Re: ACTH 77

Lavinia Fiscaletti

Hi Larina,

It may not be your computer - Neo has been making things difficult again. If you continue to have problems, feel free to send your updates to one of us and we can get them into your folder for you.

I don't see any insulin results in the tests in your case history - are there any? I am only seeing some glucose and T4 numbers.

The barn staff is being negligent. If you have a boarding contract this may be actionable.

Daisy's ACTH is definitely not controlled - it is about 3 times what we would recommend it to be at this time of the year and the seasonal rise effect hasn't officially started yet. The information you were given regarding the Oct results was not correct - 95.7 is way out of the range to be considered "normal" even during the seasonal rise. How much pergolide was she on at that time and was the same boarding barn handling her meds?

Once on a targeted dose of pergolide, the ACTH should stabilize in 2-3 weeks time at whatever level the dose is controlling it to. Obviuosly, you cannot tell how much effect the pergolide may/may not be having as the barn staff is not fulfilling their obligation to make sure she receives her meds. Is there any way you could pay someone - a friend/relative/barn buddy - to make sure she gets her meds on a regular schedule? Not getting her meds regularly is allowing her PPID to progress and putting her at increased risk of laminitis. NOT something you want to do. Plus, when the schedule is erratic like that she may have issues with pergolide veil kicking in when she goes several days without meds then gets a full dose. That type of bouncing around with her endocrine system is certainly not healthy. I know you know this - just making a point for everyone else that is reading this.

Given how high her ACTH was and how elevated it is now I wouldn't see any harm in raising her dose to 1.5mg daily but you need to make sure she receives it daily as a larger dosage is also more likely to create larger swings when doses are missed then reintroduced and may cause other reactions.

Sorry, is that clear as mud?

Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team


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