I had an interesting talk with Heather at BET Labs yesterday. My vet drew blood for a Cushing's panel about 9 days back, and I was impatient for the results (her office was closed yesterday).
Heather was kind enough to give them to me when I called, and discussed what they indicated in detail.
Turns out that Bug is now only slightly hypothyroid, so she suggested I increase his Thyro-L from one 1 to 1.5 scoops per day.
His insulin is also off a bit, and the suggestion for that was to add 10 mg. of Chromium to his feed each day. Does anyone else use Chromium? It will supposedly aid his body in regulating insulin, much as Glucophage does for diabetic or insulin resistant people.
Of the most concern was his diurnal cortisol rhythm. While his two cortisol levels (a.m. and p.m.) were not terribly high, the difference between them was only 2%, not the 30% you would find in a non-Cushingoid horse.
According to Heather, this would be an indication that more aggressive treatment is needed, that the 100 mg. of Cypro Bug is taking now is not sufficient. She suggested that I start him on Permax at 1 mg. per day, then slowly build to 2 mg. per day if warranted (in conjunction with the Cypro).
Does anyone on the list feed 2 mg. of Permax? I thought the dosages I've been hearing were much lower, say .25-1 mg. per day.
These results were not a suprise. I'd been expecting that I'll have to adjust or add to his daily dosages. <sigh> I'll definitely discuss all of this in detail with my vet before do so. I should feel lucky, though. Bug is actually in very good shape, even though this year's summer coat is a bit long.
Also, I told Heather about this list, and she indicated that some of the BET staff might be interested in joining. It would be great if we could get some vets and other clinical staff to do likewise!