My major concern for my PPID/IR mare is the rising trend of her insulin values over the last several months. Back in January 2015, her insulin was good at 14.5 (4.5-20 uIU/mL). Then in April insulin was high at 23.3 (5-20 uIU/mL), and this most recent blood draw on Aug 31, her insulin was way up at 31.2 (5-20 uIU/mL), putting her in the severe IR range -- GI ratio.
She is looking and acting quite well and has no hoof sensitivity or pulses. She is at a good weight. When her ACTH elevated last year during seasonal rise, her insulin level stayed within normal range. (She has been on increasing pergolide, up to 4.5 mg now, as her ACTH rises with the season.)
Her diet has been restricted to hay in the 7.5% NSC range (for months) plus ODTBC. No pasture. The best guess I have as to cause is lack of exercise for the last several months due to summer heat and a couple of injuries. But her insulin level has more than doubled since January - which seems like something else is going on. I am wondering if the glycemic value of Teff Hay is known, as that has been her primary hay for several months. And would it be wise to add ALCAR? Other suggestions?
I just updated Silhouette’s Case History. Thank you.
Claudia & Silhouette 2014 Central Coast of California