Early Cushing's??


I apologize I have not gotten the case history filled out yet. There are some very extenuating circumstances.  So I am wondering if any of the moderators or Dr. Kellon can give a little feedback while we care for this horse, find a knowledgeable vet and get the case history done.

First week of August
Non-fasting, hay only

Insulin 15.85
Glucose 75
Leptin 10
ACTH 34.5
Regular CBC normal
Compensated IR
High Insulin Responder
G/I Ratio 4.7

Horse is showing signs of laminitis in all four feet but front worse. Developed crusty neck, and very pendulous stomach developed about the same time-6-8 wks before blood work
Excellent balanced hoof care, was wearing Clouds now 24/7, hand walked 20-30 mins a day 6-7 days a week, always in a dry paddock. Was eating from slow feeder at time of and prior to testing.

Since blood work, he also gets BP, flax, Vit. E. Mg, Se, and Iodized Salt.as suggested on website. Slowly being weaned on to soaked hay as he will refuse to eat for up to 24 hrs. Pain is getting worse, more lethargy.

A well-studied and past moderator on here kindly consulted and suggested I ask the vet for "a trial" of pergolide because he has this long history of dealing with milder laminitis and past owner said he had foundered once. She said horses with this long-standing history sometimes just can't tolerate the ACTH at the higher level let alone it rising into the fall months. I think that makes a lot of sense. He did also have the tell-tale rings of founder and was lame when I first got him. We were able to get him under control previously and comfortable feet. Now we are in completely different circumstances

The one vet I initially got on board has abandoned case as he thinks there is no evidence of iron overload having anything to do with IR. His suggestion was Oral dextrose test, Ace, Bute, Levothyroxine and continued hoof care and soaking of hay ( He keeps forgetting this horse has in past attempts refused all soaked hay. )

We are waiting for our hay to arrive this weekend, then a hay analysis and more vet. and mineral balancing to come along with the case history but could I get some feedback if other horses have turned out to need pergolide to manage so far non-responsive laminitis, along with the test results I wrote above. 

I have asked another vet to come on board but I don't want to be barking up the wrong tree or pretty soon no reasonable vets will work with me.

Thanks so much!


March 2013

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