Asking your vet for a pergolide increase. Here is what I did ..

LJ Friedman

Jesse's labs from Cornell were reported today.    
  acth   35.5      9-35
insulin 116.91    10-40
Labs will be posted soon,

So, I;m asking for a pergolide increase  from 16,0 to 18.0 mg.. Last time. vet didnt want to increase bec acth was just in the normal range.. I sent this email to him today,

Thanks for the results.. Leave it to Jesse to be just out of the normal range.for ACTH.  Dr. Kellon makes a big fuss that  acth levels should be  in the hi teens, low 20's  year round,  when a horse also has PPID,  IR  and previous laminitis.  Jesse has the worst category of IR.. uncompensated. and  prior laminitis   Hoping you will approve a  2 mg  increase to 18 mg total   at  Petshealth. (called in today)
Here is a  reply from Dr. Kellon from  the ecir group messages:
 Eleanor Kellon, VMD
Oct 25   #213821 

The 41 pg/mL is within the range found in normal horses during the rise, and they tolerate it well. The problem comes in with horses that are IR along with their PPID. The IR worsens and can tip them into laminitis. I'm not saying there aren't PPID horses that can still show a seasonal rise and not have laminitis issues but some do. If the horse has a prior laminitis issue, keeping ACTH well within the normal range all year is best.  It's also advisable for the best prevention of fall laminitis ever developing. That said, every horse's threshold will be different. 
Eleanor in PA

LJ Friedman  Nov 2014  San Diego, CA 


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