Paddy's blood results & vet's opinion...


Got the results 2 days ago, vet finally rang this morning.

Have updated case history but here they are:

***These bloods were taken after 3 weeks on pergolide - no prior bloods to compare to for various reasons, see case history for info pls***

ACTH *>600 pg/mL (no actual figure as above lab's range - lab's normal range is <100, and >300 considered very high)

Cortisol 105 nmol/L (normal 25-155)

Insulin 54 uIU/mL (normal 8.9-65)

Glucose 5.8 mmol/L (normal 3.4-5.9)

which by my calculations puts his G:I at 1.93 and RISQI at 0.14 and means severe IR.

Vet however is happy that cortisol, insulin and glucose are all in normal range and says though he's put other horses on metformin alongside the pergolide Paddy doesn't need it. Not interested in G:I ratio. He's (and I quote) "not a big believer in doubling the dose of pergolide" at which point I asked whether we should increase to 1.5mg but he wants to continue at 1mg for a further 4 weeks and then reassess physical symptoms.

We went straight in at 1mg and though Paddy picked up fairly quickly we have been struggling with appetite for the last couple weeks but I have changed his chaff to something even lower sugar/starch (moved from 6% combined to one which is 3% combined) but with different flavour and he loves it and is now licking bowl clean again. Was struggling to get APF into him but is taking it now and is much improved generally. No change to any fat pads, still footy over stones but nowhere near as footsore as he was prior to starting pergolide. Coat seems to have improved a bit, better condition.

I'm concerned at his G:I ratio and that PPID is not under control at all despite 1mg pergolide and feel we should be increasing it not watching him for another 4 weeks.... I also have very little faith in current vet due to events in the past with my other horses, if I was to ask for 2nd opinion from other vets at the practice it wouldn't be the first time I'd done so.

Am I right to be concerned about those results or am I over reacting and should be more patient?!

Thanks in advance,

Robyn and Paddy
Sept 2011, UK

Case History:

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