Buddy Cornell test results



After two years of fall laminitis and foot issues, I had Buddy tested last week and just received the results.  We tested ACTH as he has lost a lot of weight/muscle over the last two years, sheds late, and tends to lack energy.  He is only 8 so I knew it was unlikely he had PPID, but I wanted to test it anyway. I ran the results through the IR calculator and, assuming I did this correctly, he came up as "compensated IR".  Here are the numbers Cornell came up with:

ACTH  30.4 pg/mL   (Lab normals  9-35)

Insulin  10.79uIU/mL   (Lab normals  10-40)

Glucose  82              (Lab normals   71-113)

Leptin  1.19mh/mL    (Lab normals  1-4)

G:I         7.6
RISQI     0.30

Could someone clarify for me what exactly "compensated IR" means?  Does it simply mean that the horse would be IR if they were not on a special diet?  It seems that Buddy's insulin and glucose were on the low end of the ranges (he had hay the night before and the morning of the test), yet the G:I ratio still puts him as compensated IR.  If I am doing the math correctly in my head, his ratio would have been normal IF his glucose number was higher than 100 even though his insulin was quite low.  I guess I am having a hard time understanding why he would be considered IR at all especially looking at his low leptin.  I assume there is some margin or error with all of these results, so just how accurate are they?  I would love to not have to be soooooooo careful with his diet and access to pasture, but I know based on his history that I cannot just throw him out in the grass and hope for the best.

We have a new farrier and are working on getting the under-run heels and long toe going in the right direction.

Based on his ACTH results, do you think he still might be early Cushing's?  He does have several symptoms of it (late shedding, loss of muscle/weight/topline, lack of energy, fall laminitis...). 

Thanks for your help,
Kelly and Buddy




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