this time, it is too early to give a reliable answer whether compounded (and less expensive) pergolide will remain an option for horseowners as pill-only Prascend enters the marketplace. Ideally, horseowners will have safe and multiple alternatives to keep their horses comfortable.

Much more information will be available at or following the AAEP Convention in San Antonio later this month.
 

Everyone can recognize the advanced PPID (Cushing disease) horse. But laminitis and stretched white lines in younger horses may not seem to be related to PPID until much later, when a definitive diagnosis is made. Only careful testing will discern if horses without obvious signs suffer from PPID. (photo provided by Dr. Christian A. Bingold)

Boehringer Ingelheim’s Prascend® Approved for PPID in Horses
Product is the first and only FDA-approved treatment for the management of PPID.

ST. JOSEPH, Mo. (November 2, 2011) – Boehringer Ingelheim Vetmedica, Inc. (BIVI), has received approval from the Food and Drug Administration (FDA) to market Prascend® (pergolide mesylate), for treatment of clinical signs associated with pituitary pars intermedia dysfunction (PPID), also known as equine Cushing’s disease.

PRASCEND is the first and only FDA-approved product for the management of PPID in horses. (1) Administered in tablet form, treatment with PRASCEND can improve the quality of life for PPID-affected horses by managing clinical signs and decreasing the risk of complications of the disease, including those that have the potential to be life-threatening.

It is estimated that one in seven horses over the age of 15 has PPID (2) and horses as young as seven years of age have been diagnosed with the disease (3). In addition, up to 70 percent of clinical laminitis cases also may be affected with underlying PPID4. The most common clinical signs of advanced-stage PPID that occur in horses are hirsutism (hypertrichosis) or an abnormal amount of hair growth, abnormal sweating, weight loss, muscle wasting, abnormal fat distribution, lethargy, laminitis, polyuria/polydipsia and chronic/recurrent infections.

“Unfortunately, PPID is not a curable disease,” says Dr. John Tuttle, BIVI equine technical services veterinarian. “However, PRASCEND does offer a safe and efficacious treatment option to veterinarians and horse owners that can help reduce the clinical signs of the disease and effectively improve the quality of life of infected horses.”

While PPID is typically considered a late-stage-of-life disease in the horse, Tuttle adds that with horse owner vigilance and regular veterinary care, the disease may be detected earlier.

“Because the early symptoms of PPID may be difficult to recognize, some horses with PPID may go undiagnosed until the disease becomes more advanced,” says Tuttle. “Through regular veterinary wellness exams, oftentimes the disease can be caught earlier. By beginning treatment in the earlier stages of the disease, we are able to reduce the risk of some of the potential complications associated with PPID, such as laminitis, recurring infections, dental disease and other potential issues of uncontrolled PPID.”


Farriers often notice the early signs of PPID in horses' feet while trimming. As Cushings diseases advances, farriers are challenged to keep PPID sufferers comfortable and manage any flare-ups of chronic lamiitis. (Massachusetts farrier Allie Hayes trimming a Cushings-affected pony, photo © Hoofcare Publishing)

Not only can PRASCEND aid in the management of clinical signs of disease, the FDA approval also assures the product has been thoroughly evaluated for safety and efficacy. In addition, PRASCEND has met the standards set forth by the FDA in regard to production to preserve its identity, strength, quality, purity and consistency from batch to batch, and the product has demonstrated stability and effectiveness over time through a variety of environmental conditions.

“We are excited to offer a treatment option for horses suffering from PPID,” says Tuttle. “We encourage horse owners to continue to work with their veterinarians to find the best treatment for their horse and are confident that PRASCEND can help make a difference in the lives of horses suffering from this disease.”

PPID horses may be quite thin under all that hair. Cushings sufferers are also believed to be more highly perceptible to worms than non-sufferers. Many people clip their long-haired horses to be more aware of body condition. (photo © Hoofcare Publishing)
PRASCEND is for use in horses only. PRASCEND has not been evaluated in breeding, pregnant or lactating horses. Refer to the package insert for complete product information or contact Boehringer Ingelheim Vetmedica at 800-325-9167.

(Hoof Blog note: A web address should be available soon.)

Reference:
  1.  PRASCEND® (pergolide mesylate) [Freedom of Information Summary]. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2011.
  2. McGowan TW, Hodgson DR, McGowan CM. The prevalence of equine Cushing’s syndrome in aged horses. In: Proceedings from the 25th American College of Veterinary Internal Medicine Forum; June 6–9, 2007; Seattle, WA. Abstract 603.
  3. Schott HC. Pars pituitary intermedia dysfunction: challenges of diagnosis and treatment. In: Proceedings from the 52nd American Association of Equine Practitioners Annual Convention; December 2–6, 2006; San Antonio, TX.
  4. Donaldson MT. Evaluation of suspected pituitary pars intermedia dysfunction in horses with laminitis. J Am Vet Med Assoc. 2004;224(7):1123–1127.

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 TO LEARN MORE


AAEP Statement on FDA Withdrawal of Pergolide for Human Use: Will It Still Be Available for Horses?

Pergolide Cleared for Equine Veterinary Use by FDA

Laminitis Research: Australian Breakthrough on Insulin Function in Equine Foot

Too Fat? Too Thin? British Court Faces Conflict Over "Abused" Horse with Cushings Disease

Cornell Laminitis Research Beneficiary of Arabian Horse Foundation Grant to Study Genetic Markers in Equine Metabolic Syndrome and Cushings Disease

Equine Pituitary Dysfunction Test Choices Analyzed by New Bolton Center's Jill Beech VMD

Three Chimneys Farm Works to Help Slew 'o Gold Keep His Cool



© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  
Follow Hoofcare + Lameness on Twitter: @HoofcareJournal
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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Tuesday, November 01, 2011

Amputation and Prosthetics: Molly the Pony Leads a Parade of Animal Amputees Showing Off Their Artificial Limbs


Here's an old friend: Molly the Pony sent this blog into global "gone viral" paralysis in 2008 when we announced that a children's book had been written about the three-legged Hurricane Katrina survivor. Now she's a global celebrity, and in this little video, she leads a parade of proud prosthesis-wearing animal pals--and rightly so!

This video enhances a spectacular article in the October issue of WIRED Magazine about animal amputees. The music by the way, was a great choice, I thought. It's the uplifting Concerto in D Major for Viola (First Movement) by Stamitz.

This nice portrait of Molly by Adrian Gaut shows the pony who has become such a symbol of hope and resilience to people around the world. She met thousands of people as a star of the show at the 2010 Alltech FEI World Equestrian Games in Kentucky. Molly was abandoned when Hurricane Katrina hit New Orleans. Her barn collapsed around her but she survived--only to be attacked by a pit bull at her rescue farm. Surgeon Rustin Moore DVM at Louisiana State University's vet school (now at Ohio State) took a chance and amputated what was left of her right front leg to save her life. (photo: WIRED Magazine)
Check out WIRED's compelling portrait gallery of amputee animals who are living and moving again, thanks to prosthetic designs that are as creative and inspiring as the spunky animals who wear them.

WIRED story author Emily Anthes says she is working on a book about amputee animals.


If you're interested in what's being done to help animals in need of amputation surgery and prosthesis design, note that the BBC show The Bionic Vet was shown on cable in the USA this fall and now can be viewed as a pay-per-view on iTunes. The show highlights the groundbreaking work on British vet Noel Fitzpatrick. While this trailer is a bit dramatic, and Fitzpatrick can be that way sometimes too, the show really is excellent.


Here's a sample of a case from The Bionic Vet. I have a soft spot for Corgis. I just wish Noel Fitzpatrick had a soft spot for horses. Several other vets, including Dr Ric Redden in Versailles, Kentucky and Dr Ted Vlahos of Cody Equine Hospital in Wyoming are advocates for equine amputation in the United States and have helped a lot of horses.

 TO LEARN MORE


© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  
Follow Hoofcare + Lameness on Twitter: @HoofcareJournal
Read this blog's headlines when you "like" the Hoofcare + Lameness Facebook Page

 
Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Sunday, October 30, 2011

Happy Halloween with Osirix: A Pumpkin MRI



It's that time of year...and what better way to celebrate Halloween than with a MRI of a pumpkin, rendered via Osirix imaging software? Can you see the seeds inside?


 TO LEARN MORE
© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  
Follow Hoofcare + Lameness on Twitter: @HoofcareJournal
Read this blog's headlines in your Facebook news feed when you "like" the Hoofcare + Lameness Facebook Page

 
Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Silent Anvil: Kevin Howes' Video Would Have Brightened a Rainy Day


I believe it was 2009 when British farrier Kevin Howes of Ridgeway Forge Farriers starred in this video about what it's like to be a farrier for Kent Television and the general promotion of British farriery.

I've always meant to post it on the blog, but now regret that I saved this one for a rainy day.

Kevin was killed in a car accident a few days ago in the county of Kent, England where he lived and served as farrier at the Kent County Show.

It's terribly sad to learn of anyone's death. A very moving article on the website Kent Online about Kevin Howe's death mentions that he underwent skin cancer surgery for a malignant tumor while in apprenticeship, and that he completed college and his apprenticeship even though he struggled with dyslexia.

Another article about Kevin and his work can be read on the This Is Kent news site.

Among the racehorses credited to Kevin Howes was the 2006 Cheltenham Gold Cup winner, War of Attrition.

David Chapman Jones, founder of Tendonology, worked with Kevin Howes and remembers: “Kevin was a first class farrier who I trusted totally with the racehorses in my care for tendon treatment. Many top class racehorses are racing today thanks to Kevin's expertise. He was a pleasure to work with and what set him apart was his creativity, imagination and desire to solve a problem. There are so many cases we dealt with where I can say that Kevin's knowledge was as much a part of the treatment process as my input."

Moral of the story: Don't be leaving too many things for a rainy day. It's about time Kevin's upbeat tribute to the job he obviously loved had its day on The Hoof Blog, but I never thought it would be with this news attached to it.

 TO LEARN MORE

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  
Follow Hoofcare + Lameness on Twitter: @HoofcareJournal
Read this blog's headlines when you "like" the Hoofcare + Lameness Facebook Page
 
Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Wednesday, October 26, 2011

A Slice of Life: Behind-the-Scenes of Equine Anatomy with Dr. Christoph von Horst



Suppose you could suspend the animation of a bird or a fish or a horse...by preserving its anatomy in whatever angle or gesture or exposure you wished. That's the power that Germany's Christoph von Horst wields in his plastination laboratory.

Everything that was once alive not only lives again, but lives forever. It may no longer be living and breathing, but it's catching light and revealing its form to anyone who cares to have a look. And it has taken on an artistic, minimalist power.

You've heard plastinate slices of hoof tissue called "living X-rays" before; now we have living MRIs! (image © Christoph von Horst and Hoofcare Publishing)

Dr. von Horst's company, HC Biovision, is the world's leader in preserving anatomical specimen for educational and exhibition purposes. We are fortunate that he finds the horse's foot especially fascinating. He has been encasing microscopically thin slices of hoof tissue in Lucite for several years now, and has created a portfolio of hoof pathology to rival any in a museum.

A horizontal section of plastinated hoof tissue reveals a slice-by-slice tour of a horse's hoof anatomy (image © Christoph von Horst and Hoofcare Publishing)

Dr. von Horst will visit the USA this month; he will be helping Hoofcare Publishing introduce a new collection of plastinated hoof tissue specimen at the International Equine Conference on Laminitis and Diseases of the Foot in West Palm Beach, Florida this weekend, October 29-31.

He visited previously this year to speak at the international plastination conference at the University of Toledo and the annual convention of university veterinary anatomists at Cornell University.

Keep a hoof in your pocket; this new technique, called the "basic hoof" is impregnated with plastic but not cased in Lucite. Basic hooves cost only $50US (plus shipping) and will fit in your pocket. No two are alike!

Each plastinate is treated to resist light damage and will not fade. The cost on most blocks is $200. Most are about an inch thick and will stand up on their own.  But relief "basic" hooves start at $50--without plastic casing, just plastic impregnating the hoof tissue--and the "sheet", or thin plastic casings are $95 each.

Plastinates have many applications in the way that professionals interact with each other and with clients. On another level, they are used in anatomy education and on still another, for corporate use in detailing product or service details. When a veterinarian needs to explain why a horse with a fetlock problem might benefit from a course of Legend, this "slice" is an inexpensive, indestructible, reusable and portable tool for showing a typical fetlock to a client. (Christoph von Horst image)

Please contact Hoofcare and Lameness if you are looking for a unique gift, award, trophy, or a real treat for your own study of the hoof. Navicular damage and chronic laminitis samples are available as real models or in laminated poster form for reference, with areas of interest like the toe of a laminitic foot or a cross-section of a navicular bone and its ligaments greatly enlarged.  Sheet plastinates of the distal limbs of foals clearly show the growth plates and are perfect for explaining to horse owners why their horses need therapy sooner instead of later.

Dr Denoix's book is the perfect companion to plastinated specimen. Highly recommended for reference for academic or professional use of specimen or diagnostic images. It is simply "THE" book to have on hand. Call 978 281 3222 or email Hoofcare + Lameness to order your copy. A superb gift!

Thursday, October 20, 2011

Ohio State Belknap Grant: Laser Capture Microdissection in Equine Laminitis

via press release

The Center for Clinical and Translational Science (CCTS) Pilot and Collaborative Translational and Clinical Science Program at The Ohio State University has awarded James Belknap, DVM, PhD, a pilot grant to be used for his research of equine laminitis.

Laminitis is a crippling disease that affects horses. Similar to organ injury in humans with sepsis, it entails an inflammatory injury of the laminae, a soft tissue (of the same cell types that make up our skin) which interdigitates to support the horses’ third phalanx (coffin bone).

This life threatening disease is extremely painful and can be onset by colic, enterocolitis, pleuropneumonia, and metritis.

“It is a devastating disease,” Belknap said. As an equine surgeon, he commonly treats clinical cases of the disease at the OSU Veterinary Teaching Hospital.

Belknap believes that the first step to fighting laminitis is to find out what signaling events in the foot prompt the disease to occur.

“There is a layer of cells attached to the hoof wall called the basal epithelial cells that lose their attachment to the underlying connective attached to the third phalanx,” Belknap said. This detachment results in the third phalanx tearing loose from the hoof wall and displacing toward the ground.

“It can actually perforate the sole. We need to find out what signaling is going on in these cells that causes them to lose their adherence,” Belknap said.

In order to find out what the signaling events are, the team is using laser capture microdissection to collect and isolate RNA samples from laminar epithelial cells.

“At this point it’s sort of a black box of what’s going on with these cells,” said Belknap.

By using laser capture microdissection to collect the specific layer of cells at the point of failure, a better understanding of the role that the laminar epithelial cells play in this disease will become clear.

Graduate student Britta Leise, MS, DVM, is working in the Belknap laboratory to collect the RNA samples. Once the cells have been collected by Leise, they will be sent to Texas for microarray analysis and gene networking. The cells afflicted with laminitis will be compared to those of clinically normal horses.

“The analysis of these data will focus in on the cellular dysregulation that result in structural failure of the digit in the disease,” Belknap said.

Once the points of dysregulation are identified, Belknap believes that it would be more likely to find an effective combination of medical treatments to combat the crippling disease.