Early Diagnosis of PPID/IR

Lorie
 

My 16 year old Anglo-Arabian mare has just been diagnosed with Cushings (10.02 pool/L) and IR (26.09 uU/mL) as part of a volunteer research project (August 2019). Glucose was normal. I had already tested her in April 2019 for PPID (5.11 pool/L) so I was not expecting to get a positive result. However, since then, I have realized that I had noticed in the past two months some swelling in her udder, marked weight gain, and now I see pads over her eyes and some in her body, which are reducing. She also has a history of strong allergies and anxious behavior. I have interpreted the behavior and weight gain as being natural results of her stall/paddock confinement for the past year due to a torn collateral ligament at the coffin bone in her left front. Since the test in August 2019, she has been moved to a more open space with a long paddock and a good herd that she can see and her behavior has improved significantly. It is clear that she was very unhappy as she was more isolated in the earlier place. I am working on making some changes to her diet (no more carrots!) and she was already on teff hay, no alfalfa, corn, oats, etc. due to her allergies. I do accept that something is going on. But I have a question. On the day that the blood was drawn, she had just relaxed from a gas colic and had hives all over her body as a reaction to a new fly spray. She was very uncomfortable. How reliable are these tests given the circumstances? Could the tests be skewed, especially the ACTH? My vet is suggesting Pergolide, starting very small. I want to know if, at one point over the normal range, this is a justified course of action. Needing a second opinion. Many thanks! I am very grateful to have this information so early. I promise to fill out the case history. I just need some answers to ease my mind before I begin Pergolide.
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Lorie and Noelle
Northern California
September, 2019

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