Hi Laura,
Dr. Kellon is unavailable at the moment. I've added a few thoughts for you until she is able to respond.

The blood was drawn at approx. 11:00 a.m. in his pen before getting out for his workout. He had been taking a nap in his shavings. He had eaten 12 dry lbs. of soaked Timothy from 7:00-8:30.

How long since he had eaten before he had his breakfast hay?

1. Even though his Insulin/Glucose/Iron/ACTH have gone down since the 2/2012 testing, is it enough or should his Pergolide be increased?

As his current ACTH is solidly within normal values, and won't be rising until at least July/August, Leaving him at the current dose seems prudent.

2. Over the past 2 weeks, I have been giving him 1 flake an hour before out training session. Is that ok? I thought that a little extra fuel would be good for his training session.

See the folder Feeding the Laminitic when Back in Work in this file:

http://pets.groups.yahoo.com/group/EquineCushings/files/Insulin%20Resistance/

Ususally, recommendation is to add extra fuel immediately after the work session as that is when the body can make the most use of it more safely.

3. Do you think these current figures from Cornell could be lower if I wasn't feeding him these flakes? Should I stop doing that?

How much, by weight, is one flake?

4. I have been giving him 1/2 lb. of Timothy Hay pellets so he'll finish his ration. Do they have enough sugar/starch that would have made his results higher than they could be?

Do you have a guaranteed analysis for the timothy pellets? Is this 1/2 lb per day or 1/2 lb per meal?

5. After the fact, I read that Leptin (?) should also be tested because without it the insulin isn't a true reading? Should I have it tested and if so just by itself?

Leptin is an additional test and should be run concurrently with insulin so that the snapshot occurs at the same time. It provides more information than insulin alone but not having it does not negate the insulin value.

http://pets.groups.yahoo.com/group/ECHistory5/files/Laura%

20Mollrich/

Hope this helps some.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team